Bringing Out the Best in Children with AD(H)D - Dr. Debra Mandel

What is AD(H)D-Attention Deficit (Hyperactivity) Disorder?

“He won’t sit still, he doesn’t complete his school work and he gets distracted by everything. I don’t know what to do,” complains Sandi about her 11-year-old son.

Mary and Tom, exasperated by their 10-year-old daughter, exclaim, “Sarah constantly forgets where she put her homework, never finishes her chores, and loses important stuff, no matter how often we remind her. It’s like she’s in la-la land.”

These parents among millions of others have children suffering from AD(H)D, not to be confused with temporary crankiness or irritability. Rather it’s a real disorder characterized by a cluster of many symptoms.

AD(H)D is characterized by inattention, and/or hyperactivity/impulsivity that is more severe than what typically appears for that child’s age group. The child experiences symptoms for a minimum of six months, showing problems in more than one arena (e.g. both at school and at home). Symptoms are not due to another disorder like depression, anxiety or autism. However, because of tremendous overlap in symptoms among a variety of other disorders, diagnosis can be very difficult and require expert assessment.

Signs of inattention often show up as failure to follow through on instructions, poor task completion, difficulty with organization, avoidance of tasks requiring concentration, loss of important materials for school or other activities, high distractibility, and forgetfulness. Typical signs of hyperactivity/impulsivity include fidgetiness, inability to remain seated, restlessness (running around, climbing on chairs and other behaviors inappropriate for the setting), difficulty handling quiet time, being revved up, and talking or interrupting others excessively. A child with AD/HD may have either inattention or impulsivity, or both.

Children with AD(H)D frequently suffer from low-self esteem and a sense of social failure as their behavior can be quite annoying to people around them. These problems become especially pronounced in children who haven’t been properly diagnosed or who have been pegged as a “bad seed.” If left untreated these problems often get worse and the sufferer may also develop a propensity toward failure, a negative self-identity, problems in social and intimate relationships, and difficulty functioning in the workplace.

Though the child clearly faces enormous obstacles and challenges, those who are close to the child—parents, siblings, teachers, etc., experience multiple challenges as well. Therefore, AD(H)D must be viewed as a family issue. And everyone surrounding the child needs to work together to minimize its negative consequences.

Causes

As with most conditions, the jury is still out on what causes AD(H)D. However, most experts point to heredity/genetics, problems during pregnancy (e.g., premature birth, abuse of alcohol/drugs, poor nutrition), and/or abnormal levels of neurotransmitters (i.e., the brain chemicals that regulate behavior). Brain trauma such as a blow to the head with a baseball or a serious car accident may also contribute to the development of AD(H)D.

Helping Your Child

If your child has been diagnosed with AD(H)D or you suspect that he/she meets the criteria, be proactive and take positive action. Don’t get bogged down by feelings of shame or inadequacy. Your child’s behavior is not a reflection of poor parenting or of lack of intelligence. Also, don’t fool yourself into believing that things will improve with time. The sooner the child is treated, the better he will ultimately fare in school, at home, and later in the community at large.

First and foremost, create a treatment team that includes you, your child’s teacher, principal, pediatrician, and a mental health professional. Consider a combination of counseling, behavior modification, and medication therapy. While the thought of medication can be frightening, it can facilitate the effectiveness of other therapies. Plus, a variety of medications are now being used in addition to the well-known stimulant Ritalin, such as a non-stimulant, Strattera. Specialists typically don’t prescribe medication before the child reaches kindergarten age. Because of the abundance of literature on the pros and cons of drug therapy, it’s crucial to discuss all possibilities with a pediatrician or psychiatrist.

Below are a few tips you can apply right away to help keep your child on track particularly with regards to his education.

Designate an area in the house to keep all school supplies (books, pencils, notebooks, etc). This will help minimize the tendency to misplace, forget or lose important things.
Keep distractions to a minimum while your child needs to be focused on a task. Turn off the television, radio, or other noisemakers.
Enlist the help of siblings.
Help your child create a checklist of tasks completed to encourage a sense of accomplishment.
Divide tasks into small pieces. During the breaks, have your child blow-off steam with some kind of physical exercise or stretching or an activity he finds appealing.
Applaud positive behavior with praise instead of material things. This helps build self-worth and intrinsic motivation.
Cultivate your child’s strengths such as creativity and imagination, traits often associated with AD(H)D.
Be flexible. Pay close attention to what works for your particular child and modify as she develops and gains more control.

Resources

There exists an abundance of information on the Internet and in self-help books; take advantage of it. Also, be assertive in requesting assistance from your child’s school. Many states provide special programs for extra support. When searching for a mental health specialist, contact your county’s psychological association, your pediatrician or your local hospital for a recommendation. Most importantly, get the support you need for yourself so that you’ll remain an anchor for your child and refrain from pulling your hair out!