Each year, tens of thousands of kids across the U.S. say goodbye to desks and books and hello to summer camp. For most it means a season filled with swimming, softball, arts and crafts, and tons of fun.
For some, however -- a select group of children with a behavioral disorder known as attention deficient hyperactivity disorder (ADHD) -- it's also an opportunity to build skills and increase self-esteem and confidence for a lifetime. That's precisely the point of an increasingly popular type of summer camp -- programs designed specifically for children with ADHD. Carefully structured, intimately monitored, even scientifically proven, the focus is on improving behavior while still giving kids a darn good summer's worth of fun.
"We never forget that fun is an essential part of the equation here -- the children need to enjoy themselves and they do, but they also know and understand that the program is about fostering the development of important skills and coping mechanisms that can not only help them when they return to school, but throughout their lifetime," says Karen Fleiss, PsyD, the director of the Summer Kids Program for children with ADHD at New York University Medical Center in New York City.
A behavioral disorder marked by a specific set of symptoms, ADHD frequently causes problems focusing or paying attention. Children with this disorder are often considered "hyperactive," with a continual need for stimulation and motion. Impulsivity, another common trait, often manifests in the form of combative behavior. Although doctors aren't certain what causes ADHD, many believe it's based on a biochemical imbalance in the brain that may also be linked to anxiety and possibly depression. The National Institute of Mental Health estimates 3% to 5% of all children -- more than 2 million American kids -- have ADHD, with boys affected almost twice as often as girls.
"Many of these children are singled out as being 'difficult' -- some are earmarked as bullies or troublemakers, who tease other children, sometimes relentlessly, which frequently leads to fights or other disruptive behaviors," Fleiss tells WebMD. This, combined with difficulty in focusing, says Fleiss, often makes it hard to socialize with other children -- one reason the special summer camps are such a plus.
"Here they learn to recognize their behaviors and, more importantly, learn how to make smarter choices when dealing with others -- and ultimately that helps build their self-esteem, which in turn helps them to better cope in all areas of their life," says Fleiss.
Rewards and Self-Confidence
Yeah, but is it fun? Fleiss says definitely. "There is nonstop activity along with built-in reward systems that give the children something to work toward, so while we are building self-confidence, we are also keeping the kids active and entertained," she says.
The NYU program, which unfolds each year at a bucolic private school in Riverdale (about a 30 minute bus ride from Manhattan) is one of 17 treatment/fun summer "camps" across the U.S. and Canada modeled after a prototype created more than 20 years ago by William Pelham Jr., PhD, a psychologist from the State University of New York in Buffalo. Known as the STP or Summer Treatment Program, thousands of children have participated since it's inception in the 1980s, and, in fact, there are some interesting clinical data showing the approach does work.
In a study published in the Journal of Abnormal Child Psychology in 2000, researchers compared children with ADHD taking medication alone with those taking medication and participating in an organized summer treatment camp. The study, conducted at the University of Pittsburgh and the University of California at both Berkley and Irvine, showed those children on the combined medication and activity regimen far exceeded those on medication alone in various behavioral categories.
Bart Hodgens, PhD, director of the Summer Treatment Program at the University of Alabama at Birmingham, is offering the STP approach at their day camp for 5- to 18-year-olds with ADHD for the first time this year. He says he has high hopes that local children will respond favorably.
"We have a very high counselor-to-camper ratio, a lot of individualized attention, and programs that are designed to allow the children to recognize and understand their behavioral problems and then come away with some skills needed to change them -- all while participating in a variety of carefully planned and structured daily activities," Hodgens tells WebMD.
Indeed, a typical day at an STP program looks something like this:
8:00 - 8:15 -- Social skills training
8:15 - 9:00 -- Soccer skills
9:00 - 9:15 -- Transition
9:15 - 10:15 -- Soccer game
10:15 - 10:30 -- Transition
10:30 - 11:30 -- Academic learning center
11:30 - 11:45 -- Transition
11:45 - noon -- Lunch
Noon - 12:15 -- Recess
12:15 - 1:15 -- Softball
1:15 - 1:30 -- Transition
1:30 - 2:15 -- Arts and crafts
2:15 - 2:30 -- Cooperative tasks
2:30 - 2:45 -- Transition
2:45 - 3:45 -- Swimming
3:45 - 4:00 -- Transition
4:00 - 5:00 -- Computer skills
5:00 - 5:30 -- Departure
"We plan every minute, but that doesn't mean it isn't fun -- the activities are structured in a way that allows the kids to be fully engaged at all times. Ultimately, they are not only entertained and occupied, they also learn important coping skills that work in all areas of their life," says Hodgens.
Survivor: ADHD Style!
Taking the theory in a slightly different direction are sleep-away camps like Talisman, a North Carolina program for children aged 9 to 17 with ADHD, as well as a variety of other learning disabilities and behavioral problems. Based on programs developed by the nationwide Aspen Education Group, Talisman has been ongoing for nearly a quarter of a century. Director Linda Tatapough says structure, discipline, and positive reinforcement are the keys to its success.
"Our programs are designed to be highly structured and highly supervised -- one big difference from your typical summer camp. But we feel this approach is important for children with ADHD because if you give them too much freedom there are just too many choices -- and that leads to problems," says Tatapough.
Although in the past Talisman's activities focused primarily on sports and leisure, this year they will incorporate skill strengthening, academic-related activities into the program as well. But Tatapough says what really sets their camp apart is a commitment to helping children recognize and work out their behavioral problems as they occur.
"We deal with issues in a group process, and whenever there's a problem, we sit down and discuss it right then and there -- the child learns to take immediate responsibility for their actions, and we talk about what can be done to change things in the future with more appropriate choices," says Tatapough.
Another active force: Encouraging the kids to work together toward a common goal that benefits all of them. "If we all work together to climb a mountain in three hours instead of six, then everyone benefits with more free time," says Tatapough. This, she says, encourages relating to peers and helps diminish feelings of isolation that many of these kids experience in their normal academic setting.
A bit bolder and somewhat more daring is a sleep-away summer program called SOAR -- Success Oriented Achievement Realized. A program for preteens, teens, and young adults with ADHD or other learning disabilities, you won't find any ceramics, computers, or other classroom activities here. Instead, summer life at SOAR is pure high adventure wilderness living, along the lines of Survivor -- at least in terms of coming face-to-face with the unexpected almost every day. And that, say experts, is the magic of what makes this program work.
Indeed, the philosophy behind SOAR is that children with learning disabilities or ADHD "flourish" when allowed to focus on their strengths in a totally new and challenging environment. And challenging they are. While SOAR's home bases are located in Balsam, N.C., and DuBois, Wyo., their two- and four-week programs lead expeditions throughout the Southeast, Florida Keys, Caribbean, Rockies, and desert Southwest, with special programs also available in Belize, Central America. Activities include wilderness backpacking, horse packing, rock climbing, whitewater rafting, wildlife studies, mountaineering, scuba diving, snorkeling, sea kayaking, and wilderness medicine.
Because up to 80% of all children with ADHD or other learning disabilities are on some type of medication regimen, SOAR as well as all of the camps previously mentioned, is staffed with psychologists, nurses, and counselors trained in administering treatments and watching over those who are on medication. The counselor-to-camper ratio is also quite high in nearly all the ADHD summer programs throughout the country, thus ensuring that the children are not only well cared for, but also that they receive the necessary emotional support as well as physical attention.
For more information on the summer treatment programs philosophy, visit ctadd.net/ctadd/stpmanual2.html.
To learn more about The NYU Program, visit www.aboutourkids.org.
Find the University of Alabama program at www.circ.uab.edu/sparks/adhd.
For information on SOAR, visit www.SOARNC.org.
To learn about Talisman, check out www.talismansummercamp.com.