Specific application: Attention Deficit/Hyperactivity Disorder
Consider a plan for motivating a child with attention deficit/hyperactivity disorder to improve his listening skills, ability to sit still and impulse control which are features of ADHD. In the STOP THINK DO framework, children with ADHD are stuck at DO; they are mentally and physically active, and rarely stop to think in the learning or play context. Once these weaknesses in concentration and behavioral control have been identified at STOP and the child’s interest in improving these areas has been gained, options to consider at THINK may include drawing up a concentration plan for the classroom and a behavior plan for the yard. The main goal of these plans is to remind the child to stop and think first before he reacts in any situation, to insert some ‘thinking’ between ‘feeling’ and ‘behaving’. A concentration/behavior plan considered at THINK is essentially a plan within a plan; a specific STOP THINK DO plan for concentration or behavioral control within a broader STOP THINK DO plan for motivating the child to learn and behave better generally. Specific concentration/behavior plans involve cognitive and behavioral retraining using
visual, auditory and tactile cues to remind the child to STOP self-talk strategies to help him THINK about controlling himself behavioral redirection to implement these strategies at DO.
STOP THINK DO plan for concentration/behavioral control
| STOP | When I see or feel red tape on my pencils or my watchband (or other reminders),
I will STOP and |
| THINK | THINK ‘Concentrate’ or ‘Control myself’ or
'What will happen if I keep doing this? Then I will |
| DO | DO the following concentrating/behavioral things (choose which)
stop fiddling, wriggling, rocking, talking, daydreaming, calling out, fighting listen to or look at my teacher get on with my work tell my friends I will speak to them at lunch go to another place in the yard to get away from trouble
If I forget my plan, my teacher could remind me by (tapping me on my shoulder).
I'll change my reminders regularly to keep them novel until I remember myself.
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If the child is also taking medication (eg, psychostimulants) for the problem, the medicine is identified as yet another option at the THINK stage. However, the child needs to understand that while medicine can help him STOP (ie. stop his attention and behavior zapping around), it is up to him to learn how to THINK and what to DO in the longer term. When the child is confident in these skills, medicine may be withdrawn. Many children with ADHD also have specific learning difficulties/dyslexic problems. When options for improving learning and work output are being proposed at THINK, specific remediation programs to develop written language or maths skills may be included as options together with concentration and behavioral control plans. Similarly, speech or occupational therapy programs may be considered to enhance the child’s developmental maturity. Dietary management is another possibility, plus practical environmental changes like modifying seating arrangements to reduce distractions. Involvement in social skills training is also a viable option.
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