ADHD
Help your child
And ADHD is not caused by poor parenting, family problems, bad teachers or schools, or too much TV. Environment can influence the severity of ADHD and how well the child copes and functions with the condition, but it's not a cause.
Keep in mind that ADHD is a relatively new term and the condition has received a lot of media attention in recent years. Researchers are still trying to decide on the best ways to treat it, and as new studies are publicized, your friends and family may give you an earful about what you should do. The best solution to any confusion and anxiety you feel is to work closely with your child's doctor and therapist, focusing on the solutions that seem most helpful and effective for your child.
What can I do at home to help my child?
The first step is to accept that your child has a behavioral disorder and adjust your expectations of what she's capable of just now. Many kids with ADHD are terrifically bright and creative - your child may well grow up to be an eminent scientist or film director. But you'll need to rethink the way you parent her as well as the type of environment you establish for her. Here's where to begin
- Sign everybody up. If you do get a definitive diagnosis, notify family members (at least those who spend a lot of time with your child), close friends, teachers, and anybody else who can offer support. Some parents of children with ADHD used to keep quiet for fear their child would be stigmatized, but it can be comforting and grounding to be able to give the condition a name. And it's important to build your support network so your child can get all the help she needs in the months and years ahead.
- Change the scene. Eliminate sources of over stimulation and distraction in your child's environment. At home, make sure her room is tidy, stashing extra toys or books where they won't catch her eye. At school, ask the teacher to place your child where she can keep an eye on her or to move her away from kids and objects that tend to divert her attention.
- Structure your day. All children do well with routines, but kids with ADHD need them more than others do. A regular schedule prevents the anxiety and tension of not knowing what's going to happen next. You don't have to be rigid - just make sure your child knows when and where she'll have her meals, snacks, homework time, baths, and so on.
- Reward instead of punish. You've probably already discovered how useless it is to try to punish your child when she's running around or tuning you out. But you may not know how well kids with ADHD respond to simple rewards. Praise good behavior immediately ("You brushed your teeth, just like I asked you to! Thanks so much!"), and give your child some little token that pleases her - a gold star, a funny rubber stamp, or an extra bedtime story. The reward should be something she can enjoy right away, since kids with ADHD don't like to wait.
Getting a tangible show of appreciation will make your child feel good, and she'll be inclined to repeat the behavior that made her feel that way. Over time, the good feeling will start to come from inside and there'll be less need to provide those external rewards.
Challenges
Every parent faces challenging days, but if your child has ADHD, you know that the struggle to keep it together can often be overwhelming. Teachers, doctors, and even other parents may tell you that you're just not trying hard enough to manage your child. Here's the advice we've culled from specialists and other parents on how to feel better about yourself and your child.
Don't blame yourself
It's common for parents of children with ADHD to believe that they're somehow to blame for their child's behavior problems, but that's seldom the case. While good parenting skills can certainly help you manage your child better, experts believe that ADHD is most likely caused by problems with brain chemistry not by anything a parent did or didn't do.
Seek support
You don't have to go this alone. Consider seeing a counselor or joining a support group. It can be comforting to talk to other parents who know what you're going through. "One of the most helpful things for me was finding a counselor who meets with my son and then meets with me and my husband to work on parenting," Your pediatrician should be able to make a referral can also be a big help.
Arm yourself with information
The more you know about ADHD, the easier it will be to understand why your child takes forever to get his pajamas on and constantly forgets his lunch box at school. The more you understand, the better prepared you'll be to deal with situations effectively instead of spinning your wheels. Years of ADHD research, treatment, therapy, and interventions have produced a body of helpful parenting recommendations. Start with our list of resources for more information.
Take care of yourself
Taking time for yourself will allow you to stay centered and be a more patient parent. Make a weekly date for grown-up activities you find relaxing, such as dinner and a movie, a long walk, or a game. Try to give yourself regular breaks rather than waiting until you bottom out and run off screeching. "You need to take care of your needs in order to take care of your children's needs,"
Don't neglect your relationship
Parenting children with ADHD is tough on marriages. Make time to be alone with your partner without the kids. Hectic family life allows precious little quality time for couples, so you need to work to make it happen. "Parents will be amazed at what one hour of free time can do for themTry to talk often and openly about the demands of your situation. Airing childrearing frustrations, concerns, and delights can strengthen bonds between partners, reinforcing a teamwork approach. If you run into a snag that you can't solve alone, try a few sessions with a counselor who specializes in ADHD
Enjoy your child
Parenting a child with ADHD can be so overwhelming it's easy to lose sight of how wonderful your child is. Sure he fumbles, but he also has a unique perspective on the world that you don't want to miss out on. You'll enjoy parenting more if you can take breaks from being the teacher, moderator, organizer, and disciplinarian once in a while and just play with your child on his level. Get goofy. Scribble pictures together, outside the lines. Put the schoolbooks aside and lie on your backs talking about dinosaurs. "Not only does humor help me keep things in perspective, it helps derail episodes of inappropriate behavior. When you feel a bad moment coming on, say something outrageous to your child or have a tickle and roll,". Remind yourself daily of your child's strengths, and remind him, too. It's a win-win formula for feeling better about the day.
Parent training
In addition to teaching you how to use the above techniques, a therapist can help you understand what drives your child's behavior and how to adjust the way you interact with your child accordingly. This advice is aimed not only at shaping your child's behavior, but also at helping him feel good about himself in the process. (While this is often called "parent training," it doesn't mean that your current style of parenting is the cause of your child's problems.)
Maintain routines All children need structure to feel safe and in control; those with ADHD are no exception. They do best when they know what's coming 'round the bend, so stick to a schedule and follow consistent routines each day for things like getting ready for school, having an after-school snack, doing homework, having dinner, and going to bed.
Make expectations and consequences clear and consistent Because a child with ADHD is less capable of managing his own behavior and controlling his impulses, he needs you to clearly establish what is acceptable and what isn't - and to follow through when he oversteps those limits. Reward systems like the ones described above are an excellent way to communicate consistent expectations and consequences.
Stay positive Use positive statements to motivate your child and preserve his self-esteem. For instance, instead of saying, "Stop throwing a tantrum," say "Once you show me you have control over your body, we can talk about what you want
Stay calm ADHD kids are highly tuned in to their parents' nonverbal cues such as body language, tone of voice, and facial expressions. The more stressed out you act, the more your child will mirror your stress. Keeping your own mood in check helps your child feel like he can do the same.
Help your child find ways to excel Some kids with ADHD may feel like they aren't good at anything and can't seem to please anyone. Your role is to encourage your child in areas where he demonstrates a special ability, whether it's in painting, a sport, or storytelling. Assuring a child he's good at something makes him feel valuable.
What is attention deficit hyperactivity disorder?
Attention deficit hyperactivity disorder (ADHD) is a condition that makes it hard for a child to control her activity level and reactions to what's going on around her. A child with ADHD also finds it tough to keep her attention on what she wants to do. ADHD shows up in early childhood and often lasts through adolescence and adulthood.
What are the symptoms?
They can vary depending on the child. Health professionals have identified three main types of ADHD: inattentive ADHD (previously called ADD); hyperactive-impulsive ADHD; and combined ADHD, in which a child has both inattentive and hyperactive symptoms.
In diagnosing ADHD, a doctor will assess whether a child has often behaved in some of the following ways, in more than one setting, for longer than six months. The behavior also has to be negatively affecting the child's life - at home, at school, and in social situations:
Signs of inattention:
- Has a hard time paying close attention to details
- Makes careless mistakes in schoolwork or other activities
- Daydreams, has trouble focusing her attention
- Has difficulty listening to what's being said to her
- Is easily distracted from tasks and play
- Doesn't follow through on obeying instructions and fails to finish schoolwork or chores (but not out of rebellion or failure to understand)
- Forgets things
- Has trouble organizing tasks and other activities
- Loses important things or items needed for tasks and activities, such as toys, school assignments, pencils, books
- Avoids or strongly dislikes tasks (such as homework or games) that require sustained mental effort
Signs of hyperactivity:
- Often fidgets or squirms, seems to be in constant motion
- Leaves her seat in the classroom or in other situations where she's expected to stay put
- Talks too much
- Has trouble playing quietly
- Often runs about or climbs in situations where it's inappropriate
Signs of impulsivity:
- Blurts out answers before the whole question has been asked
- Has trouble waiting her turn or standing in line
- Acts and speaks without thinking
- Runs into the street without looking
- Interrupts or intrudes on others' conversations or games
Of course, all children are occasionally "hyper" or inattentive. That's why experts say it's tricky to diagnose this condition - it's sometimes hard to tell a child with ADHD from one who's simply energetic. But a child with ADHD is more easily distracted and more impulsive than most kids her age, and her activity can border on the frenetic. If you think your child behaves that way a lot - more so than other kids her age - and you can see it's giving her problems, talk to her doctor.
Behavior therapy
The terms "behavior therapy" and "parent training" refer to a set of techniques you can use to motivate your child to modify his behavior. "These techniques can be useful for any child with disciplinary problems" They just happen to be particularly effective for children with ADHD." Whether or not your child is on medication, these techniques can help him manage his symptoms. Some studies show that you may be able to lower your child's medication dosage if behavioral therapy is working well. But it's a full-time commitment and many parents find that the best way to learn how to use these techniques is to work directly with a therapist.
Behavior therapy
Behavior therapy can include any strategies that you use to help your child behave better,. The key is to make sure the goals you set for your child are specific and simple, such as "Get dressed by 8 o'clock in the morning" or "Don't interrupt during dinner." Don't ask your child to work on too many goals at once, and remember that one goal may take several days or longer to achieve. Be very careful if you decide to use any of the "punishment" strategies below; you want your child to remember the rule that was broken, not what the punishment was. Most important of all, remember to be as vigilant in looking for examples of good behavior to reward as you are in noticing your child's transgressions.
Positive reinforcement Entice your child to comply with your requests in exchange for small treats, such as trading cards or stickers, or privileges, such as being allowed to play on the computer. The eventual goal is to get your child to behave without the promise of a reward and to "cement" the behavior so that it becomes routine. This technique works best with younger children who need to see immediate consequences. Be careful not to promise your child too large a prize; luring your child with big-ticket items shifts the focus off the behavior and onto getting the goods. And keep in mind that your praise, love, and affection should never be used as a reward; these are things your child should enjoy on a regular basis, regardless of his behavior.
Reward systems For an older child who's more capable of understanding longer-term goals, you can set up a reward chart where he accumulates points for good behavior that add up to a bigger payoff after a certain time. Place the chart where your child can see it easily such as in his room or on the refrigerator. Use stickers or colored markers to check off when goals are completed and let your child know that for every five gold stars, he gets a prize, like a special dessert or an action figure you know he's had his eye on.
Time-out and time in "Time-out is an effective strategy for ADHD kids if it's used judiciously," It works better if it's used less as a punishment and more as a way to cool down. If your child is becoming frustrated or is about to lose his temper, send him to sit quietly in a boring area for a minute or two with no interaction from you. If you can teach your child to physically remove himself from a stressful situation on his own, his emotions will often follow suit. If your child is able to calm down, give him "time in" by praising his effort and welcome him back into your company. Using "time in" as a reward for good behavior is an important complement to time-out.
Withholding privileges This technique, also known as "response cost," involves taking away privileges when your child is misbehaving. Withholding has to be used carefully to be effective without damaging your child's already fragile self-esteem. "This technique should not be the cornerstone of treatment,". You may want to reserve this technique for one particularly troublesome area or dangerous behavior, such as hitting a sibling or running out into the street. Never withhold your praise or affection as punishment; all children need and deserve to feel loved regardless of their behavior. You also shouldn't withhold activities that are instrumental in managing your child's ADHD: "For example, you don't want to deprive a hyper kid of running around outside if burning off extra energy helps him stay calm,"
Token economy Token economy is a more complicated reward system in which your child earns points (or tokens) when he behaves and loses them when he misbehaves. For example, he may accumulate stars on a chart for accomplishments such as completing his homework and lose stars for breaking rules such as leaving the table during dinner. At the end of the week, he may receive a prize depending on the number of stars he has left. This is a sophisticated technique often used in the classroom with older children. A counselor can help you figure out how to make it work effectively at home.