Understanding and Parenting your ADD/ADHD Child
Although there is some controversy regarding the diagnosis of Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) as a psychiatric disorder, most children who are'diagnosed' with either share similar features.
Features of ADD/ADHD
What I am going to do is to briefly discuss those features and their possible causes - and explore various methods of helping your child (and yourself!) to avoid pitfalls and to allow potential to be maximized.General characteristics of children with ADHD
So first - what are the features that many ADHD children share? Here I am going to speak more about my observations of ADHD, rather than what the textbooks say.
Every parent will identify with this! Over the years, I have seen many children with ADHD type problems in my practice and, quite frankly, the parents and the children have often taught me more than the textbooks have! Obviously, not all children show exactly the same symptoms and these may or may not apply to your child.The textbooks distinguish between ADD (Attention Deficit Disorder) and ADHD (Attention Deficit Hyperactivity Disorder). So one of the most common features of children with ADHD is therefore hyperactivity.
They don't stop! They may have difficulty sitting still in class (or anywhere!) and even struggle to lie still for long enough to fall asleep at night.They also struggle to pay attention. This is usually due to a combination of two things - short attention span and high levels of distractibility.
Most of us have the ability to focus on something we are doing and to effectively 'shut out' sounds and other stimuli that are not important to the task at hand. ADD/ADHD children will try to focus, but are unable to minimize other distractions like traffic outside, dogs barking, a bird cheeping, etc. They also become distracted by their own thoughts! The only thing some children are able to focus on is TV or perhaps a computer game, due to the hypnotic nature of these activities.
Other features are difficulty in planning activities (always intending to do something but never managing to get round to it or complete it), losing or misplacing possessions, forgetting things, impulsiveness, recklessness and invading the personal space of other children and even adults. Because they are often in trouble, ADHD children may also develop poor self-esteem and can also become angry and frustrated very easily.
They often appear to be immature for their ages and may learn to lie and deceive to try and avoid trouble.Sometimes there are associated learning problems like poor handwriting, reading and calculation problems and difficulty distinguishing left from right.
Evaluation & Treatment
While most children will experience some of these symptoms at times, in the ADHD child they may be frequent and severe.
Have your child diagnosed
The first thing to do if you suspect or are told that your child has ADHD is to have him assessed. Many well-meaning doctors simply prescribe very strong drugs like Ritalin without having the child assessed by a psychologist to determine what the problem really is.
Some causes of ADHD type symptoms are food intolerance, hypoglycemia (low blood sugar), allergies, low muscle tone, perceptual difficulties, nutritional problems, candida, hyperthyroidism, Tourettes Disorder, brain dysfunction, family and emotional problems, poor discipline, depressionand other conditions.
Each of these problems would require different treatment and some may even be exacerbated by Ritalin.
So assess before prescribing is the golden rule! If your child has already been assessed and diagnosed and is taking prescription medication, be aware that there ARE alternatives!
Now that we have covered some of the features and possible causes of ADHD type symptoms, let's have a look athow to manage your child in ways that will be kind, firm and effective.
What You Can Do
If you are very consistent with some of these suggestions and interventions, you may even find that your child's 'symptoms' disappear or become much less severe (as I see in almost 90% of the children that I treat if parents are committed to the process!)
Examine your child’s diet
The first thing to look at is your child's diet. While some professionals dismiss this as nonsense, I have see some spectacular changes in children once certain foods have been removed from their diets.
Not all children respond, but there are definitely some children who do - and quite dramatically!
Things to avoid are soda pops (especially cola drinks), anything with caffeine (again cola drinks, coffee, Ceylon tea and chocolate), food with high sugar content as well as anything containing tartrazine (an artificial food coloring) or artificial preservatives.
One must make allowances for the occasional treat and freedom to enjoy a birthday party for example, but educate your child and be firm about what he may and may not eat, especially on school days.
Limit distractions
Secondly, limit the hours spent watching television and playing computer games (Here the family will have to be disciplined as well) I advise no television on school nights and perhaps two hours in total during the weekend. No television before school.
Television and computer games in excess affect th child's ability to concentrate at school and can also cause reading problems in sensitive children.
Maintain routine and consistency.
Thirdly, maintain as much routine and consistency in your child's life as possible. ADHD children respond very well to routine and ritual as it helps them to use their limited concentration abilities on other things and also helps them to feel safer. If your child is little, have a definite bedtime and stick to it.
Have a routine at night (dinner, shower, story, lights out) and keep it the same every night. Try to avoid major or frequent changes if possible. Ensure that family relationships are stable. All children need this, but ADHD children find conflict and chaos in the family even more difficult to handle and often show this by becoming out of control and disobedient.
Be very consistent in your discipline. If you are a two-parent family, try and follow through and keep all rules the same and do not allow inconsistency. What applies to today must apply to tomorrow. Don't be tempted to allow your child to 'get away' with something because YOU are tired, for example!
While on the subject of discipline, try not to use physical punishment like hitting your child and try hard not to shout and yell. Rather work out a system of 'points' or rewards along with a system of 'consequences' and apply it very firmly. It is very easy to become frustrated with ADHD children and they are often punished and yelled at.
Teachers and parents tend to say hurtful things like 'YOU NEVER listen!' or 'What's WRONG with you?!' and all of these things become part of the child's self concept, causing further behavioral and emotional problems.
Communicate with your child
Younger children may have to be taught social skills more carefully than the average child.
Most children learn about social cues and messages almost automatically. Children who are impulsive or have difficulty paying attention often misinterpret social cues. They may snatch toys, push in front of other children or interfere with their games. They may be labeled selfish or called bullies.Try and be patient and explain to them what is the right thing to do, rather than yelling at them.
Say "Johnny was mad at you because he was busy with a puzzle and then you tried to do it for him. Try and find one to do by yourself" or "People sometimes feel uncomfortable if we stand very close to them.
Additional Tips
We each have our own space that we like to keep. Pretend that you have a hula hoop around you and don't get closer than the hula hoop space!" This may seem simple, but think about it carefully! GET YOUR CHILD'S ATTENTION BEFORE YOU GIVE AN INSTRUCTION! Do not communicate with your child from one room to another, for example. Some children may cope with this, but it is difficult for ADHD children to focus on what you are saying.
Call your child. Stand in front of her. Look in her eyes and say her name -say "Jane, look at Mom. I want you to go and take a shower, OK?" Keep eye contact all the way through the instruction.
Make sure your child replies to you and says "Yes, Mom" before she runs off. If she fails to carry out the instruction, call her back and get eye contact again. Kindly but firmly say "What did I just ask you to do?" Repeat your instruction if necessary.
Tell your child WHEN you want something done. If you say "I want you to take a shower" or "Go and do your chores" your child will readily agree - and then not do anything! You must always try to give some warning to get your child used to the idea first -
"In five minutes it will be time for your shower, OK" (Remember to do this with eye contact) Then when the time comes, say "I want you to take your shower now."
Give ONE instruction at a time!
Most parents are guilty of not doing this at the best of times! If your child struggles to pay attention and remember things it makes sense to say one thing at a time.
So don't say "I want you go to your room, get undressed, put your clothes in the laundry, take a shower and then do your homework. Oh - and don't forget to feed the dog!" The chances are good that your child will follow the first instruction ("Go to your room") and then get lost in some other activity!
Help an older child to learn to use check lists and other prompts to assist his memory. (e.g. "Before leaving school, I must have three things - school bag, lunch box and sweaters."
"When I get home, I must check off my chores on the list I have pinned up in my room") Devise a reward system should the lists work for a whole week.
Speak often to your child's teachers.
Tell them what works for you and hear what works for them. Communicate with the teachers on a regular basis so that you know what is happening in your child's life outside the home and don't only find things out when they are too far advanced.
While on the subject of school, ADHD children tend to function better in smaller classes (less distraction) with teachers who are kind, consistent, patient, bu tvery firm and who communicate clearly!
It is usually better for them to sit in front of the class and in a place which has the least distractions.
Play games that promote concentration listening skills and memory A good one is the alphabet game. It can be played by two or more people.
The first person thinks of an animal name that begins with 'A'. (e.g. Antelope).
The next person repeats this and adds one with 'B', (e.g. bear). So she says 'Antelope, Bear'.
The next person then thinks of an animal beginning with the letter 'C' (e.g. Cow) and says 'Antelope, Bear, Cow'.
Continue until the whole alphabet is used up. It can be quite fun and is excellent for promoting listening skills, memoryand concentration.
You can also play the Shopping List game.
Again using the alphabet, each person thinks of an item of shopping beginning with the relevant letter and says "I went to the store and bought some........." Turn by turn the list is repeated and a new item added on each time.
The last round would look something like this "I went to the store and bought some apples, butter, cabbage, donuts, eggs, fish, grapes, ham, ice pops, jelly, kleenex, lettuce, mayo, nectarines, onions, plums, quinces, rice, sausage, tomatoes, umbrellas, vitamins, water, xerox paper, yams and zucchini!
For visual memory and concentration, ask your children to cut out pictures of five or more items and paste them on a page.
Each child gets a turn to show her picture to the group for 10 seconds and then turn it face down. Every child then writes down the items that he can remember.
See who can remember all the items! The older the children, the more items should be used.
Games like 'Simon Says' and 'Statues' are familiar to all of us from our childhood and also help to promote listening skills.
There are many inexpensive card games which one can buy which help to develop memory and concentration skills. Pay a visit to your local toy shop and see what you can find.
Prescription Drugs or Alternative Treatments
Consider alternatives to strong prescription drugs and inform yourself about the side effects in the long and the short term (see the reading list below). Some children respond very well to homeopathic remedies for ADHD.
I have formulated homeopathic remedies that I've used for years in my practice. The response to these remedies have helped many children, especially if the above guidelines are also followed.
Above it all, it is very important to keep a positive attitude!
Also make a special effort to highlight the positives in your child. It is something we all need!
Make time to have fun and spend time with your child and keep the communication channels open. Tell him/her that you love and admire them and show them often by giving them a hug!
Recommended Reading
No More Ritalin: Treating ADHD Without Drugs
by Dr Mary Ann Block. A Mother's Journey.
A Physician's Approach.
The A.D.D. Book: New Understandings, New Approaches to Parenting Your Child
by William Sears & Lynda Thompson.
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