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Understanding ADHD – What Parents, Carers & Teachers Need to Know

Attention deficit hyperactivity disorder (ADHD) causes severe behavior problems in children, along with impairing their learning capabilities. The good news is that with early intervention, it is possible to overcome both these problems. This article looks at the ADHD-induced behavior and explores what is known about ADHD, plus what can be done by carers, parents, as well as teachers to help children with the condition.

First though, here are some quotes from frustrated parents on how the problem affects them and their children…

“I always worry when I go to pick [my son] up from school. It seems every day some problem has arisen. I feel people think I’m just a bad parent.”
“To try and get [my daughter] to do her homework and hand it in, in a presentable form, can take all night. We often get comments from the school on how messy her work is, but she does try so hard”.

“Ben is so unpredictable; one minute he will be in a good mood, and the next he will be shouting at his sister. When we have other children around, he will act very silly, and then boss them about. I don’t care what you call the problem, my child needs help.”

What is ADHD?

All children show some untamed behavior now and then, and this is a cause of concern to their parents, but the difference in the case of children with ADHD, is that the extent of this behavior is clearly “off the charts.” A child with ADHD exhibits this challenging behavior all the time, everywhere, regardless who they are with, and, unless they get help to deal with the condition, ADHD can be very damaging to the child.

It can ruin their future, and it can negatively impact the lives of members of their family.

The problem behavior can start when the child is still very young. Parents of ADHD children describe a child that is overly active, restless, clumsy a lot of the time, and attention seeking. When they join school, their teachers report that the child is unusually untidy, disruptive to the others in class, highly unorganized and forgetful.

One distinctive sign that a child has ADHD is speaking and acting without thinking. A child will say and do things they should not, which eventually earns them a reputation for acting impulsively, even stupidly.

Children with ADHD have trouble learning, and this is most evident when it comes to learning to write. Because they have trouble paying attention, and concentrating, they end up making many mistakes in their work. And as a result, their teachers will complain that the child is never in one place, but romping around doing this and that, and never finishes what they started, or pay any heed to what they are told.

Children with ADHD also have a hard time making friends. This is because they tend to be bossy and very talkative, in such a way that they cut others off in mid-sentence, never pausing to listen when another person is speaking. It doesn’t help that they’re also very moody at times.

So it is not surprising that other children can’t stand being around them. And as these children with ADHD get older, their restlessness turns into an inner nervousness and anxiety, which can only be exacerbated by the frustration they feel and their dismay at how others react to their behavior.

It’s common for children to misbehave once in a while, and this is normal, but if this goes on for long, it could mean there is a problem with this child, but you shouldn’t rash to the conclusion that such a child has ADHD. Still, if your child’s behavior worries you, it’s OK to seek help, whether the child has ADHD or not.
How common is ADHD?

Because experts don’t agree on a single definition of ADHD, it becomes hard to tell how many children have this condition. And for parents and others involved with hyperactive children or those with attention disorders, this becomes very confusing. In the United States it is estimated that between three (3) and seven (7) out of every one hundred children in schools have ADHD – that is, 3% to 7%.
Although it’s not clear why, more boys than girls get diagnosed with ADHD. This could be the result of some sort of stereotyping at work. Black Americans have also argued that more Black boys are diagnosed with ADHD than should be, all because of the stereotyping.

Something similar is reported in the United Kingdom: a study found that Asian kids who had been rated hyperactive by their teachers were actually less hyperactive in class than their white classmates who’d also been rated hyperactive.
Given this, how we define ADHD will continue to change. Currently, ADHD basically defines a set of behaviors, it is not a clear-cut “illness” – if we can even use that word.

What causes ADHD?

Heredity seems to play a part because it’s been found that a child with ADHD is four times more likely to have a relative who had the condition in their early years. But other factors also play a part, as some America researchers have claimed. According to these, ADHD is caused by a shortage of certain chemicals in the brain, chemicals that help with concentration, planning, execution of tasks, and control of emotions.

Other experts argue that it can’t be just the shortage of chemicals in the brains of ADHD children. They say that other factors in a child’s life that have been at work since childbirth contribute to the development of ADHD.

Stress is one such factor that has been mentioned, and it’s true that stress in the child’s family can mess up the parent-child relationships, which can cause behavior problems in some children.

This family stress/ADHD connection however is something of a conundrum because families in which you find a child with ADHD usually show signs of stress, but then again which parents wouldn’t be stressed if they have such a child? A parent who has a child with ADHD can quickly lose confidence in his or her parenting abilities, what with the constant push and pull with their child because of the hyperactivity, the disruption, or the attention issues.

So, what comes first, the family stress or the ADHD?

Others have theorized that certain foods, food additives, or exposure to lead are to blame for why children develop ADHD. Many experts don’t agree.

For the parents and carers, it’s true that some foods such as caffeine and certain additives can make your child agitated and hyperactive, but when this happens, cutting out the foods is all that is needed.

As for special diets for children with ADHD, you should consult a doctor for advice regarding any such diets that have been recommended to you.

Whatever is responsible for causing ADHD in your child, however, as a parent you should never feel that you’re to blame. But you need to understand the problems you’re facing and will face as your child grows, as well as what help you need to deal with them.

Do children grow out of ADHD?

Many children outgrow the problems caused by ADHD and you shouldn’t assume that yours won’t. But having said that, a portion of people who had ADHD in childhood go on to have problems as adults, including drug abuse, alcoholism, as well as criminal and/or anti-social behavior.

Experts believe that in the case of those who go on to develop these problem behaviors in adulthood, other factors come into play that work in tandem with the ADHD to cause the behaviors.

The more that a child is helped, and the earlier that this starts, the higher the chances that the child will go on to enjoy a positive, successful life as an adult.
And the longer that the problem behaviors continue in a child’s life, the higher will be the chance that this child comes into situations where they react against family or their community at school – or the other way round!

These two influences, family and school, are critical for shaping how a child grows up.

What your ADHD child wishes you knew… Do you sometimes wish you could “touch base” with your ADHD child – know what they’re thinking and think like them – pick their brains? They too wish that -and apparently, it may not be as hard as it sounds…. Read more here.

How is a diagnosis for ADHD made?

An ADHD diagnosis is made basing on psychological tests, so there are not special lab tests done that have to do with DNA, or blood samples. In the United States a child mental health expert, such as a psychiatrist or an educational psychologist or a pediatrician, will make the diagnosis basing on the latest DSM manual, the Diagnostic Statistical Manual of the American Psychiatric Association.

In Europe they use a different manual, the ICD. But the goal of these tests is the same: to eliminate the possibility that the child’s problems are not the result of certain other conditions, including hearing problems, language difficulties, depression, dyslexia, Asperger’s syndrome, autism, or epilepsy.

ADHD or ADD – Attention Deficit Disorder – as it’s also called really describes two types of conditions. The first is hyperactivity which is a set of behavior problems. The second is attention deficit which is a set of learning problems.

Most children with ADHD have both hyperactivity and attention deficit, and a smaller percentage have only one or the other.

And because of this, you will sometimes find the term written as AD/HD, to mean attention deficit and/or hyperactivity disorder. For the child that isn’t particularly hyperactive, the diagnosis will be “ADHD without hyperactivity.” This is the most common diagnosis for girls, while boys tend to have AD plus HD.

If you’re the parent, the person that diagnoses your child will carefully observe him/her and will typically give him or her some psychometric tests as well as Continuous Performance Tests, all designed to help build a clear picture of his or her mental processes.

This testing will also involve collecting as much information as possible from parents, social workers, teachers, health personnel, playground staff and anyone with anything to do with looking after your child. All this is designed to see what other medical reasons could explain the child’s behavior and what else could be going on in your child’s life.

When the person or persons doing the diagnosis feel that they know what’s wrong, they will decide on the best treatment for the child from among available options. Not all children with ADHD get the same treatment.

What are the treatments for ADHD?

The best thing would be to get a full set of treatments as suggested by the diagnosis – behavior management, counselling/psychotherapy, special assistance at the child’s school, and in some cases medication. The problem is, lack of money sometimes means the child doesn’t get access to all these various forms of help.
Along with all this treatment, it is critical that the child’s parents get help and support to learn the skills they will need to help their child. Learning these skills helps by reducing stress. The parents will be more confident about coping with having an ADHD child in the home, plus, they learn how to minimize conflict with the child.

Behavior management

Children crave the attention of their parents. It’s a powerful reward. Parents, on the other hand, get their children’s attention by doing things such as shouting at them, scolding them, or arguing with them. All these are negative forms of parental attention.

And so, because children with ADHD aren’t easy to manage, they tend to get a lot of negative parental attention. They continue to misbehave. This cycle feeds on itself, to produce what’s called negative behavior reinforcement.

This cycle has to be broken, and that’s where behavior management comes in. Parents are taught to notice when their child is being good, and to reward them when this happens.

When the child is consistently being praised in a clear and enthusiastic manner, and told why he or she is being praised, that child will want to repeat that good behavior to reap the benefits.

This is now positive behavior reinforcement, and it can eventually replace the negative cycle we saw above.

While this is going on the parents also have to learn to ignore bad behavior, such as whining, tantrums, swearing, arguing. The natural instinct when a child does any of these intolerable things is for the parents to tell the child to stop.

But for a child with ADHD, doing this usually has the opposite effect. So parents are taught to learn to ignore it, avoid eye contact or discussion when it’s happening, and move away from the child.

Parents are also taught not to use “stop instructions” when communicating with their children. So, instead of “Stop shouting” tell the child instead, “Please speak more quietly.” The other thing is to try and ease off and let it pass if your child repeatedly refuses your request. This gives you both a chance to cool off.

These behavior management techniques above take time and patience for both parents and their children, and parents sometimes find they have as much to learn as the children, and need more support than the kids. But the techniques are very effective, and once a positive reinforcement cycle takes hold, the forward momentum is fast, and this pleases all concerned.

A major goal of this behavior management is to help the child with ADHD acquire more self-control skills both at home and at school. So, as a first step, parents should help put more structure in the child’s daily life and help the child become better organized.

One way to do this is to use alarm clocks to break homework for example into manageable chunks, and to create lists of tasks, to-do style, so that you can tick the tasks off as they’re completed.

Today, with smartphones and printers all over the place, this should be easy-peasy.
Routine is the keyword here, so get a good routine going. At school the child with ADHD should be encouraged to actively participate in learning. The teachers should help the child set his or her own pace. Children should be given lessons that offer the child the right content level content that offers variety and that can hold their interest.

The best people for both parents and teachers to talk to regarding effective learning programs for children with ADHD are educational psychologists.

Social skills training

Children are taught how to manage relationships better with other people for example by learning to read and decipher the hidden signals others use in communication.

Another important part of social skill training is teaching ADHD children how their behavior affects others around them, so that they can change this behavior.

Counselling

Professionals who counsel children suffering from ADHD help them by getting them to talk through why they behave as they do and the consequences of this behavior. ADHD children almost always feel bad about themselves, something that counselling can help them overcome.

With counselling they become better at controlling their impulses and their emotions, they become more focused and attentive, they get better at learning, and they become much more organized.

At the family level, parents should also look closely and with total honesty at how their family works as a unit. It could be that family therapy is required to expose an undercurrent of worries or problems that could be fueling the child’s bad behavior.

This discussion should be mediated by family services such as child consultation services or family therapy centers, the family doctor, etc.

Psychotherapy

In some cases children diagnosed with ADHD become very anxious, or they could get very severely demoralized, or depressed, to the point where they need expert attention. A child psychotherapist helps such children to recognize and deal with these issues, both for the short term and the long term.

Medication

Experts don’t agree on the use of drugs to treat ADHD, with some of them saying that treating the condition with drugs helps to buy their families and the children themselves some time out from the disruptive behavior pattern – time the parents can use to nurture and sustain a more loving relationship with their child.

Other experts feel that using these strong drugs on the children with ADHD is not necessary, especially given that the drug may have adverse side effects.

These experts fear that using these drugs, especially with the very young, carries the risk of keeping hidden some emotional causes of the problem behavior, as well as other as yet unknown causes. As a result most of these drugs are banned for children below five years.

Ritalin is the most popular of these drugs used to treat ADHD. Its chemical name is methylphenidate. Other trade names include Concerta and Equasym.

Dexedrine is another, chemical name Dexamphetamine.

Both these drugs are Schedule II controlled drugs, in the same class as methadone and the barbiturates. But they’re more related to the amphetamines (of which “Speed” is one).

It is thought that they work by “topping up” the chemicals inside the brain which facilitate communications between the brain cells.

The consensus today is that these drugs shouldn’t be the first line of defense against ADHD, and should only be used when other options have failed.

The drugs themselves are not a cure. But they help the child with ADHD think more clearly. Additionally they improve the child’s understanding and self-control, as well as making the child feel very calm.

All this creates a situation where the child can benefit from the other help they’re getting at home and at school to lessen the impact of ADHD.

For some children the drugs can have some side effects especially at the start of the treatment. Some of these side effects include loss of appetite, problems going to sleep, and loss of weight.

In a small percentage of children the drugs can make them tearful or withdrawn.

The effect of the drug lasts for three or four hours, although there are so-called slow release (SR) formulations that can stay active for longer.

The duration of treatment is about six months for some, and much longer for others. How long depends on how helpful the treatment has been for the child.

Doctors may decide to use anti-depressant drugs instead of the stimulants (Ritalin or Dexedrine) in cases where the stimulants aren’t suitable for some reason, maybe because they’re not working, or the side effects are too unbearable for the child.

The anti-depressants are especially helpful where the doctor feels that the depression is the bigger problem for the child than the problems caused by the ADHD. Anti-depressants come with their own side effects of course.

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