Although many of us may struggle with sitting still, paying attention, or controlling our impulses at some point in our lives, people with AD/HD (Attention-Deficit/Hyperactivity Disorder) struggle with it daily and it can impact their behavior and performance at home, school, work and in the community.

AD/HD is a neurobiological disorder, which basically means that some people brains are “wired” or chemically balanced in a way that causes problems in the areas of attention and hyperactivity. Currently the research indicates three types of AD/HD: the predominantly inattentive type, the predominantly hyperactive-impulsive type, and the combined type. Inattentive behavior can look like the following: an inability to finish tasks, disorganization, a tendency to make careless errors, daydreaming or being in your own world, poor listening skills, forgetfulness or always seeming distracted. Hyperactive-Impulsive behaviors include: fidgeting or squirminess, trouble remaining seated, tending to “run” form place to place, loud or boisterous behavior, excessively talkative, impatient or having trouble taking turns, interrupts, blurts out or is intrusive. As you might guess, in the combined type the individual may have all of the above.

AD/HD affects about 3-5 % of the population. Many kids and adults display a lot of these behaviors, but do not have AD/HD- you might wonder how to tell the difference. Individuals with AD/HD present these symptoms in many, if not all, settings; the symptoms are severe; and they occur with an intensity or duration (at least 6 months) that causes problems for the individual. Many of us would like to have more energy and be more out spoken; however, for the individual with AD/HD these characteristics are extreme and become an ongoing source of difficulty for them. In children if the behaviors are infrequent or do not require constant monitoring and supervision to perform daily tasks it is likely that they are simply typical childhood behaviors.

Parenting children with AD/HD can sometimes be overwhelming because the behavior can be unpredictable and downright challenging. It is important to remember that the setting or task may contribute a lot to the type or intensity of behavior that you’re seeing; in addition, just like anyone else, individuals with AD/HD have “good” and “bad” days which might mistakenly lead people to believe that they can control their behavior and are choosing not to behave. Many times, the individual with AD/HD’s behavior can be misinterpreted by those who aren’t knowledgeable about the disorder. Often the terms lazy and unmotivated are thrown around to describe the individual with AD/HD- because they may have mastered a task or skill, but may not be able to perform it on a consistent basis. The best way to help your AD/HD child is to educate yourself, those around you and your child about the disorder and ways to help the individual with AD/HD be more successful. Keep reading… you’re on your way!

What causes AD/HD?

The most recent research indicates that AD/HD is a neurobiological disorder. It is not the result of poor parenting, something you did wrong, a “bad” home environment, etc. The most recent research clearly indicates that it is attributable to inherited genetic factors that affect the parts of the brain that are responsible for controlling impulses and modulating behavior. It definitely runs in families and in many cases parents struggled with some of the same behaviors they see in their own kids. There is very little evidence to suggest that true AD/HD is related to dietary factors (like artificial coloring or sugar intake) or a poor home environment; however the have not ruled out that these can make the symptoms worse. The recent evidence also suggests that children will not “outgrow” AD/HD although the type and intensity of the symptoms can change over time. If you think you or your child has AD/HD and would like help consult a professional in the field of medicine or psychology to provide an appropriate diagnosis, rule out other disorders that may “look” similar and suggest a method of treatment.

How do you treat AD/HD and why do you need to?

If left untreated, AD/HD can lead to low self-esteem, social and/or academic failure, substance abuse, or in some cases criminal behavior. While no treatment is a “cure” for AD/HD a multimodal approach is recommended and considered in the research to be most effective. Work with your medical or mental health professional to see about which “modes” you need to concentrate on to develop a plan to best meet your child’s needs.

Treatment should begin with knowledge and training. Seek out the most recent and up to date research that you can find on the disorder and be a good consumer. Consider your information source and learn to distinguish accurate and reliable information from rumor or speculation. AD/HD is highly researched and new findings are emerging daily. Educate yourself and others on how AD/HD is impacting your child and family, the neurobiological basis of the disorder, and strategies that might be helpful in working with your child.

Behavioral Interventions strategies can sometimes be helpful to increase positive behaviors and decrease those behaviors that are less pleasant. Behavioral interventions are aimed at changing behavior based on rewards and consequences. They operate on the premise that you are likely to see a behavior more often (increase) if the consequences (what immediately follows the behavior) are pleasant (reward). You are likely to see a behavior less often (decrease) if the consequences that follow are unpleasant (punishment). These rules must be applied consistently to change behavior. AD/HD children often require very frequent rewards and punishments which make this type of system difficult. Often a mental health practitioner can assist you in creating a behavior intervention plan for your child. Other behavioral intervention strategies might incorporate teaching problem solving strategies, communication skills, appropriate self-advocacy skills, and self-monitoring strategies. Sometimes these children and families may benefit from individual or family counseling to help work through strategies and specific problem areas.

In order for your child to be successful in the school environment, certain accommodations and behavioral strategies may be necessary there as well. Good communication with your child’s teacher and creating an alliance with school personnel can help ensure that your child gets the most out of time spent at school. The majority of children with AD/HD can be successful in the regular classroom when some small changes are made. These might include: preferential seating (near the teacher or away from distractions), a “study buddy”, longer time to complete tasks, the use of a timer, short frequent breaks, a signal or cue to stay on task, praise of appropriate behavior, small rewards and incentives, etc. Consult your child’s teacher or the school psychologist for additional strategies. Some children may require special education services if an educational need is apparent. Work with the school to facilitate a plan that meets your child’s needs.

Finally, although talking about this topic can be anxiety provoking to many parents, the research is clear that the majority of children with AD/HD (70-80%) are helped by medication. This shouldn’t be that surprising in light of the fact that AD/HD is a neurobiological disorder -- not a matter of choice, environment or temperament. In fact, in a recent study by the National Institute for Mental Health, children who received medication alone or medication in combination with the above strategies showed significant improvements in their behavior and academic performance as well as more positive relationships with peers. Ultimately, it is a parent’s decision, in conjunction with the doctor, as to whether medication for AD/DH is a viable and/or appropriate treatment for the child. Our goal here is to ensure that as consumers and parents of a child with AD/HD, you are well informed about all of the treatment options.

Medications for AD/HD work by correcting the neuro-biochemical imbalances in those centers of the brain that modulate attention, behavior and impulse control. Specifically, the two neurotransmitters in the brain that control most of the functions that are impaired in AD/HD are norepinephrine and dopamine. Much research has been done on medication uses in the treatment of AD/HD and many prior misconceptions have been dispelled as myths. If appropriately managed by a qualified medical professional, the medications used to treat AD/HD will not directly result in stunting your child’s growth, causing him to become a drug addict, or turning her into a zombie. Research has proven that medications used to treat AD/HD will likely increase children attention span, reduce hyperactivity and reduce impulsivity. For some children, they have been shown to improve frustration tolerance, compliance and even handwriting. It is important to note that medication is not a “cure” for AD/DH. Similar to prescribing glasses for poor eyesight, when removed, the condition remains. A close relationship with your physician can help you determine whether medical management could helpful for your child as well as to monitor whether the medication you are trying is having the desired effect.

What’s the Prognosis?

Because children with AD/HD are “at-risk” for significant difficulties it is important that the disorder not go untreated. The notion that your child will grow out of it is another myth that the research has dispelled. Studies show that with treatment early on, most children with AD/HD have fewer problems and more improved overall functioning than those who do not get treatment for the disorder. Symptoms persist into adulthood for roughly 60-70 % of children diagnosed with AD/HD; however, as adults many people become more adept at using coping strategies to minimize the negative impact of AD/HD symptoms.

Resources

Your Hyperactive Child by Barbara Ingersoll, Ph.D.- Dr. Ingersoll sheds light on symtpomns and behavior of ADHD throughout the span from childhood to adolescence and offers practical suggestions for coping with ADHD children.

Putting on the Brakes: Young People's Guide to Understanding Attention Deficit Hyperactivity Disorder, Revised Edition by Patricia Quinn, M.D. and Judith Stern
Important information about ADHD along with practical suggestions for coping with the problems ADHD presents. For children ages 8-13.

www.chadd.org - Find helpful information and a link to other parents and families affected by AD/HD