Topic of the month – ADHD
Posted by: Sue Atkins
There are an estimated 365,000 children in Britain diagnosed as having ADHD (Attention-Deficit Hyperactivity Disorder) which means they find it hard to concentrate, have extreme difficulty in sitting still, and find learning or concentrating very challenging too.
These children are also very easily distracted and restless, have great difficulty remaining in their seats and find it difficult to wait their turn. They find it hard to play quietly or follow instructions, and often shift from one incomplete activity to another constantly interrupting others.
For these reasons they also find it hard to make and keep friends at school and often suffer from bullying because of their disruptive and unruly behaviour.
Children with ADHD often suffer from very low self esteem and self confidence.
It is therefore no wonder that parents of children diagnosed as having ADHD often feel despair, isolation and guilt as ADHD can make family life very difficult, frustrating and stressful, leading to many difficulties in family relationships.
The encouraging recommendations from the NICE report are that parents should be supported and given practical training and help in managing and caring for their child’s ADHD, and that the use of strong drugs like Ritalin should be used more sparingly.
The needs of a child with ADD/ADHD can overwhelm families and make home life chaotic — but they don’t have to. You can use strategies to influence and channel your child’s behaviour and can use exercise, the natural environment, and possibly diet to alleviate and reduce their symptoms.
Living in a home that provides both love and structure is the best thing for a child or teenager who is learning to manage ADD/ADHD.
You need to develop patience, compassion and a positive, confident attitude to handling your child’s behaviour. It also helps for you to join a support group to talk, discuss and share successful strategies that work so you don’t feel alone or isolated.
Tips for family life
It is important to remember that your child with ADD/ADHD who is ignoring you, annoying you, or embarrassing you, is not acting wilfully or rebelliously.
Having ADD/ADHD is extremely frustrating and frightening for children as they want to fit in, to sit quietly, and make their rooms tidy and organised. They want to do everything their parents and teachers want them to do but they don’t know how to. So if you keep this in mind, it will be a lot easier to respond to your child in positive, supportive ways.
One key attitude I work with parents to develop is the ability to genuinely believe in and find positive ways to support their child.
Here are some helpful tips to believe in and practically support your child:
- Recognise and praise everything that is positive, valuable, and unique about your child. Look for their creative talent, their kindness, their ability in music or sport and praise them openly and often.
- Trust and believe that your child can learn, change, mature, and succeed. Believe with strategies, techniques and perseverance you can help them mange their condition positively.
- Let your child make mistakes and learn from them, but be there to comfort and support them when their mistakes upset and distress them.
- Encourage and nurture their self-esteem by your unwavering love, approval, and support when things go wrong.
Keep things in perspective.
- Remember, your child’s behaviour is related to their disorder and most of the time it is not intentional.
- Hold on to your sense of humour – what is embarrassing today may be a funny family story ten years from now.
- Don’t sweat about the small stuff – one job or task left undone isn’t a big deal when your child has completed two others successfully, plus their day’s homework. So look for progress and small successes all the time and really celebrate those. It keeps everyone motivated with a feeling of moving forward.
- Be willing to make some compromises – if you’re a perfectionist or someone who really enjoys order and correctness, your child is not the only one who needs to change. Look for ways to ask yourself what you could do differently to handle the situations.
- Keep a journal and write in it last thing at night what went really well that day. This keeps you focused on the positive things that you are doing and helps you to feel more in control and confident as you fall asleep ready to wake up positively the next day.
Pay attention to siblings!
- Educate and teach your other children about their brother or sister’s ADD/ADHD. You are teaching them compassion, tolerance and respect for others and building the “we” mentality of a family.
- Establish a clear set of rules that everyone in your home must follow as this leads to clarity and high expectations. Clear boundaries of what you expect creates less confusion and helps a child with ADHD
- Spend quality time with all your children from reading a story to playing a game with them individually – ADHD children often demand far more of your attention so spending quality time with your other children builds bridges not walls between you. Also it’s a good idea to plan activities that are enjoyable for the whole family too to create happy childhood memories for everyone.
- Don’t take the successes of your unaffected children for granted. Praise their unique qualities, abilities, and achievements openly and often too. They need to be recognised for their achievements too.
- Let your unaffected children be kids. Don’t burden them as assistant parents — or blame them if their sibling with ADD/ADHD misbehaves under their supervision. It damages your relationship with them and with their brother or sister long term.
Take care of yourself.
- Look after your own health and energy and find ways to reduce your stress. Find “me time” where you go to the cinema, go out for a drink or take a long foamy bath or you will begin to “run on empty”, feel resentment and become exhausted.
- Find the support you need and take advantage of it.
- Be patient with yourself if you become frustrated, angry or overwhelmed you’re a parent and bringing up a child with ADHD can be challenging
Managing your child’s ADD/ADHD
Children with ADD/ADHD generally find it difficult to think and plan ahead, organise themselves effectively, control their impulses, or follow through and complete tasks. That means you need to take over as the administrator or manager, providing extra guidance while your child slowly acquires executive skills of his or her own.
Your most important attributes in this process are common sense and a positive attitude. Common sense will tell you which behaviours to work on the most, when to negotiate and when to stand firm, and how to head off problems before they start.
A positive attitude will help you see the small, praiseworthy successes that can add up to permanent improvement in your child’s behaviour.
Tips for managing your child’s ADHD:
- Communicate – be clear and concise when communicating with your child. Give instructions one step at a time and make requests one at a time.
- Be consistent – what you expect one day should be what you expect every day. Don’t give in just because you’re tired or the child is nagging. Be firm, be fair and be consistent.
- Set a good example – show your child the behaviours you’d like to see. Be a model of patience, healthy habits, good manners and be organised. You are a role model in all you do, act and say, no matter how old your children are they take the lead and example from you.
- Anticipate and avoid problems – know your child’s triggers and what situations lead to problems. Become adept at heading off trouble before it starts.
- Praise good behaviour – praise is a powerful reinforcer, so make every effort to “catch your child being good”.
- Negotiate and consult with your child – try to avoid barking orders at your child and start a dialogue, and be open to what your child has to say. It creates respect and independence if you learn to listen attentively.
- Choose your battles – not every situation requires intervention. Keep the big picture in mind and let the little things slide. If you don’t, your home will be one of constant conflict and criticism.
Behavioural strategies for parents
There are many strategies you can use at home to increase your child’s appropriate behaviours and reduce the inappropriate, disruptive ones.
Strategies for improving communication
- Go up to your child and make direct eye contact before giving an instruction.
- Check for understanding and ask them to repeat back to you what you’ve asked them to do. E.g. “Tell me what I want you to do.”
- Give verbal directions one at a time, not in a long list.
- Gentle physical contact can help your child focus.
- Encourage your child to talk through a situation rather than just plunging in.
- Go over the steps in a procedure slowly and clearly before and during the activity, including those you and your child do together. It keeps them focused and more in control.
- Express your expectations in a written or visual form as well as verbally, such as a star chart or a checklist as again it helps your child to be focused and structured moving forward positively
Strategies for maintaining structure
- Establish predictable routines for morning and evening.
- Keep your child busy with scheduled, supervised activities, but don’t pile on so many that your child is overwhelmed.
- Make sure that they get sufficient sleep as lack of sleep makes attention problems worse, so insist that your child have a regular bedtime and enough rest.
- Make sure your child has a quiet, private space of his or her own as it creates a sense of peace and belonging.
- Plan ahead to make sure your child doesn’t become overtired or hungry during outings as low blood sugar levels acerbate ADHD symptoms.
- Make sure other people looking after your child and also their teachers are familiar with your daily routines and behavioural goals so everyone can sing from the same song sheet. It creates high expectations and consistency.
Strategies for improving organisation and time management
- Set up your home in an organised way: a place for everything and everything in its place.
- Your child should have a specific, regular place for doing homework, away from distractions.
- Have your child lay out clothes for the next morning before going to bed; make sure what they need to take to school is in a special place, ready to grab.
- Give your child a special notebook for writing down homework.
- Put clocks throughout the house, with a big one in your child’s bedroom to help them focus on time keeping and time management.
- Always allow plenty of time for what your child needs to do, such as homework or getting ready in the morning. Rushing just sets everyone off to a bad start and ADHD children pick up on the stressful vibes and it makes them worse.
- Build lots of regular breaks into homework time.
Using Rewards and Consequences to Promote Good Behaviour
- Make a chart with points or stars awarded for good behaviour, so your child has a visual reminder of his or her successes.
- Reward your child with privileges or activities, rather than with food or toys.
- Change rewards frequently. Kids with ADD/ADHD get bored if the reward is always the same.
- Immediate rewards work better than the promise of a reward in the future, but a system where small rewards lead to a big one can also be effective.
- Reward your child for small achievements that you might take for granted in another child.
Remember, hugs, smiles, and praise are rewards, too.
- Spell out rules and the consequences of inappropriate behaviour in advance.
- Use time-outs and the removal of privileges as consequences for misbehaviour.
- Take or keep your child away from situations and environments that trigger inappropriate behaviour.
- Let your child know how you feel when he or she misbehaves.
- Have your child come up with alternatives to his or her disruptive behaviour, then have your child demonstrate the appropriate behaviour you want them to model.
- Always follow through on what you say. Do what you say you’re going to do, whether in reward or punishment. It is far better in the long run.
Using the mind-body connection
Although ADD/ADHD is a condition that affects the mind, studies show that exercise, physical surroundings, and diet can make a huge difference in symptoms.
Exercise and physical awareness
Physical exercise can be a huge benefit for children with ADD/ADHD as they have plenty of energy to burn, and organised sports and other physical activities can really help them focus their attention on specific movements and skills.
Exercise also improves concentration, decreases depression and anxiety, and promotes brain growth. So find a sport that your child will enjoy and that suits his or her strengths. Individual sports or team sports like football and hockey that require constant motion are better options. Children with ADD/ADHD may also benefit from martial arts training, tae kwon do, and yoga, which enhance mental control as they work out the body.
Researchers have found that children with ADD/ADHD benefit from spending time in nature. Kids experience a greater reduction of ADHD symptoms when they play in a park full of grass and trees than on a concrete playground.
Diet and nutrition
All children benefit from fresh foods and regular meal times and it’s best for all children to stay away from junk food and fizzy drinks but this is especially true for children with ADD/ADHD, whose impulsiveness and distractedness can easily lead to missed meals, disordered eating, overeating and obesity.
Research has shown that there is a connection between toxins and chemicals found in many foods, deodorants, scented tissues and toothpaste as well as natural allergies like wheat, corn, diary foods or chocolate as well as artificial colours and other additives and the severity of ADD/ADHD symptoms. So it’s a good idea to keep a diary of what your child eats so you can notice any patterns that may emerge so you can restrict or eliminate that food for a while.
Guided meditation CDs are also a wonderful way to help children relax and wind down naturally www.relaxkids.com
Relationship help for kids with ADD/ADHD
Children with ADD/ADHD often have difficulty with simple social interactions and with reading social cues. Their often emotional immaturity can make them stand out amongst other children their own age and make them targets for other children’s teasing.
They may talk too much, interrupt frequently, and come across as aggressive or “too intense.” Naturally parents often worry that their child with ADD/ADHD will attract undesirable people as friends or will be unable to make friends and to sustain important relationships as teens and adults.
Your job is to help and teach your child how to become a better listener, how to learn to read other people’s faces and body language, and how to interact easily in groups and how to become more confident socially.
Finding support for childhood ADD/ADHD
One of the most important things to remember in rearing a child with ADD/ADHD is that you don’t have to do it all by yourself. Be willing to ask for support and coordinate services from your child’s doctors and teachers. Also, take advantage of support groups for yourself and for your child.
Join support groups for parents of children with ADHD:
Connect with others dealing with the same issues.
Offer a forum for giving and receiving advice.
Provide a safe place to vent feelings and share experiences.
Find support groups for children with ADD/ADHD:
Show children that they aren’t alone; they’re not the only children with these problems.
Teach children how to transfer the skills they’ve learned to the bigger world.
I think it’s positive to point out that people such as Alexander Graham Bell who invented the telephone had ADHD, so did Beethoven, Hans Christian Anderson the author of The Ugly Duckling and Thumbelina, Jim Carrey the actor, Sir Winston Churchill and Prince Charles, Thomas Edison, Leonardo da Vinci , Tom Cruise, Walt Disney and Michael Faraday the famous physicist and Will Smith to name but a small selection of people with ADHD.
So take heart from the NICE report: your child’s ADHD is not all that they are – with the right attitude, support, nurturing, routines and boundaries, and diet who knows what your child can go on to achieve.
The future belongs to those who believe in the beauty of their dreams.
To read the full NICE Report click here