MANAGE YOUR CHILD’S HYPERACTIVITY USING PLAY THERAPY


It’s normal for children to occasionally forget their homework, daydream during class, act without thinking, or get fidgety at the dinner table. But inattention, impulsivity, and hyperactivity are also signs of attention deficit disorder ADD. ADD/ADHD makes it difficult for people to inhibit their spontaneous responses—responses that can involve everything from movement to speech and attentiveness. Having ADD/ADHD (for the child) can be just as frustrating as dealing with someone who has it. Kids with ADD/ADHD want to sit quietly; they want to make their rooms tidy and organized; they want to do everything Mom says to do, but they don’t know how to make it happen. They do not intentionally want to annoy you. If you keep this in mind, it will be a lot easier to respond to you child in positive, supportive ways. Like all kids, children with attention deficit disorder (ADD ADHD) sometimes make bad choices regarding their own behaviour.
Rima was getting ready to go for a swim with Akshay, her 10 year old son. Saturday morning is a planned outing with him and some of his school friends and their mothers and a special time for Akshay, something that he looks forward to the entire week. Rima asked Akshay to finish his breakfast, take a bath and pack his swimming bag while she went on hurriedly going about doing her household chores. Expecting Akshay to have finished at least with his breakfast and bath in the past half an hour, Rima went to check whether he needed anything. She found him sitting on the dinning table with the breakfast untouched and watching his favourite cartoon show. What is his problem? Yes, he has ADHD, but how hard is it to do three simple things? He loves to go to for the swim with his friends. Why is it such a struggle to get him to listen? As Rima hurries Akshay around, she is thinking of what her husband would say if he were around. ‘You are spoiling him by not being stricter with him and doing his work for him. He pays attention when he is playing with his video game, but not when we ask him to do his chores.’ Rima thinks that Akshay’s failure to comply is due to a lack of motivation – if he wanted to do it, he could. But Rima isn’t so sure. She’s been consistent with discipline. Rima also knows that Akshay feels bad about himself when he doesn’t succeed at school or when she constantly fusses at him at home. She knows that he has begun to compare himself to his peers. He seems frustrated with his inability to accomplish simple things that seem effortless for his friends. She has heard him refer to himself as “dumb.” She can’t understand why Akshay doesn’t comply with the instructions he receives from adults, but she doesn’t think it’s a lack of motivation. She knows in her heart that he would comply if he could. Rima has recently attended a talk by the school counselor on Executive Functions of ADHD. Equipped with this information she tries to understand what actually must be Akshay’s mental process.
Executive functions are mental processes that give organization and order to our behavior, allowing us to direct our actions through time toward a goal. Let us take Rima’s working of a single evening as an example of executive function. The previous evening, Rima left office for the weekend. She was tired and would have loved to go straight home especially with the heavy down pour since late afternoon. But she recalls that she needs to fill in some grocery first for dinner (working memory) and heads for the super market. She decides to pick up the lap top adaptor on the way to the grocery store (strategic thinking) so that she can work over the weekend and does not have to make another round this side of the town for the adaptor. She thinks of how comfortable her Sunday morning will be if she could in between the cooking do her work and then relax the entire day (internalized language). She begins to feel more energized as she weaves herself through the evening traffic (regulating motivation). As she reaches the grocery shop after picking up the adaptor, she makes a list of things that she would require to buy for the dinner (initialization action). Just as she gets her pen out, her cell phone rings, she checks the display and sees it is a friend who was returning her call. She makes a mental note of calling her later after dinner (strategic thinking) and chooses not to respond to the call right now (interference control). While entering the grocery store she sees that there are some attractive schemes on the 15 litre oil cans but decides to check on it the next week (interference control) as she is running late (a sense of time). As she heads for the vegetable section, she takes a quick look at her wrist watch. She has time to stock in the fruits and makes a bee line for section (self-monitoring). She decides to check on Akshay as she waits in the billing queue (shifting between tasks) so that his work is done by the time she reaches home. In the night before retiring in front of the television, Rima remembers to make the call to her friend (working memory) and calls her.
Rima’s executive functions work smoothly and efficiently. Because this functioning occurs without her conscious awareness, she takes it for granted. But the development of these functions took place over time. Imagine Rima at the age of 10, would she be able to do all this planning simultaneously? She would probably be able to only concentrate on her chore of buying chocolate at the super market. It was a gradual process for her actions and sense of time to become internally directed. Researchers believe that this capacity for self-direction is neurologically based and concentrated in the pre-frontal region of the brain. Rima learns that current research regarding ADHD is moving away from an emphasis on impulsivity and inattentiveness and toward an emphasis on executive functions. Many experts in the field recommend that individuals with ADHD compensate by using tools that “externalize” the executive functions. is a natural form of integrating these skills and Play therapists are specially trained counselors who use play appropriately to help children regulate their behaviour. The school counselor suggested Play therapy for Akshay. In many children’s games –Froggie May I, Statues, Simon Says, Freeze, mountain and river, saakli–while fun, also provide an engaging external framework for children to practice behaviors that are central to executive functioning. The therapist lets both Akshay and Rima know that a large part of each session will be devoted to play, and that she will even give some home assignments that involve play. Rima relates the history of Akshay’s diagnosis and treatment over the past three years her own attempts to firm up discipline and provide extra structure and support in Akshay’s day to day life. Both Rima and Akshay are tearful as they describe their frustrations and guilt and an overwhelming sense that they are not good enough. The therapist comments that they might want to add to their treatment plan is for Akshay to become a working member of the “treatment team.” The following weekend Akshay has an assignment from his therapist. Chores are a sore point in their household. Rima has always been frustrated that she has to remind Akshay each and every step of the way. Akshay’s assignment is to use the time honored habit of making a list to supplement his working memory and free him from dependence on his mother’s reminders. To engage Akshay’s interest and sense of fun, the therapist has given this tool a playful spin. An hour later, chores done, Rima and Akshay are on their way to the swim. “That was fun,” Akshay says to his mother. “And I got all my chores done by myself! Let’s do that again next week.” Rima reflects that it doesn’t matter whether Akshay relies on his working memory or uses a list. The results are what she cares about. She is pleased that the chores got done but is even more pleased to see that Akshay himself is so pleased. She was right; Akshay is motivated to succeed. But she had been expecting him to succeed in ways that were not in line with his development. She has now seen that, with the right external support, Akshay can experience the success that he so much wants for himself.

CREATING AND INCLUSIVE ENVIRONMENT IN THE COMPANY


You are at a senior managerial post in an innovative technical company. By enlarge the company environment is that of commaradie and the competition is healthy. You had employed Rita at a managerial post few months ago. You value her talent and her input to the company is crucial. She is an amicable personality and excellent with her work. One day she steps into your office with a grim expression on her face and informs you that she has decided to look for a new job and would appreciate a reference from you. After briefly discussing with her you realize that she likes her work and she is leaving because she feels marginalized and isolated by the other office colleagues. You have been aware of socializing of office staff, mainly male staff, at a beer joint over the weekends for quite some time, and have encouraged it by going there yourself along with them occasionally as it seemed to increase their commaradie. You did not pay much attention to a few who seemed to avoid going there for example Ramesh who has two elder sisters who are to be married and an ailing mother. He chooses not to go for his family responsibilities. Harsh too who is a single parent does not visit the joint as he has to pick up his child from the day care, nor does Ritesh who does not drink. Rita too does not visit the joint as she is the only woman in the office.
Many a times office information is informally circulated amongst the staff members at this joint and it also seems to encourage mentoring of rookies. Govind who visits the joint regularly learnt of one such possible opening in the organization a few months prior to its announcement at the joint. He then strategically placed himself in such a manner that he would be the most eligible person fitting the profile for the position by the time it was announced. Rita who is technically sound would have been better suited for the post were she aware of the information before hand like Govind or if the information was released simultaneously to all.
Rita hit her limit when she found this out and feels left out of the crucial information which could have been a crucial promotional move upwards for her career. She believes this will be an ongoing phenomenon in the company politics as she is excluded from the group and therefore wants to move. You value her talents and skills and do not want to lose her. You now realize that those who are not in the beer joint clique feel isolated and left out although the clique does not intentionally sets themselves out to be exclusive. You also know that such cliques are a part of regular office politics but cannot deny that they provide few with benefits that give them a head start to many promotions. You wonder whether you have been complicit in this matter and how you could promote an atmosphere of inclusiveness or even how you could help Rita.
This incidence has opened your eyes to the following facts:
• These socializing outside of office colleagues having similar interests like sports, gym, hobby classes, bars, prayer places etc is natural and unavoidable. The inclusion of those based on the commonalities of gender or religion or lifestyle, although unintentional, provides them with opportunities to pass on crucial company information as a privilege of being a part of the ‘haves’ clique.
• The loyalty and intimacy amongst the ‘haves’ community which allows these special privileges is obvious to them. While they enjoy the benefits it also creates a self doubt and they are bound to worry about securing the same based on purely their merits and abilities, especially since they may not receive specific and honest feedback on their shortcomings.
• On the other hand, the ‘have nots’ are undeniably going to feel that such favoritism is unfair and will be demoralized. Tying opportunity and promotion to anything other than performance hurts the morale of the workers leading to poor performance, mistrust and reluctance to seek guidance when necessary.
• A leader who is aware of these dynamics but tolerates such inequalities is unlikely to be respected both by the haves and the have nots because at some level both the cliques know the practices are unfair. Given these facts t0 transform this atmosphere into an all inclusive environment is not possible.

The leaders could deal with such situation the following ways:
• Explicit information about the expectations and performance evaluations must be given to the staff. Feedback must be timely, specific and direct.
• You could introduce the inclusive policy while formulating project teams to promote collaboration and opportunities for staff from diverse backgrounds to interact and bond with each other in an mentorless environment.
• If the managers don’t have the skills to mentor people different from themselves, companies could provide training and coaching to the managers. Such training when done on a regular basis reflects company’s policies to be fair and caring.
• Special socializing work- based opportunities could be provided by the company for all. Many companies have now introduced sports based activities for the same.
• Leaders should be prepared to face resistance by the haves as they may perceive it as a loss of a status or privilege as they can be frightening and disorienting. This could lead to targeting the have-nots as scapegoat or sheer rage towards the have nots. Leaders have to be firm in setting limits and consequences of such behaviour.
• Rita’s situation is not irreversible but will require sensitive understanding and communication to her about many such past hurts and upsets. Talk to her about how things could be changed and what kind of a support would she like from the company to make her feel comfortable.
• Help her identify mentors and supportive co workers, encourage them to include her professionally both in office and outside the office.
• Insist and encourage Rita to include herself in social activities and accept invitations for the same although she may not enjoy it initially.
• Help her to gain insight that awareness of emotions could help her to make free and powerful decisions rather than limit her. Most wise decisions are not solely based on how a person feels rather takes both the emotions and thoughts into consideration. That she could still go ahead and socialize based on logical choices and decisions if she wants to move up the corporate ladder and that handling her own momentary uncomfortable feelings is not that difficult.
An inclusive and welcoming workplace will improve not only company morale but also the company’s bottom line, too.