Caring for a Child with ADHD or ADD

Advice for families and caregivers

Attention-deficit hyperactivity disorder (ADHD) occurs when a difference in the brain makes it difficult to control behavior. The disorder has three characteristics: inattention, hyperactivity, and impulsivity. Eight to 12 percent of children have ADHD.
Q&A for Special Needs and ADHD and ADD
General Information
Attention-deficit hyperactivity disorder (ADHD) occurs when a difference in the brain makes it difficult to control behavior. The disorder has three characteristics: inattention, hyperactivity, and impulsivity. Eight to 12 percent of children have ADHD (according to the University of Michigan health system). ADHD can range from mild to severe and in severe cases can significantly impact both behavior and learning and interfere with many dimensions of a person's life. About half those who have ADHD also have a learning disorder and/or a behavior disorder (such as oppositional defiant disorder).
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How are ADD and ADHD diagnosed?
The symptoms are inattention, hyperactivity, and impulsivity. To fit the official diagnosis, these symptoms:
  • Must appear by age 7
  • Must have lasted at least six months
  • Must be present in at least two settings, such as home, school, social gatherings
  • Must negatively impact a person's school, family and/or social life
  • Must not be a result of the child's normal developmental level

Also, ADHD or ADD cannot have other causes, such as:

  • Behavioral disorders (oppositional defiant disorder or conduct disorder)
  • Learning disabilities
  • Major life events trauma (such as death of a loved one, bullying, illness, divorce or a recent move)
  • Medical conditions (thyroid problem, epilepsy, sleep disorder, neurological disorder)
  • Psychological problems (such as  anxiety, depression, bipolar disorder)
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Do all children with ADHD and ADD behave the same way?
No, there are three patterns in which the disorder may appear:
  • A child may be consistently inattentive, disorganized, and daydream a lot, but not very active or impulsive.
  • A child may be much more active and impulsive than others his age, but not very inattentive.
  • A child may be all three: inattentive, hyperactive, and impulsive.
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Are ADD or ADHD learning disabilities?
No, a learning disability occurs when a difference in brain structure or function in a person with normal intelligence creates a problem with learning. Some people with learning disabilities also have ADHD, but ADHD refers to a problem controlling behavior or attention.
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Are ADD and ADHD linked to low self-esteem?
Yes, they are linked to low self-esteem. Here are some examples of how they can lead to low self-esteem:
  • Even though he tries his hardest, a child may find it impossible to be still or pay attention. When he realizes he can't meet expectations, both at home and at school, he loses self-esteem.
  • A child may get in trouble with peers for not following directions or playing games by the rules, causing a loss of self-esteem.
  • Teachers may object that a child skips necessary steps in assignments, doesn't complete tasks, and doesn't organize time or assignments. Realizing he can't follow the teacher's instructions can cause a loss of self-esteem.
  • A child may blurt out answers in class, interrupt others, have temper tantrums, overreact, and be moody, which makes it difficult to maintain friendships, causing a loss of self-esteem.
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How can I foster self-esteem in my child with ADHD/ADD?
  • Try to focus on your child's strengths rather than his weaknesses.
  • Help him develop areas of strength.
  • Notice his positive habits and behaviors and mention them.
  • When he has a problem, work with your child to figure out the cause and come up with solutions. Then, next time a problem arises, remind him in a calm voice of the agreed-upon solution.
  • Listen to your child and validate his experience.
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What can parents and caregivers do to help children with attention-deficit disorders?
Children with ADD or ADHD usually do best with:
  • Structure
  • Consistency
  • Clear communication
  • Rewards and consequences for behavior
  • Love and support as they try to meet expectations in all areas of his life
  • Encouragement to pursue whatever interests they have
  • Both parents reacting similarly to positive and negative behavior
  • Both parents rewarding positive behavior more than punishing negative
  • Daily feedback on behavior. (Have teachers email you feedback each day about how your child did in school. Then offer rewards or time-outs as is appropriate based on this information.)
  • An uncluttered, calm, and soothing atmosphere in the home, with TV screens covered up so that they don't tempt
  • A good night's sleep (symptoms get worse with inadequate sleep)
  • Avoidance of situations that are difficult to handle
  • Time-outs that help them regain control
  • A quiet place to study
  • Receiving one direction at a time, with eye contact made while giving it
  • Ample warning before they must change what they are doing or where
  • Small goals
  • Change of only one or two things at a time
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What reinforcements work best for kids with ADD or ADHD?
  • Immediate positive feedback is best. Kids with ADHD succeed most if quick praise is given when they complete a boring task.
  • If they don't complete a task, giving immediate, mild negative consequences (such as timeouts) is most helpful. Delayed consequences are ineffective.
  • Frequent feedback, both positive and negative, helps.
  • Clear and unambiguous consequences, both negative and positive, work best.
  • Frequent reminders that you believe your child will eventually overcome difficulties and succeed in life can be a strong motivator.
  • Paying attention to your child's strengths, and helping to build on them, can be powerful.
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How does having a child with ADHD or ADD affect family life?
The child's problems can cause friction and stress for the whole family:
  • The need to constantly monitor the child can be exhausting.
  • Siblings may resent the extra attention the child receives, the constant disruption the sibling causes, and the sibling's demands or aggression.
  • When one parent has ADHD or ADD and has child is born with the disorder, the other parent may be resentful.
  • Family outings may be unpleasant as a result of the child's behavior.
  • Parents may be overwhelmed by frequent doctor and school appointments to deal with the child's problems, as well as the extra expense involved.
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Are there special safety concerns when caring for chidren with ADHD or ADD?
Yes, people with ADD and ADHD have many more accidents than others. They receive more head injuries, injure more parts of their body, are hospitalized more for accidental poisoning, and are more likely to get hurt while riding a bike or walking. Therefore, they must be more closely monitored than other kids.
  • Make sure your child wears a bike helmet when biking.
  • Take extra care with household chemicals or tools that could harm a child.
  • Be especially careful if your child is climbing or near water
  • Tell your child to avoid listening to the radio, speaking on the cell phone, or giving rides to passengers while driving, as distractions increase the chance of an accident.
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Who treats ADD or ADHD?
Specially trained clinical social workers, child psychiatrists, psychologists, developmental/behavioral pediatricians, or behavioral neurologists treat ADD and ADHD.
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How are ADD and ADHD treated?

ADHD is usually treated with a combination of medication, behavior modification, changes in lifestyle, and counseling. Exercise and nutrition may be important components of treatment, along with classroom modifications. Interventions in which teachers, parents, therapists and physicians collaborate often work best, and a supportive family can make an enormous difference. Ongoing assessment of interventions is critical. Parents and therapists must set goals and measure progress to see if interventions are actually helping the child.

Some therapeutic interventions that often help include:

  • Psychotherapy, in which older children and adults look at negative behavior patterns and learn how to avoid them.
  • Behavior therapy, in which parents and teachers learn how to help the child behave differently. This usually involves using rewards and time-outs.
  • Family therapy, which helps parents and siblings cope.
  • Social skills training, in which the person with ADHD learns appropriate social behavior.
  • Support groups, whether for the person with ADHD or for their families, in which people share coping strategies, information, and support.
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What about dietary interventions for ADD/ADHD?
Although no scientific studies as yet have shown a definitive link between diet and changes in behavior, many parents feel that their children are less disruptive when they eliminate processed food, additives, sugar, and caffeine.
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Are there treatments for ADD and ADHD that don't involve medication?
Some people are experimenting with brain wave biofeedback to see if learning to control brain wave patterns can make the brain waves more normal.
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What are some activities where children with attention-deficit disorders may succeed?
Every child is unique, but often kids with ADD and ADHD do well with:
  • Martial arts
  • Art
  • Dance
  • Chess (helps teach problem-solving techniques and patience and has been successful with many kids who have ADHD)
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Do relaxation techiniques help children with attention-deficit disorders?
Many children with ADD or ADHD do find that using relaxation techniques, in combination with other interventions, helps them manage their behavior.
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How do I help my teenager with ADHD or ADD follow rules and avoid behavior problems?
  • Recognize that your child will need extra supervision and more time than others to learn new responsible behaviors.
  • Break desired behaviors into small parts and let your teen learn each in sequence. For example, if he wants to stay out till midnight, begin by letting him stay out until 10. If that goes well and he gets home on time, he can then stay out until 11. But if it doesn't go well, move his curfew back to 10 until he can responsibly stay out later.
  • Monitor your teen's behavior outside the home, such as who he is with, where he is, what he is doing, and when he will be home. Establish clear rules for behavior -- what is and is not permissible.
  • Anticipate problems. Develop behavior contracts for potentially difficult situations, such as doing homework or being home on time. You and your child should both know the consequences of not following the rules. Consequences must be applied with fairness and consistency, with everyone knowing in advance what they will be.
  • Certain things should be negotiable and others inflexible. Teens are often more compliant with rules they have helped create, but there should also be some non-negotiable rules, too. To help teens develop independence, gradually give them more of a say in decision making once they have done well in previous attempts.
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Am I a bad parent or caregiver if I lose my temper or don't enforce rules?
Many parents of kids with ADHD feel this way, as it is difficult to be consistent and to not give in to your child's arguments.  Recognize that you are dealing with a difficult situation and forgive both yourself and your child for imperfections. Also, consider joining a support group where you can meet other parents and share strategies for coping.
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What can schools do to help children with ADHD or ADD succeed?
  • Let your child sit near the teacher and away from windows and doors.
  • Let your child tape-record verbal assignments (which kids with ADD and ADHD often forget).
  • Assign your child a buddy who will take notes for him.
  • Reduce the amount of homework he has.
  • Let your child take longer on tests.
  • Let your child run errands for the teacher as a way of using up some extra energy.
  • Let your child use a computer in the classroom instead of writing by hand.
  • Make sure the school's plan for dealing with your child's needs really works for your child and isn't a generic solution that won't help.
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How can I advocate for my child with ADHD or ADD in the public school system?
  • Remember not to be hostile or alienate the people you will need to work with.
  • Speak in a firm but cooperative manner.
  • Before the school year begins, write a letter to your child's teacher explaining his strengths and weaknesses, what techniques you've found to deal with him most effectively, and restate the main points of your child's IEP or 504 plan.
  • Establish frequent and regular communication with your child's teachers. The goal is for them to let you know as soon as a problem begins to arise so you can work together to prevent it from escalating. Always thank the teacher for taking the time to communicate with you.
  • Before the end of the school year speak with your child's current teacher about your child's needs and which teacher would work best with him for the coming year. Getting placed with the teacher with whom he will work best will be very important.
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How can I help a child with ADD or ADHD with homework and school?
Here are several suggestions:
  • Some kids prefer to have time after school to run around freely before settling down with homework. If this describes your child, let him burn off some energy before focusing on more work.
  • Some kids may need the help of medication to focus on homework. Speak with your child's physician to see if it is possible to get a small amount of medication that will let him do the work but won't keep him up at night. It may take several adjustments to get the right dosage.
  • Let your child take a five-minute break after every twenty minutes of homework.

You can also devise a plan for tracking assignments:

  • Some schools post homework assignments on the school's website. That way parents can make sure their child does his homework. If your school doesn't yet do this, perhaps you can request that they do so.
  • Other options are to check with someone else in each class to find out what the assignments are.
  • Or, ask the teacher to write the assignments on the board and to set aside time each day for kids to copy them down. Having a specific assignment book to write them in may help your child.
  • If your child frequently loses textbooks, perhaps you can arrange to get an extra one that you keep at home. That way your child won't have to keep track of it outside of the classroom.
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What is oppositional defiant disorder?
Oppositional defiant disorder is a behavior problem in which a child:
  • Frequently loses his temper, becomes resentful or vindictive
  • Frequently argues with adults or refuses to comply with their rules
  • Intentionally annoys others and easily becomes annoyed
  • Frequently blames others for his one faults

The behavior problem causes difficulties both at school, home, and/or with friends.

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How will ADHD and ADD affect my child's future?
  • ADHD can range from mild to severe. For some adults with ADHD, problems with concentration, organization, prioritization, and focus get worse. They may miss deadlines and important events.
  • On the positive side, hyperactivity itself improves and most adults are able to sit still, although they may feel restless and unable to relax.
  • The most damaging symptom for adults is impulsivity, which can result in angry diatribes, impatience, mood swings, and troubled relationships.

Adults with significant ADHD may want to be proactive about employment. It may help to:

  • Avoid dull and detail-oriented jobs
  • Structure work environments to minimize distractions (arriving before others do, etc.)
  • Work on boring assignments when one is most alert
  • Make sure assignments are clearly understood before starting to work on them
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How can I meet the needs of my child with ADD or ADHD without being overwhelmed?
It's important to care for yourself, as well as your child. Find a respite caregiver -- whether a friend, relative, or special needs caregiver -- and be sure to inform that person of:
  • The specific needs of your child.
  • The extra demands that will be made on the caregiver's patience.
  • How to handle different situations that may arise.
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How can I find someone to care for a child with ADD or ADHD? is a website that lists caregivers throughout the United States who provide assistance to people with special needs. You can search for caregivers near you and review caregiver profiles including photos, references, background checks, and work history. For specific listings of special needs caregivers, go to
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