Dr. Hokehe Effiong is a certified board pediatrician, a TEDx speaker on ADHD, and the mom of three awesome kids. In today's interview, Dr. Hokehe Effiong helps us to look beyond medication for ways to help students with ADHD to thrive in math. Her simple teaching strategies include tips for breaking down lessons, explaining assignment instructions, giving breaks, providing resources, and supporting students in ways that build their confidence.

In today's Allison Loves Math Podcast interview, Hokehe shares simple, practical, actionable strategies that educators and parents can use to help students with ADHD thrive in math.

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Connect with Hokehe: 

• Linkedin: HokeheEffiongMD
  Facebook: HokeheEffiong
  email: [email protected]

Connect with Allison:

• Amazon: https://www.amazon.com/Allison-Dillard/e/B07PV43V59
• Facebook/Instagram: @allisonlovesmath
• Email: [email protected] 

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Allison: I am super excited to introduce today's guest Dr. Hokehe Effiong. She is a certified board pediatrician. She is a TEDx speaker on ADHD. She's a mom of three awesome kids and advocate for kids in foster care and the CEO of Glow Pediatrics, which is a virtual integrative pediatric practice for students with ADHD. So I am super excited to have this expert here today to share with us how we can help our math students with ADHD. Welcome, Hokehe.

Dr. Hokehe Effiong: Thank you so much, Allison, it's such an honor to be here. Thank you for having me.

Allison: Yeah, thank you so much for being here. I'm very excited to learn from you. To start out really quickly, how did you get started working with students with ADHD?

Dr. Hokehe Effiong: As a pediatrician, of course, I came across kids with ADHD and I've noticed in the last few years, that number has been increasing more and more, especially since the pandemic with all the changes and all the assaults to our mental health and it's also affecting children. I realized a few years ago, the way I was trying to take care of children with ADHD didn't quite seem to really be helping them, be all that they could be. And I got to a point one day, I was like, "Is there not more to just handing meds to our children? I mean, the meds help, but they wear off, and then what? Nothing. Right back to where we started." I went on this journey and that's when I discovered lots of research about other ways, or complementary ways we could help our children in combination with the medications and without the medications, just helping them really thrive, from the inside out, not just "we're medicating you for the eight hours, you're at school," and then after that, your behavior is back to where it is. 

Since then, I haven't looked back. I cannot address children the same way with ADHD, just from a point of view of, "Hey, I'm just going to give you medication." 

Instead, I look at, what's going on with the parents, I look at what's going on in the home, I look at the environment, what they're eating, how they're sleeping, because ADHD could even cause the sleep disorder because if children don't sleep, their behaviors off. We have to look at everything from a holistic point of view to help this child and the family because ADHD affects, even the child affects the family as a whole. So that's how I got here.

Allison: I like your approach of dealing with both, not just medication, but other aspects that affects students with ADHD. Let's talk about ADHD and math. We know that can affect a child's performance and love of math and success in math. Was there anything that you wish that you knew when you first started helping students with ADHD, if you sort of looking back at the beginning of the journey?

Dr. Hokehe Effiong: Yes, I wish I knew that I needed to address the things I had mentioned [crosstalk] the environment and the food and sleep and all of that because it's really important to understand how ADHD affects math. I mean, affects the way the children process math and see math. 

Some kids with ADHD have working memory challenges. And if we don't address that, and we just treat them like every other kid, then they're not going to do well and they will not love math, because it's the way they memorize facts, we have to tailor that to help them because they have the working memory challenge. And the other thing is children with ADHD also habituate to stimuli or respond to stimuli very quickly. So, that makes it really difficult for them to maintain attention to learn the math facts that you've given them. They may start off two plus two plus, and then trail off to thinking about lunch or something else. And that means we have to change the approach to help them refocus so that they can complete the math fact and actually learn it.

Allison: That makes perfect sense. As a math teacher, that's a really good thing to consider with a student that there are so many different things that are affecting it. What are some tips and pieces of advice that you have for math teachers to help students with ADHD?

Dr. Hokehe Effiong: The first one I will say is explicit instruction. What I mean by that is breaking down what's your instructions are into small bites for the children to be able to handle them. I know this conference is not just for kids in elementary, it's all the way up to college. Same thing for your college-age students. They need to understand what exactly you want from them in bite-sized amount.

Allison: When you said that I was thinking that pertains exactly to college students as well.

Dr. Hokehe Effiong: Yes. And it's really important for you to highlight the key concepts and the keywords, because if you hand them, or if you give them this long oral instruction, they may not remember the first, the second thing you said, the third thing, the fourth, and they may just hear the beginning and the end, because maybe they zoned out in the middle. It's really important to write it out. 

And the other thing with that is, with elementary school, not having the kids copy from the board. Yes, we're trying to help with their handwriting, well, when they're copying from the board onto the paper, it's very easy for them to make mistakes, then frustration level grows, because these children have a low tolerance for frustration. It's just the way their brains are wired. The whole copying process also creates errors and frustration for the children. If you just have it written out in bite-size, highlight what they really need to know, then it helps them.

Allison: I think that's super helpful, even at the college age, because I did notice that with some students just the copying down of things from the board can add an extra layer of frustration that then is there before they even actually start in on the math. I love that tip of just eliminating that part frees them up to spend that sort of focus on learning the actual math aspect of it. What's next?

Dr. Hokehe Effiong: What's next is provide real-life examples, because the children are able to visualize what you're saying and then it helps them remember it, as much as possible, I mean, and manipulators things that they can-- when you're doing addition problems, give them things to add together or to take away, so that it's concrete for them and that's how they learn but better. 

And to add to that would be charts and graphs. Instead of giving the kid playing paper to do a graph, give them graph paper, so the lines help them, the grids help them stay on track and so they don't feel so overwhelmed and like, "Okay, we can draw a straight line then." It's like panic sets in, then work doesn't get done. and then it just goes downhill from there. So those things help too.

Allison: Gotcha. Graph paper, you were saying, just to help them not have to worry about getting things exactly straight and stuff.

Dr. Hokehe Effiong: Right, and charts.

Allison: I never actually wouldn't have thought about that. That's a great idea.

Dr. Hokehe Effiong: Yeah, and charts too, because it helps the concepts come alive to them. And we're just trying to play to their strengths. They are very visual.

Allison: I like that. Play to their strengths, get very visual, that's a perfect piece of advice. What's next?

Dr. Hokehe Effiong: And if possible, giving them tools to help them, things like calculators and sheets that are already pre-printed for homework and a sheet for multiplication table because that way, it's easier for them to learn and the calculator helps them. It helps them get compute the problem because of the added frustration of the multiple steps that they have to write down which I was trained, I went to school in the British system, and my goodness, yes, you have to memorize everything, like the whole multiplication table. And, oh, I mean children who have ADHD, it helps them if they're able to get aids and tools to help them solve the problems.

Allison: Gotcha. Do you have any guidelines on when providing that calculator support is-- other clues for when that's needed versus when it's important to really have the student double down and memorize the multiplication tables because within ADHD, like with everything, there's going to be a lot of differences, right?

Dr. Hokehe Effiong: Right. I would say, yes, of course, every student has a different strength. Yes, teach them the steps. And if they're not getting it, then you can assist them with a calculator. And I know it's important for them to learn their multiplication chart. So that's why I say give it to them as a chart. So that they can see how the connections work between the different tables. Six times table, seven times table, so they can see that seven times six is the same thing as six times seven. And if you add the numbers, you also get the same result at the end because some kids don't realize that, because when they're memorizing the multiplication table, just by itself, they don't recognize that you can actually add the numbers.

Allison: Right, yes.

Dr. Hokehe Effiong: As you add seven plus, seven plus, seven plus, seven, you're going to get the same thing as multiplication. I think it just helps them bring that concept of life to them

Allison: Are there any big mistakes that you hear students and families talk about that their teachers or educators are making?

Dr. Hokehe Effiong: Yes, I hear a lot of the kids saying, "I can't do it. It's my ADHD. And I feel like a failure because I can't do the speed math problem at school." Oh, that was the other tip I had was, please don’t do speed math problems for them, because they have trouble doing things fast sometimes and then they forget, and then it just becomes a rabbit hole, they go down. 

But if the teachers will recognize that, ADHD is a brain-based disorder, it's not a behavioral problem. It's the child's brain is wired. So, it's important to see the child as the child that they are. Yes, their behavior can be disruptive, yes, we all agree. But it's the way their brain is wired. It's not like they're coming in there, wanting to act like that. They just need the tools and they just need the understanding from you, too. So that it builds up their self-esteem because they already feel bad. They already compare themselves with other children and feel like they don't learn and they're not as good as the other children, which is far from it because children with ADHD have lots of strengths. And we know famous ones like Michael Phelps and Simone Biles, Albert Einstein had ADHD. It's just them playing to their strengths. 

Teachers, when you recognize what the strength of this child is, if it's in math, memorizing certain things, so build on that strength and tell them specifically what you see them doing well, say, "I like the way you did that." And they're more likely to want to repeat that behavior. And it just boosts the way they feel about themselves because they're already beaten down at home with the way parents see them and talk to them about their limitations. And so please at school, as much as you can boost them, the way they feel about themselves.

Allison: Yeah, I love that piece of advice. And then you said something that really struck me, which is that a lot of times students say, "I'm just bad at math because I have ADHD." I think it's really easy to just fall into that fixed mindset for not just students with ADHD but just acalculia or any sort of learning disability that's impacting their ability to learn math the regular way that we're teaching in class. I love the suggestion about telling them what they're doing well. Are there any others that you have for helping students to develop that growth mindset around math? 

Dr. Hokehe Effiong: Yeah. Something else I'd like to talk about is brain breaks. I know it can be difficult, I understand that classrooms are full and teachers already doing such an amazing job and all of that. But this has been really found to help children, you put them in charge, brain breaks are basically you're given the child's-- so if you know, they can work well for 10 minutes, and then after that, you give them like one or two minutes brain break. 

And it can be with manipulators in their hands. And some schools have gotten like the cycling under the desk, whatever it is, but it helps them just get that energy down a little bit and helps them refocus when they come back to their work. Or, if you'd like set the timer and put them in charge of their timer. So that gives them some sense of ownership in this. And this also helps with homework as well. But it's something that teachers can try and just giving the kids the breaks. And so they feel more accomplished when they come back to finish their work because they're able to focus better.

Allison: Yeah, I love that. It's a great suggestion. Well, my goodness, thank you so much. This was so impactful of so many helpful things. I was making crazy notes throughout our whole conversation. So just to do a quick recap, like, the first suggestion was making sure we give explicit instructions, keeping things in small bites. Number two is real-life examples. Things that can be visual, concrete, things like charts and graphs. Three is helping them with tools that can help them. If they need that calculator, giving them permission for that pre-printed sheet, stuff like that. Four is that mnemonics that helps them to memorize better. Five is avoiding speed math, which totally makes sense. So definitely, definitely, rethink that if we're pressing for that in the classroom. Tell them that they're doing well and give them that positive encouragement. And last, but not least, those brain breaks can help as well. Thank you so much, this was hugely helpful.

Dr. Hokehe Effiong: Pleasure.

Allison: Yeah, before we go, can you share where people can find out about you, and your practice, and especially, I feel like you could be an amazing resource, not just for teachers, but for parents as well. Perhaps teachers can even pass along their students too, and stuff. So where can people find out more about you?

Dr. Hokehe Effiong: Yes. I have an email address. My practice site is being built right now. It's called Glow Pediatrics. And it's going to be a virtual practice serving people all over the country, and the world, of course, just helping families and teachers with ADHD and helping so that our children can thrive because there are lots of kids with ADHD that need help. That’s where to find me. My email address is [email protected]. That's all one word together. I'm also on LinkedIn at Hokehe Effiong MD. I'm on Facebook, Hokehe Effiong. And my website that will soon be up is glowpediatrics.com. All one word.

Allison: Awesome. Perfect. Thank you so much. And I will be sure to link to all of those things below. So if you have any questions or anything, definitely get in touch with Dr. Effiong. So, thank you so much for being here today. This was hugely helpful.

Dr. Hokehe Effiong: My pleasure. I wanted to add one more thing, I do have a TEDx talk that's available on the TEDx site on YouTube. The title is "We must change the way we treat Children's ADHD."

Allison: Perfect. I will link to that below as well, so you can definitely go and check that out as a follow-up. Thank you so much. 

Dr. Hokehe Effiong: My pleasure.

Allison: And if you're watching this, thank you so much for joining us. I hope that it was helpful and I will see you in the next session. Bye.

Dr. Hokehe Effiong: Bye.