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Hyperactivity and Attention

Are attention difficulties and hyperactivity found in individuals with CdLS? Can these be successfully treated without any medication? I am a special education teacher for a five-year-old boy who has CdLS. His activity level is very high. I feel that he shows potential if he could slow down enough for class.

In the years that I have been associated with the CdLS Foundation, I have seen many such children who are in perpetual motion, attracted by every sight and sound and can turn a room into a jungle in a very short time. There are many educational techniques that may help to reduce the behavior. I will try to list a few below.

  1. Probably one of the most important techniques is for the student to be in a classroom that is highly structured, where activities can be anticipated, the level of sensory stimulation is very low, the number of children is small. Basically, a beige room is good, cabinet doors of the same color, learning materials not being used put away, very organized arrangements of furniture, none of the usual paintings/pictures/charts/decorations on the wall, etc, etc. Non-patterned rugs on the floor and window coverings tend to reduce noise levels. Reduce lighting level (yes - it can be done and still meet fire regulations by removing some of the bulbs from the overhead lights, making sure there is diffuse lighting coming in from the windows by covering windows with white tissue paper, using lamps instead of overhead lights, etc). Keep extraneous noise level way down (e.g., staff talking about their weekend, electronic noises, loud music or music that has a fast beat, etc).
  2. Another important consideration is staff. Ideally, they should wear bland colors, avoid bold prints and absolutely NOT wear any artificial aromas such as perfume, perfume-based lotions, etc. Such artificial aromas tend to increase distractibility and arousal level. Staff set the tone by speaking quietly.
  3. A very structured approach to learning is particularly important. Such structure might include:
    • Use of a day schedule system for the major activities of the day but not the kind where student memorizes the days of the week and other such as rote learning. Rather, one that is set-up with the child in a format that the child currently understands (objects, parts of objects, icons, pictures or whatever is the easiest for the child to really interpret). The important point here is that the child learns process of creating schedules versus rote memorization. Memorizing schedule sometimes makes it more difficult for changes in the schedule.
    • Use of sub-schedules, set-up in the same manner as "a" to show the child what events will occur in the activity.
    • Use of activity sequence set-ups organizes the materials for the child so she/he can see what needs to be done even though they may not understand the language. Materials also may need to be adapted to be motor-friendly as persons with CdLS tend to have smaller fingers and dyspraxia.
    • Avoid too much talking. First off, many students with CdLS have a difficult time understanding language. This is a critical consideration - what and how do they understand, how to communicate with them and how can they communicate with you? There are many alternative methods to speech, pictures, communication devices, etc but it all depends on each individual child. Many of the children do much better in quiet environments and watching what needs to be done versus being told. A lot of what you do here depends on the language level of child.
  4. Slowing the pace of activities is very important. Rushing increases levels of arousal and, in most situations, ends up with the student not really learning what is presented.
  5. Making sure that what is presented is appropriate for that child - and interesting.
  6. Be flexible. Many of the children cannot sit through an entire morning circle time. Rather than a daily battle, re-arrange the sequence of events in the activity so that the child remains part of the group during those aspects she/he finds most enjoyable (e.g., singing) and then is excused for other types of activities while the circle continues.

There are many other techniques but hopefully this will be a start. It is hard to write all the different techniques that have worked for various children - and, of course, so much depends on child.

MM/TK 7-13-10

Stimulants can always be tried in children with CdLS or other developmental disabilities for ADHD symptoms. There is literature on their use on mild MR in particular (not CdLS, but general mild MR). Children with CdLS may be more prone to side effects however, and medicines should be used with caution.

MG/ TK 7-13-10



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