Attention-deficit/hyperactivity disorder (ADHD) is generally first diagnosed during the primary school years. Symptoms are always present before the age of seven, but sometimes continue into adolescence. ADHD is seen more commonly in boys. Symptoms often become less severe in late teenage and in early adulthood, although it seems that people do not 'outgrow' ADHD, but learn to master strategies to compensate for the symptoms.
ADHD is under-recognised, with less than a half of the affected individuals receiving appropriate diagnoses, and of those who are diagnosed, few receive appropriate treatment. Left untreated, ADHD could have a significant negative impact on the wellbeing of a child and his/her family. A child with ADHD who doesn't receive proper diagnosis and treatment may suffer academically and experience behavioural symptoms into adulthood.
Recognizing ADHD
Taking the First Step
When properly diagnosed, the symptoms of ADHD can be treated and managed. If you are a parent, sibling, or friend, and are concerned that someone you care for may be affected by ADHD, refer to the information below to learn more about how ADHD is diagnosed.
While it is true that people who have ADHD may have special needs, there is a need for the understanding and support from family, friends, and loved ones. Managing ADHD begins with knowing the signs that characterize it.
Recognizing the Symptoms of ADHD
In this section, learn about the symptoms of ADHD as recognized in three basic life-stages:
* Childhood ADHD
* Teenage ADHD
* Adult ADHD
CHILDHOOD ADHD
According to the National Institutes of Health, ADHD is the most commonly diagnosed behavioral disorder of childhood. In fact, ADHD is estimated to affect up to 5% of school-age children. But sometimes it can be hard to know if a child's over-activity or inattention is normal for his or her age, especially because children with ADHD do the same things that other children do. An evaluation by a doctor can help rule out other possible explanations for the symptoms of ADHD, and recommend treatments that can help.
Diagnosing Childhood ADHD
Diagnosing ADHD can be difficult, and requires information from a number of sources, including parents, doctors and teachers. A proper diagnosis depends on the report of characteristic behavior and observations, input from the child, and a doctor's evaluation.
A positive diagnosis of ADHD, especially in children, requires:
* Symptoms of inattention and/or hyperactivity-impulsivity have been observed for at least six months. With ADHD, these symptoms will be more frequent and severe than typically seen in individuals at a comparable level of development.
* Some symptoms have been present before age seven.
* Symptoms have been present in at least two settings - for instance, at school and at home.
The symptoms have affected social or academic functioning. This means above all, the symptoms must be interfering with a child's daily functioning.
Diagnostic Criteria for ADHD
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), lists the following symptoms for inattention and hyperactivity-impulsivity:
Symptoms of Inattention
1. Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
2. Often has difficulty sustaining attention in tasks or play activities.
3. Often does not seem to listen when spoken to directly.
4. Often does not follow through on instructions and fails to complete schoolwork, chores, or duties (not due to oppositional behavior or failure to understand instructions).
5. Often has difficulty organizing tasks and activities.
6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework).
7. Often loses things necessary for tasks or activities (toys, school assignments, pencils, books, or tools).
8. Is often easily distracted by extraneous stimuli
9. Is often forgetful in daily activities.
Symptoms of Hyperactivity/Impulsivity
1. Often fidgets with hands or feet or squirms in seat.
2. Often leaves seat in classroom or in other situations in which the child is expected to remain seated.
3. Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents and adults, may be limited to subjective feelings of restlessness).
4. Often has difficulty playing or engaging in leisure activities quietly.
5. Is often 'on the go' or often acts as if 'driven by a motor.'
6. Often talks excessively.
7. Often blurts out answers before questions have been completed.
8. Often has difficulty awaiting turn.
9. Often interrupts or intrudes on others (butts into conversations or games).
The first step in getting help for ADHD is making a correct diagnosis. After the diagnosis is made, a number of different treatments can offer help for people who have been diagnosed with ADHD.
The information on this page is intended to help you identify behaviors and signs that may be consistent with ADHD. Talk to your doctor or your child's doctor if you recognize any of these symptoms. He or she can guide a proper diagnosis and recommend the right treatment. Print the symptoms checklist to help guide your discussion with your doctor.
Diagnosis Subtypes
While most people with ADHD experience a combination of inattention and hyperactivity-impulsivity, in most
cases, one symptom pattern may stand out. To make the distinction between symptoms, doctors classify ADHD
diagnosis into three subtypes.
Predominantly Hyperactive-Impulsive
A person may be diagnosed 'Predominantly Hyperactive-Impulsive' if he or she has:
* Six (or more) symptoms of hyperactivity-impulsivity.
* Fewer than six signs of inattention, that have lasted at least six months. However, it is important to note that inattention may still be a significant feature.
Predominantly Inattentive
A person may be diagnosed as 'Predominantly Inattentive' if he or she has:
* Six (or more) symptoms of inattention.
* Fewer than six signs of hyperactivity-impulsivity, that have lasted at least six months.
Combined Type
A person may be diagnosed as the 'Combined Type' if he or she has:
* Six (or more) symptoms of hyperactivity-impulsivity.
* Six (or more) signs of inattention, that have lasted at least 6 months.
Most children and adolescents with ADHD are diagnosed as the 'Combined Type.'
Four Signs
Medical help may be needed if inattention or hyperactivity is causing significant problems at home, in school, and with relationships. Talk to your doctor if you have observed these behaviors. He or she can evaluate your child and determine the right course of treatment. In identifying ADHD, doctors often look for four major signs. In their book, The A.D.D. Book, New Understandings, New Approaches to Parenting Your Child, William Sears, M.D., and Lynda Thompson, Ph.D. talk about the four signs as follows:
* Selective Inattention - Instead of maintaining a relatively even attention span, children with ADHD fluctuate between inattention and hyperfocusing - showing extended concentration on things like video games, TV, or something that is of particular interest to them.
* Distractibility - A child quickly jumps from one idea or activity to the next, often without completing the thought or task. The child may also 'daydream' when you are talking to him or her.
* Impulsivity - A child with ADHD often acts without thinking, says things repeatedly, or makes careless errors on schoolwork.
* Hyperactivity - Not everyone who has ADHD is hyperactive, but identifying this trait may make the diagnosis easier.
TEENAGE ADHD
For years, doctors thought that children outgrew ADHD symptoms by the time they reached adolescence. But for many teens, this is not the case. In fact, about 70% of children with ADHD have problems with impulsivity, problem solving, decision making, and inattention throughout their teenage years.
From Child to Teen: The Picture Changes
In an article published in the journal Contemporary Pediatrics, Martin Baren M.D. notes that as children with ADHD reach adolescence, the characteristics of the condition typically change. During adolescence, some symptoms become less noticeable, including hyperactivity, attention span, and impulse control. As a result, many teens who were diagnosed with the Combined Type of ADHD no longer meet the criteria. However, impulsivity is still a major problem for many ADHD teens, and can cause difficulties with school, work, family, and social relationships. Dr. Baren notes that, for ADHD teens, while independence and responsibilities increase, so may driving accidents, low self-esteem, drug and alcohol abuse or encounters with the law. Issues associated with identity, peer-group acceptance, and physical development can be a source of extra stress. In his work with ADHD teens, Dr. Baren has noted that adolescents often deny symptoms and refuse to take medication at school because they do not want to be 'different.' Growing older and becoming more independent can be an exciting adventure for teens. Especially for ADHD teens 16 and older, learning how to set goals and make good decisions will help give them the direction they need to stay on course. But it is important for the ADHD teen to learn that managing symptoms is a key part of developing life skills and handling everyday situations.
Evaluation and Diagnosis
Since ADHD cannot be determined by a simple blood test or physical evaluation, the diagnosis should only be made after symptoms have persisted over an extended period of time, and interfere with a teen's ability to function. At that point, a thorough evaluation by a doctor experienced in ADHD diagnosis and treatment may be necessary. Also, a psycho-educational evaluation can rule out associated learning disabilities and other illnesses and identify areas of strength and weakness.
A Note About ADHD in Teenage Girls
For girls and women, ADHD can be a hidden disorder, ignored or misdiagnosed by the educational and medical communities, which may cause these girls and women to suffer in silence. In view of the serious consequences of ADHD in adolescence and adulthood, there is an urgent need for increased awareness of the prevalence of this disorder in teenagers. Adolescent girls, often are not identified until school underachievement has become chronic. To prevent this from happening, earlier diagnosis and management are essential. Primary care physicians, pediatricians, and psychiatrists all must be able to recognize the symptoms of ADHD. Learn more about ADHD in teenage girls at the National Center for Gender Issues and ADHD and National Women's Health Resource Center Web sites.
Getting Help
According to Dr. Baren, 'Parents often incorrectly interpret restlessness and thoughtless behavior by teens as malicious, fueling negative reactions and increasing conflict. In the case of adolescents with ADHD, parent interaction and response is affected by ADHD symptoms. Parents should be guided toward reasonable expectations and accurate interpretation of their teens' behavior.'
Teenagers who have difficulties in school, with friends, or have ongoing negative thoughts about themselves may benefit from an evaluation. Treatment, including counseling and/or medication, may help address difficulties with concentration and attention span. Counseling can also help address emotional and social issues, including:
* Anxiety
* Depression
* Low self-esteem
* Problems with friends, family, and teachers.
A few things that may point to having ADHD:
1. General untidiness, in school and at home.
2. Consistently late with assignments.
3. Constantly losing things such as homework.
4. Easily distracted with a brief attention span.
5. Regularly running late for school.
6. Everything with a deadline is done at the very last minute.
7. An unusual sense of fairness.
8. Many excuses for things not getting done.
9. People think you are not listening when they are speaking to you.
The Diagnostic and Statistical Manual for Primary Care, Child and Adolescent Version has formulated a behavioral description that differentiates normal developmental variations from behavioral problems and true disorders (ADHD). View the table below.
Understanding Behavioral Differences
The table below differentiates normal developmental variations and presentations
in teens from behavioral problems and true disorders. Excessive activity and
impulsivity are detected only by observations of the child in multiple
settings over time. The attention span of children normally increases
with age, so that inattention must be evaluated in the context of the child's
age and developmental stage.
Is it normal behavior, problem behavior, or ADHD?
Hyperactivity / Impulsivity in adolescence
Developmental Variations
During school years and adolescence, activity may be high in play situations and impulsive behaviors may normally occur, especially in peer pressure situations. High levels of hyperactive/impulsive behavior do not indicate a problem or disorder if the behavior does not impair function.
Behavior Problems
Hyperactive and impulsive behaviors are more intense and annoy others or cause difficulties in and out of the classroom.
ADHD
Restless, motoric, and impulsive behavior is seen during most activities; the adolescent shows problems in social situations
Adolescent gets into trouble frequently. Hyperactive symptons decrease or are replaced with a sense of restlessness.
Inattention in adolescence
Developmental Variations
Adolescent is easily distracted from tasks that are not interesting or require close attention. At times, misses instructions and explanations.
Inattention Problems
Some difficulties are seen with following instructions, completing tasks, completing games with other children or grownups.
Does not pickup subtle social cues from others.
Some difficulties with academic and social events begin to surface
ADHD
Adolescent has symptoms of inattention and distractibility that significantly impair social and academic performance
Adapted from American Academy of Pediatrics: The Classification of Child and Adolescent Mental Diagnosis in Primary Care, Elk Grove Village, IL, 1996
ADULT ADHD
Adults with ADHD often experience problems with educational achievement, employment, and interpersonal relationships; but a comprehensive treatment plan can provide the help they may need.
Why Identify ADHD in Adults?
According to the organization Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD), growing up with undiagnosed ADHD may cause devastating effects in adulthood. For some, the recognition of ADHD and the understanding that follows an evaluation can be a source of healing, put difficulties in perspective, and offer a better understanding of the reasons for a variety of lifelong symptoms.
Adults with ADHD often have negative perceptions of themselves as 'lazy,' 'stupid,' or even 'crazy.' Proper diagnosis and effective treatment can help improve self-esteem, work performance and skills, educational attainment and interpersonal relationships. Many adults with ADHD are protected under the Americans with Disabilities Act of 1990, which prohibits discrimination in employment and public accommodations against any individual who has a physical or mental impairment that substantially limits one or more major life activities.
A Proper Diagnosis
Because ADHD can significantly impact functioning at home and work, the first step is a proper diagnosis. A positive diagnosis may help explain many issues, actions and responses. It can also open the door to getting the right treatment. Points to consider that will help ensure a correct diagnosis, include:
* Past and present ADHD symptoms
* Symptoms of 'co-existing' disorders, such as depression, bipolar disorder, substance abuse disorders, or learning disabilities.
* School, work, and social experiences.
* Information from family, friends, significant others, and employers.
After Diagnosis, What Then?
Though there is currently no cure for ADHD, many treatments can help manage ADHD symptoms. Well-controlled research comparing different types of treatment has found that the greatest improvement in the symptoms of ADHD results from treatment with stimulant medication combined with counseling.
However, just as there is no single test to diagnose ADHD, no single treatment approach is right for everyone. A treatment plan should be tailored to the individual. Adults with ADHD may benefit from help with behavioral, social, academic, job-related, or relationship concerns. They may also benefit from job counseling, time management and organizational assistance, coaching, academic or workplace accommodations, and behavior management strategies.
A treatment plan that combines medication, education, behavioral and psychosocial treatments is thought to be the most effective approach. Although the research on psychosocial treatment of adult ADHD is limited, several studies suggest counseling focused on support and education can be an effective long-term treatment.
Medication
One of the most effective tools to reduce ADHD symptoms is medication when used as part of a comprehensive treatment plan.
How do ADHD medications work?
What symptoms do medications affect?
How often do I take medications?
Is it important to take 'medication holidays' on weekends and summers, or should the medication be taken every day?
How can I tell if the medication is working?
Will taking stimulants lead to drug addiction?
How safe are ADHD medications?
What are the most common side effects of stimulant medications?
Are there other treatments necessary?
How do ADHD medications work?
It is believed that ADHD results when a person has lower levels of certain chemical transmitters in the brain that regulate motor control, attention, organization, planning ahead, and decision making. These transmitters can be increased with ADHD medications, resulting in many behavioral and academic improvements.
What symptoms do medications affect?
Although there is no cure for ADHD, stimulants tend to increase attention span, decrease distractibility, and improve focus. They make it easier to stop and think about the consequence of a behavior. Medications won't teach someone a new behavior; however, they will allow a person to focus on new skills they are learning.
Research shows that stimulants improve mother-child interactions, classroom attention, and school and work performance.
How often do I take medications?
Original stimulant medications
Because traditional stimulant medications address symptoms quickly but are only effective for three or four hours, treatment has typically involved taking medications up to three times a day to maintain improvement.
Newer stimulant medications
Taking medications several times a day can result in 'highs and lows' of the medication level in the blood stream. In addition, taking medication in the middle of the day can lead to embarrassment, and thus failure to take medications during school or work.
New medications that only need to be taken once a day are available. Some of these medications last through the school/work day while others offer longer effectiveness, through 12 hours, to cover evening activities such as homework. This eliminates the need for potentially embarrassing trips to the school nurse or having to stop work to take medications.
Additionally, some medications are designed specifically to have a smooth consistent release throughout the day, thus minimizing peaks and valleys often experienced with other medications.
Is it important to take 'medication holidays' on weekends and summers, or should the medication be taken every day?
Because, in most cases, ADHD affects a person's ability to function, pay attention, and interact with others each day including weekends and holidays, medication should be taken every day as prescribed.
How can I tell if the medication is working?
Stimulants should improve your ability to focus, attend to tasks, and improve disruptive and hyperactive behaviors. Pay attention to the effect of medications on these symptoms and report your findings to your physician. Also, talk to your physician about side effects and other medications you are taking. Your physician will use this information, along with a rating scale or reports from others, to adjust medication for your specific symptoms.
Will taking stimulants lead to drug addiction?
Those with ADHD who are properly diagnosed and treated with stimulant medications by adolescence have significantly less chance of substance abuse in later years than those with undiagnosed or under-treated ADHD. Recent research indicates that children treated for ADHD show no higher rates of substance abuse in adulthood than the general population. In contrast, adults with ADHD who are untreated in childhood show higher-than-normal rates of substance abuse.
Ground rules for stimulant medication use:
1. Because stimulants are regulated medications, prescriptions can only be filled for a limited quantity without being rewritten by the physician.
2. Access to stimulants should be protected, and medication should be kept in a safe place.
3. Small children must be supervised when taking pills.
4. Older children/teens should be warned about the dangers of over-medication or sharing medications with others.
5. Medications should be kept in the original bottle that carries the name of the medication, patient's name, and dose.
How safe are ADHD medications?
Treatment of ADHD with stimulant medications, such as OROS methylphenidate HCI, methylphenate, and dextroamphetamine sulface, is supported by hundreds of research studies over 30 years, proving its safety and effectiveness. Amphetamine salts have not been studied for as long as other stimulants, but research documents their effectiveness.
What are the most common side effects of stimulant medications?
For most stimulant medications, the common side effects can include:
*Loss of appetite which may be improved by taking medications with a meal and eating high-calorie nutritious snacks after school or work and before bedtime.
*Sleeping problems which can be improved by informing your physician so that your medication treatment plan can be adjusted.
Other side effects can include: headaches and stomachaches, which typically decrease over time; blood pressure problems in those with a history of hypertension; and nervousness or jitteriness in adults overly sensitive to the medication, or who consume excessive caffeine, or have anxiety.
The incidence of side effects can vary widely among the different ADHD medications. Be sure to discuss the potential for side effects of different ADHD medications with your physician.
Are there other treatments necessary?
Usually, medication alone is not enough. Drugs don't provide a cure for ADHD, they only temporarily control the symptoms. Although they help improve childrens' ability to pay attention, they can't increase knowledge or improve academic skills.
Drugs alone can't improve a child's self-esteem or help the him/her cope with problems. Other kinds of treatment and support are needed. Many experts believe that the greatest, long-lasting improvements are achieved when medication is combined with behavioural therapy, emotional counseling, and practical support. This may involve teacher training, parent training, family therapy, or individual counseling.
For treatment to be most effective, it is essential that all aspects of the child's life should be considered. ADHD affects life at school, in the classroom, within the family, with friends and acquaintances but also affects the child's inner-life and self-esteem. This can lead to a loss in confidence and development of negative ideas about himself, based on past frustrations, struggles or failures.
Myths and facts
Myth: 'ADHD is just a diagnosis used by American doctors for difficult children.'
Fact: ADHD has been a recognized disorder for over 50 years. However, because physicians now more easily identify and understand the disorder, ADHD diagnoses are more prevalent than in the past. In the United States, ADHD is diagnosed in 3-5% of the population.
Myth:: 'My shy, daydreaming daughter can't have ADHD! I thought it only involved hyperactive little boys.'
Fact: ADHD affects both males and females. Boys are diagnosed with the disorder 2-3 times more than girls. Girls may have less impulsive or hyperactive behaviors.
Myth: It's probably all that junk food my child eats or some other environmental problem that causes ADHD.'
Fact: Special diets and limiting food additives will not prevent ADHD. However, paying attention to overall general health, including exercise, rest, and nutrition, can help your child manage their ADHD symptoms
Myth: 'If parents would discipline their kids like in the old days, kids wouldn't have these behaviors.'
Fact: Research has shown that parenting and discipline styles do not cause ADHD. However, just like diabetes and other disorders, parental involvement in treatment (behavioral management strategies and/or medications) can help manage ADHD symptoms.
Myth: 'She can't have ADHD! After all, she has no trouble focusing on things she wants to do, like playing computer games.'
Fact: People who can concentrate some of the time may still have ADHD. People with ADHD have difficulty attending to most tasks for periods of time, but they (like many people) can concentrate on things that interest them and are stimulating, such as computer games.
Myth: 'Since people with ADHD aren't as smart as their peers, they usually get put in special classes.'
Fact: ADHD does not affect intellectual ability. Individuals with ADHD are just as smart as others; however, many children with ADHD may not function as well academically as those without ADHD. Many of those with ADHD also have learning disabilities, which are addressed with specific targeted techniques. Most children with ADHD can succeed in regular classrooms with the help of parents and teachers who use techniques, such as positive reinforcement, organizational and study skills, and stimulating instructional aides.
Myth: 'It's simple; once you start taking the medications, you'll be fine.'
Fact: While no treatment today cures ADHD, treatment programs which include medication and/or behavioral modification techniques help manage symptoms. For about 70 percent of those with ADHD, several decades of research tells us that stimulant medications improve many of the symptoms of ADHD. Stimulant medications do not 'slow the brain down', rather they stimulate parts of the brain that help increase focus and one's ability to control their own behavior. Other effective treatments that may be combined with medication, or used independently, include behavioral management techniques and classroom interventions.
Myth: 'It's just a phase, he'll grow out of this.'
Fact: Children with ADHD may or may not 'grow out of it.' About 70 percent of children with the disorder will continue to have ADHD symptoms into adolescence, and some will experience symptoms that affect functioning into adulthood. For youth growing up, hyperactive symptoms appear to decrease. However, attention problems often persist into adulthood. Adults with ADHD typically find that their symptoms diminish gradually as they get older or are less bothersome as they learn successful coping strategies.
Myth: 'I can't have ADHD; I'm not hyperactive.'
Fact: Hyperactivity is a symptom that only some ADHD sufferers experience. There are three types of ADHD.
ADHD Tips
Small changes can greatly affect how well you are able to handle the challenges associated with ADHD. This section features tips and information designed to highlight specific aspects of ADHD, as well as to help improve interactions between people with ADHD and those who live, work, and play with them.
SYMPTOMS of ADHD
Establishing a diagnosis of ADHD is complex and requires information obtained from multiple sources, such as parents, physicians, and teachers. The diagnosis is dependent on the report of characteristic behaviors observed by parents and teachers (for a period of at least six months) and includes input from the child in addition to the physician's examination of the child. Download and print this helpful checklist to note symptoms you or your family member experience. Then, share the results with your doctor.
Note: This information is not intended to substitute for a clinical and psychological evaluation by qualified medical professionals with experience in the diagnosis and/or treatment of ADHD.
Information for Teachers
The information below is part of the Teacher Notes series created through the Sid Richardson Fellow School - University Collaborative Project, Texas A&M University-Corpus Christi and the Corpus Christi Independent School District.
Because ADHD behavior is considered unacceptable in 'main stream society,' many children have extremely low self-esteem and limited social skills. Helping these children gain a sense of esteem and pride in their accomplishments depends on a team approach to structure in the school and home environments. The team should include the student, parents, teacher(s), school nurse, and child's healthcare provider.
Establish an Environment for Learning
1. Seat students with ADHD near your desk, but part of regular class seating.
2. Seat students at the front of a row.
3. Surround them with good role models.
4. Encourage peer tutoring and cooperative/collaborative learning.
5. Avoid distracting stimuli such as windows, air conditioners, radiators or any other distraction.
6. Change is difficult, so avoid transitions, physical relocation, changes in schedule, and disruptions.
7. Create a stimuli-reduced study area for students.
8. Encourage parents to create a similar study space at home, with set times and routines established for study, parental review of completed homework, and periodic notebook and/or book bag organization.
Give Instructions with Care
1. Maintain eye contact during verbal instruction.
* Make directions clear, concise and consistent with daily instructions.
2. Simplify complex directions.
* Make sure students truly understand instructions before starting an assignment.
* Repeat instructions calmly and positively, when needed.
3. Encourage students with ADHD to ask for help.
* Gradually reduce assistance over time, but remember children with ADHD need more help for a longer period of time than others.
4. Require a daily assignment notebook, and:
* Make sure the student correctly writes down all assignments each day (help if necessary).
* Sign the notebook daily to signify completion of homework assignments. (Parents should sign too).
* Use the notebook for daily communication with parents.
Giving Assignments
1. Give out only one task at a time.
2. Monitor frequently and be supportive.
3. Determine specific strengths and weaknesses of each student.
4. Modify assignments as needed based on an individualized education program and consultation with special education personnel.
5. Make sure you test knowledge, not attention span.
6. Give extra time for certain tasks. Do not penalize students with ADHD who may work slowly and need more time
7. Remember children with ADHD are easily frustrated. Stress, pressure, and fatigue can lead to poor behavior.
Enhancing Self-Esteem and Modifying Behavior
1. Provide supervision and discipline calmly.
2. State an infraction without debate or argument.
3. Pre-establish consequences for misbehavior.
4. Administer consequences immediately
5. Monitor proper behavior frequently.
6. Enforce classroom rules consistently.
7. Keep medication reminders private.
8. Provide encouragement.
9. Reward more than you criticize.
10. Praise immediately all good behavior and performance.
11. Change ineffective or non-motivating behavior.
12. Find ways to encourage the child.
Helpful Tips for Parents
The way you talk to, and with, your child has a direct impact on the way your child talks to you and his or her behavior. The more you can improve the relationship and the communication between the both of you, the more you help the child with ADHD to mature into a healthy, responsible adult.
Typically, parents and children interact naturally and without much thinking about it. This kind of communication has its positive and negative sides. On the one hand, when relationships are calm, close and respectful, feelings are considered and conversations flow easily. But when conflict, resistance, and disobedience strain relations, it is easy for the relationships between parent and child to break down. One of the best ways to break out of a cycle of negative interaction is to change the way you and your child talk to each other.
Keep Emotions in Check.
When situations are tense, negative emotions - anger, fear, defensiveness - can often undermine what you, your children, or your spouse really want to say to each other. The feelings show up in your tone of voice, your posture, your actions, and the words that come out of your mouth.
That is why, before you do anything else, take a second to say to 'Stop! What is really happening here?' Then:
1. Look at your child.
2. Notice your child's body language, facial expressions, tone of voice, rate of speech, and choice of words.
3. Pay attention to their emotions and your emotions.
4. See what is 'really going on'.
Now you are ready to communicate your real feelings. And you can do it in a calm, non-threatening, and positive way.
Change the way you speak.
No one likes to be yelled at. The sound of your voice has a direct impact on the response you can expect. For children with ADHD:
1. Lower your tone and pitch.
2. Speak slower.
3. Be sure to look directly into their eyes.
4. Use as few words as possible.
5. Keep your message short and to the point.
Check Change the word 'no'.
Many children with ADHD hear the word 'no' so often, it does not even register until it has been said over and over again. There are many alternatives; it just takes a bit of thought and practice. For example:
1. Give another option ('Use crayons on paper only, please.')
2. Provide information ('That will break if you do that.')
3. Give encouragement ('You are getting closer to the answer.')
4. Say 'Stop!'
5. Anticipate before no or stop ('We cannot climb trees here.')
Turn Blame Into Communication.
Blame lets you get out anger or resentment, but it doesn't help make things change for the better. Blame messages typically begin with the word 'you', followed immediately by words like 'always' or 'never'. The result is most often defensiveness or blaming in return. As an alternative to blame, use 'I' messages. 'I' is nonjudgmental, and 'I' shows confidence and respect. For example:
Create sentences with 'I feel ..... when I ........'
Adapt Listening Habits...
Listening is as crucial to good parent-child communication as what you say. Listening and paying attention to what a child says, gives both parties a feeling of respect, and demonstrates the value of courtesy. Here a few good listening habits:
1. Try to find the positive in what is being said.
2. Try to truly understand the other person's point of view.
3. Respond with positive, non-judging 'I' statements.
4. Watch out for 'you' statements disguised as 'I' ones (e.g., 'I think you are missing the point').
5. Say back in your words what you think the person is saying.
Work Together.
The key to mutual success is making sure that both parties win something. Put your child's momentum and energy to work for you, not against you. Solving problems are easier when:
2. You ask questions that help your child get a better perspective and consider things they may not have thought about.
3. You point out that even if you disagree, you've talked it out.
4. You keep things open for discussion.
5. You continue the process by doing agreed upon items.
6. When discussions are over and some issues are unresolved, clarify why specific things are unacceptable.
Note: For teens, asking questions that lead to your direction, rather than giving orders, motivates them to reflect on the situation, or invites deeper discussion.
Have Fun!
The more you and your child can have positive interactions the better. Play together, share interests and hobbies, just hang out and talk when there is no agenda other than just enjoying each other's company.
Helpful Tips for Teens with ADHD
Judie Gade, author and ADHD Coach and Counselor, in her adhdezine.com article, ADD/ADHD in Teenagers... It Is Okay To Be DiFfErEnT! says, 'Imagine how it would feel if no-one seemed to understand HOW you were thinking (i.e., your parents and teachers are saying 'you CAN do better', the kids at school pick on you for absolutely no reason other than that you are YOU!).' On top of this, you can't concentrate on your school work, it takes you 10 times to read the one page before it sinks in, you do stupid things that you regret immediately after, and you are going through the puberty blues to boot?' If this sounds like you, then you're not alone. Welcome to the mind of an ADD/ADHD teenager!
Because time is a different concept to you, it is important that you:
1. Use constant reminders and coping tools like diaries and watches with alarms.
2. Find support from a friend or classmate who can help keep you on track.
3. Find understanding friends, teachers, and other adults who can help you.
4. Limit your time when playing computer games and stick to your time limit.
When your work shows immense promise or brilliance, but you are about to go back to acting inappropriately, then you:
1. Need help from a friend or teacher to help you realize it.
2. Need a fun code word, like 'chocolate,' 'Digimons,' 'Homer,' or anything that grabs your attention and reminds you that you're drifting.
You often see solutions to problems in a totally unique manner, and you should be encouraged and praised regularly for that.
To focus your attention, and minimize distractions:
1. Sit away from windows, radiators and other attention-getters.
2. Sit near the chalkboard and in front of other students.
Make the most of working one-on-one, by finding:
1. Student partners who seem to be doing well in a class or lab
2. Help from parents and teachers
Help your teachers to better understand you and your ADHD, by talking about how:
1. Moving sometimes helps you pay attention more easily.
2. You respond better to kind words and gentleness than yelling and anger.
3. Yelling can cause you to space out and you cannot help it. Stress can cause you to space out even more.
4. Making you laugh will make you a keen listener and a loyal student, even if a trying one!
When you feel like an outsider, turn potentially negative things into positive actions, when you:
1. 'Get addicted' to participating in sports, reading, hobbies, crafts,
or other interests you can do well in. 2. Avoid compensating for social
challenges by being promiscuous, acting the 'class clown,' taking risks,
or using illegal drugs and alcohol.
A WARNING
Canadian regulators have suspended sales of Adderall XR, a popular drug for the treatment of attention-deficit disorder or ADHD drug. Health Canada removed the drug from the market after reports of 20 sudden deaths.
Adderall, is used by approximately 700,000 Americans and is one of the most popular drugs for people with the widely-diagnosed condition known as attention deficit hyperactivity disorder. Shire Pharmaceuticals Group PLC sold $759 million of Adderall XR in the U.S. last year and roughly $10 million in Canada.
In a one-page letter to the company, the Canadian regulatory agency, Health Canada, said the "identified risk of sudden death following the recommended doses cannot be managed by label changes." The company said there have been 20 reports of sudden deaths on Adderall's extended release and a prior formulation of the medicine since 1994, when the drug first came on the market.
In a news release, Health Canada said "the incidence of serious adverse reactions leading to death was higher in" the extended release and earlier formulations of Adderall, when added together, than in other drugs in the same class. Here, the Canadian agency's conclusion appears to differ from that of the FDA. Of the 20 deaths reported in patients taking Adderall, 12 were from strokes, two in children, Health Canada said.
A recent study
A large number of children with clinical symptoms of ADHD have developmental disorders that
include learning disabilities, anxiety or mood disorder and language and communicationdisorders.
There is evidence that a deficiency in long chain polyunsaturated fatty acids (LCPs) LCPsresult
in poor development of the brain and neural function and the retina that is important forvisual function.
To substantiate this theory, Dr. E. Mitchell compared 48 hyperactive children with49 non-hyperactive
children of the same age and sex.They found all 48 of these children have significantly lower levels of the LCPs,
doco-sahexaenoic acid (DHA), dihomogammalin-olenic acid (DGLA), and arachidonic acid (AA) intheir
blood cell membranes. This fact was further verified by Purdue University that also noted that
the ADHD children were less likely to be breastfed and more likely to suffer from asthma or other
health problems.
A trial was conducted in 41 children to determine whether LCPs supplementation
could improve behaviour in a special school for children with educational problems.
The supplementused was Efalex, a patented blend of DHA-rich fish oil, evening primrose oil,
arachidonic acid,vitamin E and thyme oil. The children were randomly allocated to one of two groups.
The first group was given asupplement that looks like Efalex but with no actives (placebo) and
the other group on Efalex forthree months.The group on placebo was then crossed over to Efalex supplement
and those on Efalexcontinued with it for a further three months. At the start of the trial
(baseline), three months andsix months the Conners Parent rating scales were used to assess behaviour and
learningproblems.
There were no differences between the groups before treatment but after
three months, theEfalex group scored significantly lower on general behaviour problems, with
improvement in theanxious/shy and cognitive problems subscale. The placebo group showed no
improvements inthe first three months and some even showed deterioration. However,
when these children were crossed over to Efalex, significant improvements were seen in nine
subscales including anxious/shy, hyperactivity and the overall Conners Global scale.
The Efalex group which continued supplementation maintained its improvement or madefurther gains.
Supplementation with Efalex has shown to reduce the clinical signs of LCPsdeficiencies, allergic
tendencies especially eczema, poor visual symptoms, attention problems,mood swings,
undue anxiety and sleep problems.
There are several natural products on the market which make hard to believe claims.
I have no knowledge of these so can't recommend any of them.
If you have had success with natural alternatives, please
send an email to Dr. Jon
Attention Deficit Disorder Association, ADDA, provides information, resources and networking opportunities to help adults with Attention Deficit/Hyperactivity Disorder (AD/HD) lead better lives. We provide hope, empowerment and connections worldwide by bringing together science and the human experience for both adults with AD/HD and professionals who serve them. Learn more About ADDA
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