ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)      

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity). ADHD has three subtypes:

Predominantly Hyperactive-Impulsive Type:  Most symptoms (six or more) are in the hyperactivity-impulsivity categories.  Fewer than six symptoms of inattention are present, although inattention may still be present to some degree.  

• Children with hyperactivity may experience symptoms that include:
• Fidget and squirm in their seats
• Talk nonstop
• Dash around, touching or playing with anything and everything in sight
• Have trouble sitting still during dinner, school, and story time
• Be constantly in motion
• Have difficulty doing quiet tasks or activities.
• Children with Impulsivity may experience symptoms that include:
• Be very impatient
• Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
• Have difficulty waiting for things they want or waiting their turns in games
• Often interrupt conversations or others’ activities

Predominantly Inattentive Type:  The majority of symptoms (six or more) are in the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree.  Children with this subtype are less likely to act out. They may sit quietly, but they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not notice that he or she has ADHD.  Symptoms may include:

• Being easily distracted, miss details, forget things, and frequently switch from one activity to another
• Having difficulty focusing on one thing
• Becoming bored with a task after only a few minutes, unless they are doing something enjoyable
• Having difficulty focusing attention on organizing and completing a task or learning something new
• Having trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
• Not seeming to listen when spoken to
• Daydreaming, become easily confused, and move slowly
• Have difficulty processing information as quickly and accurately as others
• Struggle to follow instructions.

Combined Hyperactive-Impulsive and Inattentive Type:  Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present.  Most children have the combined type of ADHD.

TREATING ADHD     

Treatments focus on reducing the symptoms of ADHD and improving functioning.  They can include medication, various types of psychotherapy, or education or training.  One type of therapy used is Behavioral Therapy which aims to help a child change his or her behavior.  It might involve help organizing tasks or completing schoolwork, or working through emotionally difficult events.  Behavioral Therapy also teaches a child how to monitor his or her own behavior.  Learning to give oneself praise or rewards for acting in a desired way, such as controlling anger or thinking before acting.  Parents and teachers also can give positive or negative feedback for certain behaviors.  In addition, clear rules, chore lists, and other structured routines can help a child control his or her behavior. Therapists may teach children social skills, such as how to wait their turn, share toys, ask for help, or respond to teasing, learning to read facial expressions and the tone of voice in others, and how to respond appropriately can also be part of social skills training.

WHAT PARENTS CAN DO TO HELP

Children with ADHD need guidance and understanding from their parents and teachers to reach their full potential and to succeed in school.  Before a child is diagnosed, frustration, blame, and anger may have built up within a family.  Parents and children may need special help to overcome bad feelings.  Psychologists can educate parents about ADHD and how it impacts a family. They also will help the child and his or her parents develop new skills, attitudes, and ways of relating to each other.  Parenting skills training helps parents learn how to use a system of rewards and consequences to change a child’s behavior.  Parents are taught to give immediate and positive feedback for behaviors they want to encourage, and ignore or redirect behaviors they want to discourage.  Parents are also encouraged to notice and point out what the child does well, and to praise the child’s strengths and abilities.  They may also learn to structure situations in more positive ways.  For example, if the child has trouble completing tasks, parents can help their child divide large tasks into smaller, more manageable steps.  Also, parents may benefit from learning stress-management techniques to increase their own ability to deal with frustration, so that they can respond calmly to their child’s behavior.  Sometimes, the whole family may need therapy.  Psychologists can help family members find better ways to handle disruptive behaviors and to encourage behavior changes.  

TIPS TO HELP KIDS

• Schedule:  Keep the same routine every day, from wake-up time to bedtime. Include time for homework, outdoor play, and indoor activities. Keep the schedule on the refrigerator or on a bulletin board in the kitchen. 

• Organize everyday items:  Have a place for everything, and keep everything in its place. This includes clothing, backpacks, and toys.

• Use homework and notebook organizers:  Use organizers for school material and supplies. Stress to your child the importance of writing down assignments and bringing home the necessary books.

• Be clear and consistent:  Set consistent rules that they can understand and follow.

• Give praise when rules are followed:  Children with ADHD often receive criticism.  Look for good behavior, and praise it.

WORKING WITH YOUR CHILD’S SCHOOL     

If you think your child has ADHD, or a teacher raises concerns, you may be able to request that the school conduct an evaluation to determine whether he or she qualifies for special education services.  Start by speaking with your child’s teacher, school counselor, to begin an evaluation.  A team of professionals, including the Psychologist, conducts the evaluation using a variety of tools and measures. that look at all areas related to the child’s disability.  Once your child has been evaluated, he or she has several options, depending on the specific needs.  If special education services are needed and your child is eligible under the Individuals with Disabilities Education Act, the school district must develop an “individualized education program” specifically for your child within 30 days.  

ADULT ADHD

Some children with ADHD continue to have it as adults. They may feel that it is impossible to get organized, stick to a job, or remember and keep appointments.  Daily tasks such as getting up in the morning, preparing to leave the house for work, arriving at work on time, and being productive on the job can be especially challenging for adults with ADHD.  These adults may have a history of failure at school, problems at work, or difficult or failed relationships.  

Adults who suspect they have ADHD should be evaluated by a Psychologist and to be diagnosed with the condition, an adult must have ADHD symptoms that began in childhood and continued throughout adulthood.  Psychologists use certain rating scales to determine if an adult meets the diagnostic criteria for ADHD. The Psychologist will also look at the person’s history of childhood behavior and school experiences. For some adults, a diagnosis of ADHD can bring a sense of relief.  Adults who have had the disorder since childhood, but who have not been diagnosed, may have developed negative feelings about themselves over the years. Receiving a diagnosis allows them to understand the reasons for their problems, and treatment will allow them to deal with their problems more effectively.