Draxie, who is an OT, came to supervision today to discuss about Bobby, 8 years old, who has a diagnosis of ADHD (Attention Deficit Hyperactivity Disorder) and attends weekly OT sessions in clinic. Draxie reports that Bobby wants to be in control of the weekly sessions and his favourite thing is to get on the platform swing and spin so excessively on it that often makes Draxie feel sick, whilst he does not feel a thing.
-And what do you normally do? I ask her.
-What can I do? I stop him as soon as I feel that it is out of control, but when I do that, he starts yelling and swearing at me. He completely forgets his manners and his poor mother feels embarrassed by her son’s behaviour. Do I o something wrong?
-Why do you think he gets angry? I ask her.
-I don't know, he wants to spin so fast that instead of becoming regulated, he dysregulates himself and thus taking control of the session and I feel like an idiot, Draxie says.
- You are right saying he gets dysregulated because this is his goal. ADHD children, they are also known as sensory seekers, try unconsciously to lead themselves into a state of shutdown, that means to get dizzy, fall down, be dysregulated or feign they are helpless and needs someone to pick them up.
In fact, they aim to reach their high neurological movement threshold (threshold is the neurological limit of reaction to the stimulus) in order to be regulated. Simply put, Bobby seeks out the movement he needs and lacks, because this is how his daily routine (home-school-home) is structured.
So, when you interrupt him from this effort and his goal, he gets so angry that he mobilises the behaviour he uses everywhere, that is, to make others feel awkward and bad by swearing and using offensive language. This is what he has learned over the years to do, and this is 100% successful.'
-What else could I do? Draxie asks.
-You could very simply try to say to him, 'Well Bobby, I'll spin the swing clockwise, and when you feel something like dizziness you will say STOP and I will stop it. And right after that I will give you a nice massage on your head to help you recover, okay?
But be careful Bobby, as soon as you feel something in your belly or head, or around your eyes, you'll immediately tell me STOP, okay? Then if you want to, we will do it again the same but counterclockwise this time.
Meanwhile, Bobby will probably never say STOP, because as we said before, he is aiming for his ‘shutdown’. However, you want to help him become more aware of his needs and what his body tells him, so he will definitely start to get into the process of paying more attention to what happens when he spins so intensely and quickly.
-Try this Draxie, and let see if he reacts again with insults and yelling.
-Ok I'll try it and tell you, says Draxie.
-How would your dad or your mom react if you had such behaviour, that is, you swear and yell at them? I then ask Draxie.
-My dad? My dad would smack my bottom and I would quickly learn my lesson.
-That’s right Draxie. If little Bobby, 25 years ago, showed such behaviour in front of his mommy and daddy, he would get his bottom smacked immediately and would never again not come out of his mouth a single bad word. But now we are living in 2022, not 1987. So we have to become more innovative.
Let's have a closer look on things like this...
We're not in 1987.