Caring for a Child with ADHD or ADD

• 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)

• 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.

• 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.

• 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.

• 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

• 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.

• 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.

• 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.

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.

• Martial arts
• Art
• Dance
• Chess (helps teach problem-solving techniques and patience and has been successful with many kids who have ADHD)

• 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.

• 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.

• 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.

• 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.

• 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.

• 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

• 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.