Childhood Attention-Deficit/Hyperactivity Disorder

Attention-deficit/hyperactivity disorder (ADHD) is a condition that is commonly diagnosed in childhood. According to the Centers for Disease Control and Prevention (CDC) approximately 9% of children under 18 years of age have ADHD, and approximately 4% of adults have ADHD. Childhood ADHD will be the focus of this article.

What is ADHD?

ADHD is characterized by a set of symptoms with deficits particularly in attention, and/or difficulties with hyperactivity and impulsivity.

Some of the most common symptoms are:

  • Becoming easily distracted
  • Jumping from one activity to another without completion of any activity
  • Easily bored
  • Inability to focus attention on a single task for a sustained period of time
  • Difficulty completing or turning in homework assignments
  • Disorganization
  • Constantly losing or misplacing things
  • Unable to pay attention even when being spoken to directly
  • Daydreaming or mind wandering in the middle of an activity
  • Struggling to follow directions, particularly with multi-step commands
  • Unable to sit still
  • Constantly talking
  • Getting in and out of their seat
  • Bothering other children
  • Blurting out answers before the question has been asked
  • Low frustration tolerance
  • Difficulty waiting or taking turns

How is ADHD diagnosed?

It is most common that the diagnosis is made in childhood. Teachers are often the first to notice difficulties in focus and concentration given the task demands of school. Parents may start noticing difficulties when it comes to homework completion after school, or when assignments and homework isn’t getting turned in which leads to a decrease in academic performance.

There are no lab tests that can diagnose ADHD. However, it is important to meet with a physician to rule out medical conditions that may cause ADHD like symptoms. Children should be evaluated for vision and hearing to be sure they are able to process the information they are trying to learn. It is also important to make sure that the observed behaviors are not the product of a changing environment, stresses in the home, abuse/neglect, trauma, or other psychosocial stressors.

Once physical ailments, and potential psychosocial aspects have been rules out, it is important to also evaluate for other conditions that may explain the behavior. For example, the child may have a learning disability, may be getting poor sleep, may struggle with anxiety or depression, etc.

Treatment

There are both pharmacologic and non-pharmacologic treatments for ADHD.

Non-pharmacologic treatments include behavioral therapy, and additional support/accommodations in schools. Examples of behavioral therapy are finding ways to help the child with organization in the home and at school. Helping parents with providing structure and predictability in the daily routine and how to best manage behavioral outbursts. An example of school accommodations can include sitting at the front of the class, having the ability to stand up and walk around the classroom intermittently, an increased number of bathroom breaks, visual cues to aid with time management and scheduling, longer time to complete exams, etc.

There are many different pharmacologic treatments for ADHD symptoms. Each child is unique, thus details about type of medication that would be appropriate, dosing of such medication, and risks, benefits, side effects, and alternatives should be discussed with a licensed practitioner who is familiar with treating ADHD.

Can my child still be successful if they have a diagnosis of ADHD?

Yes! Absolutely.

Part of successful living with ADHD is teaching your child to work with their environment and capitalize on their strengths. For example, if children are stuffing clothes in whatever dresser drawer they can find space in, and it’s so disorganized they can’t find anything. Try labeled bins instead where they get a visual cue, i.e. “shirts,” and instead of taking the time to fold the shirt and put it away, they can quickly toss it in the correct bin and keep moving.

Helping your child figure out how they can be the most successful is very important. So start helping them figure out their preferences and strengths early. For example, help them to discover if they study better with complete quiet or with music playing in the background. Time management is very difficult for kids with ADHD. Knowing that it will take them longer to do projects, help them get started early so they can do small portions of it every day. If they feel they need to move around during homework, let them get up and walk a little bit, or allow them to grab a glass of water or snack. Sometimes kids need something to keep them occupied so they can better focus. A fidget spinner or fidget cube can be very helpful with this. Kids also need to fuel their bodies. Adequate nutrition, exercise, and good quality sleep are very important.

Sometimes it can be difficult to maintain a close relationship with your child, be a full-time parent, and also constantly keep on top of them to help with their ADHD symptoms. Sometimes children and parents can feel overwhelmed which leads to a less supportive relationship and more tension in the household. If this happens, there are ADHD coaches that specialize in working with children. Having a coach often helps alleviate pressure on parents to come up with interventions and implement them. It also gives the child an advocate that is outside of their immediate family.

Coaches can help kids create individualized strategies to help at school and at home. Coaching helps children develop problem solving skills that help them become more successful in both school, home, and social settings. Coaches also keep kids accountable for their behavior and commitments, which can be helpful if the child doesn’t respond well to parents providing constructive feedback.

Resources

ADHD Parents Medication Guide
www.parentsmedguide.org

CHADD
http://www.chadd.org/
A very helpful national resource for ADHD. There is also a wonderful PDF that talks about how to parent a child with ADHD. The link is as follows: http://www.chadd.org/Portals/0/Content/CHADD/NRC/Factsheets/parenting2015.pdf

Impact ADHD
https://impactadhd.com/
This is a great resource for parents who are looking for tips and strategies to parent kids with ADHD.

Understood
https://www.understood.org/en
There is a special simulation where you can view particular disorders through your child’s eyes. You just click on the child’s grade level, and problem they are struggling with. It simulates what your child experiences to give you a better understanding of what they go through on a daily basis. There is also valuable information on their website.

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