Dr. Gellner: Your child has been diagnosed with ADHD. Now what? I've got tips to help your child and you on today's Scope. I'm Dr. Cindy Gellner.
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Dr. Gellner: ADHD seems to be more and more commonly diagnosed now. It's a disorder that affects 5 to 7% of children. Children with ADHD have problems with attention span, hyperactivity and impulsive behavior. And ADHD is more common in boys than girls.
A normal attention span is three to five minutes per year of a child's age, so you'd expect a two-year-old to be able to concentrate on a particular task for at least six minutes. And a child entering kindergarten should be able to concentrate for at least 15 minutes. Please note, a child's attention span while watching TV is not an accurate measure of his or her attention span.
A child with ADHD is over six and has trouble listening when someone talks, trouble waiting his turn, completing a task, or returning to a task if interrupted. Eighty percent of boys and 50% of girls with attention problems are also hyperactive. A child who has symptoms of hyperactivity is restless, impulsive and always in a hurry.
Fifty percent of children with ADHD also have a learning disability. The most common learning disability is an auditory processing deficit. This means they have difficulty remembering verbal directions. However, the intelligence of most ADHD children is usually normal.
Current theories suggest that ADHD is probably due to small differences in brain chemistry and function. ADHD often runs in the family. Changes in daily routines such as not getting enough sleep can make the symptoms of ADHD worse.
It is important to note that ADHD is not caused by poor parenting. Medicine alone is not the answer. ADHD is like any other chronic condition. Your child will need special interventions at home and school to help with impulsive behaviors, work on structuring your child's life at home and improving discipline.
If your child also has a poor attention span, you can do activities to help them learn to listen and complete tasks. First, accept the fact that your child is active, energetic, and probably always will be.
The hyperactivity is not intentional. Don't expect to eliminate the hyperactivity, just merely bring it under reasonable control. Any criticism or other attempt to change an energetic child into a quiet model child will cause more harm than good. Nothing helps a hyperactive child more than having a tolerant, patient, low-key parent.
Daily outdoor activities such as running, sports and long walks are good outlets for excess energy. In bad weather, your child needs a room where they can play as they please with minimal restrictions and supervision.
Your child should not have too many toys. This is can cause them to be more easily distracted. The toys should be safe and relatively unbreakable. And encourage your child to play with one toy at a time. Although the expression of hyperactivity is allowed in these ways, it should not be needlessly encouraged.
Don't initiate rough housing with your child. Forbid siblings to say, "Chase me, chase me," or to instigate other noisy play. Encouraging hyperactivity can lead to its becoming your child's main style of interacting with people in general, and that's not good.
Household routines help the hyperactive child to accept order. Keep the wait times for a wake up, meals, chores and bed as regular as possible. And try to keep your environment relatively quiet to encourage thinking, listening and reading at home. In general, leave the TV and radio off.
Predictable daily events help your child's responses become more predictable. ADHD symptoms are made worse by sleep deprivation and hunger, so be sure your child has an early bedtime and a big breakfast on school days.
When a hyperactive child becomes overtired, his self-control often breaks down and the hyperactivity becomes worse. Try to have your child sleep or rest when he's exhausted. For children who have trouble slowing down at bedtime, night lights and background music or white noise are often helpful.
Except for special occasions, avoid places where hyperactivity would be extremely inappropriate. You may also wish to reduce the number of times your child goes with you to stores and supermarkets. After your child becomes older and develops adequate self control at home, they can be gradually introduced to these situations.
Children with ADHD are usually difficult to manage. They need more carefully planned disciplined than the average child. Rules should be made mainly to prevent harm to your child and to others.
Aggressive behavior should be no more accepted from the hyperactive child than any other child. Try to stop aggressive behaviors, but avoid unnecessary or impossible rules. For example, don't expect your child to keep his hands or feet still. The hyperactive child tolerates fewer rules than the child without ADHD, so be sure to enforce a few clear, consistent and important rules. Avoid constant negative comments like, "Stop that." Develop a set of hand signals and use them rather than telling your child to calm down.
Physical punishment suggests to your child that physically aggressive behavior is okay. We want to teach hyperactive children to be less aggressive, not more.
Your child needs adult models of control and calmness. Try to use a friendly, matter of fact tone when you discipline your child. If you yell, your child will be quick to imitate you. Be sure to give your child consequences for misbehavior immediately. When your child breaks a rule, isolate them in a time out if a show of disapproval doesn't work.
While your child's attention span may never be normal, it can usually be improved. Encouraging and increased attention span and persistence with tasks is helpful for preparing your child for what is expected in school.
Set aside several brief periods everyday to teach your child listening skills. When they are younger, start with reading to them daily. Coloring pictures should also be encouraged. Teach games to your child. Matching pictures is an excellent way to build your young child's memory and concentration. Later, consequence games such as checkers or tic-tac-toe can be used. When your child becomes restless, stop and return to the game later. Praise your child for being attentive. The process is slow but it's very valuable.
Plan to have your child do homework and other tasks that require attention in short blocks of time, and be sure to have breaks in between.
Try to have your child study with low level backgrounds such as white noise or instrumental music, not just the radio. Do homework and sitting away from the television, the radio or others talking. But keep your child where other adults can watch them.
Ask your neighbors that know your child to be helpers. If your child is labeled by some adults as a bad kid, it's important that the image of your child doesn't carry over into your home life. At home, your child should be noted to be a good child with excess energy.
It's extremely important that you not give up on them. Your child must always feel loved and accepted within the family. As long as a child has his acceptance, their self esteem will survive. If your child has trouble doing well in school, help him or her gain a sense of success to a hobby or sport that they enjoy and are good at.
Some theories suggests you should consider enrolling your child in kindergarten a year late, that is at age six rather than age five, because the added maturity may help them fit in better with their classmates.
Once your child enters grade school, the school is responsible for providing appropriate programs for your child's ADHD and any learning disability he or she may have. Often the schools will have the parents and pediatrician fill out paperwork for something called a 504 plan to help with their behavior needs.
Some standard approaches that teachers use to help children with ADHD are smaller class sizes and isolated studies spaces. They may also include your child in tasks to help keep them busy. Many of these children spend part of their day with the teacher who specializes with learning disabilities who helps them improve their skills and self-confidence.
Usually you can get the help your child needs with school work by working closely with the school staff to a parent teacher conferences and special meetings. Your main job is to continue to help your child improve his attention span, self-discipline and friendships at home.
Stimulant medications can improve a child's ability to concentrate. If you and your child's teacher both feel that your child's short attention span is interfering with school performance, discuss the use of prescription medications with your child's pediatrician. Stimulants are even more effective if they are part of a broader treatment plan including special education and behavior management. By working together with your child's school and pediatrician, your child will receive the support they need to be successful with ADHD.
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