Hyperactivity and ADHD can result in behavioral symptoms and distress. Often, it is not just something the child has to live with, but instead impacts the entire family system. At the Bridge Center for Play Therapy, we utilize a holistic perspective and are motivated to target underlying causes of distressing behaviors and to providing care for the individual, the family, and their unique experience. Where hyperactivity and ADHD are concerned, we view difficulty focusing, difficulty sitting still, impulsivity, and other various symptoms as evidence that the nervous system is not in balance.
When symptoms and behaviors are present, it is essential to get clear about what is really happening for the child. For instance, children who have experienced trauma or perceived danger can become hypervigilant, meaning that they are hyper aware of what is happening around them and are more focused on potential danger in the environment. They may even be jumpy and fidgety. As you can imagine, this looks like ADHD and is often misdiagnosed as ADHD. Getting a clear sense of what is underlying any behaviors or diagnoses is an important first step.
Non-directive play therapy is a great way to get a clear understanding because it is child-led. The child has full permission to show the therapist exactly what is going on. Working in this way removes all speculation about what behaviors might mean or what categories they fit into. Instead, we get to work directly on the challenge as it is experienced by the child.
The classic understanding of ADHD and hyperactivity, when we remove potential false diagnoses, is very much a product of the nervous system and the body’s ability to process sensory input. Contrary to what one might assume, individuals displaying hyperactivity actually experience lower levels of sensory input. Excessive movement and attention to a wider variety of environmental stimuli is the individual’s way of increasing sensory input; they are seeking what it is they perceive they are lacking.
The good news is that the nervous system’s functioning and sensitivity can be altered with awareness, energy expulsion/generation, and regulation skills. And play therapy can help!
1. Gain awareness of energy levels and cues in the body
The first step of our play therapy process is always to build awareness. Most children do not have a well-developed sense of what energy, dysregulation, and emotions feel like in their bodies, let alone what to do with it when they happen. As adults, we falsely assume that they know what it means to be sad, scared, mad, hyper, or shutdown, and that they know how to take care themselves. Utilizing body-based feeling statements and modeling, we can help children to gain a deeper understanding of their body’s own feelings and reactions.
This step alone can be incredibly powerful because once a child understands what is happening inside their body, it becomes a lot less scary the next time around.
2. Explore the range of energy and input to find balance
Once we have explored what their body typically feels like we can begin to explore what happens when we expel energy and build up energy. We can also explore how both high and low levels of stimulation impact the body. Each individual has a completely unique set of needs—the energy level and sensory input level that feels best to them is going to be dependent on their own nervous system, body, and perception. Exploration allows us to build even greater awareness and gain insight into what each child needs.
What we are really trying to key in on is the understanding of what dysregulation feels like and what regulation feels like.
3. Integrate skills to regulate energy
Once we have an idea of what we are trying to achieve (regulation) and an awareness of what it will feel like once we are successful, we can begin to explore various tools and skills to help us get there. The play therapist will begin by modeling those skills, and tracking which ones seem to have the best impact on the child. Because modeling is the number one way children learn, they will also begin to try on the regulation strategies.
The ultimate goal is for these skills to be fully integrated into the child’s repertoire, meaning that when dysregulation of the nervous system occurs these skills are the automatic and primary way the child copes. Like any other skill, to reach this level of integration takes practice. Often, we will see change in the play therapy setting before it is translated into the home or school environments. With that said, continued support can and does lead to transformation. Where once you had a child seeking stimulus is ways that were disruptive or just unsuccessful, you now have a child who knows that their individual system needs to reach a regulated state.
For additional resources on alternative treatments for ADHD Cognitune.