In this Article
ADD
What Is ADD? What Is ADHD?
ADD stands for Attention Deficit Disorder. It is the same thing as ADHD. The name was changed to ADHD in 1994.
ADHD stands for Attention Deficit Hyperactivity Disorder. It describes a range of behaviors that include difficulty paying attention, impulsive behavior, and hyperactivity.
Because different countries tend to use different criteria to diagnose ADHD the percentage of children considered to have the condition is very different from country to country. Thus, in some European countries less than 1% of children are thought to have ADHD, yet in the USA, where diagnostic criteria are much wider with a broader set of symptoms, as many as 10% of children are considered to have ADHD. Boys outnumber girls 5 to 1 with this diagnosis.
- In the U.S., about 3% to 5% of school-aged children have ADHD. That’s about 1 in 20 to 30, or an average of one child in each classroom.
- Adults can have ADHD.
- About one-third of children with ADHD appear to grow out of some, but not all, symptoms.
- Symptoms of ADHD will begin before age 7.
- Most children with ADHD have a close relative who has or had it.
- In the case of identical twins, if one has ADHD, there is more than an 80% chance the other will also.
- If a child receives a diagnosis of ADHD, there is a one in four chance that a parent has or had it.
Different types of ADHD:
Children with ADHD aren’t all alike. There are different types of ADHD. Each type has different symptoms.
- Inattentive ADHD
- Hyperactive/Impulsive ADHD
- Combined ADHD
Inattentive ADHD
This group of children has trouble paying attention and concentrating. A child with this type of ADHD will have six or more of these symptoms:
- Difficulty following instructions
- Difficulty paying attention to work or play
- Loses things needed for activities at school or at home
- Appears not to listen
- Doesn’t pay close attention to details
- Seems disorganized
- Has trouble with tasks that require planning
- Forgets
- Is easily distracted
Hyperactive/Impulsive ADHD
This group of children is overactive and behaves impulsively. A child with this type of ADHD will have six or more of these symptoms:
- Fidgets
- Can’t stay in his or her seat
- Runs and climbs when it’s not appropriate
- Talks too much
- Can’t play quietly
- Is always active
- Blurts out answers
- Has trouble waiting for his or her turn
- Interrupts people
Combined ADHD
This is the type of ADHD diagnosed most frequently. These children will have at least six symptoms of both inattentive ADHD and hyperactive/impulsive ADHD. For example, they may have difficulty paying attention, and also fidget, talk too much, and run and climb when it’s not appropriate.
There is also a group called “not otherwise specified ADHD.” These children have fewer than six symptoms from both of the other types of ADHD, but their symptoms are severe enough to cause problems in everyday life.
Children who have difficulty paying attention:
- Often have trouble paying attention to activities that don’t fully engage their interest
- Often act without thinking about the consequences
Children with impulsive behavior:
- Have difficulty screening out distractions and selecting what is most important to pay attention to
- May have trouble starting or finishing tasks
- Will understand rules, but may fail to use these rules to guide their behavior
Children with hyperactivity:
- Are restless and have difficulty sitting still; they seem to be in constant motion
- May interrupt others, blurt out comments and have trouble waiting their turn
| But aren’t all children like that?
All children may be distracted, impulsive and overly active some of the time – whether or not they have ADHD. To be diagnosed as having ADHD, a child needs to:
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Learning that your child has ADHD may come as a surprise. Yet for many parents the diagnosis comes as a relief, because at last there is an explanation why their child is having difficulty at school, with family and friends, and with behavior in general.
In the last 20 years, doctors and teachers have become better able to help children with ADHD and have developed new ways to help these youngsters gain greater control over their lives.
What’s It Like Having ADHD?
Children with ADHD can concentrate on activities they find interesting. When they are really involved in something or having fun or working for a reward, children with ADHD are not easily distracted. They pay attention and can stick with the task – for example they can play computer games for hours.
Problems arise when these children face tasks that are repetitive, uninteresting, and not of their own choosing. As soon as their interest in an activity wanes, they find it hard to stay with it. While most people can make themselves finish tasks, even if they are boring, children with ADHD will have difficulty.
In other words, the problem is not so much that they are distracted from whatever they’re doing, but rather that they seek something more interesting than what is in front of them.
Here is what some children with ADHD have said:
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How Common Is ADHD?
About 3% to 5% of school-aged children have ADHD. That’s about 1 in 20 to 30, or an average of one child in each classroom.
Most of the children who are referred for treatment are boys, perhaps because boys are most likely to disturb the peace at home or in the classroom. In fact, there may be just as many girls as boys who have ADHD, but they are less likely to be hyperactive, and therefore they don’t “rock the boat.” As a result, girls are also less likely to obtain treatment, and often go through school undiagnosed and quietly failing because of their wandering attention.
As your child gets older, ask what ADHD feels like. Many children like to talk about it, and that helps.
Will The Child Grow Out Of ADHD?
About one-third of children with ADHD appear to grow out of some, but not all, symptoms.
In some children, hyperactivity slows at puberty, or else the child learns to curb or to compensate for hyperactive behaviors. But the problems of inattention and disorganization may persist.
For many, ADHD will continue into adulthood. That possibility makes it extremely important to give the child the tools that can help for a lifetime.
Frequently Asked QuestionsQ: My 8-year-old daugher was just diagnosed with ADHD. Will this be a lifelong problem for her? A: About one-third of children with ADHD appear to grow out of some, but not all, symptoms. In some children, hyperactivity slows at puberty, or else the child learns to curb or to compensate for hyperactive behaviors. But the problems of inattention and disorganization persist. For many, ADHD will continue into adulthood. That possibility makes it extremely important to give the child the tools that can help for a lifetime.
Q: When examining my son for a possible ADHD problem, the pediatrician tested his hearing and reading abilities. Why would she do this? A: Other conditions, such as hearing problems and learning disabilities, can cause symptoms that mimic those of ADHD. The diagnostic process must be thorough to make sure that your child has ADHD and not a condition that produces similar symptoms. Some of these conditions may occur along with ADHD. If an additional condition is present along with ADHD, that condition must be treated as well.
Q: My doctor suggested treating my son’s ADHD with medication, but I’m worried. Do these medications work by “drugging” the child? A: The medications most often used in ADHD are stimulants. They won’t sedate your son or make him sleepy. Rather, they’ll help his brain work in the way that it would if he didn’t have ADHD. They wake up the brains “braking system” – the parts that are responsible for self-regulation.
Q: My wife and I disagree on how to handle our 10-year-old daughter, who has ADHD. I’ve suggested rewarding her for doing the right thing, but my wife considers it a bribe. Do rewards work? A: Rewards can be used to reinforce the specific positive skills or behaviors that you want to see more often. When a child gets a reward for doing something, he or she is much more likely to do it again. But don’t give rewards before the behavior has been done. That’s a bribe, rather than a reward.
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What Causes ADHD?
We don’t really know what causes most cases of ADHD. Genetics does play a role – ADHD runs in certain families. But genes alone don’t provide the full explanation.
It is likely that a combination of factors, including genetics and environment, ultimately contribute to the development of ADHD.
Most children with ADHD have a close relative who has or had it. If a child receives a diagnosis of ADHD, there is a one in four chance that a parent has or had it.
Often, parents don’t realize that they have (or had) ADHD until their child is diagnosed. This may shed some light on why they felt they could never sit still or concentrate, or why they still find it hard to organize things properly.
Latest research
Thanks to new techniques for studying the brain, scientists are getting a better idea of what’s happening in individuals with ADHD. We know that, in some cases:
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There is a difference in the level of some neurotransmitters in the brain. These are chemicals that pass messages from one nerve cell to another. There appears to be less of two neurotransmitters — dopamine and norepinephrine — in those with ADHD.
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There is a difference in blood flow to certain parts of the brain responsible for planning, organization, and self-regulation. This difference in blood flow may reflect a difference in how efficient those parts of the brain are operating.
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There is a difference of size in certain structures of the brain. In individuals with ADHD, these structures are smaller.
What About Stress?
Stressful situations, such as a divorce in the family or other family problems, are not likely to cause ADHD, but they can make the condition harder to cope with.
Having a child with ADHD can certainly be a source of stress to others in the family. This stress should be considered when you work with professionals on your child’s treatment program.
How Is ADHD Diagnosed?
Just because a young child has trouble sitting still and seems to have a short attention span does not mean that the child has ADHD.
A lot of normal, healthy children are extremely bouncy when young, and may often seem out of control. The diagnosis of ADHD must be made by an expert after a thorough assessment. No laboratory or high-tech tests are available to confirm a diagnosis.
An evaluation may be done by one of several specialists:
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A developmental pediatrician or a child psychiatrist who specializes in ADHD
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A physician with expertise in ADHD
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A psychologist who has specialized in ADHD (many school psychologists have this expertise)
The diagnosis of ADHD is based on:
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The way the child behaves in various settings (for example, at school, in the playground, and at home)
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The presence of at least six of the symptoms of ADHD, some of which should have begun before age seven
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How much harm these symptoms are causing the child academically and socially
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The fact that symptoms have been present for period of time
As part of your child’s evaluation:
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You will be asked about your child’s medical, social, and developmental background and your family history.
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Your child will be interviewed.
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Your child might be given tests to check on language and motor skills, and to rule out any learning disabilities.
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Your child’s teacher will need to answer questions about the way the child behaves, learns, pays attention, follows directions, and completes assignments.
Conditions That May Be Confused With ADHD
There are a number of conditions that may be easily confused with ADHD. That’s why the diagnostic process must be thorough to make sure that your child has ADHD and not a condition that produces similar symptoms.
Some of them may also occur with ADHD. If an additional condition is present along with ADHD, that condition must be treated as well.
Conditions that produce symptoms similar to ADHD include:
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Difficulty with hearing or with speech
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Problems with the ability to learn (such as reading problems)
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Language and communication disorders
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Problems with mood, such as anxiety or depression
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Problems with the nervous system
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Problems in the home environment that might be affecting your child
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Problems with development
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Conduct disorder (behavior problems that are more severe than most)
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Sleep disorders
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Tic disorders (involuntary movements of the face or other parts of the body)
Additional Sources Of Information on ADD – ADHD
Children and Adults with Attention Deficit Disorder (CHADD)
8181 Professional Place, Suite 201
Landover, MD 20785
Phone: 301-306-7070 or 800-233-4050
Fax: 301-306-7090
Web: http://www.chadd.org/
The National Resource Center on AD|HD (A Program of CHADD)
Web: http://www.help4adhd.org/
Attention Deficit Disorder Association (ADDA)
PO Box 7557
Wilmington, DE 19803-9997
E-mail: info@add.org
Phone/Fax: (800) 939-1019
Web: http://www.add.org/
Learning Disabilities Association of America
4156 Library Road
Pittsburgh, PA 15234-1349
Phone: 412-341-1515
Fax: 412-344-0224
Email: info@LDAAmerica.org
Web: http://www.ldanatl.org/
National Center for Learning Disabilities
381 Park Avenue. South, Suite 1401
New York, NY 10016
Phone: 212-545-7510 or 888-575-7373
Fax: 212-545-9665
Email: ncld@ncld.org
Web: ncld.org/
The American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL 60007-1098
Phone: 847-434-4000
Fax: 847-434-8000
E-mail: kidsdocs@aap.org or info@healthychildren.org
Web: http://www.aap.org and www.healthychildren.org
The American Academy of Child and Adolescent Psychiatry
3615 Wisconsin Ave., N.W.
Washington, DC 20016-3007
Phone: 202-966-7300
Fax: 202-966-2891
Web: http://www.aacap.org
The National Association of School Psychologists
4340 East West Highway, Suite 402
Bethesda, MD 20814
Phone: 301-657-0270 or 866-331-NASP
TTY: 301-657-4155
Fax: 301-657-0275
E-mail: nasp@naspweb.org
Web: http://www.nasponline.org/
American Psychological Association
750 First Street, NE
Washington, DC 20002-4242
Phone: 202-336-5500 or 800-374-2721
TDD/TTY: 202-336-6123
Fax: 202-336-5997
Web: http://www.apa.org/
ADHD: What you need to know
This is a summary of what we’ve considered in the previous sections in great detail:
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ADHD stands for Attention Deficit Hyperactivity Disorder. It describes a range of behaviors that include difficulty paying attention, impulsive behavior, and hyperactivity.
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In the U.S., about 3% to 5% of school-aged children have ADHD.
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The different types of ADHD include inattentive ADHD, hyperactive/impulsive ADHD, and combined ADHD.
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When they are really involved in something or having fun or working for a reward, children with ADHD are not easily distracted
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About one-third of children with ADHD appear to grow out of some, but not all, symptoms.
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It is likely that a combination of factors, including genetics and environment, ultimately contribute to the development of ADHD.
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Just because a young child has trouble sitting still and seems to have a short attention span does not mean that the child has ADHD. The diagnosis of ADHD must be made by an expert after a thorough assessment.
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Treatments for ADHD include educational strategies, behavioral strategies, medication, and other options.
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Teachers can help children with ADHD to avoid distractions by making classroom tasks as interesting and stimulating as possible, and by providing a system of rewards that children can earn for completing tasks.
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Parents can do many things for children at home, including improving organizational skills and teaching social skills.
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Rewards can help change behavior. They can be used to reinforce the specific positive skills or behaviors that you want to see more often.
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If a child is to be punished for breaking important rules, it is especially important for children with ADHD to know exactly what type of punishment to expect.
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Treatment with medication can often be very successful in a child that really needs medication. Medication will help your child be more receptive to learning, paying attention, and controlling impulses.
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Medication can’t do the job on its own. It should be used as part of a comprehensive program that includes behavioral strategies and educational strategies.
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Some alternative therapies have been found to be of no value, while others are as yet unproven. What works for one child may be ineffective for another. Discuss other options with your doctor.
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Counseling (or “coaching” as it is sometimes called) can be beneficial for children with ADHD, particularly if they experience problems related to anxiety or depression.
Can Counseling Help ADHD?
Counseling (or “coaching” as it is sometimes called) can be beneficial for children with ADHD, particularly if they experience problems related to anxiety or depression.
A “coach” can help children build motivation and get organized. The main role of the counselor or “coach” is to help children:
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Learn to focus on their strengths
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Become active rather than passive participants in the treatment process as well as in their home and school lives
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Examine their problems and follow through with solutions
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Understand the effect that ADHD has on their lives
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Need To Know: Keep in mind that children with ADHD may not enjoy traditional sit in a chair and talk type counseling. |
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Need To Know: To help determine if your child might benefit from counseling, answer yes or no to the following questions:
Any “yes” answers might mean that your child, or the family, would benefit from counseling. It need not be long term; sometimes just a few sessions can make a big difference. |
How Is ADHD Treated?
Each child with ADHD is different and needs a different approach to treatment. An accurate diagnosis — one that describes your child’s problem precisely and also reveals any associated problems — is crucial to designing your child’s treatment.
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Need To Know: Make sure all adults who deal with your child know about ADHD. That includes teachers, scout leaders, and sports coaches. Keep lines of communication open so that if your child is having a hard time, you’ll know about it. |
There are several research-proven and accepted treatments for ADHD. Most children do best with a combination of treatments.
Treatments for ADHD include:
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Educational Strategies
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Behavioral Strategies (What Parents can do to help)
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Medication
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AlternativeTreatments For ADHD
Educational Strategies To Treat ADHD
Much of the treatment of ADHD needs to take place at school. Unless they receive appropriate support, many children with ADHD will struggle in school. This is not because they lack intelligence, but because their early years of failure affect their self-esteem and their ability to learn.
When children with ADHD are interested in the tasks in front of them, they can avoid distractions as well as any other child.
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Need To Know: There are two simple yet very good ways that teachers can help children with ADHD to avoid distractions:
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Fortunately, most teachers are trained to understand and work with children with ADHD. And teachers are generally eager to communicate with parents. You should not hesitate to contact your child’s teachers when difficulties arise.
There are also many other ways in which a teacher can help by providing structure, and using behavior management techniques, to improve school performance.
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Need To Know: In The Classroom When you talk to the teacher, here are some points you may want to discuss:
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Most often, you will find your teacher to be your child’s biggest ally. If an outside psychologist has been working with your child, he or she can often help you make a case for the type of attention, or the type of schooling, that your child needs.
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If you feel your child isn’t getting the support he or she needs at school, talk to the teacher.
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If that doesn’t work, talk to the school administrators.
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If that doesn’t work, talk to the school superintendent or school district officials.
Your child has a right to a free public education that’s appropriate for him or her.
Behavioral Strategies (How Parents Can Help)
Parents can do many things for children at home, including improving organizational skills and teaching social skills.
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How-To Information Practical Suggestions for Working with Your Child at Home
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Helping Your Child Get Organized
A common desire of parents who have children with ADHD is to get their child organized. Here are some practical steps you can take to help provide structure:
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Establish a routine. Children with ADHD do better if their lives at home follow a routine.
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Keep a schedule, with set times for meals, homework, TV watching, and so on.
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Write out or draw the morning routine, from waking up to breakfast time. You might want to ask your child to check off each activity with a sticker or magnet as it is completed.
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Decide the night before on what clothing to wear, so it is ready and laid out.
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Together with your child, create a large monthly calendar with important activities and dates clearly marked.
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Schedule family meetings at least once a month to discuss coming events, jobs, and schedules.
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Have your child help with household duties. This will make the child feel useful, like a member of a team. It will also give the child practice in organization and follow-through.
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Share household jobs among all your children. Have each child do at least one every day. Use a chart, so that no one complains that it’s unfair. You could attach the chart to the refrigerator with a magnet, using pictures for a child who can’t yet read.
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Have a set routine at mealtimes, with each child helping. Again, make a chart, so everyone takes turns.
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Have set times for homework.
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Make sure the whole house is quiet at homework time, with no music, radio, computer games, or TV.
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Be available to help your child. Children will study better if a parent interacts with them and assists them.
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Set up a mini-schedule so that your child can work for brief periods, with short rest periods in between.
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Have a quiet time for the whole family even when there is no homework to be done or the homework is finished. As a bonus, you’ll find that the adults benefit from this quiet time too — while also serving as role models for the child.
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Limit TV. Don’t allow unlimited TV. Teach your children to be discriminating. Sit down with them and let them pick out one or two shows a day. Do it ahead of time, and write down the times of those shows on the monthly calendar. Watch the shows with your children if you have the time.
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Help your child control his or her belongings. Children, especially those with ADHD, are not naturally tidy. Help them keep their possessions under control and learn self-discipline at the same time.
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Label shelves in clothes closets with pictures or words.
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Have one color for each child’s “tools,” such as backpacks, lunch boxes, toothbrushes, and so on.
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Make sure backpacks are packed and ready for school the night before.
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Have regular clean-out days when children empty out their backpacks and make sure they have enough supplies for the next week.
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Have a laundry container in each room for dirty clothes. Insist that clean clothes be put away.
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When children are old enough, show them how to use an organizational planner to keep track of homework and upcoming events.
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Improving Your Child’s Behavior
Managing the behavior of a child with ADHD can be exhausting — but it can also be rewarding as you see progress. There is a lot you can do to help your child stay more or less in control:
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Encourage specific positive behaviors. This works much better than trying to get rid of “bad” or difficult behavior.
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Identify a behavior that you want to change and then be specific about the positive skill that should replace it. In that way, you can help your child replace a negative behavior with a positive skill.
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Work on one behavior at a time — and make sure you identify the behavior accurately.
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Encourage specific behaviors. This works much better than trying to get rid of “bad” or difficult behavior.
Changing Negative Behaviors To Positive Skills
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NOT: |
BUT: |
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Stop fighting with your brother. |
Learn how to share. |
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Don’t interrupt me when I’m on the phone |
Learn how to wait until I’m off the |
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Don’t leave your clothes on the bathroom floor. |
Leave the bathroom tidy. |
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Stop being so difficult when getting dressed. |
Learn how to tie your shoes. |
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Don’t yell. |
Use a quiet indoor voice. |
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Don’t ignore your parents. |
Pay attention to your parents’ |
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requests. |
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Finish your homework or you will be punished. |
You’ll get a reward for completing |
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With each success, your child’s sense of self-worth and self-confidence will increase. |
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Helping Your Child Get Along With Others
With patience, parents can teach their child to understand and follow the “rules” for getting along with others. When there is a problem:
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Define it (determine what the problem is).
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Consider strategies to deal with it.
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Then put them into practice.
Here’s an example:
Scott’s friends ignore him. They say he always interrupts.
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Scott often interrupts his friends. |
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Friends are annoyed. They think Scott is rude, and they stop listening to him. |
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Scott and his parents think of possible solutions. Scott says, “I could wait till it’s quiet before I talk” or “I could raise my hand” or “Sometimes it’s fun to be a listener.” |
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Scott says, “I’ll wait till it’s quiet, so I won’t interrupt, and everyone can hear what I have to say.” |
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Scott says, “I’ll listen until whoever’s talking has finished.” |
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Scott tries out his new strategy and tells his parents how well it worked. |
If the plan doesn’t seem to work the first time, it may need to be adapted. Or just keep working with the plan patiently, day after day. Your child can learn to problem-solve more effectively – one situation at a time.
Consider your child to be a partner in the treatment of the ADHD:
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Children will do best when they know what is expected of them and are rewarded for doing what is asked of them.
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Children need to learn to read their own signals and impulses, so that they know when they need to let off steam and when they need time out.
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Children will often have suggestions and insights about which problems should be tackled next — and how. You just have to ask!
Rewards can help change behavior. They can be used to reinforce the specific positive skills or behaviors that you want to see more often. When a child gets a reward for doing something, he or she is much more likely to do it again.
Rewards need not be expensive — in fact, they don’t have to cost anything.
Rewards are useful in two sizes:
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Small rewards that you give each time the child does a certain behavior.
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Large rewards to be given after the child has kept up this behavior for a while or met a goal for improvement over a period of days or weeks.
Small rewards can vary according to the age of the child. For example:
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A young child may be happy with a gold star to stick on a special sheet that shows progress.
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An older child would do better with points or tokens that can be exchanged for a larger “prize.” This prize could be a toy or a special treat.
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Money can work – a penny a time for a small child, a nickel for older ones. It adds up!
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Need To Know: Some Hints About Rewards
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Harsh punishments don’t work. Spanking only teaches your child that violence is a good way to express anger.
It’s often much more effective to “punish” children by ignoring them. This sends the message that if they want your approval, they need to earn it by doing “positive” things.
Sometimes, though, you may need to punish your child for breaking important rules. It is especially important for children with ADHD to know exactly what type of punishment to expect. If you tell them what to expect, you will seem fair.
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Discuss punishments ahead of time. For example, tell your child “if you leave your bicycle out, you can’t ride it the next day.” Be as specific as you can.
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Make the punishment appropriate. For example, don’t take away biking privileges because your child took food into the living room and made a mess of the couch.
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Always follow through. For example, don’t ground your child for three days, then relent after one day.
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Make the punishment right for the age. For example, a five-minute “time out” in the bedroom may work for a 5-year-old, but not for a teenager.
Keeping Track Of Your Child’s Improvement
You should measure how much you have succeeded in helping your child, and how much your child is improving. Here is a four-step approach:
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Keep a record. Track the number of times your child performs unacceptable behavior, such as ignoring you when you ask him or her to do something. In a notebook or diary, separate part of the day into one-hour blocks, and in each block, record how many times the behavior happened.
For example: “Ignoring me when I ask him to pay attention – How often?”
Tuesday 3 pm – 4 pm XXX
4 pm – 5 pm XXXXX
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Decide on a goal. Decide how much improvement you hope to see a month from now. Don’t ask for too much. Aim for partial improvement, just at one time of day. At first, plan to work on this one piece of behavior for a specific time — say, a week. Later you can aim for more improvement, more often during the day.
For example, if your child has been failing to pay attention about ten times between dinner and bedtime, you might want to cut the behavior down to two or three times during that time slot.
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Talk to the child about your plan. You might tell your child that he or she will get a reward each time he or she stops what he or she is doing, listens to what you are saying, and answers. Explain that at first you’ll only be keeping track at a certain time of day — for example, between 5 pm and 6 pm.
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Do it! Make sure you really can give your child a reward every single time that he or she stops, listens, and answers (it could just be a hug). Also, keep records, so you can see for yourself and show your child exactly how much improvement there has been.
Medication For ADHD
Medication is never the first resort for the treatment of ADHD. Educational strategies and behavioral strategies (see previous page) are almost always tried at school and at home before turning to medication. Often, these measures will help considerably.
But if problems still remain, the doctor may suggest using medication. Treatment with medication can often be very successful. Unfortunately, too many children have been prescribed medication for ADHD when they have not needed it. But in the appropriate setting, when a child really does need medication, it can be helpful.
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Need To Know: How the medication works The medications most often used in ADHD are stimulants. They don’t sedate the child, or make him or her sleepy. Rather they help the brain work in the way that it would if the child didn’t have ADHD. They wake up the brains “braking system” – the parts that are responsible for self-regulation. |
Below we consider:
Does Your Child Need Medication?
Many parents are reluctant to start medication, feeling that they would be “drugging” their child. They may also feel that giving the child medication means that they, as parents, have failed. This is not true.
In mild cases, children can do well without medication. They can be helped through changes in the way their lives are structured in school and at home.
But if a child has moderate or severe symptoms, medication can make a huge difference to the child’s ability to live a normal life.
What Medication Can Do For Your Child
Medication can make a dramatic difference in the lives of children with ADHD who need it. For example, it allows them to:
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Become more aware of the consequences of their actions and words by making them less impulsive
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Stay with tasks for longer periods by reducing their ability to be distracted
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Concentrate longer at school by increasing their attention span
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Increase their ability to stop and think about what they want to do
Medication also reduces hyperactive and aggressive behaviors, helping children to get along better with others at school and at home. Children become more calm, focused, and successful in their day-to-day lives. Self-esteem is increased.
Medication will help your child be more receptive to learning, paying attention, and controlling impulses — but it can’t teach those skills. You will still need to follow a strategies at home and at school, to help your child succeed now as well as later in life.
Often, the improvement after a medication is given can be dramatic. The child is better able to pay attention, to concentrate, and to sit still. It’s tempting for adults to praise the medication for the change — but if you do that, you might be short-changing the child.
It’s important to help the child see that it’s not the medication that is magically turning him or her into a “good kid.” Rather, it is the child’s own effort that is now able to come into focus — thanks to the medication. In other words, it enables children to do what they already know they need to do.
Common questions asked about medication for ADHD include:
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Does my child really need medication? Most children with ADHD will benefit from medication – but whether or not to start medication is a decision that should be made carefully after discussions with the doctor.
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Will my child become addicted? Research shows that people with ADHD don’t become addicted to their medication, and often develop a healthy disrespect for drugs.
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Does the teacher just want children to be medicated to keep them quiet? The medication will probably help your child behave better in class, but it shouldn’t make children feel sleepy or doped up. It’s a stimulant that helps them to concentrate and do their work better.
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What if my child is teased for taking medication? Very few children are teased for taking medications. With your help they can learn to cope. They are more likely to be accepted by their peers once they are on medication because they are better able to follow the rules of games and take part in conversations without constantly interrupting.
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Will my child have to stay on medication for life? Some children need medication for only a short time, but others stay on it for a long time. Adults who don’t grow out of ADHD usually choose to keep taking the medication. They appreciate how much it helps.
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What about side effects? Side effects are usually mild (see below)
What Are The Types Of Medication Used?
There are four types of stimulants that may be used for children with ADHD:
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Adderall (Dexedrine salts)
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Ritalin (methylphenidate)
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Dextrostat (dextroamphetamine) and Dexedrine (dextroamphetamine)
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Need To Know: |
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Medication |
Remarks |
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Adderall |
Adderall’s effects lasts for about 4 to 6 hours; it is taken once or twice a day. |
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Ritalin |
Ritalin is available in a short-acting form, which lasts about 3 to 4 hours. It is most often taken 2 to 3 times a day. A slow-release form can be effective for 6 to 8 hours. |
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Dextrostat and Dexedrine |
Dextrostat’s and Dexedrine’s effects last about 4 to 6 hours and are usually taken twice daily. A slow-release form works for longer (6 to 8 hours) and can usually be taken once a day. |
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In some cases, a child with ADHD may be given a different type of medication, either because the stimulants don’t work or because the child needs help with coping with other problems, such as depression or anxiety. These medications might include imipramine, desipramine, buproprion, fluoxetine, or buspirone. |
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In 70% of cases, the medication that is first chosen works well. Almost 90% of children with ADHD respond to one of the four stimulants, so if the first one doesn’t work, another probably will.
The type of medication chosen will depend on your child’s needs and his or her response to it. For example, if the main problem is behavior in the classroom, a short-acting medication would be appropriate. However, if the school day is long, a longer-acting medication might be preferable.
For those who benefit from medication, the advantages far outweigh the disadvantages. However, in the short term, stimulants may produce side effects such as:
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Difficulty sleeping
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Lack of appetite
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Upset stomach
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Headache
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Irritability
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Tics (involuntary movements; and if the child has them already, they may get worse)
Usually the doctor will suggest staying with one medication for a least a week to see if side effects bother your child before adjusting the dosage.
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If adjusting the dosage does not correct the problem, a switch to one of the other medications might work.
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If switching doesn’t work either, your child may be helped by another type of medication
In some cases, the stimulants may slow growth slightly, but usually this effect wears off, and the child’s final height is unlikely to be significantly reduced. In very rare cases, some medications may cause liver or other problems, so make sure your child has regular medical examinations.
As stimulant medication wears off, some (but not all) children experience a “rebound” effect. It is not a side effect of the medication, but rather the result of the medication wearing off. As the medication wears off, the child’s behavior is like a spring bouncing back to normal levels; behavior may worsen for a short time, and an increase in irritability or hyperactivity may also be seen.
For some children, this pattern can be reduced by adding an afternoon dose of medication. For others, reducing expectations and required tasks during this period of irritability can also be helpful. If this is a persistent problem, it is important for you to speak to your physician and work out an effective plan.
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Need To Know: Final Checklist Before Beginning Medication
Have the reasons for using the medication been explained to your child? If you answered “no” to any of these questions, you may want to delay starting medication until everyone (including your child) knows what to expect. |
Follow-Up Visits With The Doctor
Follow-up by the doctor is necessary once your child is on medication. The doctor will:
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Make sure the drug is the right one and is not causing any side effects
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Make sure the dose is correct as your child grows
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Answer all your questions about your child’s problems and progress
In some cases, doctors might recommend a “holiday” from medication — for example, during the summer months or even over weekends. But you and your child shouldn’t feel you have failed if your child needs to keep taking medication daily.
There’s no point trying to tough it out if your child really needs help.
Alternative Treatments For ADHD
From time to time, you may hear of new treatments for ADHD. For example, in the 1970’s, it became popular to limit food additives. These approaches are often sought out by parents who are concerned with the use of medication for a variety of reasons.
The value of medication in the treatment of ADHD has been proven – but alternative treatments can be used together with medication and other approaches.
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Need To Know: Some alternative therapies have been found to be of no value. Others are as yet unproven, and what works for one child may be ineffective for another. Discuss other options with your doctor. Keep communication lines open. It is possible to integrate several different treatment approaches. Your doctor will keep you child’s best medical interests in mind and is an excellent scientific consumer advocate. |
Some other approaches in treating ADHD include:
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Diet
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Nutritional Supplements
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Behavior-Changing Therapies
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Allergy Treatments
There is evidence that certain foods may affect some children’s behavior – although these foods do not affect most children with ADHD. It is nonetheless worth keeping the following points in mind:
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Good food is important for everyone. Regular meals with nutritious snacks are an essential part of every child’s routine.
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Following any diet can provide structure and control that can be helpful behaviorally and nutritionally. The rigid following of any diet, however, can worsen certain situations
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Some children become calmer when they cut down on foods containing excessive sugar, MSG, chocolate and artificial color. If you think this might be the case for your child, work with your doctor to remove these substances from your child’s diet, then add them back one at a time and see if you notice any ill effects from them.
No firm evidence exists that extra vitamins or minerals taken as supplements affect ADHD, although more research is being done in this area. However, it is important to note that nutritional imbalances may affect behavior adversely.
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Some parents have found that the use of free fatty acid formulations, which include omega-3 and omega-6 fatty acids, might be helpful. Researchers are unclear as to whether this is the case or not.
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Daily multivitamins are recommended, especially the B group of vitamins.
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Multimineral supplements including calcium, magnesium, and zinc can be helpful and can possibly improve a child’s response to the use of stimulant medication.
Check with your doctor to avoid excessive dosages of any supplement
A variety of behavior-changing therapies and educational options have been suggested as being able to allow children with ADHD to focus their attention, build self-esteem, and control their hyperactivity.
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Biofeedback might help children control “secondary symptoms” such as hyperactivity, but not the problems of inattention. Biofeedback relies on sensitive electronic equipment to help people learn to control certain physical activities. Biofeedback utilizing electroencephalographic (EEG) techniques has been used to address inattention but as yet has not been proven effective.
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Auditory integration therapies have been suggested as possible treatments for those youngsters with associated sound sensitivities and speech difficulties. Auditory integration therapies revolve around the belief that hearing has a direct bearing on behavior, and that treatment for increased sensitivity to sound results in positive behavioral changes.
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Various “brain training” programs have also been used in an attempt to correct underlying differences in brain functioning, such as motor or muscle planning difficulties.
Allergy treatments have been proposed for children with a history of allergic symptoms that are associated with ADHD. The use of antifungal treatment approaches has been used especially in younger children with a history of frequent infections and the use of antibiotics.