You’re a proud parent. You love your child. But lately he’s become more and more difficult to control. He won’t listen. He never stops moving - and everything is done at a run. If he’s at home, the house is a mess.  His teacher says he cannot focus long enough to participate in group activities, or even finish a simple drawing assignment. The school counselor suggests testing, and the results indicate that your child has attention deficit hyperactivity disorder  or ADHD.

Understanding ADHD

ADHD is a disorder that affects behavior, causing hyperactivity, impulsivity, and inattentiveness. Most of the time, ADHD is diagnosed in school-age children (ages 6-18), but some children have been diagnosed as early as 3 or 4. Kids with ADHD can be a real challenge for parents and teachers. ADHD children are the “live wires,” the kids who are always on the move: unable to focus, and unable to complete tasks or chores. Some ADHD children also suffer from depression and anxiety, as well as learning disabilities like dyslexia.

Children with ADHD may be easily distracted, frequently switching from one activity to another. They often cannot participate in one activity for too long, even something they enjoy. ADHD children may fare poorly in school. They may forget instructions and important details, or completely lose track of assignments or school supplies. Completing an assigned task on time can seem impossible. Compared to same-age peers, they may have difficulty processing information. They can seem disobedient and negligent or, conversely, overly enthusiastic. Waiting for their turn in a game or group activity can be difficult to impossible. They may be restless, irritable, and impatient. They may talk incessantly, and run around out of control. Even finishing dinner or a bedtime story can be impossible for a child with ADHD.

For these children, it is not a matter of “straighten up and fly right” or “try harder.” They are struggling with a significant, chronic disorder that may require medical treatment. If you think your child may have ADHD, contact your pediatrician and ask for an evaluation, or a referral for testing. Your child’s school and the school district may also be valuable resources for information and support. 

 

ADHD used to be called attention deficit disorder, or ADD. Starting in 1994, the name was changed to ADHD and categorized into three different types of developmental disorders; each with slightly different characteristics.

Hyperactive-Impulse

A child with hyperactive-impulse ADHD generally does not have problems paying attention but is excessively active and impulsive. They will constantly fidget, have difficulty staying seated or playing quietly when required, talk too much, and talk out of turn. These symptoms can cause a child to be disruptive.  

Inattentive

A child with symptoms of inattentive ADHD is usually first discovered by their teacher since it affects how the child performs schoolwork. Inattentive ADHD is characterized by a child’s failure to pay attention to details. This leads to overlooked mistakes in schoolwork. A child also has difficulty staying focused or following directions during everyday tasks. They can be easily distracted and forgetful, and even display listening problems when being addressed directly. 

Combined

Combined ADHD is a combination of hyperactivity, impulsiveness, and inattentiveness. It is considered the most common type of ADHD and also the most problematic. 

 

The exact cause of ADHD is unknown but, it seems to be caused by an imbalance in brain chemistry. Dopamine is a neurotransmitter, a chemical that carries signals from one brain cell to another, that controls the brain’s attention center. Some studies have shown that children with ADHD have lower amounts of dopamine in the brain.

ADHD is probably inherited from one or both parents. ADHD is also more common in babies born prematurely, and occurs more often in boys than in girls. Some children with ADHD may have suffered a brain injury that led to the disorder. Smoking and alcohol consumption by the mother during pregnancy is another potential cause for ADHD, as well as environmental factors like exposure to lead in paint and plumbing fixtures. 

Some food additives, like artificial colors and preservatives, are believed to cause ADHD in children, but more research is needed to confirm these findings. On the other hand, the popular notion that sugar and sweets cause ADHD appears to be a myth. 

 

Psychotherapy and individual counseling may help in treating ADHD in children and teens.

Behavioral therapy can give practical support to a child, to help change his or her behavior. Therapists can help a child become more organized and teach them methods to help complete schoolwork. Therapy may also help a child monitor his behavior, and teach him how to work through any frustration or sense of being overwhelmed. The child is taught to praise and reward himself for controlling his anger or thinking before he acts or speaks. 

Family counseling can be very valuable for families dealing with ADHD, reinforcing good organization and rewarding success. Therapists can help guide parents and teachers in learning how to give reinforcement and feedback, create clear rules for behavior, and establish structured routines that can help a child feel more in control. 

Medications 

There are a number of medications that may help children with ADHD. The most commonly prescribed are stimulants, such as methylphenidate, Dextroamphetamine, and dextroamphetamine-amphetamine. It may seem like the last thing a hyperactive child needs is a stimulant, but for most with ADHD, stimulants provide a calming effect by increasing dopamine levels in the brain. Side effects of stimulants can include decreased appetite, difficulty sleeping, and increased anxiety or irritability. These effects are generally minor, and often diminish after a few weeks of therapy. A doctor can usually help minimize them by adjusting the dosage. 

Selective Norepinephrine Reuptake Inhibitors, or SNRIs, are a second type of drug used to treat ADHD, specifically, the SNRI known as atomoxetine. Though atomoxetine is not a psychostimulant, it also works by increasing the amount of neurotransmitters in the brain. Possible side effects of atomoxetine include increased heart rate, insomnia and possible liver damage. All ADHD medications require close supervision by parents, physicians, and other caregivers.  

 

You are your child’s best help. It is easy for others to say “Be patient, don’t be angry, and don’t blame him, he’s just a child” - they are not in your situation. The plain truth is, if you take good care of yourself, you will have more in reserve for your child.  Simply put, it’s a lot easier to model patience and self-control for your child if you are well-rested. Blowing your stack or blaming the child is likely to add fuel to ADHD fire, and cause you more stress and heartache.

Parenting is the toughest job in the world. Parenting an ADHD child can be that much tougher. There is real benefit to learning how to relate to your child, and in helping him to develop friendships by modifying his behavior at play and at school. Rewarding your child for his success rather than constantly punishing for any shortcomings may make all the difference in improving school performance and helping to build strengths and abilities.

All children need structure. For an ADHD child, breaking down a task into a series of smaller tasks and giving encouragement after each bit is completed can mean the difference between success and failure.  Finding support groups and activities that help your ADHD child relax or enjoy exercise can be wonderful tension-breakers for everyone involved.

Some children and families deal with ADHD for a lifetime. Other children may outgrow the “hyperactive” part of the disorder as they age, while ADHD-related issues like depression and anxiety may worsen. Sometimes ADHD is not diagnosed until adolescence or even adulthood. Many adults do not even realize that they have the disorder. They may have a history of poor performance in school, multiple traffic accidents, poor work productivity, or failed relationships. It may be challenging for them to remember appointments, prepare to leave home for work, be punctual, or to stick to a job.

Outlook

Support, understanding, and attention are the very best help that you can offer your ADHD child. With treatment, many children diagnosed with ADHD can learn to not just cope but to excel. It is not an easy road for the parent of an ADHD child, but you are not alone: help is available through your pediatrician’s office, your child’s school, and support groups.