Sigh, can we talk about impulsiveness?

[Jennifer-72]

Is the only help medication? Not that I am against that. We have been doing some med trials, but no luck so far.

 

We talk a lot about using self control and being mindful and it certainly has helped, but yikes! It is the one area that I have really had the hardest time helping ds make gains with and the one that worries me the most. Fortunately he is pretty good about things that could get him hurt, ie I don't have concerns about him in the parking lots etc.

 

So tell me what works in your house.

[EndOfOrdinary]

How old is your son?

[Jennifer-72]

Oh sorry meant to put that in. He is 9 and is dx with ASD and ADHD -combined type.

[OneStepAtATime]

Can you give specifics?  Mainly at home?  Out running errands?  Around other kids?   Have you noticed a pattern?

[PeterPan]

There is no help, no cure, and it will go on FOREVER.  Ugh.  Or let's just say we had our doses of impulsivity awareness today.

 

Sympathy, no help.  Seriously, I'm not sure there is a help.  Just be glad you don't have two.  The one child could impulsively pick up a table and go through a doorway, whamming the other child in the face.  2nd child would then impulsively kick/punch in return, resulting in 1st child being angry.  Meanwhile, the person who misses social cues is left sorting out what of that is INTENTIONAL and what is IMPULSIVITY.  Oh yeah baby, it's SO pretty.

 

Psychs talk about impulsivity, but in the testing don't they call it inhibition?  So with all your mounds of marvelous therapy things you discover, hasn't there been anything known to be successful with targeting it?  Whackamole maybe?  Seriously, video games could.  But if they were too inhibited, they'd lose their spark.  It's not like we want them NT, mercy.

 

I have no clue.  When you find it, you tell me, cuz I'll buy it.

[Jennifer-72]

Can be anywhere. We do seem to have good luck with talking after the fact about the situation and generally not having a repeat offense, so that is good. Many of them are more minor, and tend to focus on a fixation he may have at that time. For instance at one of the supermarkets we go to you have to bag your own groceries and they have a conveyor belt that you can press, well he would get so excited about that he nearly bowled over people in line to get there to press the button. Like seriously dude, your nine! Lol. Thankfully for all supermarket patrons he is over that one. I do think there is an element of an OCD type thought pattern to many of them since often they do involve something he is fixated on. I usually can stop a good number of those type instances because I can literally see the thought coming to him and can intervene.

 

I also think while a good number of them are minor type things his impulse control would be causing more problems and destructive outcomes if his executive function abilities in planning and organizing his thoughts weren't also rather impaired, iykwim.

 

I guess the good thing is he is becoming more aware of these situations and that is probably the best first step to stopping them, but he sure is exhausting me!

[Jennifer-72]

Oh no OhE! That does not sound like a good day any which way! Yikes! That is exactly the type of stuff I am sure would be happening here if like I say he could actually plan that much in his head.

[MomatHWTK]

I think it may improve with age if the person is aware that it is an area in need of attention and works toward making specific changes.  At age 9- I wouldn't hold my breath. LOL!
 

Now my oldest did settle out of impulsiveness but into moodiness in the last few years, so you may see a switchover.  For my most impulsive child, we just discuss mindfulness before the fact and consequences after. Pre-briefing helps a little. We've not tried medication yet with this child though. 

[Jennifer-72]

I think it may improve with age if the person is aware that it is an area in need of attention and works toward making specific changes. At age 9- I wouldn't hold my breath. LOL!

 

Now my oldest did settle out of impulsiveness but into moodiness in the last few years, so you may see a switchover. For my most impulsive child, we just discuss mindfulness before the fact and consequences after. Pre-briefing helps a little. We've not tried medication yet with this child though.

Oh dear me, are you saying I will go straight from impulsiveness to moodiness. I think I am the one who will need medication, lol.

 

Seriously though it is good to know the discussing mindfulness before and consequence after scenario has been useful for you. That is what I have been doing. Guess it is just lather, rinse, repeat...

[LMV]

There are some CBT protocols for ADHD that specifically target the impulsivity aspect.  You might try adding them in as an adjunct to medications.

[Jennifer-72]

There are some CBT protocols for ADHD that specifically target the impulsivity aspect. You might try adding them in as an adjunct to medications.

Thanks! Any resources/books you know of, or did you do this mostly under a therapist's direction?

[Storygirl]

Oh, how I can relate! The meds have helped but not "cured" it. My watchwords when we was a preschooler were "constant vigilance," because I had to keep my eye on DS every second to keep him reigned in. I do think things are improving a bit as he gets older (he's ten now), but he has a long long way to go, for sure. We do talk a lot about making wise choices, but it's hard for him, because he really just doesn't think first before acting. We need to turn on the thinking somehow.

[PeterPan]

Oh dear me, are you saying I will go straight from impulsiveness to moodiness. I think I am the one who will need medication, lol.

 

I saw a cute little sign in a store today...

 

I'm a hybrid: I run on chocolate and wine.

 

:lol:  :lol:  :lol: 

 

I don't even drink btw, but I thought it was funny.  :)

[PeterPan]

Oh, how I can relate! The meds have helped but not "cured" it. My watchwords when we was a preschooler were "constant vigilance," because I had to keep my eye on DS every second to keep him reigned in. I do think things are improving a bit as he gets older (he's ten now), but he has a long long way to go, for sure. We do talk a lot about making wise choices, but it's hard for him, because he really just doesn't think first before acting. We need to turn on the thinking somehow.

Totally get it.  I spend all day thinking of whether his action is safe, what I need to do to keep him safe.  Somehow I don't remember feeling this way with dd, lol.  He has *2* scars by his eyes right now and we had a call into the optometrist late on a Sunday evening a few weeks ago.  He's knocked teeth out, been stung.  And really, he's not even THAT bad as far as impulsive kids go.  (no broken bones, nothing impaled or blown off...)  I just spend a lot of time trying to stay ahead of him mentally (where is he, could it turn dangerous).  The minute you let up, something happens.  I'm I claim that stress as my EXCUSE for my weight gain.  Oh yeah, that and the therapy driving, oops.  

 

Crazy question for Storygirl.  Did your ds who is now on meds have a caffeine flip?  Ie. does caffeine make him tired instead of wired?  It seems to me ds does *not* have the caffeine flip, which confuses me.  I don't get how the meds would work if you don't have the flip since that's what they're predicated on.  I could ask that question more brilliantly of a psych, but I managed to miss the return call on a dandy of a psych I called yesterday.  (That's neither here nor there, just saying.)

[Storygirl]

We generally avoid caffeine for the kids (for ourselves, it is another matter!). But the few times he has had a small amount of cola, he has become visibly tired (rubbing eyes, etc., which is totally unlike him). So I'd say yes, he has the flip.

 

I'm not sure how NOT having the flip would affect the efficacy of meds -- it would be an interesting question for the experts.

 

Hey, my 100th post!!  :hurray:

[PeterPan]

We generally avoid caffeine for the kids (for ourselves, it is another matter!). But the few times he has had a small amount of cola, he has become visibly tired (rubbing eyes, etc., which is totally unlike him). So I'd say yes, he has the flip.

 

I'm not sure how NOT having the flip would affect the efficacy of meds -- it would be an interesting question for the experts.

 

Hey, my 100th post!!  :hurray:

I think that reverse reaction is the whole point of why stimulant meds work.  

[OneStepAtATime]

We generally avoid caffeine for the kids (for ourselves, it is another matter!). But the few times he has had a small amount of cola, he has become visibly tired (rubbing eyes, etc., which is totally unlike him). So I'd say yes, he has the flip.

 

I'm not sure how NOT having the flip would affect the efficacy of meds -- it would be an interesting question for the experts.

 

Hey, my 100th post!!  :hurray:

Congratulations on your 100th post.... :)

 

FWIW, although DD is not what I would consider ADHD, she has never slept well.  Having a tiny bit of caffeine right before bed actually HAS helped her to relax and sleep better.  

 

OhE, I am curious, too, what meds would do for your son if he doesn't have the flip....

[PeterPan]

Congratulations on your 100th post.... :)

 

FWIW, although DD is not what I would consider ADHD, she has never slept well.  Having a tiny bit of caffeine right before bed actually HAS helped her to relax and sleep better.  

 

OhE, I am curious, too, what meds would do for your son if he doesn't have the flip....

Have you actually had full psych evals to determine that's not the case?  I guarantee you it DOESN'T look like what you think in girls.  If she has the flip, that's pretty telling.

[OneStepAtATime]

Have you actually had full psych evals to determine that's not the case?  I guarantee you it DOESN'T look like what you think in girls.  If she has the flip, that's pretty telling.

Nope.  We haven't.  Only evaluation of that nature that I was able to get for the kids was from a CALT tutor with evaluation certification but she cannot do the full neuropsych type work up.  We got a lot of great details, but she does not look for ADD/ADHD.   I honestly wonder about DS more than DD but you are right, girls may look different than boys and she is definitely a bit quirky in some ways.

[MomatHWTK]

Re: caffeine flip- for me it has to be just the right amount.  Too much or too little over the wrong period of time and I don't sleep.  Just right and I am out.  DS says caffeine doesn't affect him at all- as in it doesn't make him hyper regardless of amount.  So it could be that the fact that the child isn't getting hyper on caffeine is the flip.   

 

This post has made me crave coffee! 

[OneStepAtATime]

Re: caffeine flip- for me it has to be just the right amount.  Too much or too little over the wrong period of time and I don't sleep.  Just right and I am out.  DS says caffeine doesn't affect him at all- as in it doesn't make him hyper regardless of amount.  So it could be that the fact that the child isn't getting hyper on caffeine is the flip.   

 

This post has made me crave coffee! 

Interesting perspective.  Makes sense to me.  :) 

 

And as for the coffee craving... me too!

[geodob]

Their is a study going on into impulsivity, which is using computers to address it?

Where the aim is to develop greater ability to inhibit an impulse.

To begin with, different colored dots are flashed quite quickly on the screen in random order.

The observer has a finger on key on the keyboard.

Which they only press when perhaps a red dot is flashed.

 

Then another layer is added to the different colors?

Where they may be a dot, a square or a triangle.

So that the key might only be pressed for a blue triangle.

 

Though the crucial element of this? Is the way that they are processed?

So that one might first observe that it is blue.

But they need to inhibit the impulse to press the key, until they confirm that it is a triangle?

Or it might be the other way round,  seeing the triangle and then checking that it is blue.

 

Where the importance of this 'checking', is that it involves 'inhibiting' the impulse to press the key.

Until both the color and shape are confirmed.

Which all happens in less than a second.

 

Though what this study is looking at, is the idea that using this to practice inhibiting the impulse to press the key?

Develops a fundamental ability to inhibit and control impulses.

[Lecka]

My son is not impulsive, really, but if he had a behavior that happened a few times, like with the conveyor belt, we would do an ABA-type program if we needed to.

 

This would probably mean (I would go over it with the therapist first and get her suggestions) going to the store at a non-busy time.  Going through that part of the line about 5 times.  Have a token board or candy. 

 

Ahead of time we have talked about what to do, probably with first, then statements.

 

Then he has to stand in line behind me or his brother for pretend (behind his brother if I have to start out holding his hand).  Then he gets tokens or candy for waiting and doing things at the right times.  If I have to hold his hand and really walk him through it I do, but hopefully he doesn't need it as much by the later times.  

 

Then maybe we have to do that more than one time, for him to practice.  

 

I know this b/c we do a lot of this kind of thing for "waiting" and "standing in line."  

 

He has had an ABA program where there is a pencil where he is sitting and he sets it down and picks it up with directions, and has goals for how long it can sit in front of him without him picking it up without a direction to pick it up.  He has played red light/green light.  That is a really good game for him to inhibit walking, b/c he has to stop when it is a red light.  For this, we haven't played in a while, but he started with someone needing to hold his hand, then someone walking next to him but not holding his hand, etc.  Something that was really good about it at the time, is that the person talking would be really dramatic with raising their hands for "green light" and putting their hands up like "stop" for "red light."  So it was visual cues and not only auditory cues, he has worked up to auditory cues though for a lot of things.  

 

Now he has structured art projects that have the "following directions, waiting" things built into them as goals.  

 

I don't think it is impulsiveness, but since my son is headed for public school, he has specific goals for "waiting" and "standing in line."  They get their own goals and programs.  

 

But at the same time ---- he is not impulsive really, no one (informally) thinks he has ADHD.  He has autism but I have asked two therapists I think have a lot of experience and they don't think he has ADHD, they have worked with children who do.  But they also say -- that is informal, it is not the same as a specialist saying it.  But anyway -- I don't think he has ADHD either, I just wanted to see what they thought in case I was missing it.  

 

For some things that can look like impulsiveness but I don't think are for him.... I have been told that encouraging joint attention will help.  That is for things where -- he should notice *other kids* doing something and think *should I do what they are doing?* and often the answer should be *all the other kids are doing x, I should do it, too.*  When kids are not doing what it seems *obvious* they should be doing based on the environment, that can be joint attention.  For my son right now -- this does mean, if it is a situation where maybe he should be *copying.*  He is able to copy, if he can notice and realize he should.  He has goals to encourage this.  That is different than not doing something that should be obvious but requires understanding something abstract about the situation or understanding the social context.  He is working that way but those are not really goals for him right now.  

 

For the more "waiting" kinds of things, I think practice has helped a huge amount here.  It takes practice, it is not like something where it comes quickly, but over time his ability to wait has improved.  

 

So I don't know about impulsiveness overall, but there may be items that are part of his impulsive behavior that you could target to work on, if you notice there are one or two things that are consistent problems and you want to focus on one or two of them.  Then after a month or two, maybe on to the next things that are the next top one or two pressing things, or whatever new thing.  But ----- in theory for us, as he can wait for more things, it will get easier for him to wait in general, in theory it should generalize.  But his therapist has said she thinks some of his improvement is just from getting a little older and more mature, not necessarily just from the practice.  She thinks kids have natural development, too, not just progress from doing therapy, it is something I like about her.  

 

I think this is a time homeschooling has a positive, b/c if you think other goals are more important, you don't have to work on "waiting" or whatever just b/c it is a goal needed for public school.  If he was in public school, based on here, he would have had some intervention by now probably, but instead of what?  Maybe instead of something that would matter more overall.  But the bright side of public school is there are lots of chances to practice waiting, lol.  

 

But I think there is a lot more to impulsiveness than just not waiting, b/c I don't think my son is impulsive, lol.  He does not do the random impulsive things, it is just not how he is (knock on wood).   

 

Separately I have read some articles about a kind of pre-school classroom, I am blanking on the name, but a new popular thing.  They talk about ways they teach inhibition.  One way is playing Simon Says.  When the leader does not say "Simon Says," they have to inhibit their action.  They also have things where they hold up a picture of a stick figure doing an action.  After the picture is put down, then the children make the action.  This is inhibiting the action at first, then doing the action at the appropriate time.  They are not things I think are things I would do with my son (specifically, they are things that would be too hard for him right now, but we do the same kind of thing, but easier), but interesting ideas.  I will see if I can find a link.  

 

[Lecka]

The pre-school thing I was thinking of is Tools of the Mind, their homepage under "philosophy" tells some things about how they teach self-regulation.

 

But I read an article about it somewhere, that was talking about how some of their games were helping to teach inhibition.  I think.  Wherever I read it, I thought it was interesting.  It was mostly things where the child had to listen to a direction or see a direction, but then have a pause before they followed the direction.  (Honestly I think I read it in a book called The Good School, that had a section about Tools of the Mind, but I have read a newspaper or magazine article about it too, at some point, I think.)

 

That is the kind of thing I think we do, too, we are just probably more structured and offering more guidance.  

 

I will also mention, even though I kind-of think it is unlikely, "physical imitation skills."  My son was extremely, extremely low in "physical imitation" before he started ABA.  He could not copy!  But he was able to learn to copy pretty quickly.  Now he is high up in that section "imitating" in ABLLS.  He still has goals for imitating, but it is like -- "clap two times, but not three times."  So, pretty complicated.  And also ---- inhibition, lol, b/c it is hard for him to stop himself after two claps and not go ahead and do the third clap.  They can prompt him by saying "one, two, stop" -- he can do it with that prompt.  When it is his turn he says "one, two, stop."  But if they do not say it -- he does not *on his own* think that to himself and then think it to himself when it is his turn to clap, and he claps too many times.  But he is making progress!!!!  For other things he has learned to do the verbal mediation (or whatever it is called) on his own, it just takes a lot of practice.  And many things he does great with, but then there will be some things that are harder.  

 

But I tend to think, your son is probably beyond this level.  But if there is a chance he has things back in "physical imitation," then that might be something.  It has been crucial for my son, but it is a thing that started as one of his weakest areas and now is one of his strengths.  

[Lecka]

 Self-regulated children can delay gratification and suppress their impulses long enough to think ahead to the possible consequences of their actions or to consider alternative actions that would be more appropriate.

 

That is pasted from the Tools of the Mind website.  

 

I would say, we are working on "delay gratification and suppress the impulse."  I don't know to what extent we are working on "think ahead to the possible consequences of their actions or to consider alternative actions." Not to a great extent, maybe, I don't know.

 

I think for him though, it is appropriate that he work on "delay gratification, suppress the impulse" things even if he is not yet working on the second half.  But I like that as a way to think of it.  

 

With his programs we definitely try to slowly decrease his reinforcement schedule (how many tokens he needs, over how many minutes) and to suppress impulses (and to build up the amount of time, though small amounts of time, and circumstances where he can suppress impulses).  

 

 

 

 

 

 

[Lecka]

 Self-regulated children can delay gratification and suppress their impulses long enough to think ahead to the possible consequences of their actions or to consider alternative actions that would be more appropriate.

 

That is pasted from the Tools of the Mind website.  

 

I would say, we are working on "delay gratification and suppress the impulse."  I don't know to what extent we are working on "think ahead to the possible consequences of their actions or to consider alternative actions." Not to a great extent, maybe, I don't know.  Maybe not at all, yet.

 

I think for him though, it is appropriate that he work on "delay gratification, suppress the impulse" things even if he is not yet working on the second half.  But I like that as a way to think of it.  

 

With his programs we definitely try to slowly decrease his reinforcement schedule (how many tokens he needs, over how many minutes) and to suppress impulses (and to build up the amount of time, though small amounts of time, and circumstances where he can suppress impulses).  

 

(I also want to clarify, when I say "waiting" I don't mean sitting around for some long period of time... I mean like, there are 2 kids in line to use the water fountain and he needs to wait in line for 30 second.  Or, it is going to take one minute for kids to line up and walk to the playground.  Or at home, waiting for me to help his sister or talk to his sister for a very short time, without hitting me or yanking on my arm to get my attention.  I think those are appropriate.  I do not mean like ---- just sit still even though you are not engaged in anything, sit still just for the sake of sitting still.  But if I say "wait please" so I can get his sister a glass of milk and then see what he needs, and he can wait nicely, then that is just something I happen to like.  B/c I have had cases where people think I want him to just sit like an old-fashioned seen-and-not-heard child and it is not that kind of thing.  Or, I want him to sit and be bored while I am endlessly shopping -- that is also very far from the kind of waiting I want him to do and think is appropriate.  And he can almost always wait with "wait, please" for me to help his brother or sister first, and he used to not be able to, so I like it for that kind of thing and it is amazing how nice it is.)

 

 

 

 

 

[Storygirl]

Lecka, I really like the tips you have posted, because they are easily things I can do at home to help DS practice delaying gratification and suppressing impulses.  Thank you! Really helpful!

[Storygirl]

I think that reverse reaction is the whole point of why stimulant meds work.  

 

Sure, but the caffeine and the meds don't work in exactly the same way.  For example, DS feels sleepy with just a small amount caffeine, but he doesn't feel sleepy with a rather large dose of Ritalin. So maybe a stimulant med would work for some kids who don't have the flip?? Not sure, but maybe they aren't mutually exclusive.

 

DH had a conversation with the pediatrician when I was not there, so I'll have to ask him to remind me exactly what was said.  But it was something like -- the stimulant medicines work, at least in part, because they stimulate the ability to engage the inhibitions. He used the metaphor of a fence; the meds help the brain draw boundaries for behavior instead of the child being led mostly by impulse.

 

Related to something Lecka said, I do think maturity comes into play, even if the ADHD is unmedicated.  At least it seemed to be so for my son. For example, as a preschooler, I had to hold him back at every door when we went trick-or-treating, because he wanted to march right into everyone's house, and if we were vising someone else's home, he would just wander away and get into things if I didn't keep a very close eye on him. One day I was standing in a new neighbor's yard, talking, and DS took off and went into their garage.  I immediately chased after him, even though the neighbor told me that it was okay to let him go. Maybe it was okay for a NT kid to explore someone else's property on their own, but it was a recipe for disaster with my son, both for safety reasons and to protect the property of others. Now, at age ten, he can play outside with his siblings, out of my sight (even unmedicated) and I don't worry that he will go exploring at the neighbor's house. So I've been able to relax my vigilance a bit as he's gotten older. Even so, I can't give him the same freedoms that a NT child his age might have, even when he is on the meds.

[Jennifer-72]

Lecka - it is interesting to me just how well ds does with delaying gratification but is yet very impulsive. It is hard to convey here, but those that know him understand. I really think there is an element of an intrusive thought pattern that come into play with some of these things - especially the ones relating to fixations. I say that because you can see him sort of wrestle with the whole thing before he does it. I would not expect this if it was just simply impulsivity.

 

I don't know. It just seems when I read about kids with poor impulse control it doesn't quite fit with how it presents in ds. Certainly some parts do but there is something else going on there as well.

 

Fortunately he doesn't seem to need too much scaffolding to move on from something like the grocery store incident (which happened twice once with dh and once with me before we could get him to monitor himself better in that situation). What is also interesting is that now every time we go he mentions what he will do. So he gives himself his own pre warning, lol.

[Storygirl]

Jennifer, do you think the word "compulsive" describes your son better than "impulsive"? DS10 definitely has both compulsions and impulsiveness. Both the neuropsych and ped mentioned OCD in passing, not that DS has it, but that he has a tendency toward compulsions. I don't know if the compulsions are an ADHD thing for DS or related to his NVLD.  Maybe both. On another thread we discussed a bit how our children "want" things so intensely that the wanting becomes an issue.

[Jennifer-72]

Jennifer, do you think the word "compulsive" describes your son better than "impulsive"? DS10 definitely has both compulsions and impulsiveness. Both the neuropsych and ped mentioned OCD in passing, not that DS has it, but that he has a tendency toward compulsions. I don't know if the compulsions are an ADHD thing for DS or related to his NVLD. Maybe both. On another thread we discussed a bit how our children "want" things so intensely that the wanting becomes an issue.

Yes in many ways I would say compulsive describes him better. But there certainly is an impulsive side to him to. Just to keep me on my toes he apparently needs to have both! I guess I am really going to have to stop and ask myself if what he is doing in certain instances comes from impulsivity or from a compulsive need. I have the What To Do When Your Brain Gets Stuck. I think I will go through that and see if I can pull out some strategies that may support him better for those situations.

 

Excellent thought! Thanks so much!

[Lecka]

I think my son is much more having trouble with delaying gratification.  I think that may be why I don't think he is very impulsive.  

 

I think there are a lot of things that would be targeting the delaying gratification, wrt possible impulsivity, so it is good to know those are unlikely to be helpful!  

 

It is interesting how things can seem the same in one way but then be so different.

[PeterPan]

Their is a study going on into impulsivity, which is using computers to address it?

Where the aim is to develop greater ability to inhibit an impulse.

To begin with, different colored dots are flashed quite quickly on the screen in random order.

The observer has a finger on key on the keyboard.

Which they only press when perhaps a red dot is flashed.

 

Then another layer is added to the different colors?

Where they may be a dot, a square or a triangle.

So that the key might only be pressed for a blue triangle.

 

Though the crucial element of this? Is the way that they are processed?

So that one might first observe that it is blue.

But they need to inhibit the impulse to press the key, until they confirm that it is a triangle?

Or it might be the other way round,  seeing the triangle and then checking that it is blue.

 

Where the importance of this 'checking', is that it involves 'inhibiting' the impulse to press the key.

Until both the color and shape are confirmed.

Which all happens in less than a second.

 

Though what this study is looking at, is the idea that using this to practice inhibiting the impulse to press the key?

Develops a fundamental ability to inhibit and control impulses.

If you do that, in a sense are you teaching to the test?  (TOVA)  Do the results from work like this generalize and carry over to life situations?

[PeterPan]

Lecka - it is interesting to me just how well ds does with delaying gratification but is yet very impulsive. It is hard to convey here, but those that know him understand. I really think there is an element of an intrusive thought pattern that come into play with some of these things - especially the ones relating to fixations. I say that because you can see him sort of wrestle with the whole thing before he does it. I would not expect this if it was just simply impulsivity.

 

I don't know. It just seems when I read about kids with poor impulse control it doesn't quite fit with how it presents in ds. Certainly some parts do but there is something else going on there as well.

 

Fortunately he doesn't seem to need to much scaffolding to move on from something like the grocery store incident (which happened twice once with dh and once with me before we could get him to monitor himself better in that situation). What is also interesting is that now every time we go he mentions what he will do. So he gives himself his own pre warning, lol.

I'm with Story on differentiating impulsive and compulsive.  Around here impulsive is action without thought.  It's just like auto-action.  Grab the nearest glass rather than reaching in the drawer for your own.  Throw the ball because it's in your hand and you see someone.  Ram into someone because they're there.  Jump because you're up high.  Go up high because you're down low.  It's not so much the energy that differentiates it as the WOW IF YOU HAD THOUGHT ABOUT IT YOU WOULDN'T HAVE DONE IT element.   :lol:  I'm laughing, because you either laugh or cry.  

 

I think impulsivity would make the idea come into his head when he sees the spark and compulsion would make it hard to transition off.  

[Jennifer-72]

I'm with Story on differentiating impulsive and compulsive. Around here impulsive is action without thought. It's just like auto-action. Grab the nearest glass rather than reaching in the drawer for your own. Throw the ball because it's in your hand and you see someone. Ram into someone because they're there. Jump because you're up high. Go up high because you're down low. It's not so much the energy that differentiates it as the WOW IF YOU HAD THOUGHT ABOUT IT YOU WOULDN'T HAVE DONE IT element. :lol: I'm laughing, because you either laugh or cry.

 

I think impulsivity would make the idea come into his head when he sees the spark and compulsion would make it hard to transition off.

I can't bold on the iPad, but I think it is exactly the impulsivity gives him the idea and the compulsion makes it hard to to transition off. So definately a double whammy. And yes, I always choose to laugh about it rather then cry. It is what it is. All I can do is keep giving him tools to help himself out. I am grateful that he really seems to use the ones I give him. Clearly I just need better ones here. The lives of supermarket goers are counting on me....

[geodob]

OhE, you asked: "Do the results from work like this generalize and carry over to life situations?"

 

Though this what this study is looking into.

Where their is strong indication that it is transferable, as the same part of the brain is used.

Their is a part of the 'pre-frontal cortex', that works like a switch board operator.

Constantly sorting incoming information from different parts of the brain.

Sitting at the switchboard, when it recieves a message, it first needs to decide whether to accept or dismiss it?

If it accepts it?

Then it needs to be set at a level of priority for attention.

As a part of a network of 'things' demanding attention.

Where it does 'generalize and carry over to life situations'.

As our brain only has one switchboard, to deal with everything.

[Tiramisu]

I'm planning on giving pycnogenol a try. It's supposed to increase micro-circulation and help the body get rid of waste products. There have been studies about this and also ones about how it reduces hyperactivity and impulsivity. It's an antioxidant and it's supposed to be safe. 1 mg per kilo of weight.

[iammommy]

The Interactive Metronome Program helped my son with impulsiveness. Not a miracle cure, but it did help. Also, I've noticed as he hit the teen years, he outgrew some of the impulsiveness. His obsessions remain, BUT, his primary obsession with emergency vehicles has turned into his passion. He's now a junior firefighter, hoping to become an EMT/Paramedic. Hang in there, it does get better.

[LMV]

Thanks! Any resources/books you know of, or did you do this mostly under a therapist's direction?

 

 

This was with DH's godson who became our foster son after his father's death. At the time DFS was thirteen and worked with a CBT trained therapist who had a lot of exercises that focused around grounding and taking a moment to think before acting.  DH or I, (ok, more DH than I, that was just how our lives were at that time) sat in on sessions so we could encourage and assist with skills use at home in between sessions.  We were doing this at a time when CBT for ADHD was rather new so I think some of it was developed as we went along (which wasn't all bad because it was very tailored to DFS) now there are more established protocols so you may find a good book to use alone or as an adjunct. I do think DFS benefited from CBT and it was a good lead in to DBT which was more helpful with some of the emotional dysregulation that is part of adolescence for many kids but was so much more of a disaster in light of the ADHD and his concommitant grief issues.

 

I know your son is younger, and some will argue that therefore CBT is out, but I do think CBT can be very useful with younger kids you just need to adapt it to where they are cognitively and developmentally.  We used TF-CBT for PTSD when our DD14 was our DFD11. She worked with several very skilled therapists and DH and I were both very involved in modeling and encouraging skills use in between sessions. I do think CBT with younger kids can require good parental buy in and support but it can work well.  If you have other questions, please ask.

[Ottakee]

Lots of good discussion and ideas.

 

I will just say that after lots of work the day my daughter darted across a parking lot and said "you don't have to watch for cars EVERY time" was the day we called the doctor and started on the med route.  It makes SUCH a HUGE difference for her.  Her biggest issue now as a teen is verbal impulsivity which can get her in a lot of trouble.  With the meds, she has a pause button before she speaks.  She really is a great kid who just needs a pause button.

[Jennifer-72]

Thanks everyone for your input.

 

After looking through Zones of Regulation, I decided to use the triggers lesson to discuss with him some of the more complusive/impulsive behaviours he engages in. Previously, I had only connected that lesson with stuff that would make him upset not really stuff that would just be the silly side of yellow zone behaviour. So that was really helpful to discuss how some of this stuff is a trigger for him and puts him in the yellow zone. We also made a series of stop and go index cards and wrote various impulsive actions on the stop side and discussed how we need to flip that and tell our brain a go picture so it doesn't just get stuck on the what not to do message. He really liked coming up with the go statements. I used a whole bunch of impulsive actions that were and were not common to him

 

Of course, this won't be the end of all impulsive behaviour! But it feels better to have some consistent language and approach to use for him. He always responds well to that type of stuff, so here is hoping it keeps proving helpful.