8 Tips for Helping Your Child with Attention Deficit Hyperactivity Disorder (ADHD)
ADHD is a commonly diagnosed neurodevelopmental disorder in children under the age of 12 years old. According to the Center for Disease Control and Prevention (CDC), the average age of diagnosis is 7 years old. Children are also often misdiagnosed with ADHD due to many of the symptoms being aligned with anxiety disorders, mood disorders, learning disabilities, trauma or abuse, and many other possibilities. Make sure you seek professional help from a medical or mental health provider that you trust, before self-diagnosing your child with ADHD, as a treatment for these different problems varies. Even well-meaning teachers or other professionals from different fields are not qualified to make such recommendations or informal diagnoses and may actually cause unnecessary stress or harm to the child and their family.
So, you have a formal diagnosis from a trusted professional. Great...now what?
There are a few treatment paths you could possibly take and often times it is best to combine these paths for the best possible outcomes.
There is medication. Which is a common treatment that is recommended and can come with negative side-effects that parents and/or children are rightfully hesitant about. Don't take this as me saying that medication is bad, because I'm not. I fully believe that if that is the decision made by the treatment provider and the parent or guardian, and the child is showing improvement, then that is great news and a quality intervention.
The chances are that if there are negative side effects while taking a medication, there needs to be a medication change or adjustment. Possibly moving from a stimulant to a non-stimulant medication or the reverse. This can take time and significant trial and error, however, if the balance is found it can mean a positive change in the child and their family's quality of life.
There are natural/homeopathic paths to take. This is not one I am as familiar with or trained in, therefore I cannot comment much on this. However, some past clients and research I have seen have found this to be a helpful treatment for some. Consult with a naturopathic professional to find out more about this treatment method.
The final path, and one most recommended by this writer (of course I am not biased at all...sarcasm), are mental/behavioral health professionals who provide an array of therapies to the child and their families. These could include cognitive behavioral therapy, behavior therapy, social skills groups at school or the community, or others.
Behavior therapy is in part focused on changing negative behaviors to positive behaviors. For example, a child may have difficulty with disruptive behavior, such as acting out aggressively and impulsively in social situations. The negative behavior is that they become frustrated when other children don't want to play with them and therefore they lash out physically or verbally. The child's goal is a normal and healthy one initially; to make a friend and have someone to play with. However, the ways they go about trying to make friends can be offputting to other children and even adults. The goal for this particular issue would be to teach the child how to appropriately make friends through counseling, modeling, practice, and skill-building.
One intervention I am particularly fond of is the use of reward-based systems. During or after the child is in a social group and learning the appropriate skills, talking with a counselor about their struggles and what is going on for them, and parents are supportive and model appropriate behaviors at home and in the community, a counselor or trained professional can help you create a rewards-based system. These may appear easy, and they are in many ways, however, if not implemented correctly they can be worthless and possibly reinforce negative behaviors as well.
Below are 8 tips and recommendations for parents and professionals to use to better help a child struggling with ADHD.
1) School accommodations (IEP, 504, or informal accommodations): IEP stands for Individualized Educational Plan and the term "504" is referring to section 504 of the Rehabilitation Act, which simply put is giving struggling students access to the same education as their peers are receiving. An IEP has more strict requirements a student has to meet, including requiring that the child have one or more out of 13 specific disabilities listed under the Individuals with Disabilities Education Act (IDEA). Additionally, the disability must have a negative effect on the child's educational performance and/or their ability to learn using the typical education curriculum. A 504 requires that the child have any disability and said disability must get in the way of their ability to learn.
For more information on these educational accommodations check out the link below and consult with your child's school. There are more protections for those covered by an IEP, however, if your child doesn't qualify for one, a 504 plan or informal accommodation is a great alternative to make sure your child is able to succeed at school. Your school should be willing to work with you and your child to provide the appropriate services for your child to succeed. If you believe your school is not doing all it can to help your child, reach out to a parent advocate, or possibly seek legal representation if necessary.
My tip to parents on seeking school accommodations is to push push push! You are the advocate for your child and you have the right and responsibility as their parent to make sure your child is receiving what he or she needs and deserves. Most schools will do a great job of helping you through this difficult process of obtaining accommodations, however, there are always those who do not, or say they cannot, for one reason or another. Just continue to advocate and push for your child to be able to succeed in school. This is extremely important, as feeling like a failure in school is detrimental to a child's psychological development, and a child should always feel accepted, successful, and cared for at school.
2) Counseling for the child: If your child is struggling with his or her ADHD, seek help from a qualified mental health professional. A counselor can help a child learn about social and coping skills that he or she can use in their lives. This will require practice and support from the adults in his or her life, however, learning to cope with ADHD is another important step in treatment and for their future as an adult, potentially with ADHD.
3) Parent/guardian and family training/counseling: A counselor can also help provide you (the parent(s) or guardian(s)) with tools to assist your child in being successful at home, as well as in life. In addition to parenting training, a counselor can be a supportive person to lean on when you begin to struggle or become overwhelmed with your child's behavior. It is not easy to be a parent...period, let alone when your child has additional difficulty controlling themselves or other intrusive symptoms of ADHD taking control of their lives and minds.
4) Positive reinforcement: A simple reward system or a more complicated one can be very helpful in changing behavior. Remember to seek out professional help when considering this option. Positive reinforcement doesn't have to be anything formal though. When your child does something when asked once, provide positive feedback (e.g., "great job doing your homework!", "I'm proud of you for having a great day at school", etc...). That two seconds out of your day where you provide positive feedback to your child may stick with them, especially when consistently repeated, and drive them to want to please you more.
Punishments, such as yelling, grounding, or taking things away, are not nearly as helpful in changing most children's behavior and are possibly just building spite, anger, more self-loathing, etc. That is not to say all consequences are BAD! Just consider your specific child for a second. How often do they get yelled at or reprimanded every day? Is it working? Maybe it is, however, most likely it isn't very successful. Give positive reinforcement a shot and reduce your stress levels as well!
5) Socialization practice and modeling: How do you and the other members of your household act with each other? This is one of the primary environments children learn from and if you set poor examples repeatedly they will learn this is how they are to act as well. For a lighter example; how often are you having to tell your child to get off their phone, computer, or electronic device? Like 5, 10, 20 times a day? More? Well, how many minutes of the day are you or your other family members on their phones, computers, or electronic devices out of the day? For the record, I'm not perfect (nearly, but not quite), and I know it is difficult to break away. However, set the example. You are the adult. Your child looks up to you and wants to be just like you! Try to remember that next time you wonder why your child is acting a certain way and consider how you may be able to change things at home. It may just help your child make his or her own positive changes and will certainly help create a healthier home environment for all.
6) Support and Love: This one may require some reassessment and refinement on your part. We all love our children, but sometimes we don't particularly like what they are doing or how they are acting. Make both of these clear to your child.
For example, when they act out at the store, it is super embarrassing and frustrating because you just want to get what you need and get out! But, they really want that cereal in the colorful box, with the marshmallows, and the tiny little toy made in China inside, that they will forget about in about an hour after opening it. After getting out of the store, or if you can do this in the store that could work too, talk with them about how you love them very much, but are not happy with the way they acted. Maybe ask them what they were trying to accomplish with their outburst (get the cereal). Then teach them how they can earn that cereal and/or how they can ask for the cereal next time in a more appropriate and effective way. Try your best to keep calm and speak clearly and in short sentences. This applies to anytime you are talking to your child, however, when they are escalated they will not hear or understand what you are saying past the first few words.
***EXTRA TIP*** DO NOT BUY THE CEREAL FOR THEM AT THE TIME OF THEIR TANTRUM! That is exactly what they want and it is teaching them that acting out in the store = awesome cereal. You want them to learn that acting out in the store ≠ awesome cereal, and rather, acting appropriately and asking politely = awesome cereal. This is a tip for working with all children, not just those who are struggling with ADHD. For many parents, we want our children to be happy and have everything they ever want. You must remain strong in your decision because, in a battle of negotiation endurance between an exhausted, worn-out adult and a youthful, energetic child, the child will win 99 percent of the time. You have been warned!
7) Create Physical Checklists or Charts: If your child forgets things and doesn't seem to remember something you told them 50 times just yesterday, help them out by creating a physical reminder. Maybe they continually forget to do their one chore each day (super frustrating), however, create a chore chart together. Make it colorful, fun, and allow them to have as much input as possible. Then refer to this chart every day for a while and eventually you will notice they are able to do so on their own. I would also suggest creating a way for them to check off or mark that they have accomplished something. How satisfying is it for us adults to have a to-do list and check things off? Heck, I even add things I have done already to my to-do lists to feel that sense of accomplishment another time! Give it a shot and feel free to check online for ideas to help you.
8) Medical Consultation: Consult with your child's primary care physician or a child psychiatrist about possible medical interventions to help with your child's ADHD symptoms. Even if you are not sure about medication, it cannot hurt to get a consultation and learn about the differences between stimulants and non-stimulants, both the negative and positive side effects of taking a specific medication, and to rule out any other medical possibility for your child's ADHD symptom presentation. This alone is not the most effective treatment, however, with the right medication, the right mental health professional, the support of his or her school system, and you as the parent or guardian doing your part as well, your child's treatment team is going to be looking at the issues from all kinds of different angles. If the collaboration is there between you and the professionals in his or her life, your child is in good hands and will be set up for success!
As always, feel free to reach out to me via the contact page on pratherbhc.com/contact or to another trusted mental health or medical professional in your area.
Below are a couple of helpful videos that focus on ADHD, how it presents in children, and available treatment. The first video is from the National Centre for Mental Health (NCMH) and the second is from Understood.org. I hope this article and these short videos are helpful to you in some way. Please let me know by providing feedback here, on Facebook https://www.facebook.com/PratherBHC, or via email at firstname.lastname@example.org. Also, let me know what you would like more information about regarding mental health. I look forward to hearing from you!
-Joseph Prather M.S., PLMHC, CCMHC