How many times have you wished for just one trip to the supermarket without your child running around, knocking things down and impulsively putting items into the shopping cart?
Do you dread homework time, hoping that just once your child will complete it without becoming distracted, bored and finally frustrated? Every time your teenager leaves the house, do you constantly worry about his choices because he never seems to think before acting?
It could be ADHD.
ADHD stands for Attention-Deficit/Hyperactivity Disorder, and it affects about 3-5 percent of school-age children. It is a biologically based disorder with a genetic link in families and is not directly related to parenting, stress or sugar. There are many different chemicals in the brain and when these chemicals are not in balance, difficulties with attention, organization and self-control occur. In other words, when your child says they can’t sit still, they really can’t.
There are three different types of ADHD: inattentive, hyperactive-impulsive, and combined. Children with primarily inattentive ADHD often have trouble focusing on details and frequently make careless mistakes. They have difficulty finishing work or doing things that require concentration. They are easily distracted by noises or things happening around them.
Children with primarily hyperactive ADHD often appear fidgety or restless. Some children have impulsive symptoms and have difficulty waiting their turn. They struggle to think before acting, which can lead to accidents or risky behaviors.
Occasionally all children and adolescents may exhibit inattention or hyperactivity, but children and teens with ADHD act this way more often and with more intensity when compared with other children of a similar age. Their behaviors negatively impact academic performance, self-esteem, family relationships and social interactions. It is important to note that ADHD symptoms vary among children and can change in different settings like home, school and social situations. Symptoms typically begin early, before age 7.
Getting an accurate diagnosis of ADHD is critical. Once the diagnosis is made, there are three options for treating ADHD: medication without behavioral modification therapy; therapy without medication; and the most effective option, medication and therapy. Medications (both stimulant like Ritalin and non-stimulant like Strattera) act to restore the chemical balance in brain cells. Combining medication with therapy helps kids learn strategies to manage symptoms and cope with the negative consequences of their actions and choices. Family therapy can also be important because it encourages parents and siblings to develop useful strategies for interacting with someone with ADHD.
Neurotherapy (or neurofeedback) is an intervention that can be used as an alternative to medication. In neurotherapy, children learn to concentrate and motivate themselves.
Here are five tips for managing ADHD symptoms:
- Use short, specific instructions. Break down big tasks into smaller tasks and ask your child to repeat the directions.
- Follow a similar routine every day to allow for predictability and consistency. Children with ADHD often feel quite out of control so involve your child in establishing routines, activities and rules. This will help them to develop a sense of responsibility and control over their environment.
- Use different types of communication (written, verbal and even pictures) to aid memory and to try to tap into the child’s learning style.
- Focus on your child’s strengths. Repeatedly reprimanding and saying “no” can negatively impact your child’s self-esteem.
- Parents should seek parent support groups or even become involved in online chat groups. I also recommended parents collaborate with their child’s school to develop appropriate school-based interventions. Interventions may include guaranteeing that a child is seated next to the teacher and away from distractions or that a child is allowed extra time on tests or frequent movement breaks throughout the day.
Children and teens with ADHD truly want to do well in school and have friends, but their symptoms interfere. The best news for parents is that with appropriate treatment, children with ADHD can learn to manage their symptoms and live successfully.
Dr. Alfreda Grosrenaud, a child and adolescent psychiatrist, is the mother of two teenage boys. She is the medical director of outpatient psychiatry at Mt. Sinai Hospital in Chicago and has a private practice in Kenilworth. She can be reached at guidance@afgfamly.com.
Dr. Lisa Thornton, a mother of three, is director of pediatric rehabilitation at Schwab Rehabilitation Hospital and LaRabida Children’s Hospital. She also is assistant professor of pediatrics at the University of Chicago. E-mail her at drlisathornton@gmail.com
