Support strategies for attention, activity, and behaviour (parents/carers)

Many children can find it difficult at times to focus or concentrate on work or play activities. Our ability to pay attention can be impacted by many different things including anxiety and stress, lack of sleep, diet, significant life experiences, bereavement and trauma, and underlying neurodevelopment.

If your child is struggling with attention and concentration, we would recommend the following support is put in place.

• Regular prompts to help them maintain focus. 
• Repeat instructions as necessary.
• If you are asking your child to do something, give instructions which are brief and specific. For example, instead of asking: "Can you tidy your bedroom?" say: "Please put your toys into the box and put the books back onto the shelf." This makes it clearer what your child needs to do and creates opportunities for praise when they get it right.
• In lessons, they should sit near the teacher, away from distractions like window and doors, and other children or young people who may distract them.
• Present work in small chunks. Keep communications short and simple. Give one instruction at a time, allowing them the chance to complete one task before directing them towards the next one. 
• Write instructions down for them so they have something to refer back to if they forget the instruction they were given.
• Encourage them to continue with complex tasks rather than abandoning them.
• Help them set up and uses routines (e.g., putting items in the same place whenever they are not being used, so that this becomes a habit, and they lose things less).
• Use visual reminders such as lists, organisers, personal planners and phone reminders.
• They could also practise and use memory aids, such as verbal mediation or rehearsal and mnemonic strategies.

Many children and young people can show increased levels of activity at times. If this is something your chid experiences, we would recommend the following strategies are put in place to keep them regulated.

• Offer regular breaks - watch for warning signs that they are overloaded or overexcited and intervene early.
• If they need movement breaks to help them regulate their activity level in school, perhaps use a time out card or agree a signal that they can use to let teachers know they needs a movement break. It is important that they are given a break when they need otherwise they may become restless and disruptive. 
• The opportunity to occasionally stand up or walk round the classroom in a non-disruptive way in order to guard against the frustration of having to sit still for long periods can be useful. Even standing up to work sometimes could help.
• Asking them to complete tasks for you which involve physical activity (it can be as simple as putting dishes or classroom resources away). This may help them settle down and allow them to return to their desk ready to concentrate.
• Regular exercise will help to manage their activity and possible restlessness; it could be useful to find a sport which they enjoy and can play regularly.
• Permit them to play with small objects kept at their desk that can be manipulated quietly, such as a soft squeeze ball, if it isn’t too distracting.They may find fidget toys helpful

If your child struggles with their organisation skills, we would recommend the following.

• Set well-defined schedules of activities (daily schedules, planners) and help them to estimate time frames (e.g., how long an assignment will take).
• Timetables (visual, audio or written) are very useful for home as well as school activities, as it makes it clear what the young person has to do next.
• Plan the day so that they know what to expect, with tasks presented in structured steps, possibly with visual cues, especially if they respond well to visual cues and /or have difficulties in retaining orally presented information.
• Use visual reminders such as lists, organisers, personal planners and phone reminders.
• Keep desk clear of unneeded material, arrange material in advance, help your child to organise their backpack.
• Encourage them to plan what will be needed for a task before beginning it.
• Using things like egg timers or stop watches may be useful to remind them of the time they have left during certain activities.

If your child struggles with processing speed, we would recommend the following.

• Allow them longer response times to make decisions, respond orally and complete assignments.
• Do not require them to work under time pressure.
• When copying is required, do not require speed.
• Allow extra time for them to proofread for accuracy.
• Provide copies of notes rather than requiring them to copy from the board in a limited time.

If your child is struggling with their attention, activity and behaviour, they may benefit from modifications to their environment.

• Provide them with low-distraction work areas at school.
• Some pupils with attention difficulties can concentrate much better with background music that helps to filter distractions; this may be possible in some lessons.
• Sitting near the teacher so they are less likely to be distracted and so that the teacher can keep and eye on them and provide additional support if needed.
• Increased distance between desks in lessons so they are less likely to get distracted by peers.
• Encourage them to sit near positive role models to ease the distractions from other students. This also provides the opportunity to work cooperatively and to learn from peers.
• Make sure that the desk and chair used in class is the right size. If not, they may be more inclined to fidget or squirm. A general rule of thumb is that the child should be able to put their elbows on the surface of the desk and their chin fit comfortably in the palm of their hand.
• Movement breaks could be built into the lesson as a whole class activity (e.g., 2 min break to do star jumps).
• Give prompts for how to behave in social situations, phrasing these positively as a ‘Do’ rather than as a ‘Don’t’ (e.g., “stay seated in your chair” rather than “stop standing up”).
• Use things like egg timers or stop watches to remind them of the time they have left during certain activities may help to keep them on track.
• Frequent communication with home re equipment needed, homework, upcoming activities, etc. to facilitate planning.
• Consistency between home and school settings is key. Regular and effective home-school liaison, including a system for reviewing progress regularly (e.g., an Individual Education Plan or Individual Behaviour Support Plan) is needed. A daily or weekly communication sheet with feedback about specific targeted behaviours could enable parents to follow through at home with appropriate consequences, as well as keep teachers informed of significant events at home that may affect the child’s behaviour at school.
• The emphasis should be on positive reinforcement of wanted behaviours and effort, rather than sanctions. Notice instances when the child achieves the desired behaviours (e.g., sitting still, following instructions and completing tasks) and notice what has made these instances successful. Try to repeat the positive aspects of these instances as often as possible. 
• The child should be involved in the selection of targets and rewards if possible, which will aid their compliance and motivation.

Some children to experience sleep difficulties. Some strategies that can help to improve sleep hygiene are included below.

It is important to remember that getting to sleep when you are not feeling tired is not easy. Make sure your child knows they are not perceived as being 
disobedient or naughty and that you will try to find solutions together to overcome the difficulty. 

Daytime

• Avoid naps to ensure your child feels sleepy at night time.
• Children with high energy levels may need to increase physical activity in the day so they feel tired at bedtime. This could include playing sport, running, trampolining or going to the park.

Bedtime

• Introduce a consistent and set bedtime routine which occurs at the same time each day. This aims to reduce stimulation at the end of the day to help your child wind down and relax before bed.
• A routine may involve finishing an activity by a certain time (especially computer/media activities, physical activities and emotive programmes) and introducing a less stimulating one, such as:
  • Reading a book or having a book read to them (often better when read in bed)
  • Having a bath
  • Making a story up together
  • Drawing a picture
  • Listening to relaxing music
• Screen based activities should end at least one hour before bedtime (television, computers/laptops, mobile phones, tablets, game consoles). The light from these screens is thought to prevent the release of melatonin (a hormone which helps us to sleep).
• Avoid stimulating games and interactions at least one hour prior to bedtime to allow your child to calm down.
• The routine can also include: packing their bag for school the next day, changing the bed, washing, brushing their teeth.
• Specify the time your child should be up in their bedroom and what time they should be in bed. Going to bed at the same time every night helps the body develop a routine and a sleep cycle.
• Put up a notice or checklist about the bedtime routine in your child’s bedroom. Include on it the times the routine starts on weekdays and weekends. 

Sleep Environment

• Create an optimal environment for your child to sleep in. Consider all the things around your child which may affect their sleep.
• Minimise levels of noise as much as possible, although some children do settle better if you play soft, relaxing background music, white noise or an audiobook. 
• Make sure the room is at a comfortable temperature and the bed is warm and cosy. 
• Put in a night light if your child is afraid of the dark. 

Keep a Diary

• Keep a sleep diary and record in a chart:
  • All activities one hour before bedtime
  • All foods/drinks consumed one hour before bedtime
  • Time your child went up to bed
  • Time your child got into bed
  • Time your child went to sleep and the hours slept
  • All sleep disturbances
  • Time your child awakens in the morning
• Also note what methods seem to help and what doesn’t seem to help.If you consult a clinician about your child’s sleep difficulties, take the sleep diary with you as this will help your receive appropriate advice and support.

Disruptive Behaviour

• Set rules about getting out of bed and playing. The child must have clear rules about what they can and cannot do. Add these rules to the bedtime routine notice or checklist.
• Reinforce bedtime routines that are not kept to by pointing to the notice or checklist and remind your child to go back to bed. Re-set bedtime music or noise to help them settle. Try not to shout or argue with your child as the aim is to keep the child calm and settle them back to sleep. 
• Remove relevant items, such as technology, from your child’s room at night which they may be tempted to play with.
• Do not give your child reasons to get out of bed. Make sure they have had a drink, been to the toilet and got their things ready for the next day before they go to bed. 
• Use a star chart to reward good effort and behaviour. You can find these online.

Diet

• Cut out caffeine and avoid it for at least 6 hours before bedtime. This includes tea, coffee and fizzy drinks.
• A glass of warm milk before bed can be helpful. 

Managing behaviour that challenges can be very difficult. In general, when difficulties arise, discuss options openly and carefully with your child. They may benefit from clear descriptions of emotions, consequences, and expected reactions.

If your child is stressed, reduce the language you use when talking to them. Say their name first. Use key worlds such as “I” language (e.g. “I can see your upset” or “I can see you are angry”). Allow time for your child to process what you have said. Repeat the information using the same words if necessary. Give instructions in order and break them down into simple steps.

Confrontation is rarely helpful. If your child makes a deliberate choice not to comply and is struggling to overcome the situation a careful sensitive approach that offers alternatives and choices could be more helpful.

Having clear, firm and consistent boundaries at all times for your child is key. Be clear about what is acceptable behaviour and what is not and be consistent with this.

Acknowledge feelings

Acknowledge the angry and frustrated feelings - do not dismiss the emotions that your child feels (e.g. ‘‘wow, that made you upset, I wonder if you are sad 
that he took your toy away”). Acknowledging feelings helps a child feel more understood.

• Help your child to appropriately express their feelings. This will make explosions become less likely. E.g. ‘Why don’t you show me how you’re feeling by...’ 
• Using words to say how you feel 
• Going to your calm place to give your brain some thinking time 
• Drawing a picture 
• Tell yourself you can handle this
• Say to yourself ‘be calm, be calm, be calm’
• Walking away
• Counting to 20 
• Breathing deeply
• Tensing and relaxing muscles
• Do exercises (running/ jumping)
• Hitting a cushion 
• Ripping up scrap paper

Develop some flashcards together that your child can write or draw on how they are feeling. They can use these to show you if they are unable to say how thy are feeling. Or use them during your 1:1 time to get them to tell you how they were feeling mostly during the day.

Develop a calm down ‘toolbox’ to place items in that will help your child calm down or cope when feeing angry or overwhelmed. Items that might be helpful include bubble wrap, paper to rip, music to listen to, a soft ball to throw, paper and pens to draw with and boxes to kick. This toolbox can be transferable to different places to use.

Allocate time each day to talk to your child about feelings and how they are doing. Having 15 minutes each day as ‘worry time’ or ‘special 1:1 time’ will help your child to containing any anxieties or frustrations. Questions such as “how did you feel in school today?” or “what made school fine/bad/ok?”

Create a safe space

• Negotiate with school that your child has a safe space or 'time out' space to access when they begin to feel distressed.
• Create a time out/safe space/ access to a calming activity at home that they can use when they begins to feel distressed.
• Build opportunities for relaxation, and engaging in favourite physical activities, into the daily routine. 
• Relaxing activities could include looking at bubble lamps, smelling essential oils, listening to music, massage, or swinging on a swing. 
• Difficult behaviour can often be diffused by an activity that releases energy or pent-up anger or anxiety. This might be punching a punch bag, bouncing on a trampoline or running around the garden.

Ground rules

• Make expectations for behaviour clear to your child by setting ground rules.
• Keep the number of rules to no more than 4 or 5. This will make it easier for them to stick to.
• Cooperation and non-cooperation with rules must have an outcome
• Rule discussions involving the child and other members of the family can be effective – this ensures everyone understands, active participation from your child in setting up rules should be praised
• Writing the rules down can help. Put them somewhere visible where your child can see them. 

Praising and rewarding positive behaviour 

• Praise frequently and offer other social rewards to encourage positive behaviours and let your child know what it is you want them to do. Using rewards and motivators can help to encourage a particular behaviour. 
• Pay attention to positive behaviours. If positive behaviours, such as playing nicely, are ignored then they may decrease. A hypothetical example is, if you are trying to reduce your child’s shouting, it would be really important not only to ignore the shouting, but to praise and reward them when they vocalise quietly so that you reinforce the good behaviour.
• If your child requests an item and is denied it, and they tolerates the denial (i.e. doesn’t become angry when you say no to them praise them (e.g. ‘good waiting’) and give a reward.

Making praise effective:

• Practice catching your child behaving in a positive way.
• Be specific – give praises that are labelled (e.g. “good sitting – well done!”).
• Use hugs, kisses, pats and so on added to verbal praise to make it even more powerfully reinforcing to them.
• Use rewards – Rewards can take the form of preferred activities, toys, tokens or sometimes small amounts of favourite foods or drinks.
• A token system may be helpful for your child. One idea may be to keep a record or chart of positive behaviour (it might be useful to place this somewhere visible). One incident of positive behaviour (E.g. Playing a board game nicely) would give them one point and after accumulating a certain number of points they can select a prize (e.g. after 10 points they could choose their favourite food for dinner, or after 20 points they could  get a new football). Make it clear what behaviours your child needs to do to gain points. Do not take away points already earned if they display challenging behaviour.
• Praise immediately - Rewards will be best carried out immediately so that your child knows what it is they are being rewarded for and then they will be more likely to show this behaviour (e.g. tolerating denials) again. Try to praise and reward at the time the positive behaviour is occurring. In order to do this, you may need to carry round some items that you feel your child would find highly rewarding (e.g. a chocolate bar).
• Show enthusiasm – If your child enjoys positive behaviour directed to them, be energetic, smile, tickle, hug, use and enthusiastic voice to show how pleased you are. Be sincere.
• Doubling the impact –praise your child in front of others and to others in front of them.
• Give your child ‘special’ tasks around the house, which are theirs and no one else’s (e.g. Like a plant that they have to look after and water or a set household job that is their responsibility). This will give them a sense of pride, self esteem, ownership and offer a great distraction. Write the responsibilities clearly and outline what you want them to do.

Spotting early warning signs: Diversion 

• Diversion aims to intervene just before the outbursts occur. This involves spotting that your child is just about to have an outburst and distracting them with another task or activity
• This diversion strategy should be used as soon as possible to prevent the behaviour and the diversion needs to be more interesting than the behaviour you are trying to stop
• You need to divert your child before any challenging behaviour occurs; otherwise you may accidentally reward the behaviour. For example, if theyshout and you give them chocolate to get them to stop shouting, they will learn that they get a treat if they shout.
• Remember to have on hand a secret supply of games and activities that you can use to divert your child.
• Help your child to calm down when they are becoming irritable. Identify calming activities (e.g. massage, music, physical activity such as jumping on trampoline) and then use these when they is becoming irritable.
• Use barriers: If your child is injuring themself or others, consider placing a barrier between the person and the object that is causing harm. (E.g. if they are hitting you, place a pillow or cushion between them and you.

Planned ignoring

• If the behaviour your child is doing is not dangerous and you believe it is for attention or to get a response from you - ignore it (i.e. deliberately pay no attention to them whilst they are having an outburst.
• Behaviour is often maintained by the attention it receives. Even negative attention such as shouting, nagging and scolding can be rewarding to children. You are ignoring the behaviour, not your child.
• When you ignore problem behaviour, do not look at or talk to your child so they also gets no reward through your attention. 
  • Give no eye contact or expressions of disapproval.
  • Do not speak to your child - do not say anything. Do not make angry comments, do not tell them to stop, do not ask them what they are doing and do not tell them that you are ignoring them.
  • Do not touch your child.
  • If they attempt to grab you get up and walk away calmly
  • Your child may increase their tempo at first to try and get your attention or to get what they want. If necessary, walk away, but do not give in to the demand.
  • Try to stay and look calm.
  • Do not give them what they want – ensure the behaviour is not communicative and is not reinforced.
  • Withdraw attention from his behaviour for as long as the problem behaviour continues.
  • As soon as your child stops the problem behaviour and behaves appropriately, praise and respond (E.g. ‘thank you, you’re using your nice voice.’). 
  • Try to make sure that everyone is ignoring the behaviour.
• With time, your child will learn there is no positive payoff to challenging behaviour, when you say no you mean no and that other forms of communication are more effective. The outbursts will reduce.
• DO NOT ignore very dangerous behaviours. If you have to intervene, do so but stay calm and give minimal interaction and response. Do not talk or give your child what they request. Block the behaviour until your child calms down and then give them lots of attention.