Here are a few occupational therapy tips that are useful for many children with LD, particularly those with motor difficulties.

In the school setting:

1. Ask the teacher to review rules and routines with the child individually so s/he is clear about expectations and timing of recess, lunch, changing for gym class, etc.

2. Introduce computers as early as possible. Although keyboarding may be a little harder initially, your child should be able to become proficient and this will reduce the amount of handwriting that is required.

3. If your child has handwriting difficulties, try to provide paper that matches the difficulties; for example, widely spaced lines for a child who writes very large; raised, lined paper for a child who has trouble writing within the lines; graph paper for a child who has trouble keeping numbers aligned.

4. Arrange for the child to have extra time to complete activities such as printing, copying notes, writing a story and artwork. If speed is necessary, be willing to accept a less neat production.

5. Provide the child with different methods of presenting information at school. For example, children may present reports orally, use drawings to illustrate ideas, record a story or exam on a tape recorder, or type a report on the computer.

At home and in the community:

1. Try to establish a daily routine for getting ready for school and for doing homework. Some children find it helpful to have morning dressing routines or bedtime routines posted with pictures or words that show the sequence of events.

2. Encourage your child to wear clothing that is easy to get on and off. For example, sweat pants, sweat shirts, leggings and velcro shoes. When possible, use velcro closures instead of buttons, snaps or shoelaces.

3. Try to introduce your child to new sports activities or a new playground on an individual basis, before s/he is required to manage the activity in a group. Try to go over rules and routines that are part of the activity when the child is not concentrating on the motor aspects; for example, "What do you do when you hit the ball?"

4. Your child will probably prefer, and perform better at, individual sports; for example, swimming, running, bicycling, skiing rather than team sports. If this is the case, try to encourage social interaction through other types of activities such as music, drama, cubs, etc.

Written by occupational therapist Cheryl Missiuna, Ph.D., O.T. (C), assistant professor at the School of Rehabilitation Science, McMaster University, Hamilton, Ontario.

Articles

Segal, Ruth. (1998). The construction of family occupations: A study of families with children who have Attention Deficit/Hyperactivity Disorder. Canadian Journal of Occupational Therapy, 65, 286-292.

Abstract
Families are the main caregivers of children who have special needs and are essential in the client-centred occupational therapy practice. They also provide the immediate social and cultural environments of their children who have special needs. A qualitative study of daily experiences and adaptations of 17 families with children who have attention-deficit/hyperactivity disorder is described in this paper. The analysis of interviews with parents revealed that they developed and used strategies to enable their children's occupational competence. Further, whenever parents reported on the success of these strategies, they also described changes in the daily routines of other family members. The interactions between these enabling strategies and the daily routines of family members are presented and discussed in this paper.

For the full paper in Acrobat PDF format, download ADHDSegal98.pdf

Book Reviews

Beyond Ritalin: Facts about medication and other strategies for helping children, adolescents and adults with attention deficit disorders (1997)

Stephen W. Garber, Marianne D. Garber, Robyn F. Spizman

Harper Perennial
201 East 50th Street,
New York, NY 10022
255 pages; $18.50

In this excellent book pertinent information regarding attention deficit disorders is interpreted for the reader in layman's terms. The authors review medical, psychosocial, and educational factors that contributed to behaviours similar to those diagnostic of Attention Deficit Hyperactivity Disorder (ADHD). This information is very important in the accurate differential diagnosis of ADHD, and suggests a range of treatment options beyond Ritalin to manage the behaviours.

Regarding management of ADHD, the authors discuss the different medications available, how they work, and when the medication is useful. They have highlighted what medication cannot do, i.e., remedy deficits in academic achievement, teach social skills, or correct a defeatist attitude produced as a result of untreated ADHD. This valuable information emphasizes the role teachers and other professionals play once medication is effective, to enable learning. The book also addresses the problems of the adult with ADHD.
Occupational therapists will notice one glaring mistake in the chapter discussing alternative treatments. The work of Dr. Ayres is referred to as "Integrated Sensory Training" and brushing is discussed as one "form of exercise" used in the "training". This ill-informed reference to the theory of Sensory Integration raises doubt regarding the accuracy with which other alternative treatments are discussed. Information in some of the other chapters appears repetitious, for example the references to learning and achievement, solving social problems, and learning self-control.

Apart from these shortcomings, this book is an informative resource for any parent or professional dealing with ADHD. Beyond Ritalin is one book which gives a holistic picture of the ADHD Syndrome, with emphasis on how to get an accurate diagnosis, alternatives to consider before trying medication, and what needs to be done in addition to medication to ensure success in daily life.

- By occupational therapist Asha Asher

Other sources of information

The Learning Disabilities Association of Canada has a nation-wide network of provincial and local organizations that provide support, educational resources and programmes for children and adults with Learning Disabilities.
Visit their web site at http://educ.queensu.ca/~lda