On the very first occupational therapy session that my son attended, his therapist invited me inside their playroom and directed me to a white board filled with drawings and words. On top of the board it said, 8 RULES FOR MICHAEL.
The first drawing I saw on the board was a chair. Next, there was a hand with five fingers. The third drawing was a pair of opened eyes. After that, the drawing of closed lips. Next, I saw a drawing of ears. After the drawings, there were phrases that said “FINISH WORK”, NO HITTING HEAD” and lastly, NO SLAPPING, GRABBING, PUSHING”. Beside the 8 rules, there were three boxes and one of those boxes had an “x” mark.
I asked the therapist what the “x” meant and she told me that I will understand it better if she explained first what the drawings and phrases were all about.
My son is extremely hyperactive and that’s because of his ADHD. I know that now. And one way to control a child with their excessive energy is the “The Chair” wherein they have to sit and wait for a few minutes. The therapist told me to teach my child to “sit and wait” for 5 minutes at home – doing nothing, but just IT.
This rule is focused on the concept of patience which kids with ADHD don’t possess. They have to understand that they can’t stand until the time is up. Also, there is no asking when it’s done and no fidgeting, as well. They just have to wait it out. The number of minutes has to increase each day until he learns to behave on his own without the need to prompt him.
“The Hand” means not to touch things especially if it’s not yours. Kids with ADHD don’t understand the concept of boundaries and they would grab anything that has their interest. They won’t even ask permission to borrow a certain thing and that behavior needs to be curbed.
This rule will teach the kids to be aware of ownership. They can only borrow things if they ask permission from the owner. Grabbing is not allowed.
Kids with ADHD, before treatment and therapy, cannot focus on a certain task at 100%. But with “The Eyes” rule, they are being practiced on the concept of attentiveness.
The therapist will give the child an activity which requires his full attention to finish it. And in order for the child to complete the activity, he has to direct his focus on it instead of looking around the room.
“The Lips” rule is very simple – don’t talk when inside the classroom and while the teacher is speaking. On the same platform, don’t interrupt a person while he is talking and wait for your turn to speak. It practices the child on the concept of silence whenever necessary. Children with ADHD are excessive talkers and this is one way to minimize that behavior.
It will also give time for the child to collect his thoughts, organize it in his mind and speak out when called upon or when it’s his turn to talk. Restraint is being practiced by the child and the rule will hone this skill.
Kids with ADHD don’t have the skill to listen intently. In order to treat this type of behavior, the children are being taught the concept of listening – listen to your teacher, mom, dad, older siblings and etc. In time, the child will learn to “listen” without the inattentive issues. That is “The Ears” rule.
As for my son, he is sometimes unable to finish his tasks or activities. It’s not that he doesn’t want to finish it. His fine and gross motor skills are delayed (he also has ASD) and that interferes with what he is doing. With the “Finish Work” rule, he has to act accordingly and efficiently in order to complete his work.
“School–at least school as usually defined these days–is a place where you must concentrate on what you are told to concentrate on, no matter how tedious; follow the teachers’ directions, no matter how inane; complete assignments for the sheer purpose of completing them, even though they accomplish nothing useful; and, while doing all of that, control your emotions,” writes Peter Gray Ph.D.
At first, it was really difficult for him because of his impairment. But with his will to complete his task and as pushed by the rule, he was able to do it.
No Hitting Head
When my boy gets frustrated, he hits his head on the wall or with his fists. This too was treated by the therapist – she made him understand that it’s ok to be frustrated at times. You just have to let it out vocally, instead of hitting your head. (He doesn’t do it anymore with just after 8 OT sessions.)
“Previous longitudinal studies have found a higher suicide rate in a sample of both men and women with ADHD. It is also one of the first studies that shows a higher self-harm rate in women with ADHD,” writes Stephanie A. Sarkis Ph.D.
So, when he is angry or sad, he talks to me about it. The “No Hitting Head” rule made him learn how to speak what he’s thinking and feeling, like any normal person would do.
No Slapping Grabbing Pushing
This rule is an extension of the previous rules mentioned. A kid with ADHD is impulsive and his hands tend to be heavy or rough without realizing it. The therapist is imposing this rule so that the kids will learn the concept of self-control.
“The nonstop activity, impulsive actions, and more frequent aggressiveness of children with the hyperactive or combined types of ADHD are obvious sources of annoyance to peers. They are more likely than other children to argue and start fights,” writes Eileen Kennedy-Moore Ph.D.
It was a very productive first session not only for my boy, but also for me – I learned about THE RULES and why it was necessary. I needed to change the ways on how I handle my son. These rules were truly needed for his behavioral modification.
After all that, I asked – “Teacher, what’s that “x” in the box.”
“If your son, breaks a rule, there will be an “x”. This “x” is his punishment like – no tv, no gadget, no dessert, no candy, no going out, no playing with new toys and etc. I need your help with this at home. Will you do that?”, she said.
Me? Can I punish my son for having ADHD? My heart cringed at that thought, but it needed to be done. I had to be strict. The rules must be implemented. He has to learn how to behave.
“Yes, I’ll do it.”
Now, as I look at my son – rarely fidgets, sits down in class, includes himself in family conversations, a toy sharing older brother and a whole lot more – I know I made the right decision.