Helping families understand AD/HD

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Have you ever asked your six-year-old to go brush her teeth at bedtime only to find her, twenty minutes later, playing with the dog, teeth still not brushed? Does your third grader sit to do homework then seconds later jump up for some juice, a trip to the bathroom and a stop off in his bedroom to flip through his YuGiOh cards? In all likelihood, these are very “normal” behaviors. From time to time all elementary-age children forget directions and can have difficulty paying attention. However, if these behaviors are more the norm than the exception, they might signal a problem. 

The American Psychiatric Association estimates that between three to five percent of school-age children have Attention-Deficit/Hyperactivity Disorder (AD/HD.) AD/HD is a neurobiological condition (one that affects the way the brain works) and, in most cases, is inherited. 

Children with AD/HD exhibit various combinations (though not necessarily all) of the following characteristics: 
• An inability to get focused or stay focused on a task or activity. 
• Hyperactivity/impulsiveness — many children with AD/HD are very active and often act without thinking. This characteristic is more often present in boys with AD/HD. 
• Difficulty controlling their tempers.
• Social immaturity/lack of ability to make friends.
• Difficulty adjusting to change. 
• Learning difficulties. 
• A low tolerance for frustration.
• A lack of self-esteem.
• Poor eating or sleeping habits. 
• In some children, serious defiance or rebelliousness. 

My child has some/all of these characteristics. How do I know if it's AD/HD?
Dr. Barbara Zimmerman, behavior specialist and author of Why Can't They Just Behave: A Guide to Managing Student Behavior Disorders says that children with AD/HD frequently forget directions and can have difficulty paying attention in a variety of settings. In children with AD/HD, these behaviors make life more difficult and can interfere with learning.

Generally, symptoms of AD/HD begin before children are seven-years-old and last for six months or longer. However, just because a child shows some signs of AD/HD doesn’t necessarily mean he/she has the condition.

Currently, there are no medical screening tests to diagnose AD/HD. Instead, a diagnosis of AD/HD is based on information from families; school professionals like classroom teachers, the nurse and social worker; and by analyzing a child’s developmental history and results from a series of formal evaluations.

If you think your child might have AD/HD it is important to carefully observe his behavior over a period of time. In families where children spend their time between two households, it is important that both parents pay careful attention to how their child behaves while with them. When observing your child, it can be helpful to write down what you’ve seen. Noting other factors that might be negatively affecting your child’s behavior like a death in the family, a separation or divorce can provide a more complete picture.

Some things to look for:
• How does my child behave during activities like homework, chores, or reading — when she should be paying attention?

• How does my child react when he should be sitting still for a while, such as during family meals? 

• Does my child think before acting? How does she handle dangerous situations like crossing the street or when frustrated? 

• How do my child’s surroundings change or affect behavior? Talk with adults like teachers, scout leaders, coaches who work with your child in structured activities and can report on how your child plays and interacts with other children. Relatives and neighbors that spend time with your child can also provide important feedback. 

• How is my child doing in school? Talk with your child's teacher(s) about how things are going with his schoolwork and his interactions with classmates. Compare your child's behavior when studying a subject he enjoys vs. those he finds less interesting or difficult. 

“It is important for parents to know that a classification of AD/HD is not the end of the world,” says Dr. Barbara Zimmerman. “Just as you would get your child eyeglasses if he had trouble seeing the chalkboard, getting children with AD/HD all the help they need as soon as possible is key.”

Children with AD/HD often have difficulty mastering their behavior on their own. Instead, they need what Zimmerman calls a “toolbelt” of skills such as practice with relaxation and/or extra help learning organizational techniques. In some, but not all cases, doctors may recommend medication to help children be more successful in school, and life.

Although children with AD/HD can be very successful in life, without identification and proper treatment, AD/HD can have serious consequences, including school failure, family stress and disruption, depression, problems with relationships, substance abuse, delinquency, risk for accidental injuries and future job failure. Early identification and treatment are extremely important.
Source: Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD), www.chadd.org. 

If you think that your child might have AD/HD: 
• Make an appointment with your child’s doctor and/or a pediatric neurologist, preferably when both parents are present to talk about their concerns. 
• Enlist the help of school professionals. Talk with your child’s teacher, the school nurse and school social worker about your concerns and how you can work together.


Books and other resources for families on AD/HD 

• Taking Charge of AD/HD by Russell A. Barkley, Ph.D. 

• Driven to distraction: Recognizing and Coping with Attention Deficit Disorder From Childhood Through Adulthood by Edward M. Hallowell

• Making the System Work for Your Child with ADHD by Peter S. Jensen, M.D.

• Understanding Girls With AD/HD by Kathleen G. Nadeau, Ph.D., Ellen B. Littman, Ph.D., and Patricia O. Quinn, M.D.

• Dr. Larry Silver’s Advice to Parents on ADHD by Larry B. Silver, M.D.

• Why Can’t They Just Behave by Barbara F. Zimmerman, Ph.D. Available online at www.lrp.com/store or by calling (800) 341-7874, ext. 275. 

• ADDitude — an online magazine at www.additudemag.com

Helping children with AD/HD be successful with schoolwork
Adapted from the American Academy of Pediatrics and the National Initiative for Children’s Healthcare Quality

If your child has AD/HD, there are some important things you can do at home to help him/her be more successful with schoolwork. For example:

• Review your child’s homework assignments with him each day. Make sure he understands what is expected. Speak clearly and have him repeat instructions back to you.
• Turn off the TV and computer games during homework. Set aside a special spot in your home where your children can complete homework and projects without distractions. Make sure that all supplies they need to complete their work are stored in this location. 
• Provide your child with planned breaks during long assignments. 
• Set a regular time for homework, mealtimes and bedtimes. Write down your child's schedule and post it where the entire family can see it. As much as possible, stick to a consistent schedule for bedtime, homework, chores and other activities. A chaotic schedule can be particularly difficult for children with AD/HD.
• Keep a record of what sets off problem behaviors and then try to eliminate these triggers (e.g. closing the curtains if neighbors playing outside are a distraction during homework time.)