October is ADHD Awareness Month

/in , /by

What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children (8.4 percent), though it also affects many adults (2.5 percent). General or common symptoms of ADHD include: 

  • Inability to stay focused, which can lead to not paying attention
  • Hyperactivity, which means the person is moving their body too much and/or inappropriately for their setting (for example, bouncing up and down during quiet reading time in school)
  • Acting on impulse in any given moment without thought 

ADHD is most often initially identified in school-aged children because the symptoms lead to disruption in the classroom or problems performing schoolwork. ADHD is more common among boys than girls, though the cause of that factor is unknown.

No specific causes of ADHD have been identified, though some evidence suggests that genetics contribute to ADHD. In approximately 75 percent of cases, a relative of someone with ADHD also has the disorder. Other factors that may be linked to ADHD include premature birth; brain injury; or the mother smoking, drinking alcohol or experiencing extreme stress during pregnancy.

What are ADHD symptoms?

Many ADHD symptoms, such as short attention spans, sitting still for extended periods and high activity levels, are common in most younger children. In children with ADHD, though, their heightened activity level and inability to focus are much more noticeable and greater than expected for their age. Their symptoms also cause distress and problems with daily functioning, whether at home, school or with friends.

ADHD symptoms are not due to the child being defiant or hostile or unable to understand and follow instructions or complete a task.

A diagnosis is typically based on symptoms experienced during the previous six months. ADHD is diagnosed as one of three types: 

  1. Inattentive: six (or five for people >17 years old) of these symptoms occur often:
    • Has a hard time staying focused with activities or tasks, such as listening to lectures, participating in conversations or completing long reading
    • May start tasks, but does not follow through or quickly loses focus
    • Seems to not be listening when spoken to (inattentive)
    • Doesn’t pay close attention to details; makes seemingly careless mistakes in school or at work
    • Is easily distracted
    • Difficulty with organizing and managing time; may miss deadlines and turn in messy work
    • Forgets to do regular daily tasks, such as chores or errands; for older teens and adults, examples include grocery shopping, returning phone calls, going to appointments, paying bills
    • Often loses commonly needed daily items or tools, such as a cell phone, car keys, wallet, schoolbooks
    • Avoids or dislikes (more than average) anything requiring a sustained mental effort
  2. Hyperactive/impulsive type – six (or five for people >17 years) of the following symptoms occur often:
    • Always go, go, go
    • Fidgets, taps hands or feet, squirms in a seat
    • Unable to stay seated in the classroom or at work
    • Runs around or even climbs when and where it is inappropriate
    • Has difficulty waiting for their turn
    • Unable to play or do leisure activities quietly
    • Talks too much (others may not get a word in)
    • Interrupts conversations or in class; may not wait to answer before a question has been finished or is not directed at them; may finish other’s sentences
    • Intrudes into other’s activities without being invited; may even take over a task (a symptom more of older teens and adults)
    • Uses other people’s things without asking permission
  3. Combined type

How is ADHD Diagnosed?

No laboratory tests can diagnose ADHD. Diagnosis involves a medical evaluation to rule out other possible medical problems. Information is gathered from parents, teachers, the patient and possibly others. Checklists also help make a diagnosis. 

What do I do if I notice symptoms in my child?

Though teachers and school staff can provide information about resources or tools to help evaluate behavior and learning problems, they cannot diagnose ADHD or make decisions about treatment or administer medication at school without an official diagnosis. If you are noticing symptoms and/or your child’s teacher brings up behavioral issues, you should start with making an appointment with your child’s pediatrician.

Students diagnosed with ADHD that impairs their learning may qualify for special education under the Individuals with Disabilities Education Act or for a Section 504 plan (for children who do not require special education) under the Rehabilitation Act of 1973. These benefits allow children with ADHD to receive instruction on study skills, behavioral modification techniques, changes to their classroom setup (for example, a yoga ball “chair” they can bounce on), alternative teaching techniques and a modified curriculum.

What should I do if I notice symptoms in myself or my adult partner?

Many adults with ADHD are unaware they have the disorder. Often, an adult partner or other close person who starts to recognize symptoms. If you recognize symptoms in either yourself or your partner, make an appointment with your primary care physician. They will be able to help begin the diagnosis process and provide you with referrals and resources. 

The diagnosis procedure is the same as for children, but with the use of adult rating scales or checklists. Adults with ADHD are typically treated with medication, psychotherapy or a combination of both. Behavioral modification strategies can also help, such as finding ways to minimize distractions and increase your daily structure and organizational skills. Involving immediate family members can also be helpful.

What can I do to raise awareness about ADHD?

The Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) organization recommends the following to raise awareness. 

  • Print out the NRC fact sheets on ADHD and share them with your friends and community.
  • Find additional resources on how you can increase awareness about ADHD and share them with others.
  • Host an event promoting ADHD Awareness Month or local resources for ADHD and mental health. You may want to partner with a local organization. During the COVID-19 pandemic, a virtual event is the safest choice.
  • Use your social media platforms to help dispel myths about ADHD and provide facts and other helpful information.
  • Speak out. Whether commenting on a social media post, having a conversation with family or friends, volunteering at your child’s school, contacting your local news media, or even your elected officials—use your voice to foster positive education and change. Let everyone know what it is like to live with ADHD and refer them to evidence-based information they can use to help spread awareness. 

Awareness is education. The more you educate others, the more benefit you promote to those living with ADHD, especially for those who are unaware they or their child might have the disorder.

ADHD is a serious health condition that can create much adversity in a person’s life. With identification, proper treatment and support, they can be successful and have fulfilling lives. The ADHD, Mood & Behavior Center is always available to help you, whether providing resources or telepsychiatry visits with an online psychiatrist or online therapist. Contact us with questions and concerns or to make an appointment.

How to Prepare Your Child to Go Back to School Online

/in , , /by

As the COVID-19 pandemic continues to spread, many schools have opted to function completely online or in a hybrid format, with some days of in-person learning and the rest online. This format is new to most schools, parents and children. This new way of educating children is daunting enough for parents, but especially challenging for parents of children with attention-deficit/hyperactivity disorder (ADHD).

Now, children must face an extended period of no socialization with their friends and peers, canceled sports, clubs and other activities, and being stuck at home for months without any assurance of a date that they can get back to “normal.” They may be having to face a new normal that looks different than the comfort of their past routines, except that no vision of what this new normal will be is available.

 

Impact of COVID-19 on Children’s Lives

Having our regular routine disrupted unsettles all of us. Anxiety, mood, ability to learn and more are all affected. When a scary pandemic is the cause, our emotional and mental reactions are even more heightened. Frustration and confusion are common. Just having the news on can cause anxiety in an adult, but for children, it may cause even more confusion and fear. 

Take care of your family and your community. Stopping the spread of COVID-19 is the bottom line. Follow whatever guidelines are being made, from reputable sources like the American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC). In those areas of COVID-19 “hot spots,” stay home if you can and keep your children at home unless necessary to leave. If you have to go out, wear a mask, be sure your children properly wear a mask, and stay at least six feet away from other people. For most kids, unfortunately, that means not getting together in person with friends for now as well as canceled sports, clubs and other social activities.

 

Challenges of Uncertainty for Children, Especially Children with ADHD

Children mentally process things differently than adults. Uncertainty is abstract for kids. Be realistic but also reassuring about the pandemic and how it personally affects them and your family. Encourage discussion often and questions. Children often need straightforward answers to their questions first. Avoid oversharing and flooding with facts. Then wait and see what further questions your responses elicit. Answer those in the same way—brief and to the point, honest, and reassuring.

 

Using Mindfulness to Normalize Mood

Though you can’t change the pandemic and school situation, you can work on keeping your children mentally settled. Trying mindfulness may help normalize their daily lives. Mindfulness builds resilience during stressful and difficult times by giving deliberate attention to how we relate to what is happening in our lives each moment. 

The level to which you can employ mindfulness with children depends on age. Teenagers are likely to be able to fully grasp the concept and practice on their own. Younger children may need more planting of seeds of mindfulness, where you normalize the experience of awareness. Then the practice of mindfulness grows over time. 

If your child is receptive to the idea, set aside a few minutes a day to start for a mindfulness practice. Don’t force it as this may make your child resist the idea completely. Find a guided practice online if needed, or a book or app. Make it a family activity and schedule mindfulness “breaks” during the day and evening.

For kids (and parents), focus on keeping mood or emotions close to neutral. Think of mood on a scale of one to 10. A settled, calm, “normalized” mood is a five. You and your child will slide a bit over and a bit under and that’s normal. What you want to avoid is a huge swing one way or the other, closer or at a one or a 10. Big swings can lead to heightened emotions and distraction.

There is nothing you need to expect to happen. The purpose is to gently guide children back to their present awareness when they get distracted. Keep mindfulness breaks unforced and fun, and let the practice develop at its own pace. 

 

Schedule, Schedule, Schedule

Create structure and routine. Both adults and children are happier with a daily schedule. For families, post it somewhere for everyone to see, whether on a piece of paper or using an online family calendar. Posting a hard copy will be easier for younger children who do not have access to an online calendar or know how to use one.

  1. Exercise. Our mental health is connected to our physical routines. Exercise daily, even if your children complain. Regular exercise has a positive outcome on mood, energy level, learning and more. 
  2. Sleep. A consistent routine of wake up and bedtimes encourages better sleep.
  3. Eat healthy. Don’t use food as bribes or to keep kids happy. Stick with a balanced diet. 
  4. Limit screen time. The more screen time kids have the more wound up and agitated children get. No limits lead to arguing with you over putting a device away. Set a total amount of time or a set time period during the day and stick to it. 
  5. Keep up with relationships. One place screen time is very useful and helpful is in sustaining relationships with friends and family. Support is there for you and children when you reach out regularly during this challenging time.
  6. Create a chore schedule to keep to reduce the stress of a messy home, keep a routine and teach responsibility.
  7. Schedule and prioritize everything else if you wish, like family time, outdoor time, hobbies, art, etc.

 

Adjusting to Virtual School 

Almost all kids can get off-track or miss details without strong adult supervision and guidance. Expect your child will need additional home supervision and guidance while working online. The success of online learning in previously in-person learning environments is unknown, and some to many teachers have little experience in this area. There will be a learning curve for students, parents and teachers. Try not to form preconceived ideas of how much progress will be made during this initial learning curve. 

If your child has ADHD, remember he or she has difficulty with self-management and lag behind the non-ADHD norm. Children with ADHD need more structure and direct involvement than their peers to complete online work. Inform your child’s teacher and work with your child’s teachers and administrators and counselors to keep an open line of communication. Your child may have an Individual Education Plan (IEP). Contact the school to see how this will impact your child with online learning. Ask for support early and often, and if your child is still struggling, ask your school’s counselor or administrator for advice on what to try next or additional resources.

Your school will likely send out a supply list. If you don’t receive one, ask the teacher. Even though they are learning at home, your child will need many items for the virtual learning to support his or her learning and classroom lessons.

Find out what virtual classroom platform your school will be using. Get comfortable with using it so you can help your child when needed. If your school is not offering tutorials and your child needs one, you can find many online. Many schools are using Zoom, which can record class sessions for students who are unable to attend due to family obligations or other scheduling conflicts or who wish or need to review the material again at a later time.

Ideally, students should have access to learning anytime, anywhere. Teachers of younger students may also work with families to determine the specific needs of their children, including built-in time for completing assignments away from the computer that may differ from what is given in the daily schedules.

 

Synchronous and Asynchronous Learning

Synchronous learning takes place in real-time with a group and the teacher either live in person or live via videoconferencing, such as Zoom meetings.

Positives:

  • Frequent live interaction with teachers and peers
  • Questions can be answered quickly
  • Feedback is immediate
  • Closest format achievable in a virtual setting to replicate in-person learning

Challenges:

  • Less flexible schedule; students need to be online at specific times to learn
  • Feedback given in a large group setting may not be specific to each child

Asynchronous learning is anytime, anywhere learning that provides students with structured and engaging independent practice and possibly pre-recorded lessons. Examples include independent reading, video lessons, online assignments and discussion boards.

Positives:

  • Students choose the time and place that they learn
  • Students have more time to review and reflect on their learning
  • Students can follow the learning pathway in whatever way meets their personal learning needs
  • Many traditional learning strategies such as group discussions, individual student conferences and assessments are accessible in an online format 

Challenges:

  • Students need a degree of self-motivation or adult support to stay on task
  • Presents additional challenges for ADHD children and their parents
  • Lack of live interaction with others

 

Setting up Your Home School Environment

  • Set aside a time for school. This may be dictated by your school except for offline learning activities (asynchronous learning), which you will have to schedule.
  • Create a dedicated school work area for your child with a minimum of distraction. Take away phones, turn off TVs and music and shut down anything else that is distracting. 
  • At the start of the day, check school assignments posted online. Make a to-do list from it. Play time must wait until that list is complete.
  • Supervise schoolwork. You are a parent, not a teacher, but most kids need an adult around to stay efficient. Kids have immature self-management skills by definition and ADHD kids have even less self-management skills and computers are distracting to even adults.
  • Use timers if necessary. Children may find it easier to focus and behave if they know when a break is due. If not already defined by the teacher, define for your child what he or she is to do at the start of each work period. For example, for the next 20 minutes, do only this math sheet. Make the timer visible to them.
  • End each school day by having your child clean and organize his or her work space, just as it would be in school. 
  • Emphasize “recess” daily. Remember the benefits of exercise, as this will help your child learn.
  • Encourage reading to promote academic success. Read with your kids and have them read alone. They can even read aloud to pets. Schedule it each day. 
  • Limit non-school screen time, as mentioned earlier.

 

For middle school and high school students:

  • Focus on behavior management instead of “brain breaks.” When it comes to middle and high schoolers with ADHD, they need help sustaining their motivation and attention versus preventing learning burnout (which is where “brain breaks” come into play in the classroom or live online environment). Getting these students engaged to start with may be the most challenging aspect at home.
  • Choose the best time and place to remove distractions from their environment. Though having a dedicated work space is very helpful, a change of scenery may be useful if they are having trouble staying focused. If it’s nice outside, perhaps a school day outside in fresh air is an option.
  • Allow teens to use electronics (usually their phone) for fun only if they have completed all of their academic tasks for the day. Parents will need to develop a strategy of how they can monitor student performance consistently. Some schools have academic parent “portals” and even text and email reminders of assignments that are due, what is outstanding, what has been turned in and grades. Check if your school uses this extremely helpful tool and sign up.
  • Help your teens plan out their work in advance and use time management strategies. 
  • Dividing their work into smaller chunks is helpful while being sure they are aware of expectations. Then monitor whether it’s completed.
  • Recognize and praise your teens for staying on-task and getting work done. 
  • Refrain from micromanaging or taking over for them. This behavior is tempting for many parents, especially when they become impatient and have their own work to get done. 
  • Do not give in to attempts to get out of work.

 

This school year is going to be challenging for everyone, with extra challenges for children with ADHD and their parents. The ADHD, Mood & Behavior Center is always available to help you, whether providing resources or visits with an online psychiatrist or online therapist. Contact us with questions and concerns or to make an appointment.

Productivity versus Procrastination in the Remote Work Environment

/in , /by

Working from Home

Working from home sounded great at first. The idea of not having to get up early (in theory), wear uncomfortable clothes and shoes, and drink horrible breakroom coffee all day sounded appealing to many former office workers. Now that some – or a lot – of weeks have passed, it hasn’t turned out to be the pajama party you thought it would be. With those perks come distractions: television, your personal phone, social media, kids, errands that are easier to run during the day, household chores to get done. And let’s not forget that fridge and pantry full of snacks. 

If you are struggling to maintain productivity while working remotely, you are not alone. These easy, but effective tips may help:

  • Make a list. Start your day by making a to-do list. Write down everything you need to get done each day or use an electronic list or app. Put everything in order from most important to least important. Checking them off as you finish will also provide you with a sense of accomplishment, which helps fuel motivation to keep working.
  • Reward yourself. Sometimes it helps to keep yourself accountable by putting a reward system in place for yourself. For example, after you complete five tasks from your list, you get to treat yourself to a snack break, one (short) episode of your favorite show on Netflix, reading a chapter of a book, taking a quick power nap, or anything that will keep you motivated to keep going. 
  • Switch it up. Many people recommend having one designated space for your home office. You’ve probably heard not to work in the same room you sleep or watch TV. However, sometimes switching to a more comfortable chair with your laptop and getting a change of scenery is just what your brain needs to stay productive. Weather permitting, take that laptop outside for a bit while you soak up some energy boosting Vitamin D.
  • Get dressed. It doesn’t have to be a suit and tie or a skirt and heels. It doesn’t even necessarily need to be jeans. Just don’t wear what you wore to bed last night when you work. The routine of grooming and getting out of sleepwear is needed to switch your brain from sleep mode to work productivity mode.
  • Take breaks. It’s important to get up and stretch your legs every once in a while. Stand up, drink some water, walk around, grab a snack. It can even be helpful to go outside for a couple minutes and get some fresh air. While there may not be time to take a walk around the whole block, exercise is very beneficial to a brain with ADHD. Also, sitting for extended periods is harmful to your health in many ways.
  • Take your medication. Adult ADHD medication works best when taken regularly. Just because you’re working from home in a familiar and comfortable environment does not mean you can skip a day of taking your medication. 
  • Stick to a routine. Set your alarm and get up at the same time each day and go to bed at the same time each night. Set your work hours. Eat meals and snacks at roughly the same times. Do not perform any chores or errands you would not be able to perform if you were working in an office, which will throw off your entire work routine.

Learning from Home

Online learning for children is another big adjustment many people have had to make. It can seem overwhelming to parents who had to transition from working in an office, uninterrupted by the needs of school and childcare, to working at home while facilitating a learning environment and being constantly interrupted for snack demands to needing help getting back on Zoom. 

To help lighten the load, many of the steps listed above for working from home also apply to learning from home. Also, remember that even though your child is usually spending around seven to eight hours at school, they really don’t need to spend that much time hitting the books at home. They had lots of breaks at school, too. These guidelines can help provide a structure for your day:

  • Kindergarten through second grade only need a maximum of 90 minutes of active curriculum learning per day
  • Grades three through five only need a maximum of 120 minutes per day
  • Grades six through eight need a maximum of 180 minutes per day (30 minutes per class)
  • Grades nine through 12 need a maximum of 270 minutes per day (45 minutes per class)

These timeframes can even be broken down into smaller chunks throughout the day. 

Getting your child involved by giving them new age-appropriate responsibilities will help both you and your child. Some ideas include:

  • On the weekend, make up breakfasts and lunches together for the week and refrigerate or freeze them
  • Teach your child how to safely use the microwave
  • Keep healthy snacks within their reach in the pantry or fridge and set a timer for snack times or limits on the number of snacks
  • Set a reading time for each day. Have your child read out loud to you or a pet if they are younger and need supervision.
  • Plan physical activities in advance and offer a choice to your child to avoid them sitting in front of a screen all day.
  • Keep art supplies on hand and an area set up where your child can get their art on. 
  • Give them an age-appropriate chore list. When they are bored, have them pick a chore. This won’t be their favorite activity, but it will help you keep them occupied while getting housework done. Chores also teach responsibility, even though their standards are likely going to be a lot lower than yours.
  • Bless the mess. Most children are messy. Art is messy. Snacks are messy. Having them dance in the background of your work Zoom meeting is messy. As you watch the mess expand like the blob throughout the day, your frustration level will likely rise in accordance. Instead of yelling, ask your children to behave as if they were at school – would their teacher allow them to leave a mess? Learning to accept some degree of messiness is also key. You’ll need to find the balance that works for your home. Just remember to keep your expectations reasonable for your child’s age and development level.
  • Set boundaries (like no dancing during meetings), but remember kids aren’t always going to follow the rules. They don’t at school either. Talk with your pediatrician or look online for ways to keep them engaged so they have less of a chance to break the rules, and a discipline structure for when they do.

If you are still feeling overwhelmed and having difficulty coping with the new arrangements, schedule a session with a therapist here. Online psychiatrists are also available when needed for your convenience. We are here to help.

The Video Game Dilemma and the ADHD Child

/in , , , /by

Do you sometimes wonder if your child is addicted to video games?  Is getting off or ending video game sessions often the cause of fights or meltdowns for your child?

In an increasingly digital world, children are spending more time in front of screens and parents are left  to negotiate the muddy waters of figuring out how much screen time/video game time is healthy for their child.  This can be particularly difficult for a child with ADHD as video games lend themselves to being ‘time sucks’ and can often distort a child’s temporal awareness.  Here are some tips for setting and maintaining healthy boundaries for video games and screen time.

  1. Communicate clearly with your child about the amount of screen time that is allowed

During a calm period of the day, sit down with your child and discuss your concerns about screen time and present your concerns.  Make sure to listen to your child and reflect their concerns.

  1. Consider the time of day when you agree to schedule gaming/screen time.

Scheduling screen time right before homework or bedtime can be a recipe for disaster especially for children who have very difficult moments detaching.  Try to involve your child in problem solving and ask for ideas of when you can best schedule screen time so that it is not disruptive when it must come to an end.  Be flexible.

  1. Always monitor and preview content before your child views it.

Some games and videos can have violence or sexual content that may be inappropriate or overwhelming for your child.  Always check the suggested ages and consider watching the video game first before you purchase or rent it for your child.

  1. Consider what your child is getting out of screen time.

Playing a video game or watching a youtube video may provide much needed zone out time for the ADHD brain.  Make sure to expose your child to a range of other activities that may also provide relaxation and self-soothing feelings such as yoga, meditation, music lessons etc.

  1. Practice what you preach.

Modeling is one of the most powerful tools of influence that parents possess.  Practice your own healthy boundaries with your cell phone and screen time.  Schedule regular family media -free times or zones, such as meal times, bedtime or family outings.

  1. Use Screen time to build on your child’s strengths

Not all screen time is unhealthy. There are amazing tools available that can help support learning.   Research some great new learning sites or games that support your child’s reading or math and spend some time with your child exploring their interest in art or science by checking out online museums.  Speak to your child’s teacher or the school librarian for recommendations.

 

 

ADHD: Myths vs. Reality

/in , /by
 

Attention difficulties commonly occur in children and adults for various reasons. Sometimes they can be related to mood issues, motivational issues, environmental challenges or physical health issues. But, when there are significant and persistent difficulties, with a combination of inattention, overactivity, impulsivity, and distractibility that impairs functioning or development in multiple settings, this can be attributed to Attention Deficit Hyperactivity Disorder in children and/or adults.

Of children aged 4-17 years of age in the United States, 5.1 million or 8.8%, have a current diagnosis of ADHD, with boys (12.1%) more than twice as likely as girls (5.5%) to have ADHD. Approximately half of children with ADHD continue to have symptoms into adulthood, or 4.4% of adults overall.

The exact cause of the disorder is unknown but research shows that areas of the brain are affected and there is a family/genetic connection. The impact of the disorder includes lower academic performance, increased risk of injury, increased risk of traffic accidents, increased likelihood of smoking, poorer social function and lower self esteem. Treatment can reduce the symptoms of ADHD, but it does not completely eliminate the impact of these complications.

When it comes to ADHD, it’s important to separate the myths vs. the facts. Here are some important considerations to keep in mind when thinking about an evaluation, diagnosis and treatment.

Myth


Fact


“ADHD isn’t a real disorder”

  • It is a recognized medical condition
  • ADD = ADHD
  • Exact cause unknown
    • Multiple factors have been implicated in the development of ADHD – family history/genetics, certain environmental factors, problems with the central nervous system /an imbalance of chemical messengers, or neurotransmitters, within the brain.
  • Research has shown that certain brain regions don’t synchronize properly and overall brain architecture is different.

“ADHD is overdiagnosed”

  • Studies show that ADHD is underdiagnosed in minority populations
  • Awareness of the disorder has been growing since the 1990s when it became recognized under special education law as a condition that affects learning.

“ADHD only occurs in childhood”

  • The symptoms of ADHD can occur as early as the preschool years. The intensity of the behaviors and how they are affecting a preschooler’s life, development, self-esteem, and general functioning is considered.
  • Some children with ADHD continue to have symptoms during their teen years and about 50 out of 100 have symptoms into adulthood.
  • Symptoms in adults look different.
  • Hyperactivity tends to diminish
  • Inattentive symptoms become more troublesome
  • Sense of “inner restlessness”

“Children outgrow ADHD”

  • ADHD is a lifelong condition
  • Some children do outgrow their symptoms
  • Most children carry the disorder into adolescence and adulthood
  • Symptoms change as a child gets older and learns ways to manage them

“My child is just lazy or dumb or unmotivated”

  • ADHD has nothing to do with a person’s intellectual ability.
  • A child who finds it nearly impossible to stay focused in class, or to complete a lengthy task may try to “save face” by acting as though he/she does not want to do it or is too lazy to finish.
  • This behavior stems from real difficulty in functioning and possible frustration.
  • They simply work differently.

“My child is a handful or is a daydreamer – but that’s normal”

  • There are variations of “normal”
  • How much behaviors consistently impede a child and their ability to succeed at school, fit into family routines, follow household rules, maintain friendships, interact positively with family members, avoid injury or otherwise manage in his/her environment should be considered

“My child focuses on video games for hours. He/she cannot have ADHD”

  • ADHD poses problems with tasks that require focused attention over long periods of time, not so much for activities that are highly engaging or stimulating
  • Less or unstructured time can be difficult to manage
  • Social situations can also be problematic due to the constant, subtle exchange of social and emotional information

“ADHD is caused by poor parental discipline”

  • ADHD is not caused by bad parenting.
  • Parenting techniques can affect symptoms.
  • Try to stay positive
  • Establish structure and stick to it
  • Set clear expectations and rules
  • Encourage healthy lifestyles – eating, exercise, sleep
  • Teach how to make friends
  • Learn to anticipate potentially explosive situations
  • Be a good role model

“If after an evaluation, a child does not receive the ADHD diagnosis, he/she doesn’t need help”

  • ADHD is diagnosed on a continuum
  • A child may not always show symptoms of ADHD, especially in an unfamiliar setting
  • Monitoring symptoms and behaviors in multiple settings is critical
  • Counseling, home management tools, school behavior management recommendations, social skills interventions, and help with managing homework flow, organization and planning can be helpful

“All you need are medications to treat ADHD”

  • Medications often curb symptoms
    • They help children focus and be less hyperactive
  • Typically a combination of treatments are the most effective way to treat ADHD
    • Behavioral therapy
    • Notes/reminders to prevent self from forgetting tasks
    • Academic help

“Medicine for ADHD will make a person seem drugged”

  • Properly adjusted medicine for ADHD sharpens a person’s focus and increases his or her ability to control behavior
  • Sedation or personality changes are not side effects of the medication

“ADHD stimulant medication leads to addiction”

  • No evidence
  • Research has shown that people with ADHD who take medication tend to have lower rates of substance abuse than people with ADHD who don’t take the medication
  • A long-term study looked at childhood & early teen use of stimulants and early adulthood use of drugs/alcohol/nicotine in males with ADHD and showed no increase or decrease in substance use.

“Treatment for ADHD will cure it. The goal is to get off medication as soon as possible”

  • ADHD is a chronic condition that changes over time
  • Depending on the circumstances and demands as a person matures, the need for continuing medication or other treatments varies
  • TRUE GOAL = function well at stage of development in all environments

Children Who Can’t Pay Attention/ADHD

/in , /by

Parents are distressed when they receive a note from school saying that their child won’t listen to the teacher or causes trouble in class. One possible reason for this kind of behavior is Attention Deficit/Hyperactivity Disorder (ADHD).

Even though the child with ADHD often wants to be a good student, the impulsive behavior and difficulty paying attention in class frequently interferes and causes problems. Teachers, parents, and friends know that the child is misbehaving or different but they may not be able to tell exactly what is wrong.

Any child may show inattention, distractibility, impulsivity, or hyperactivity at times, but the child with ADHD shows these symptoms and behaviors more frequently and severely than other children of the same age or developmental level. ADHD occurs in 3-5% of school age children. ADHD must begin before the age of seven and it can continue into adulthood. ADHD runs in families with about 25% of biological parents also having this medical condition.

A child with ADHD often shows some of the following:

  • trouble paying attention
  • inattention to details and makes careless mistakes
  • easily distracted
  • loses school supplies, forgets to turn in homework
  • trouble finishing class work and homework
  • trouble listening
  • trouble following multiple adult commands
  • blurts out answers
  • impatience
  • fidgets or squirms
  • leaves seat and runs about or climbs excessively
  • seems “on the go”
  • talks too much and has difficulty playing quietly
  • interrupts or intrudes on others

A child presenting with ADHD symptoms should have a comprehensive evaluation. Parents should ask their pediatrician or family physician to refer them to a child and adolescent psychiatrist, who can diagnose and treat this medical condition. A child with ADHD may also have other psychiatric disorders such as conduct disorder, anxiety disorder, depressive disorder, or bipolar disorder. These children may also have learning disabilities.

Without proper treatment, the child may fall behind in schoolwork, and friendships may suffer. The child experiences more failure than success and is criticized by teachers and family who do not recognize a health problem.

Research clearly demonstrates that medication can help improve attention, focus, goal directed behavior, and organizational skills. Medications most likely to be helpful include the stimulants (various methylphenidate and amphetamine preparations) and the non-stimulant, atomoxetine. Other medications such as guanfacine, clonidine, and some antidepressants may also be helpful.

Other treatment approaches may include cognitive-behavioral therapy, social skills training, parent education, and modifications to the child’s education program. Behavioral therapy can help a child control aggression, modulate social behavior, and be more productive. Cognitive therapy can help a child build self-esteem, reduce negative thoughts, and improve problem-solving skills. Parents can learn management skills such as issuing instructions one-step at a time rather than issuing multiple requests at once. Education modifications can address ADHD symptoms along with any coexisting learning disabilities.

A child who is diagnosed with ADHD and treated appropriately can have a productive and successful life.

Re-printed with Permission from American Academy of Child & Adolesccent Psychiatry