How To Get Hyperactive Kids To Focus Better

Episode Transcript

Dr. Nicole Beurkens:

Hi everyone, welcome to the show, I am Dr. Nicole, and on today’s episode, I am answering a question from a listener. I get many questions each week, and this is a way for me to provide answers that many of you might find helpful. If you have a question you’d like me to consider answering on a future episode, email it to support@drbeurkens.com and you just might hear it on an upcoming show.

Now, onto today’s question, which comes to us from Heather. Heather writes: “Hi Dr. Nicole, my four-and-one-half year old son is a good kid, but we can’t get him to focus on learning. All he wants to do is run and play. When they have circle time at school, he’ll only sit for four minutes, then he’s up and looking for something else. I am trying so hard to teach him his ABC’s, and he just says, “Nope, let’s play.” or “Not now, mom”, but yet if I give him my cell phone, he can be on it for an hour watching shows without a problem. I just don’t know what else to try. He’s also lacking in some speech development by about a year, and I have an appointment to get a referral for speech therapy. Not sure if I should ask about ADD or other issues.”

Great questions, Heather, and I think these answers that I’m going to give are going to be helpful to you and to many other people listening. So, let’s start with some of the big picture pieces here: First of all, it is fairly normal for a four-and-a-half-year-old to be very interested in physical activity and movement and finding new curious things to be involved with, as opposed to sitting and doing what they might perceive as boring or repetitive academic kinds of activities. Now obviously, there is a range of what’s typical there, and certainly there are four-and-a-half-year-olds who are well outside the range of what we would consider as typical in terms of just being so hyperactive, inattentive and driven to move that they can’t really focus on anything. So certainly, there can be a concern about that, but I just want to put it in the developmental context that four-and-a-half-year-olds do want to run and play, and it’s not uncommon for them to say, “Nope! I would rather do this. You want me to do ABC’s, I want to go and chase after the squirrels or look at this cool thing that I saw over there”, or whatever it might be. So that’s one of the big picture things to consider.

Another thing to consider is that it is very, very common for kids to struggle to focus on things that are not as interesting to them, like in this case maybe learning academic skills, but to be able to sit and focus for an extended period of time on screen time kinds of things, on devices, on apps, on TV shows, on videos, on that kind of stuff. And the reason for that is that things like videos and apps and that kind of stuff provides a constant stream of stimulation to the brain. So yes, they’re sitting there and they’re not doing anything, but from a stimulation standpoint, their brain is being constantly stimulated by the constantly changing visual images and the sounds and the activities and the things that are going on. So that helps, hopefully to explain why your kiddo who struggles in engagement with real world tasks, to stick with something for very long, especially if it’s a repetitive kind of thing, can sit in front of TV shows or videos on your phone for hours at a time without a problem. That’s pretty typical and it has to do with the level of stimulation that is going on.

So, let’s dive into this: Kids move to learn. Kids need movement to learn. All kids do, some kids need much more of that than others, but the reality is that a child’s brain needs physical activity and movement in order to form new connections, in order to grow and develop. So not atypical at all for kids to be wanting that movement. Now, movement can get in the way of participating in certain kinds of activities and so we want to figure out how to structure things for a child to help them get the movement that their body and their brain seem to be needing, while also being able to engage in the kinds of tasks and activities that are beneficial to them.

So one of the things I’m going to recommend, Heather, is that you incorporate things like academic skills learning, ABC’s, that kind of stuff, into movement-oriented activities, that you figure out how to merge the two. That is probably going to be much more successful for your son and for you. So what do I mean by that? Well, you want to look for ways to embed these sorts of academic or learning skills into structured movement-oriented activities. An example could be: If you’re using flashcards for ABC’s — and I’m not sure what you’re using to do that, but let’s just take a simple example of flashcards because that’s what a lot of people use. So you’ve got these flashcards and you may want him to sit there and go through the flashcards, and he is not having any part of that, he’s like “Nope, not interesting to me, I would rather run around.” So you can create a game out of it where maybe you put a chair right in front of you, and then you put a box or maybe a shoebox with a slot in it or something across the room. And this is a game, where you’re going to show him a flashcard, he’s going to tell you what it is or you’re going to practice that with him, and then he’s going to take that card and run from his chair to the other side of the room, put it in the slot in the box and run back to the chair and sit down to do the next one. And what you’re doing here with something like that is creating structure, you’re giving an opportunity for movement — movement is built into the game or the activity, but you’re keeping it structured in a way we’re he is not trying to meet his own needs by chaotically running around, you’re getting your need met of working on this thing with him that you feel like is important for him to learn, but doing it in a way that is productive for his brain and his body and meets those needs. So that’s an example.

Another example is creating an obstacle course. Obstacle courses are great ways to provide structured movement, because for kids who are really, really driven to move, particularly if it’s a kid who does have issues with hyperactivity and impulsivity with physical movement, we want to structure that for them because structured movement is regulating. Chaotic movement, it might meet their need for movement and stimulation, but it isn’t regulating and organizing for the brain. So we want to structure the movement. So we might create a simple obstacle course, or maybe we’ve got the mini tramp, then we’ve got some colored squares on the floor to hop across or walk across, maybe then we’ve have a tunnel that they go through, and then we have a little table that they’re going to climb under. That would just be an example of maybe some things that you might have around the house, and you create this circuit where okay, we’re going to jump on the trampoline 10 times, then we’re going to take these big steps across these colored squares, then we’re going to go through the tunnel and then we’re going to climb under the table and back to the trampoline, and it’s a circuit. Now, you get that circuit going for that structured predictable movement, and then you can embed some of these ABC activities in it. Maybe while he’s jumping on the trampoline, he looks at some letters that you hold up and names them. Maybe you’ve got some letter cards on these colored squares, and you give him instructions like “Jump to the one with the letter B” or “Step over the letter Q” or something like that so he is having to think about these letters within the context of the movement. Maybe you create a game where you have three containers set up, each one has a different letter on it, and you give him some bean bags to toss in there and you say “Toss it in the A bucket, toss it in the B bucket”. You can do that with numbers, you can do that with all different things. So hopefully this is getting your wheels turning in terms of thinking about some of the ways that you can create structured movement activities that then incorporate some of these learning or academic skills in them. That’s going to be key.

Another great one for a younger kid would be to use bubbles. So maybe they’re going to sit in the chair and you’re going to show them the flashcard or they’re going to have the little activity or something that they’re going to do sitting right in front of them, and then when they have done one or two or however many of them, you’re going to blow some bubbles and they get to run around and pop all the bubbles with their body and their hands and then they’re going to sit back down. That’s another simple way to keep them in the same spot but give them the movement opportunities. And the thing is when you do this kind of stuff, you’re showing them that you understand what they need, what their brain and body needs with the movement and that you’re going to provide that, so they don’t have to try to control by racing around, refusing, whatever, because they know that you’re going to meet their needs in that way. So it helps them to relax into the activity, it helps them to know their need is going to be met so they don’t have to control by refusing or running around. So any kind of active games that you can use to incorporate these skills into is a great idea.

Now, another thing to think about with a kid like this is really structuring and defining the space where you’re doing these activities. So Heather, you mentioned at school he’s only sitting for four minutes in circle time, and at home he’s running around. So you want to think about defining the space for these kids. Some kids with these issues really struggle to know where they are in space, they struggle to stay in a defined area, they’re not very body-aware, they’re not very aware of the environment around them. So moving is their way of being more aware of where their body is in relation to everything else. So these kids really benefit from having more structured, defined spaces for where they’re supposed to be. Sometimes that can be as simple as sitting in a chair with arms on it. I’ve had kids when I consulted in classrooms where sitting on the floor and staying in one spot there for an extended period of time. That is not enough of a structured or defined space for them. But if we give them a chair to sit in with a back on it and arms, that gives them a structured space, that’s helpful. Sitting on a ball chair, giving them a spot to sit on on the floor, having everybody have a colored square or a sit disk or something that defines that spot. Sometimes, I’ll give kids in a group setting like that, or when you’re working with him 1-on-1, give him a hula hoop: “This is your spot to sit in. You can do whatever you want in this spot, but we’re staying in this spot.” It just defines the area for them, it can be really helpful. Sometimes kids benefit from something like a weighted lap pad or a heavy stuffed animal or a heavy beanbag or something like that that they can put on their lap or on top of them that helps ground them, helps them be more aware of their body and helps them to be able to keep themselves organized in one spot. Also consider allowing him to stand to do some activities. Some kids will stand still, and that’s helpful to them just to be able to stand. Some of them will bounce, some of them will pace a bit. You can define the area, tape off a square or something on the floor. “This is your area that you can move in while we’re doing this.” So again, you’re looking at structuring and defining the space. And also, when you’re doing these things with him at home, choose your environment carefully. Choose a more quiet and closed-in space. I would not work on an activity like this with a very movement-oriented, impulsive four-and-a-half-year-old in the big, open family room where there is all this open space to get lost in and to race around and to move around. Nope, I would not do that. I would pick a quieter, more closed-in structured space, maybe a spot in the bedroom, maybe sitting at the table in the dining room — a space that is more closed-in, easier for me to control the materials and not have my kid racing around, so that now we’re doing a game of chase. I would also encourage you to sit very close to him. That physical proximity helps create some structure and can be organizing and helpful for some kids, so you want to think about how you can use your proximity to the child, as well as choosing the environment carefully to help support this.

I also think that some visuals for the length of time that things are going to go on is helpful. Now, this is beneficial if the issue is that he’s feeling like he’s going to be there forever or he’s not going to get a break, or he is feeling anxious because he has no idea how long this is going to go on, or he’s feeling anxious because he doesn’t really know what the expectation is. Important to remember that hyperactivity, lots of chaotic physical movement, kids refusing and leaving activities is not necessarily an attention or an impulsivity problem. That is what anxiety can look like in young kids. When they’re feeling anxious and they’re like “I’ve got to get out here because this is making me uncomfortable, I’m feeling stressed, I’m feeling too uncertain.” And so kids who are really anxious at this kind of age can look very impulsive and hyperactive. So, it is important to keep that in mind. So what can be helpful is to give them a visual goal that you’re working towards. “Okay, let’s lay these five flashcards out on the table here. When these are gone and we’ve done them and put them in the box, we’re done.” Keep it short, keep it successful, and give them a visual so they can see exactly where they are in the process of this activity. Or maybe it’s something that’s more conducive to “We’re going to put a checkmark/smiley face/red dot on the paper for each of these things that we’re doing, and when we have 10, when we’ve filled all the boxes, then we’re done and you can go play.” Those are great ways of giving kids more structure, helping them know what the expectation is so they can anticipate. You have to remember that young kids really do not have a good sense of time. And that goes even as kids get older, they really don’t have a good internalized sense of time until they are in the mid to later elementary years, and sometimes kids even beyond that struggle with that. So we want to help define time for them and the passage of time, and help them get a sense of how long things are going to be, how long he’s going to be there. So that can be helpful. Using things like visual timers can be helpful too. You can turn the visual timer to let’s say one minute or five minutes or whatever and he can see that timer moving, so he knows when he’s going to be done. That can be very helpful as well.

I also think that it’s important, as I mentioned a few minutes ago, to build in the movement breaks before he’s trying to escape or leave or refuse or run around. You want to keep these little work sessions or practice sessions or ABC sessions, whatever it is, you want to keep them brief and successful. Start with just one or two quick things, and then, “Oh, great job! Go play.” And then you can slowly extend it over time, so that he starts to learn and trust that this is going to be successful. You’re going to stop before the whole thing starts to unravel and become upsetting and stressful for both of you, and you’re going to start with where his level of tolerance is and build from there so that he feels successful and you feel successful with it. And also, that shows him that he can trust staying with you and doing this, that you’re going to give him a break, that he doesn’t need to control in that way. That you’re going to keep it to what he can manage, and then he’s going to get to go and play. So that is a helpful way, starting off very simple, very brief, and then increasing over time. Okay, so that gives you some practical, tangible tools that you can use for helping with this.

I do want to touch on just a couple of other things to be thinking about here for those of you who have a child who seems to be constantly driven by this internal motor that is always on 100% go, go, go, go, go. Maybe this ends up being a diagnosable condition like ADHD, maybe not. It doesn’t matter. The tips that I just gave are going to be helpful, and I want to talk about just a few sort of underlying things that might be beneficial to look at if you’re in this situation: The first is really to look at sleep. We know that kids who’re not getting enough quality sleep look very, very active, and can be very dysregulated in their movement and activity level, in their ability to focus, and struggle with emotional and behavioral regulation in general. So if you have a kid who you are like, wow, just really struggling with regulating emotions, behaviors, movement, managing age in a developmentally-appropriate expectation, you might want to look into what’s going on with the sleep piece of things. Also blood sugar stability and nutrition pieces in general. Sometimes kids are very sensitive to blood sugar fluctuations, so you see more of this constant, almost hyperactivity, impulsivity, drivenness, because they’re having these blood sugar spikes and crashes, if they’re eating a lot of things with added sugars or simple carbs, they’re not getting enough proteins and healthy fats to balance those carbs out, so they’re having these spikes and these crashes of their blood sugar levels, and that can really exacerbate a lot of these kinds of tendencies and issues in kids. So you want to look at a consistent eating schedule, making sure that they’re having carbs and proteins and healthy fats together as much as possible and trying to minimize the added sugars. Keeping them hydrated is another really important thing. Hydration with water. Another thing to look towards if you have a kid who is really struggling with a level of hyperactivity and impulsivity that is not developmentally appropriate, look at things like iron level. That can be very, very much an issue in kids who have these kinds of challenges, you may want to look into other nutrient levels as well, but iron is a big one for these kinds of issues, and also food sensitivities. Not unusual at all in my clinical experience for kids who are struggling with just this constant overactive drivenness, inability to stick with anything, that there are some negative reactions to some things that they’re eating that could be going on. So these are some things you want to be thinking about. As I said at the outset of answering this question, it can be real developmentally-appropriate for kids at these younger ages to have these challenges. But if your gut feeling is nope, this is really beyond what is in the range of developmentally appropriate at my child’s age, or it’s just creating a lot of stress and a lot of issues, you do want to talk with their medical provider. Think about some of these things, investigate some of the options because addressing these kinds of underlying things can make a big difference.

So, I hope that this is helpful for you, Heather and for all the rest of you who may have a really active child or a developmentally-young child who is struggling to focus on these kinds of non-preferred activities. I hope you got some good tips and takeaways. Remember, if you have a question you would like to hear answered on a future show, email it to support@drbeurkens.com. Please put “Podcast Question” in the subject line, that helps us sort through those, and thank you, as always, for being here, for listening, for being a fan of the show. I look forward to catching you back here next time.