A Self-Reg Look At ADHD: Do Meds Need To Be The Answer?

I remember seeing this article around the beginning of the school year on the increase in ADHD numbers. While these statistics are from the States, my experience over the last 18 years in an Ontario school system, is that our numbers are also on the rise. I will admit that over the years, I’ve suggested to many parents that they see their family doctor regarding a child’s inability to focus. I’ve filled out more forms than you can count, highlighting many different inattentive behaviours. And I did all of this under the belief that I was truly doing what was best for the child. But then, a couple of years ago, I took the Foundations 1 course through The MEHRIT Centre, and Stuart Shanker and Susan Hopkins caused me start to question my beliefs. Is an identification always best?

I started to look at if Self-Reg could help those children that were exhibiting these attention problems. Thankfully I wasn’t alone in this investigation. Both my teaching partner, Paula, and I looked closely at what would help our most challenging students. (These are not just great Self-Reg options for these children, but for many other kids in our class. As you’ll see in the documentation below, all students benefit from Self-Reg.)

  • Sometimes it was drawing.
  • Sometimes it was the large blocks of free play in our forest space. This article speaks to why this play might be so very valuable.
  • Sometimes it was heavy lifting, which might even include moving heavier items around the classroom, or from our indoor classroom to our outdoor space.

  • Sometimes it was creating with plasticine. 
  • Sometimes it was washing items in the sink. The key to this was usually having the child stand up on something high, as then there’s the combination of balance plus sensory play, which seems to be the most calming.

  • Sometimes it was creating with LEGO. This year, we found that making a space under a table, provided an additional level of comfort and calm for some kids. It was almost like a tent. 

The amazing thing here — and the key to what Paula and I both noticed when we started to look more closely at Self-Reg — was that at least one of these many options helped each of our children self-regulate. When kids are calm, they are able to learn. So for students that might struggle with attention, finding options that help them self-regulate, can certainly change their focus and behaviour within the classroom. Even more incredibly, as we helped initially support students in choosing these different options, pretty soon, most of them were able to recognize their own needs and self-select what worked for them. Now this is Self-Reg.

In the past three years then, I’ve become a changed teacher. My many recommendations to take children to their family doctors, occur far less frequently. I still see children with attention difficulties, but I also see ways that Self-Reg can change things for them. Now I do realize that there are exceptions to this rule, but certainly fewer than I would have initially thought.

  • If there are strategies that work, is medication necessary?
  • Do we need to get even more creative with possible strategies first? 

I know that physicians can give us different perspectives and more information. Maybe identifications help us see and program for kids differently, but at times, even unintentionally, do they also create a self-fulfilling prophecy?

  • I realize that kindergarten is different from other grades, but could these same strategies that work for our youngest learners, continue to work?
  • How might Self-Reg support some inattentive learners throughout the grades? 

Attention difficulties may be on the rise, but maybe there are more med-free solutions than we realize.


10 thoughts on “A Self-Reg Look At ADHD: Do Meds Need To Be The Answer?

  1. Aviva, while I read all of your posts with great interest, this one hit home personally for me. You see, when my son (now 37 years of age) was young, so many people from my nurse and doctor sister and brother-in-law to relatives and friends with no real knowledge of ADHD to speak of, commented on his “ADHD” and asked if we had considered medication. I have always felt that we are generally too quick to slap a label on children at too young an age and stage in their development. So while we watched and monitored and kept lines of communication open with his educators, what we discovered was that when he was challenged, when his “behaviour” was not seen as a negative but rather channeled into things that he was interested in AND challenged him mentally, he was quite fine! No “labels”, no medication. Just educators who saw him for what he was and were willing (and able) to meet his needs. Of course this was before we acknowledged of the notion of children being able to self- regulate. Interestingly, by grade 3 he was IEP’d Gifted. I have always been thankful for those educators, like you and Paula, were willing to see children’s strengths rather than labelling them “ misbehaviours” and to try to use and challenge those strengths in a positive way.
    Thanks for this post. I hope it resonates with others as it did for me.
    Best wishes to you both

    • Thank you Jill for your very kind words, and for sharing this very personal story. It’s such a great reminder for us that despite our best of intentions, we cannot be too quick to label kids. With the right challenges, your son was incredibly successful, and without a need for medication. I think there’s something to be said for this. I can’t help but think of Stuart Shanker’s phrase here: “See a child differently, and you see a different child.” I’m grateful to Paula, who also pushed my thinking around this topic, and has helped me see many different children. I’m hoping that others share their stories here, as I think this is a topic that’s definitely worth discussing.


  2. It can be difficult at times to tell the difference between ADD/ADHD and other disorders and just plain old being a little kid. I love that there are so many strategies at play in this post. I feel like many years ago people used to try so many more things for kids before medicine became the answer. I remember a family who tried all sorts of dietary adjustments first, and they took away TV, and they had their boys constantly moving. They eventually did go to medication, but not until they tried the other options first. Now there are so many people who say, “We don’t want to put him on medication.” but then they don’t do anything else either. One family I knew tried the medication and it was not good for the child. Another family tried the medication and it bothered Dad so much that I’m sure they eventually stopped (he was really, really bothered by the fact that the child rarely wanted to eat while the medication was in his system. They managed it by giving the meds after breakfast, and not giving any on the weekends. And of course the meds were out of the boy’s system by dinner time. The child was only actually skipping lunch, but it still really, really bothered Dad.)

    My husband just started ADD meds a year ago and he is 47. 🙂 He definitely self-medicated with smoking when he was in high school and university. That’s the sort of strategy we need to actively try to avoid!

    I kind of went off on a side road there. 🙂 What I really wanted to say was that these alternate strategies do work with older children too! I have a few children who have play breaks worked into their personal schedules. Years ago I had a boy who was my office runner. I would write a note and he’d take it to the office. He enjoyed having a helpful job, but hated being sent on a walk-about. He never really realized that the notes I was sending him with were meaningless most of the time, but he did eventually say to me, “What are you doing with all this tape?” LOL

    • Thanks Lisa for your comment and for sharing so many different stories here! Your point about food is a great one. I’ve seen a change in diet really change behaviour before, and I know some families that do this. With really young children too, what we’re seeing could definitely be students at that developmental stage where focused attention is hard. What are we requiring kids to do, and are these requirements developmentally appropriate for them? How might we change these our practices, and what impact might these changes have on kids? These are questions that I think about a lot, and your comment really highlighted them for me. I know that the “eating issue” is one that comes up frequently when it comes to ADHD medication. I’ve known a lot of parents that have tried different medication options, or taken kids off of meds on the weekend or on holidays. I wonder what impact these constant changes have on behaviour though. Maybe it’s okay to go on and come off meds, but I can’t help but wonder if this just makes it harder for kids to adjust.

      I love how you mentioned that these Self-Reg options are possible in other grades, and I have no doubt that there are other ones that also work. I’m thinking now about the JUMP, WIGGLE, LEARN TED Talk that I love, and how Self-Reg options can change — almost organically — throughout other grades.


      I also appreciate how you mentioned your husband going on these meds a year ago at 47. And yes, we definitely want to avoid things like smoking as a way to self-medicate. Maybe, at his age and after trying different options, medication was the best possible choice. I have no doubt that it might be for some, but it necessary for all (or even the current number taking meds)? I think that my biggest concern came with all of the very young children being referred to doctors. And I was part of this referral process, so I feel some of my own guilt here. Do three-year-olds need to be on ADHD meds, and how do we differentiate between developmentally appropriate three-year-old behaviour and needs that might be more than this? I wonder if some reduced carpet times and more time to play/explore (things that are encouraged in the Kindergarten Program Document), would help reduce some of our concerns?

      Thanks for continuing to give me more to think about!

  3. You bring up a lot of good questions! Back in the day, Ritalin was the drug of choice for helping people with ADD/ADHD. It is a fast catching drug – in and out in 4 hours. That’s why kids have to take a dose at lunch time. Now there are several different medications used, and they are generally longer lasting so don’t need to be taken at school. I think Ritalin was easier for people to go on and off. The amazing thing to me is that kids could and can come to me and articulate that they think they have not had their pill in the morning. That to me is a sign that the effects of the medication have allowed the child to recognize the effects of the medication (if that makes sense.) When they first start on it, I think they don’t really connect the dots. It’s been interesting to have an adult to talk to about how it feels and how he notices when it is working and when he has forgotten to take it. (This happens on weekends when we are on a different schedule!) I think medication vacations are important, especially as the child grows and learns some coping strategies. However, I also worry about the on/off cycle and how this might be counterproductive. If my children ever need the meds it is something I will definitely consult with the doctor about!

    • Thanks for continuing the discussion here, Lisa! I’ve also noticed that children could tell me if they did or didn’t have their pill. This also makes me think a bit about Self-Reg. Do we need to label “calm” for children as we recognize this in them so that they can also recognize this in themselves? Are they noticing how the pill makes them feel differently, and with some Self-Reg options, would they also notice how this makes them feel differently? I do wonder about the on/off cycle with these kinds of meds, and am curious to know what doctors say about this. How long does it take for the body to get used to them again? You’re giving me even more to think about here.


  4. Great suggestions for classroom accommodations. ADHD is a very complex, multilayered issue that really needs to be fully understood from a physiological standpoint before we discuss whether or not medication is necessary.
    As a teacher, mom and wife of students, kids and a husband with ADHD, I have done my fair share of research and continue to do so, in order to best understand how to support my peeps.
    What I love about Self-Reg for ADHD is the fact that we pay attention to stressors in all 5 domains, not just biological, as all 5 play a huge role in the impact of ADHD. I also find the ‘self’ part especially valuable as it encourages ADHDers to be self-aware and have agency over their own regulation. So often ADHDers struggle with feeling competent in academic, social, emotional, and variety of other areas in life. Self-Reg helps to build a foundation of self-awareness and self-competency that serves to support positive self-esteem which can be very hard for an ADHDer to maintain.
    Thx for sharing your fab ideas!

    • Anne, thank you so much for your comment and sharing some of your own experiences with ADHD. I love how you highlighted the importance of understanding the stressors in all Five Domains. I think this is what I used to miss so often. I just looked at the Biological Domain, where really I needed to consider all five. This “self” part is key too, and it’s something that Paula and I have spent more time on in the last few years. While we often help co-regulate students, especially at the beginning of the year, now more children are aware of what they need to self-regulate. For the first time in my teaching career, almost all children can also be co-regulated by each other. Very powerful! This means that everything no longer rests with just the teacher. ❤️ Thanks for adding to this important conversation!


      • However, we need to be careful about stigmatizing the use of meds for ADHD. They are often not an option for ADHDers as ADHD is very energy expensive and may be required to help reduce stressors across all 5 domains. Once again, it is a very complex issue which effects all areas of life.

        • Thanks for replying again, Anne! I would definitely agree about not stigmatizing the use of meds, but is there a stigma attached to using them? Many children I know that are diagnosed with ADHD are on medication, and all of the educators that I know, love how the medication works for these kids. They are very supportive of students taking it. I can definitely see the need for medication in some cases, and I’m certainly not a doctor, so maybe meds are needed even more than I think. I know that the medication often reduces the inattentive behaviour that we see, but does it reduce the stressors? I’m still trying to figure that one out.


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