ADHD and After-School Activities: Finding the Right Fit

Last Editorial Review: 1/31/2005

ADHD can be a challenge but it needn't sideline kids from after-school activities.

WebMD Feature

Reviewed By Brunilda Nazario

Getting through the school day can be a struggle for kids with ADHD -- but after-school activities don't have to be. Given the right activity and adequate support, kids with ADHD can shine.

Consider Olympic champion Michael Phelps. ADHD made it nearly impossible for him to sit still in the classroom or grasp abstract concepts on the athletic field, but in the pool he displays extraordinary focus and drive. While not every kid with ADHD can become the next "phenom" swimmer, he or she can learn to feel like winners outside the classroom. Here's how.

"Know your kid," says Carol Watkins, MD, child psychiatrist and spokeswoman for CHADD (Children and Adults With Attention Deficit Disorder). "Children with ADHD are really quite varied. Some are hyperactive, and need to get the energy out. Some are more inattentive, and that's not what they need. Others have social skills issues. And some are really impulsive," she tells WebMD.

Activities to Pursue

While there's no single activity that guarantees kids with ADHD instant success, certain types of activities tend to reap more positive results. Here's what the experts suggest.

Seek activities that offer individualized instruction. Examples include diving, wrestling, tennis, and martial arts. "Most kids learn by watching kids around them, but many kids with ADHD don't learn as well by being thrown into the mix," says E. Mark Mahone, PhD, research scientist at Kennedy Krieger Institute and assistant professor of psychiatry and behavioral sciences at Johns Hopkins University in Baltimore, Md. Rather, these kids tend to benefit from one-on-one instruction.

Consider activities that involve movement. Swimming and running top this list. "Kids with ADHD, especially boys, tend to show a preference for activities that involve a lot of movement, and intolerance for things that involve sitting around. They really benefit from physical exertion," Mahone says. But psychiatrist Steven Kurtz, PhD, warns that benefit cannot be considered a replacement for treatment. "There's no evidence that 'getting that energy out' will carry over into self-control," Kurtz, clinical coordinator of ADHD Institute for New York University's Child Study Center, tells WebMD.

Look for activities with a singular focus. Examples include archery, swimming, and running. Focusing on fewer things makes it easier for kids who struggle with hyperactivity and inattention to concentrate.

Try highly structured activities that promote self-control. Experts consistently cite martial arts as an excellent activity for children with ADHD because it develops increasing levels of physical control through practice and self-discipline. "Kids tend to do very well in this setting. And a well-run program holds kids accountable for how they use these self-defense skills," Kurtz says.

Explore activities that result in tangible rewards. Gardening and service-oriented activities can fulfill these goals. Watkins explains. "In gardening, you go out and you hit the dirt. It's very physical and you actually get a result from it," she says. The same holds true for service-oriented activities. "Getting kids involved in service activities can help build self-esteem. Helping others makes kids feel good," Watkins tells WebMD.

Activities to Approach With Caution

Just as the "right" after-school activities can help build self-esteem, instill self-control, and provide a sense of calm in children with ADHD, the "wrong" ones can do just the opposite. And while every child with ADHD will respond differently, certain activities are likely to present greater challenges than others. But that's not to say they need to be ruled out entirely.

"Activities that are very difficult for some kids with ADHD might prove to be less difficult for others," Mahone tells WebMD. "It depends on their support system, age, level of ability, and the severity of the ADHD." With this in mind, experts recommend that parents exercise prudence before introducing their kids to the following types of activities.

Activities that involve a lot of down time (Mahone cites baseball as a prime example) -- especially when kids are in a position that doesn't afford much action. "If you watch kids with ADHD on the playing field, they're often the ones doing other things, like cartwheels or picking at the grass, or distracting other kids," Mahone says. Kurtz agrees. "Down time is bad time for these kids," he says.

Activities that require too much divided attention. "In soccer or basketball, you're focusing on a dozen things at a time," Mahone says. That's not to say a child with ADHD should avoid soccer entirely. "If you have a skilled coach or teacher who can communicate information in ways that make it interesting, and the step-by-step pieces of being organized more doable, then it may work," Mahone tells WebMD.

Activities that require fine motor skills. "It's fairly well documented that in children with ADHD, some parts of the brain are less developed, particularly those involved in providing control over motor activities," Mahone explains. Therefore, activities like painting or manipulating puzzle pieces might leave some children with ADHD feeling frustrated.

Strategies for Success

For kids with ADHD, success in after-school activities depends not only on the chosen activity, but also on the circumstances under which that activity is performed. Here's how parents can help create favorable ones:

  • Give the child the tools he or she needs to succeed. In some cases, this may mean continuing the medication taken during the school day. "It makes no sense to medicate a child during the school day and not to give them the benefit of the medication during extracurricular activities that require focus," Kurtz says. Parents can make the best choice for their child by consulting their prescribing physician.
  • Know the coach or instructor. A child's success can hinge on how experienced, mature, and flexible the instructor is. "Often, after-school activities are run by people not as well trained [as the teachers]," Kurtz tells WebMD. He suggests that parents make an effort to identify instructors who know how to respond to the unique needs of kids with ADHD.
  • Communicate with the coach or instructor. While it's helpful for parents to let instructors know if their child has ADHD, making them aware of ADHD-related behavioral or social issues can be critical. Mahone provides this example: "Girls with ADHD are often 'quietly inattentive.' The instructor might need to know that she has difficulty sustaining her attention for longer periods of time."

Make kids aware of their schedule. Kids with ADHD tend to thrive on routine, and shun surprises. "Post a schedule on the wall that kids can see," Mahone suggests.

Respect kids' fatigue. "At the end of the school day, kids with ADHD are often mentally fatigued, although they may look like they're up like a top," Mahone tells WebMD. "Be sensitive to overprogramming and follow their cue," Watkins adds.

Sometimes, success in after-school activities comes down to gut instinct. "There's no one way that works for everybody. If a kid has a passion, you want to kind of go with that," Watkins says.

Published Sept. 7, 2004.

SOURCES: Carol Watkins, MD, child psychiatrist; and spokeswoman, Children and Adults with Attention Deficit Disorder. E. Mark Mahone, PhD, research scientist, Kennedy Krieger Institute; and assistant professor, psychiatry and behavioral sciences, Johns Hopkins University, Baltimore, Md. Steven Kurtz, PhD, psychiatrist and clinical coordinator, ADHD Institute for New York University's Child Study Center.

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