With ADHD on the rise, and following the controversial investigation in the Toronto Star on the use of ADHD medications, I felt it was probably a good time to provide some education on the topic of ADHD.
An ADHD diagnosis is one that needs to be made only following a thorough assessment and cannot be attached to children just because they demonstrate some of the associated behaviours. On the other hand, many children with unidentified ADHD get stuck with an unofficial “behavioural” diagnosis that manages to stick throughout their public school years, affecting their self-esteem, their academics and contributes towards negative feelings about school and how they fit into their world. Had these children been identified and diagnosed in their earlier years, they could have received the support, strategies, and/or medication to help them manage their behaviours in a more positive way, nurturing their development rather than hindering it.
As an Assistant to the Developmentally Handicapped and as a parent of a child with severe ADHD, I understand the importance of early identification and I would like to share the following information on ADHD in Children. Comments in brackets are my own, and the bulk of the information is directly from an article published by the American Academy of Family Physicians.
What is ADHD?
Attention-deficit hyperactivity disorder (ADHD) is the name of a group of behaviours found in many children and adults. People with ADHD have a pattern of inattention (lack of attention) or hyperactivity (too much activity) that is worse and more frequent than what is considered usual for their age. A child who is both inattentive and hyperactive will have 6 of the 9 symptoms from both of these lists. It is a common disorder that affects 3 to 5 percent of school-age children, and it is more common in boys than in girls.
(Which has changed since 1999 when this information was published. It is now equally found in girls and boys, however, it just shows differently. My next blog will address this topic.)
The child with ADHD who is inattentive will have 6 or more of the following symptoms:
Has difficulty following instructions
Has difficulty keeping attention on work or play activities at school and at home
Loses things needed for activities at school and at home
Appears not to listen
Doesn’t pay close attention to details
Has trouble with tasks that require planning ahead
Is easily distracted
The child with ADHD who is hyperactive/impulsive will have at least 6 of the following symptoms:
Runs or climbs inappropriately
Can’t play quietly
Blurts out answers
Can’t stay in seat
Talks too much
Is always on the go
Has trouble waiting turn
What causes ADHD?
We now know that the brain structure of children with ADHD is normal, but the chemistry in the brain isn’t normal. Children with ADHD do not make enough chemicals in key areas of the brain that are responsible for organizing thought. Without enough of these chemicals, the organizing centers of the brain don’t work well. This causes the symptoms in children with ADHD.
ADHD is not caused by bad parenting, but a disorganized home life and school environment can make the symptoms worse. ADHD isn’t caused by a diet that contains too much sugar, too little sugar or aspartame. It isn’t caused by food additives, food colorings, food allergies or other allergies, or a lack of vitamins. It also isn’t causes by too much TV, fluorescent lights or video games.
What can I do to help my child with ADHD?
A team effort, with parents, school officials and doctors working together, is the best way to help your child. Medicine helps many children, and some children may need counseling. Ask your doctor what treatment he or she recommends. (If you are concerned about what your doctor is recommending or hesitant to accept your doctor’s diagnosis, I highly encourage you to seek out a second opinion. There are doctors that specialize in ADHD that may be better prepared to assess and diagnose your child. Many family doctors do not have the specialized knowledge or education to accurately diagnose or treat a child with ADHD and many parents are hesitant to question their family doctor, which can result in a misdiagnosis.)
How can I help my child at home?
Children with ADHD may be difficult to parent. They may have trouble understanding directions. Children with ADHD are usually in a constant state of activity. This can be a challenge to adults. You may need to change your home life a bit to help your child. Here are some things you can do to help:
Organize your schedule at home. Set up specific times for waking up, eating, playing, doing homework, doing chores, watching tv or playing video games and going to bed. Write the schedule on a blackboard or a piece of paper and hang it where your child will always see it. If your child can’t read yet, use drawings or symbols to show the activities of each day. Explain and changes in routine in advance.
Set up house rules. Make the rules simple, clear and short. It’s important to explain what will happen when the rules are obeyed wand when they are broken. Write down the rules and the results of not following them. Hang this list next to the schedule. The punishment for breaking the rules should be fair, quick and consistent.
Be positive. Tell your child what you want rather than what you don’t want. Reward your child regularly for any good behaviour – even little things such as getting dressed and closing doors quietly. Children with ADHD often spend most of their day being told what they are doing wrong. They need to be praised for good behaviour.
Make sure your directions are understood. First, get your child’s attention. Look directly into his/her eyes. Then tell your child in a clear, calm voice specifically what you want. Ask your child to repeat the directions back to you. It’s usually better to keep directions simple and short. For difficult tasks, give only 1 or 2 directions at a time. Congratulate your child when he or she completes each step.
Be consistent. Only promise what you will deliver. Do what you say you are going to do. Repeating directions and requests many times doesn’t work well. When your child breaks the rules, warn only once in a quiet voice. If the warning does not work, follow through with the consequence.
Help with school activities. School mornings may be difficult for children with ADHD. Get ready the night before, lay out school clothes and get the knapsack ready. Allow enough time for your child to get dressed and eat a good breakfast.
Set up a homework routine. Pick a regular place for doing homework. This place should be away from distractions such as other people, tv and video games. Break homework time into small parts and have breaks. For example, give your child a snack after school and then let them play for a few minutes. Then start homework time. Stop frequently for short “fun breaks” that allow your child to do something enjoyable. Give your child lots of encouragement, but let your child do the school work.
Focus on effort, not grades. Reward your child for the effort they put into completing their work and not just for the good grades. You can give extra rewards for earning better grades.
Talk with your child’s teachers. Find out how your child is doing at school. Ask for daily progress reports or notes from the teacher. These notes should include good things, and not so good things. Find out the teacher’s lesson plans in advance so you can prepare and work with your child at home.
Will my child outgrow ADHD?
We used to think children would “grow out” of ADHD. We now know that it is not true for most children. Children with ADHD often get better as they grow older, and learn to adjust to their problems. Hyperactivity usually stops in the late teenage years. However, about half of children with ADHD continue to be easily distracted, with mood swings, hot tempers and an inability to complete tasks. Children with loving, supportive parents who work together with school staff, mental health workers and their doctor have the best chance of becoming well-adjusted adults.
Kimberly Smith is a Registered Early Childhood Educator with focus on children with special needs. She is the mother of a 9-year-old boy with Aspergers, Tourettes Syndrome, ADHD and Anxiety Disorder. She works with the York Region District School Board as an Assistant to the Developmentally Handicapped. She is a regular blogger with Kiwi Commons and is actively involved with the York Region Anti Bullying Coalition.
Image source: Caves of Spiel