Susan Young, author of The STAR Program, talks about the innovative methods she has developed to help children with ADHD develop their self-control, concentration and problem-solving skills.
I started working with young people with Attention Deficit/Hyperactivity Disorder (ADHD) over 20 years ago. The clinical picture has changed over these years due to research, which has considerably advanced our scientific knowledge and understanding about the aetiology, presentation, treatment and prognosis of ADHD. ADHD is now recognised to be a lifespan condition yet, despite international guidelines on the assessment, treatment and management of ADHD, too many young people reach adulthood with undiagnosed ADHD. As a psychologist, I am less concerned with a “clinical” diagnosis than the functional problems associated with inattention and the immediate or longer-term effects on a child’s development and life satisfaction. As a mother I know how worrying this can be and, as a clinician, I know that steps can be taken to help and support a child in overcoming these difficulties. I know how important it is for everyone to work together to help children effect change in their lives, so I wanted to develop an intervention that may involve teachers, parents/carers and the children themselves. We do not often intervene directly with children and treatments: we usually aim to make change by teaching those who interact with them to change the environment around them in some way. I think this underestimates our children’s abilities and misses an important opportunity. Why can we teach children academic skills but not life skills? I wrote the STAR Intervention to provide these life skills to children, their parents/carers and, hopefully, others involved in their care.
Training courses to deliver the programme will shortly be advertised. In addition 5–day non-residential bootcamps based on the programme will be delivered from October 2017 during school holidays. To register your interest in the training or the bootcamps, please go to www.psychology-services.uk.com/events.
The Skilled Thinking And Reasoning (STAR) programme is a new and innovative intervention designed by Dr Susan Young to teach children psychological techniques to improve their self-control and prosocial competence. Using the metaphor of a detective to understand personal emotions, children learn skills of self-regulation, concentration and problem solving. It is based on policing skills techniques used by New Scotland Yard which promote problem-solving procedures of Scanning the environment, Analysing information, Responding in an appropriate way and Assessing the outcome (SARA). The technique has been adapted for use by children in a fun and imaginative way and draws on the appeal of them developing real life detective skills.
Using role play, group and individual discussions, fun games and exercises, the child will be introduced to Thinking Tools which will remind them to use the techniques they need to improve their ways of thinking and behaving. Each child will receive a ‘STAR Detective Workbook’ to use in the group sessions of the STAR Programme.
Managing the behaviours of a child with ADHD at home can be challenging and at times very distressing. Although parents and carers always wish to do their best, it is not always easy – especially when having to balance work and family demands. In the STAR Programme, parents and carers are taught to become a ‘Coach’ for the child; this role provides a bridge between the therapy room and daily life as children learn to consolidate and practice newly acquired skills.
In addition to the more formal coaching role, there is general advice for parents and carers about supporting and managing their child as follows:
Make clear rules: These must be consistent and understandable. Remind your child of the rules in a slow and calm manner.
Impose structure and boundaries: Structure is very important for the management of children with attentional and/or behavioural problems. Set up a consistent daily routine, e.g. homework time, meal time, bed time.
Set achievable goals: Break these down into small steps. Reward at each step, e.g. by using a Star Chart or stickers. Setting time limits for tasks will help your child stay focused.
Set breaks: Schedule in time to take a break for activities that require sustained attention (e.g. homework tasks) as this will help your child to stay on task. A clock alarm could be used to indicate the end of a break period.
Get their opinion: Your child should be actively involved in their behavioural development. Ask them what they think will work best for them (e.g. how to remove distractions). Try it out! If your child feels involved they are more likely to maintain interest and motivation. You can also get feedback from your child about whether the changes have worked and how they can be improved. Also, check that your child has understood what is required by asking them to repeat back important information or instructions.
Model the behaviour: It is important to ‘model’ the behaviours that you wish to see. A growing body of research demonstrates that individuals who communicate empathy, positive regard, respect and warmth can promote change and development. Furthermore, the more time and effort you can give in supporting your child to apply new skills in their daily life, the better the outcome for your child.
Gain support: If you are feeling upset or run down, talk things over with a family member or friend. Work out comprehensive ways to help each other and learn from one another – two heads are better than one!
Give rewards: Reward your child for good behaviour, effort and success. This can be achieved by giving praise and encouragement, praising them to other people so they feel proud, giving them a sticker, using a Star Chart and/or giving a treat. Immediate or short term rewards will motivate children to stay on task and to continue and repeat their efforts. Children respond better to immediate feedback. Offer advice, constructive criticism or praise as soon as possible e.g. “You did really well to stay seated throughout dinner”. For further information, go to www.psychology-services.uk.com/resources. Information on rewards can be found in the section, “Do’s, don’ts and rewards: a guide for parents and carers of children with ADHD” and downloaded for free!
If your child attends the STAR intervention then you can also promote their behavioural development by discussing what they learned in the group sessions, helping them to recognise situations where their newly acquired skills can be applied whilst reflecting upon situations where the skills were conversely not applied and how they could have helped.
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