Summer Camp Strategies for children with Autism and ADHD

Summer McMurry:

Welcome to the Carolina Pediatric Therapy podcast. This is Summer McMurray, founder and CEO of Carolina Pediatric Therapy. I’m here this morning with Philip Pearce, certified occupational therapy assistant here at Carolina Peds and also the lead clinician onsite at our Waynevilles Clinic, and a PLC Team Leader here at Carolina Peds as well. So good morning Philip.

Philip Pearce:

Good morning.

Summer McMurry:

Thanks for joining us this morning. So we’re in the middle of summer camp season and so we thought we would share a little bit about what we’re doing in the community as far as educating summer camps programs on kids who have difficulties with behavior. So we had a phone call from our friends at the North Carolina Arboretum and Philip tell me a little bit about that day, you went over there for an in-service, and tell me a little bit about what you taught them there?

Philip Pearce:

Yes, the UFED staff asked us to come over and provide them some education regarding behavior management for some of their campers who are coming. Some of whom may be on the autism spectrum diagnosis, or may have an ADHD diagnosis. So what we wanted to do was provide them with some education about some of the hallmark symptoms of those two diagnoses, and then some practical strategies for how to manage those in their camp.

Summer McMurry:

So what ADHD and autism spectrum are, so can you give us a couple of the definitions and maybe some behaviors that kids with these diagnoses may struggle with at summer camp?

Philip Pearce:

Sure those kids with ADHD, that’s an acronym for attention deficit hyperactivity disorder, and that is a neurological condition that kind of effects really behavior and attention, and ability to control oneself, especially in overactive settings.

Then with autism spectrum that could be a number of things, it’s a very wide spectrum. However, most of the kids that these folks will be encountering are closer to the, I guess you could say, the high functioning end of the spectrum, but they’re still going to see challenges with things like social interaction, lots of sensory input that we may be able to modulate really, really well, they find overwhelming. So that can put them into some kind of distressing situations that we wouldn’t otherwise think would be distressing for us.

Summer McMurry:

So what type of behaviors might a camp counselor see in a child with autism spectrum disorder or ADHD that may cause some challenges for this child’s experience at summer camp?

Philip Pearce:

So those kids with ADHD are going to be the kids you see that have difficulty sitting still, have difficulty waiting their turn, have difficulty not blurting out the answer. They may have problems with some physical boundaries, they may get too close or play too roughly with others.

Some of the challenges you might see with kids on the autism spectrum, they’re likely to struggle with social interaction, understanding jokes and sarcasm, being able to deal effectively with transitions, especially those that are unexpected.

Then they may encounter different types of sensory inputs, at summer camp you know there’s a lot outside play, so there’s all kinds of opportunities to be wet, to be dirty, to be sweaty, to be in the sun. So all those things can really affect their participation and their willingness to have fun, I suppose.

Summer McMurry:

Yes, absolutely. I can see that would make it maybe not such a pleasant experience, like the camp counselors were hoping for, for the child at camp. So what advice did you and Dr. Funk gives to the camp counselors there?

Philip Pearce:

One of the most important things that we conveyed was that these behaviors are not intentional, often they’re not fully under the control of the kids. So these are kids who are not attempting to be willfully disobedient or malicious, they’re just trying to make it through their day the best way they know how.

So if we can prepare the camp counselors to have that kind of mindset going in, then they’re more likely to be supportive, rather than punitive. So that was one of biggest things that we tried to stress.

Summer McMurry:

Yes, and so what strategies did you give them that they could implement or some things that they could modify the environment or provide some outlets for these children if they need it, for those kids who need to retreat in those types of situations? What advice did you give?

Philip Pearce:

Well one of the easiest and perhaps most respectful ways that they can do is to coordinate with the parents. If they know that these kids are coming in, then hopefully they can reach out beforehand or during drop off, and say, “What kind of behaviors does your kid, your specific individual kid present with that we might be able to support and look out for?”

So that was one way is really coordinating with the parents, because these kids have had these diagnoses for a while likely, so parents have worked through these challenges on their own, so if they have something that works for their kid and they can do that at camp, that would be best.

Summer McMurry:

Yes. So encouraging parent interaction and communicate, a high level of communication with that parent before the child comes to camp?

Philip Pearce:

Mm-hmm (affirmative).

Summer McMurry:

Then what about throughout camp if they notice behaviors, the camp counselors, what, should they reach out to the parent and kind of problem solve through those types of things, or recommend?

Philip Pearce:

Yes, we did stress that it would be important to leave some time at the end of the day during pickup to say, “This is what happened and this is what we did.” Then what kind of input does the parent have about that? How should we tweak it?

Some other things that’s important that we stressed were that summer camp’s an unfamiliar structure, an unfamiliar schedule with unfamiliar authority figures. So these are kids who thrive on structure and thrive on expected things happening in an expected order. So they come into this new environment with these new kids they don’t know, so they could already be in some form of heightened arousal level coming in.

So it’s important for them to be able to, for the staff of the camp to be able to pregame, prepare, understand what the weather’s going to be that day. So, “How is that going to affect our activities?” Also, to know what’s next, because we all know kids regardless of their diagnosis, they want to know, “What’s next? What are we doing now?

Summer McMurry:

Right.

Philip Pearce:

What’s next? When are ae going to get there? How long is this going to take?” So one of the most practical strategies that we gave that works for any kid, actually all theses strategies are going to work for any kid, regardless of their diagnosis, is to have a visual schedule. A simple first then next kind of visual schedule.

Summer camp also presents a lot of opportunities for craft-making, that’s a fairly popular summer camp activity. So having a visual of each step of the crafts can really help out the kid.

Summer McMurry:

Okay. So like a picture type of a-

Philip Pearce:

Like a picture or physical model of, “If you’re making this craft, this is what it looks like when you do step one. This is what looks like we you do step two, step three and so on and so on, until you have the finished product.” Because a lot of times you’ll have the presentation of, “This is how you do it, and then here’s your finished product” but the steps in between are missing. So providing those for the kids.

One other important thing that we stress is to be positive So when you do see these challenging behaviors to provide redirection and a purpose, not just to say, “Stop that” or, “Calm down” or, “Sit still” but give them something to do.

Summer McMurry:

So use your language a little bit differently-

Philip Pearce:

Yes.

Summer McMurry:

… instead of negative language, you’re giving them more of a positive language. So give me an example of that, so if they’re running, and they’re not supposed to be running?

Philip Pearce:

If they’re running and they’re not supposed to be running, we said especially if it’s a transition, perhaps you give the kid a job to do. They collect this item from everyone. They make sure everyone has their water bottle before we lineup. They carry something.

Summer McMurry:

Maybe just heavy lifting-

Philip Pearce:

Do some heavy lifting.

Summer McMurry:

… and take pleasure, yes.

Philip Pearce:

Heavy lifting is always calming, always helpful, but more importantly what it does is it invests the child in the activity. So if you don’t give these kids anything to do then they’re going to come up with their own creative thing to and that’s not always the best.

Summer McMurry:

Right.

Philip Pearce:

We always love creativity in kids, but there’s a time and a place for it, and while you have 15 other children running around is not the time and place for creativity. So being directive in a way that empowers the child to complete a task, a motivating task would be extremely helpful.

Then we did, speaking of transitions, we talked a lot about transition strategies. So using that visual schedule for sure, but also a timer if appropriate, or a countdown. Tell the kids, “We have five minutes left before clean up. We have two minutes left. We have one minute left. 30 seconds. Okay, everybody clean up.”

Then if there are any changes to the schedule, then perhaps these are the kids that we need to check in with first. Before we make the group announcement we go over to the child and we say, “Hey, we know that our schedule says we’re going to do this next, but this is, we need to change it for this reason.” So tell them first, allow them a chance to digest it, and then tell the whole group.

Summer McMurry:

That’s really a great strategy. It just prepares them mentally before they just get the surprise and shock that, “We’ve got to transition quickly.” Okay. What I always think too, that behavior is communicating something, and so it’s figuring out what that behavior is communicating.

Philip Pearce:

Yeah, and to that point, behavior does communicate a lot. One of the things that we did stress is that especially with those kids who are on the autism spectrum, they may be experiencing some kind of sensory overload and they may not feel comfortable communicating with these unfamiliar people. So being proactive in asking parents, “What kind of behaviors do you see when this kid is in distress?

Summer McMurry:

Right.

Philip Pearce:

What are the triggers? What are the things that you see the kid doing that indicate they’re building up possibly towards a meltdown or an explosion, or a retreat, or what have you?”

So being proactive in communicating with parents about that, while also recognizing those, and then kind of naturally, and as well as you can, organically as you can, providing that kid maybe a break, maybe a retreat, or a structure.

Summer McMurry:

Right, preventative measures?

Philip Pearce:

Exactly, preventative measure.

Summer McMurry:

Right.

Philip Pearce:

So that may be a hand gesture, a codeword, it may be that when you go to a certain spot, and you have a spot where if the kid needs to retreat and get away from the group, then that’s their designated spot.

Summer McMurry:

Right.

Philip Pearce:

That we know that, that’s their safe space. So instead of running away or acting brashly and pushing a kid, or yelling, or any of that stuff, prior to that you’ve developed a system where they know where to go and how to go there, so that they can get themselves a little bit more comfortable.

Summer McMurry:

Great. Okay. Well that’s great. Okay, so thanks Philip so much for joining me this morning. Parents out there or summer camp counselors, if your summer camp or after-school program would like some consultation from our team of child experts on summer camp and some of these strategies and implementing those, you can call us at 828.398.0043 or visit us on the web at CarolinaPeds.com. Thanks, Philip.

Philip Pearce:

Thank you.