How To Help Your Child With Attention Deficit Hyperactivity Disorder (ADHD)

There is not one best way to help your child with Attention Deficit Hyperactivity Disorder (ADHD). Each stage of a child's development is different, therefore, we thought it would be beneficial to break down ways to help your child at different stages in life.

Preschool Years: There are few medications that have been approved for children at this age. You must be willing to make the environmental changes when necessary. Behavior modification is the best way to manage your child.  Your child will have an easier time if you start introducing a routine in their daily life.  Limiting their surroundings will also help to manage their ADHD symptoms.
In order to help prepare your child for preschool, it is best to:
1. Offer consistent praise.
2. Ignore negative behavior (unless danger presents itself).
3. Utilize time-outs (time for the child to calm down).

School-age Years: This is typically when most children are diagnosed with ADHD. Most children are diagnosed at this stage in life because their difficulties with maintaing focus and control are more evident in this social and educational setting. This is the perfect time to speak with teachers, administrators, and counselors to find they resources that are available to both you and your child.
At this stage, it is important for you as a parent to:
1. Show your expectations clearly.
2. Continue to implement behavior modifications.
3. Establish limits (especially with behaviors).
4. Follow through and be consistent.

Pre-teen/Adolescent Years (Middle School): Adjustments to medications may be necessary at this stage. You have to help your child adapt to the more challenging curriculum they will face. You may also have to help your child to develop different coping strategies to help them with the more complex schedules they will have at this age group. 
At this stage, parents should:
1. Allow your child to take on more responsibilities for themselves.
2. Help students to develop strategies to help them complete their work.
3. Ensure that they start to understand their diagnosis more (make sure they know that ADHD is not a punishment or something they caused to happen).
4. Ensure that your child knows that they can be successful in all areas of life despite their medical condition.

Teenage Years: At this stage, despite independence, parents should still continue to advocate for their children.
Parents should:
1. Ensure that their child is continuing to receive the necessarey services (ex: extra time on tests).
2. Support your child's struggles (ex: with identity and peer pressure).
3. Find your child's strengths and provide them with opportunities for success.

Your Child and Attention-Deficit Hyperactivity Disorder

A Parenting Manual

I.                 What Is ADHD?

Attention-deficit hyperactivity disorder (or ADHD) is best conceptualized as a pervasive, developmental, biopsychosocial disorder.  It is one of the most commonly diagnosed behavioral disorders in childhood.  Common characteristics of children with this disorder include inattentiveness, hyperactivity, and impulsivity.  ADHD can be a chronic lifelong condition.  Evidence implicates that brain dysfunction is the primary cause of ADHD.  Deficiencies in dopamine and norepinephrine also play a contribution to the cause as well.  These children generally have deficits in executive functioning.  Children with ADHD tend to be concrete thinkers.  They have an inability to think and plan ahead, organize, control impulses, and complete tasks.  In order to learn something new, they like to touch or take part in the experience. 

II. What Are The Signs and Symptoms of ADHD?

According to the diagnostic and statistical manual of mental disorders (DSM-IV-R), children need six or more symptoms of inattention and hyperactivity to be diagnosed with attention-deficit hyperactivity disorder. 

Symptoms of inattention include:

·        Difficulty in attending to details.

·        Making careless mistakes in schoolwork or other activities.

·        Difficulty sustaining attention.

·        Difficulty following through with instructions or duties.

·        Difficulty organizing tasks and activities.

·        Difficulty focusing on tasks that require sustained mental effort.

·        Misplacing or losing objects necessary for completing tasks or activities.

·        Easily distracted by outside stimuli.

·        Forgetful in daily activities.

Symptoms of hyperactivity-impulsivity include:

• Fidgeting.
• Lack of being able to sit still.
• Feelings of restlessness.
• Difficulties playing quietly or participating in quiet activities.
• Constant movement.
• Talking incessantly.
• Blurting out answers before questions are completed.
• Difficulties waiting for their turn.
• Interrupts and/or intrudes on others.

III. What Are The Requirements for Diagnosis?

1. In order to be labeled Predominantly Inattentive ADHD, one must have 6 or more symptoms of inattention.
2. In order to be labeled Predominantly Hyperactive-Impulsive ADHD, one must have 6 or more symptoms of hyperactivity.
3. In ordered to be labeled Combined ADHD, one must have 6 or more symptoms of both inattention and hyperactivity.
4. Diagnosis requires the presence of some symptoms before the age of 7 and symptoms that are displayed for at least 6 months.
5. A diagnosis is only made when symptoms are at odds with developmental level.
6. There must be clear evidence of impairment in social, academic, or occupational functioning.
7. Symptoms must be pervasive (they must occur in at least two settings, such as at school and home).

IV. What Are The Prevalence Rates?

1. There is an estimated 3-7% prevalence rate of ADHD found in U.S. school-age children.

2. More boys than girls typically have ADHD.

3. Some cases of ADHD begin during infancy or the preschool years.

4. Most cases of ADHD are referred between the ages of 6 and 12.

5. Core symptoms of ADHD may decrease during adolescence.

6. There are cases of adults who have ADHD.

V. What Other Areas May Be Affected?

1. Motor coordination and timing difficulties are displayed through:

• Clumsiness.
• Delay of motor milestones.
• Poor performance in athletic activities.

2. Intelligence, including specific learning disabilities in:

• Reading.
• Math.
• Other academic areas.

3. Reduced academic achievement.

4. Difficulties in executive functions (cognitive processes).

5. Adaptive functioning difficulties.

6. Socialization difficulties with peers, teachers, and family members.

7. General or specific health problems including:

·        Allergies.

·        Asthma.

8. Sleeping difficulties including:

• An inability to fall asleep.
• Waking up at night.
• Only receiving a few hours of sleep a night.
• Involuntary movements while sleeping (ex: restless leg movements and teeth grinding).
• Treatment with stimulant medications.

9. Children with ADHD are also more prone to accidents.

VI. What Can You Do To Help?

·      Keep children away from lead-based paint, toys, automobile emissions, leaded crystal and ceramic dishes, and solder on old copper pipes.

·      Seek early treatment of symptoms.

·      Minimize secondary problems that interfere with a healthy development.

·      Interact and play with your child.

·      Take interest in the interests of your child.

·      Ensure that your child is interested and motivated in all life/work situations.

·      Emphasize to your child that they are “not bad.”

·      Praise your child for “being good.”

·      Increase positive attention.

·      Regulate your child’s behavior.

·      Monitor and control all disruptive behaviors in order to prevent further development of noncompliant or oppositional child behaviors, which could put your child at risk for Oppositional Defiant Disorder and/or Conduct Disorder.

·      Establish a system for monitoring behavior that works in your home.

·      Have positive and negative consequences for all behavior.

·      Write down rules, punishments, and rewards.

·      Create a schedule that sets specific times for waking up and going to bed, eating, playing, doing homework and chores, watching television or playing videos games, and post the schedule in an area where your child will always see it.  Changes to any routines must be explained in advance.

·      Be more rewarding, positive, and non-directive.

·      Keep an open line of communication with your child’s teacher(s).

·      Provide as much information as possible (specific problems, impairments, strengths, developmental and medical history, academic achievement, and peer relationship) to the people involved with your child, such as doctors and teachers.

·      Collaborate with your child’s doctors and teachers.

·      Speak with your child’s teacher or counselor at least once a month.

·      Communicate and advocate for your child’s needs.

·      Create goals with your child’s teacher.

·      Find your child an academic tutor.

·      Seek social skills training for your child.

·      Seek pharmacological treatment if necessary.

·      Seek parent training if help is needed.

·      Make sure your child is always supervised.

·      Establish an award system for motivation.

·      Maintain a positive attitude.

·      Give simple instructions one step at a time and repeat any steps when necessary.

·      Use a lot of visual aids.

·      Designate a quiet area in your house for your child to go to when necessary.

·      Help increase your child’s organizational skills.

·      Read to your child.

·      Plan “play dates” with neighborhood kids.

·      Promote extracurricular activities.

·      Seek community resources and services.

·      Take your child out and around their community.

·      Play various games with your child (ex: board games, video games, sports, and/or any physical activity).

·      Draw with your child.

·      Be willing to make compromises.

·      Join an organized support group for parents of children with ADHD.

·      Keep your child busy.

·      Teach your child self-advocacy skills.

·      Stay consistent.

·      Remove your child from situations and/or environments that trigger inappropriate behavior.

·      Involve your child in quiet activities one hour before their bedtime to relax them.

·      Ensure that your child receives a proper amount of sleep each night.

·      Increase the level of exercise for your child.

·      Monitor your child’s eating habits.

·      Minimize your child’s caffeine intake.

·      Build upon your child’s strengths.

·      Build up your child’s self-esteem.

·      Increase your child’s social skills by helping them make friends, read social cues and body language, teach social norms, and how to become a better listener.

• Keep a record of all documents, treatments, and placement regarding your child.
• Learn everything you can about ADHD and your child’s educational rights.
• Take care of yourself.

VII. Activities to Do With Your Child

·        Go on a family vacation.

·        Go on a bicycle ride.

·        Go for a walk or hike.

·        Take your child to a “hands-on” museum.

·        Work on a puzzle.

·        Play a sport.

·        Play an instrument.

·        Play board games.

·        Take your child out to the movies.

·        Create a calendar.

·        Build something with your child (for example: models, legos, Lincoln logs, and/or blocks).

·        Cook meals.

·        Create a book or story.

·        Plant a garden.

·        Design a treasure hunt for your child.

·        Create a play with your child (for example: dress-up or a puppet show).

VIII. Lesson Plan Ideas

Here are three lesson plans that will help provide you with ideas for functional, cognitive, and fun activities to do with your child:

1. Cooking with your child their favorite meal(s).

Purpose:         The purpose of this lesson is to teach your child the process of cooking a meal in order to promote independence.  This lesson will teach one necessary life skill: feeding oneself.  The hope is to teach your child the essentials and importance of cooking meals while promoting safety and showing that cooking can be fun.

Objectives:    

Your child will be able to:

·      Practice safety within the kitchen.

·      Learn which ingredients go into their favorite meal(s).

·      Prepare their favorite meal(s).

Lesson Presentation:

Set Induction:

            As a way of getting your child interested in cooking, tell your child that you need their help.  Asking for help makes your child feel important and needed within your family.  Tell them that you need help making whatever meal you know that they enjoy.

Procedure:

·      Before beginning to cook, stress the importance of washing one’s hands before preparing a meal.

·      Make sure you both wash your hands thoroughly.

·      It may be helpful to your child to have a list of the ingredients needed to make the meal.  You can even have your child write out the list for future reference.

·      Have your child gather all of the ingredients needed to make the meal(s).

·      In sequential order, give your child step by step instructions for making the meal.  Make sure the directions are simplistic.

·      Supervise each step.

·      Encourage and praise your child throughout the preparation.

·      Have your child set the table.

·      Help your child serve the portions on everyone’s plate.

·      Enjoy the meal!

Closure:

            Once the meal is finished cooking, make sure everyone is sitting down and eating the meal with your child.  Comment on how well your child did while preparing the meal with specific appraisal.  After cleaning up, sit down again and write out the steps to creating the meal with your child for their future reference.  Ask them if they would be interested in making other meals with you.

Materials and Resources Needed:

·      A kitchen.

·      A stove.

·      A microwave.

·      Other kitchen appliances that might be needed such as a toaster and can opener.

·      Pots.

·      Pans.

·      Spoons.

·      Any other cooking supplies that may be needed.

·      Food.

·      Forks.

·      Knives.

·      Plates.

·      Napkins.

·      Sponge.

·      Water.

·      A sink.

Follow-Up Activity:

            If the activity turned out to be a success and you enjoyed yourselves, challenge each other to make something that neither one of you have made together.  You can also try baking together.  You can use the same procedure above for any style of cooking.

2. Plant a garden with your child.

Purpose:         The purpose of this activity is to promote outdoor activities and teach your child discipline in taking care of something over an extended period of time.  Planting a garden will also promote confidence within your child in the ability to maintain living things.  It also teaches responsibility for taking care of a living thing, which is a good life skill practice.

Objectives:    

Your child will be able to:

• Choose what will be grown in the garden.
• Prepare the design of the garden.
• Work in the garden.
• Plant what was chosen to be grown.
• Water the garden.
• Weed the garden.
• Pick what is grown in the garden.
• Eat what is grown in the garden (if it is edible).

Lesson Presentation:

Set Induction:

            As a way of getting your child interested in gardening, tell your child that you want to work on a special project with them.  Explain that you want to design a garden with them.  Ask them what they would like to grow, (whether it would be flowers, vegetables, or both).  Suggest that it might be nice to have both if possible because not only will your family have something pretty to look at, but you will also be able to eat the vegetables that you decide to grow.

Procedure:

• Before starting your garden, you must decide what you would like to grow.
• Once you figure out what to grow, decide where the garden will be planted.
• Once a site is chosen, measure how much land you have to create the garden.
• Decide on the style for growing the garden (ex: in rows or in a greenhouse).
• Make sure you leave room for walking in between your plants without crushing them.
• Prepare the soil.
• Purchase the seeds needed.
• Plant the seeds.
• Label which seeds are planted in which designated area.
• Water the plants regularly.
• Weed when necessary.
• Keep up all gardening maintenance.
• Harvest your plants when fully grown.
• If you planted vegetables make sure you wash them thoroughly before consuming them.

Closure:

            Once the garden has been planted, continue to keep up the maintenance of it.  Make sure that your child keeps taking care of it and that they are enjoying themselves.  Praise your child for their hard work and signs of responsibility.

Materials and Resources Needed:

• Land.
• Soil.
• Seeds.
• Sunlight.
• Rakes.
• Hoes.
• Shovels.
• Gloves.
• Garbage bags.
• Water.
• A hose.
• A watering can.

Follow-Up Activity:

            If the garden turns out successful and everyone has fun, try to garden other types of plants.  Invite people over to share or help working in your garden.

3. Design a treasure hunt for your child.

Purpose:         The purpose of this activity is to allow your child to practice their cognitive ability skills, as well as their ability to following directions.  Another reason to create this activity is to raise your child’s self-esteem by feeling a sense of accomplishment by finishing the activity on their own.

Objectives:    

Your child will be able to:

• Follow directions.
• Use their cognitive abilities.
• Practice perseverance.
• Find something using clues.
• Develop confidence in one’s abilities to find something on their own.

Lesson Presentation:

Set Induction:

            As a way of getting your child excited for the hunt, tell your child that you have hidden a treat for them.  Explain to them that you forget where you put it, but they can use clues to help you find it. 

Procedure:

• Before starting the treasure hunt, chose the location of where you want your child to look (ex: inside or outside of your home).  Limit the area where your child will be able to look.
• Chose what the prize will be at the end of the hunt (make sure it is something your child likes).
• Decide on the level of difficulty.
• Decide on where you will hide the “treasure” and clues.
• Create and hide the clues.
• Give your child hints if they are struggling to find the clues.
• Praise your child for finding the “treasure.”

Closure:

            After your child finds the prize, ask whether or not they enjoyed the hunt.  Remember to praise them for their effort and success at finding the item.  Suggest that maybe they can design their own treasure hunt.

Materials and Resources Needed:

• A “treasure”.
• Paper.
• Something to write with (ex: pen, pencil, markers, crayons etc.).
• Space.

Follow-Up Activity:

            If your child enjoyed the hunt, there are a few things that can be done.  One thing you can do is increase the level of difficulty and design another treasure hunt.  You could also change the location or make the area for the hunt larger.  You could also involve other people with either helping hand out clues or to help find the treasure, in order to increase your child’s social skills.

IX. Online Resources

·        http://familydoctor.org/online/famdocen/home/children/parents/behavior/118.html

-This website contains factual parental information about ADHD.  It includes advice for how to maintain a stable home environment for your child.

·        http://www.chadd.org/

-This organization focuses on children and adults with attention deficit/hyperactivity disorder (CHADD).  It provides information about the organization, membership, causes, symptoms, evaluation, treatment, FAQs, terminology, and research studies on ADHD, and listings for conferences, training, and support.

·        http://www.helpguide.org/mental/adhd_add_teaching_strategies.htm

-This article contains tips for helping your child become successful academically. 

·        http://www.helpguide.org/mental/adhd_add_parenting_strategies.htm

-This article has parenting tips for parents who have children diagnosed with ADHD.

·        http://www.help4adhd.org/en/living/parenting/WWK2

-Another website from CHADD with parenting tips.

·        http://www.taalliance.org/centers

-This website contains a listing for a parent training and information center that provides information on your child’s rights for each state within the U.S.

·        http://www.adult-child-add-adhd.com/categories/child/child_activities.php

-This website contains several activities you can do with your child.

·        http://www.empoweringparents.com/Five-Simple-Brain-Exercise-Activities-for-Your-ADHD-Child.php#

-This website contains activities you can do with your child that strengthens their cognitive ability.

·        http://adhdparentsupport.com/43/25-activities-for-children-with-adhd/

-This article contains more activities you can do with your child.

·        http://www.adhdsupport.com/

-This website is an online support group for people dealing with or who know someone diagnosed with ADHD.  There is also a hotline number you can call to speak with an expert on ADHD.

Advocating For Accommodations Slideshow

The link above is a slideshow for parents to help them get their child's proper academic accommodations in school.

Things You Can Do To Help Your Child Academically:

1. Communicate with the school and your child's teacher

2. Creat goals with your child's teacher

3. Share information of your child (ex: observations

4. Develop and use a behavior plan

5. Help with organizational skills (ex: go shopping together for school supplies)

6.Check and help organize your child's belongings on a daily basis (exL backpack, folders, pockets, etc.)

7. Help your child learn to make and use checklists (cross off items that are accomplished)
8. Select a specific time and place to do homework that is free from distractions

9. Allow breaks (every 10-20 minutes)

10. Teach how to monitor clocks (have analog clocks readily available)

Attention Deficit Hyperactivity Blog
The blog link above presents ways to help children with ADHD socially, as well as how to improve their executive functions and organizational skills