Attention and ADHD: Tell them to Fix Their Feet!


There are a lot of antsy kids out there.  Some of them have ADHD.  Not all of them get occupational therapy.  Most of my work with these kids centers on sensory processing treatments that improve attention and emotional regulation.

But some of my treatment strategies concern  positioning.  That is a therapy word for how they sit, stand, or kneel.  And my work isn’t just prescribing a “wiggle cushion” and walking away thinking that the job is done.  That is a rookie move, not what you get from  skilled licensed therapists.

Every OT and every PT knows that positioning determines head control.  Our kids with ADHD can look like they have a head on a lazy susan; their eyes go everywhere but where they are supposed to!  Getting them in an aligned and balanced sitting position to listen and perform can work like magic.  Their eyes go in the same direction as their hands.  Their hands go in the same direction as their feet:  forward, to the teacher or the page.

Why do I say “Fix Your Feet” instead of “Sit up Straight”?

Because I want kids to pay attention to their bodies.  I AM an OT, after all.  I want them to tune in, not move robotically on my commands.  The older ones might have some insight, so I will ask them to notice if their work was easier to do or faster to finish after they fixed their feet.  Something like that sends home the message that they have a tool they can use.  But it will take lots of practice.  They have been “all over the place” for years before I got to meet them.  They have been allowed to sit any way they wished, then criticized for their inattention and distractibility.

Some kids will need meds to really focus well.  That is a fact.  But all medicated kids should be on the very lowest dose that allows them to function.  Always.  Those drugs have side effects that aren’t minor.  So every bit of non-pharmacological support we can give makes a difference.

Want more information on this subject?  Read  Hypermobility and ADHD? Take Stability, Proprioception, Pain and Fatigue Into Account Before Labeling Behavior and  Sleepless ADHD/ASD Kid Taking Stimulants? A Drug-Free Solution .

By Cathy Collyer

I am a licensed occupational therapist, licensed massage therapist, and certified CBT-i sleep coach in private practice in the NYC area. I have over 25 years of professional experience in adult and pediatric treatment. It has been a joy to help people of all ages improve their ability to grow and thrive! Occupational therapists are focused on enhancing a client's functioning in everyday life. We are practical healthcare providers, interested in teaching, adapting actions and environments, and building a client's useful skills for living their best life, regardless of their challenges. I am the author of five books, including "Staying In The Room: Managing Medical And Dental Care When You Have DID" and "The Practical Guide To Toilet Training the Autistic Child". I lecture on many subjects, including sleep, trauma, and development. Contact me to learn more about how I can help you achieve YOUR goals!

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