Is it hard for your child to sit still? Does your child act without thinking first? Does your child start but not finish things? If you answer yes, to any of these questions – it does not mean that your child has Attention Deficit Hyperactivity Disorder (ADHD), but they could.
Attention-deficit/hyperactivity disorder (ADHD) is a neurobiological disorder characterized by developmentally inappropriate impulsivity, inattention, and in some cases, hyperactivity. The important thing to remember is “developmentally inappropriate”. Children under the age of five may be impulsive, inattentive and hyperactive; yet this is common for the age. A young child is not and should not be expected to sit for any longer than their age in minutes. As children enter school and mature, their attention span extends. It is after children enter school that a child can be adequately diagnosed and treated for ADHD. Some children may experience severe issues prior to school, but as a health care provider, I prefer not to begin treatment until the child enters school.
Children with ADHD generally have problems paying attention or concentrating. They can’t seem to follow directions and are easily bored or frustrated with tasks. They also tend to move constantly and are impulsive, not stopping to think before they act. These behaviors are generally common in children. But they occur more often than usual and are more severe in a child with ADHD.
Who Is Affected By ADHD?
ADHD is more common in boys than girls, and it affects 3-5 percent of children in the United States.
Could My Child Have ADHD?
If after reading this you think your child might have ADHD, take this quiz. Then print out the score and take it to your child’s health care provider.
This information will help you and your child’s health care provider make decisions about the next step in caring for your child.
Before I Start My Child on Medication:
It is very important that you and your child’s teachers meet and set goals for your child. I encourage parents talk to not only the child’s teacher, but also the school counselor. Just because on teacher thinks that your child needs medication does not mean that is the case. Develop a good relationship with the school and staff. It may be a good idea for the child to be moved into another class. So, what are some things you can do to help your child:
1) Make sure your child is eating a good diet. Fruits and vegetables are important. Limit fast food, sugar, and caffeine. Not only is eating at home healthier, it is a good time for family to talk and discuss day’s events. You can gain a wealth of knowledge from your children at the kitchen table. I also recommend that child take a daily multi-vitamin.
2) Make sure your child is getting adequate sleep. A child between the age of 6 – 12 needs about 8.5-10 hours per night. Establish a nightly ritual – warm bath, reading, music, etc.
3) Parent-Child Conflict: In many situations, the first step in behavioral treatment is to enhance the amount of positive feelings between parent and child. One helpful way to do this is to set aside a certain amount of time each day (30 minutes is certainly sufficient) that is designated as the child’s “special time.” During this time, the child gets to choose the activity (it must be within reason, of course), and the parent’s sole focus is on trying to have a good time with his or her child.
4) Using Positive Reinforcement: The simple logic is that you can increase the frequency of desired behavior (e.g. putting away toys) by providing rewards when such behavior occurs. At the simplest level, this requires nothing more than noticing when your child is doing something you want to encourage (e.g. playing quietly) and making sure to comment on it (“You’re doing such a nice job of playing quietly. I really appreciate that.”).
5) Using Negative Consequences to Reduce Misbehavior: Simply stated, when a particular behavior is consistently followed by negative consequences for a child, it should diminish in frequency and intensity.
For example, suppose you are trying to reduce your child’s tendency to “talk back,” and this is being targeted in your behavioral treatment plan. Here is a general approach one might take.
- First, your child would need to understand exactly what you mean by “talking back” so it is clear what should not be done.
- Second, you would want to teach your child an acceptable way to disagree with you – how he or she is allowed to express disagreement and how the child cannot.
- Third, as discussed above, you would review with your child the rewards they will earn for not talking back and for expressing disagreements in an acceptable way.
- Finally, you would discuss with your child what privileges he/she will lose each time the child “talks back”. For example, talking back could result in their having to take a “time out”, losing TV time, having to go to bed early, etc. If you are using a token system where your child is accumulating tokens that can be used to purchase rewards, talking back can result in the loss of a pre-specified number of tokens.
By setting things up this way, what you are trying to do is to make sure your child understands that there is simply no pay-off for bad behavior. Instead, when he or she acts appropriately, it will always result in good things coming their way. In contrast, when behavioral expectations are not met, the consequences are always negative. This should not be a focus – more positive reinforcement, rather than negative.
Things to Remember Dealing with a Child with ADHD
- Children with ADHD generally require more frequent feedback about how they are doing in meeting the parent (or teacher’s) expectations.
- Children with ADHD do better with short term goals than long term goals.
- Children with ADHD require more frequent reminders about what is expected of them and what they can earn for meeting those expectations.
- Children with ADHD often require frequent changes in the program to remain interested in it.
Remember; don’t take on to many things at once. Try to set things up so the child has a good chance to experience some early success. Don’t expect or require perfection. Even a small improvement is still an improvement.
Medication may be an appropriate therapy for your child. Children with ADHD often do best with medication, as well as the above behavioral therapies. Medication does not mean you or your child have failed. Your child’s success is the most important thing. Partner with your child, their health care provider, teachers and school counselor in developing an appropriate plan of action.
Share your stories, what has worked for your child.
Coming up – What about Adult ADHD: Do I Need Medication?