By Elizabeth C. Allen, MD
Behavioral Pediatric Specialist
Does my child have ADHD? How is it treated? And what can I do to help my child do his/her best? These are questions parents often ask.
Children who have Attention Deficit Hyperactivity Disorder (ADHD) typically have more difficulty than other children their age in two areas: Inattention and/or Hyperactivity-Impulsivity. Their symptoms significantly impair their ability to function academically, emotionally, and/or socially.
It can be very helpful to ask your child’s teacher whether or not your child has any of the following symptoms, more than his/her peers:
Does he/she have a short attention span? Difficulty listening or following directions? Rush through work? Make careless errors? Avoid or give up easily on difficult tasks? Need repeated reminders to complete work? Lose things? Seem disorganized, distractible, or forgetful?
Is my child fidgety? Often out of his/her seat? Loud? Often running or climbing? “On the go”? Very talkative? Much more active in large group situations than with 1:1 attention?
Does my child blurt out the answers to questions? Talk out of turn? Interrupt others? Have trouble taking turns? Do and say things before thinking about the consequences?
Ask how your child does in the types of situations in which the symptoms are often worst – during non-favorite activities (morning or bedtime routines, chores, school work, or homework) and large group settings (lunch, recess, sports, and celebrations).
Look for relatives with symptoms of ADHD, since it often runs in families. In my experience, adults who would have difficulty doing a desk job and/or who drink a lot of caffeine are more likely to have ADHD than others.
Seek Help from a Professional: A parent-teacher conference is a great place to start. If you are still concerned, schedule an appointment with your child’s pediatrician. Report cards, test scores, and a note from the teacher can help the doctor, who may also ask you to complete a behavioral questionnaire.
Behavioral treatment really works! A child psychologist can serve as an experienced “coach” to help you find the best ways to provide structure, consistency, and positive reinforcement. Pick your battles. Give short, clear commands. Act, don’t yak! Small, frequent, immediate, consequences are much more effective than large, delayed consequences.
We now have many excellent, convenient medications to treat ADHD. Finding the best dose and medication is a process – a lot like trying on a dress. It requires frequent communication with the teacher and physician. You may need to try more than one medication, adjusting the dose of each one. To improve effectiveness, ask the doctor about increasing the dose. To decrease side effects, ask about a lower dose. Most ADHD medications are better tolerated on a full stomach. Stimulants are the first line treatment, followed by Strattera. In November, a new medication called Intuniv will be available, designed to help children with ADHD who are hyperactive or have trouble sleeping.
How can you help your child? Build on his/her strengths. Schedule an appointment with a child psychologist for behavior management counseling. Agree to a trial of medication, if recommended. That will help you make a more informed decision. Read books about ADHD (especially those by Drs. Russell Barkley and Ross Greene). Talk with other parents. Take advantage of helpful online resources, such as www.wrightslaw.com, www.chadd.org, and www.help4adhd.org. You are your child’s best advocate!