For Parents of Children With ADHD, General Tips for Dealing with ADD/ADHD
1. Rules should be clear and brief. Your child should know exactly what you expect from him or her.
2. Give your child chores. This will give him or her a sense of responsibility and boost self-esteem.
3. Short lists of tasks are excellent to help a child remember.
4. Routines are extremely important for children with ADHD. Set up regular times for meals, homework, TV, getting up, and going to bed. Follow through on the schedule!
5. Identify what your child is good at doing (like art, math, computer skills) and build on it.
6. Tell your child that you love and support him or her unconditionally.
7. Catch your child being good and give immediate positive feedback concerning Common Daily Problems. It is very hard to get my child ready for school in the morning.
■ Create a consistent and predictable schedule for rising and getting ready in the morning.
■ Reward and praise your child! This will motivate your child to succeed. Even if your child does not succeed in all parts of the“morning routine,” use praise to reward your child when he or she is successful. Progress is often made in a series of small steps!
■ If your child is on medication, try waking your child up 30 to 45 minutes before the usual wake time and give him or her the medication immediately. Then, allow your child to “rest” in bed for the next 30 minutes. This rest period will allow the medication to begin working and your child will be better able to participate in the morning routine.
My child is very irritable in the late afternoon/early evening (common side effect of stimulant medications).
■ If your child is on medication, your child may also be experiencing “rebound, the time when your child’s medication is wearing off and ADHD symptoms may reappear. Adjust your child’s dosing schedule so that the medication is not wearing off during a time of “high demand”, when homework or chores are usually being done.
■ Alternatively, let your child “blow off extra energy and tension” by doing some physical exercise.
■ Talk to you child’s doctor about giving your child a smaller dose of medication in the late afternoon. This is called a “steppeddown” dose and helps a child transition off of medication in the evening. My child is losing weight or not eating enough (common side effects of stimulant medication use). ■ Encourage breakfast with calorie-dense foods. ■ Give the morning dose of medication after your child has already eaten breakfast. Afternoon doses should also be given after lunch. ■ Provide your child with nutritious after-school and bedtime snacks that are high in protein and in complex carbohydrates. Examples: Nutrition/protein bars, shakes/drinks made with protein powder, liquid meals.■ Begin meals with any highly preferred food before giving other foods.■ Consider shifting dinner to a time later in the evening when your child’s medication has worn off. Alternatively, allow your child to “graze” in the evening on healthy snacks, as he or she may be hungriest right before bed.■ Follow your child’s height and weight with careful measurements at your child’s doctor’s office and talk to your child’s doctor.
Homework Tips.■ Establish a routine and schedule for homework (a specific time and place.) Don’t allow your child to wait until the evening to get started.■ Limit distractions in the home during homework hours (reducing unnecessary noise, activity, and phone calls, and turning off the TV).■ Praise and compliment your child when he or she puts forth good effort and completes tasks. In a supportive, noncritical manner, it is appropriate and helpful to assist in pointing out and making some corrections of errors on the homework.■ It is not your responsibility to correct all of your child's errors on homework or make him or her complete and turn in a perfect paper.■ Remind your child to do homework and offer incentives: “When you finish your homework, you can watch TV or play a game. If your child struggles with reading, help by reading the work a certain amount of time and then stop working on homework." “Common Daily Problems”, adapted from material developed by Laurel K. Leslie,MD, San Diego ADHD Project.
Many parents find it very difficult to help their own child with schoolwork. Find someone who can. Consider hiring a tutor! Often a Junior or Senior high school student is ideal, depending on the need and age of your child. Discipline ■ Be firm. Set rules and keep to them. ■ Make sure your child understands the rules, so he or she does not feel uninformed. ■ Use positive reinforcement. Praise and reward your child for good behavior. ■ Change or rotate rewards frequently to maintain a high interest level.■
Taking Care of Yourself ■ Come to terms with your child’s challenges and strengths.■
Help other family members recognize and understand ADHD. Seek support from family and friends or professional help such as counseling or support groups. Punish behavior, not the child. If your child misbehaves, try alternatives like allowing natural consequences, withdrawing yourself from the conflict, or giving your child a choice.
Treatment of Attention Deficit Disorder / Attention Deficit Hyperactivity Disorder, Language Disorders and Autistic Spectrum Disorders Prior to treatment at the SFCC, many of our patients suffered from some of the following symptoms. Please review these behaviors and mark those that apply to your child or adult family member. The checklist you receive should be brought to the orientation seminar so one of our clinical staff can determine if your child may be a candidate for our help.
There is a major difference in how well they can sustain focus on interesting activities (entertainment, games, Legos, video games, TV) versus routine, mundane, or academic tasks.
Inability to get homework done without frequent monitoring by a parent.
Difficulty in paying attention or staying on task.
Being easily distracted and rarely finishing one project before going to the next.
A weak or nonexistent sense of time or planning; poor time management.
Needing to reread information, (at the end of a page having to go back to the top and read it again because the information was not retained).
Poor spelling, grammar, and punctuation.
Tendency to talk in circles or rambling on and on with difficulty getting to the point; difficulty organizing your thoughts and thinking of certain words to express yourself easily.
Difficulty with written language (poor paragraph organization, unable to write a story or essay that is clear and sequential with an appropriate amount of detail. Cannot easily write your thoughts or answers)
Underachievement.
History of being criticized for being lazy or unmotivated as a child or as an adult (criticism may have been unfair).
Difficulty paying attention or staying on task.
Difficulty completing work projects without a long "to do"list and reminder notes.
Are the drugs for ADD / ADHD Safe? Physicians must always weigh risks versus benefits. Though we feel that there are patients who may require stimulant drugs, it is a much smaller percent of patients than are currently put on stimulant drugs. Short-term, the drugs can cause anorexia, tics, psychotic reactions, altered cardiovascular functioning, emotional rebound, withdrawal effects, a slowed growth rate and chromosome damage. The long-term negative consequences of these drugs in childhood or adolescence are poorly studied, so remains largely unknown. There is concern with the possibilities of increased vulnerabilities to later addictions and other health problems. For these reasons, we feel that drugs should be the last option, not the first.
Following are significant scientific studies on the risks of these drugs, particularly in children. Study:Case Report: Authors: Kristian Holtkamp, M.D., Birgitta Peters-Wallraf, Stefan Wuller, Roland Pfaaffle,M.D., and Beate Herpertz-Dahlmann,M.D., Journal Publication: Journal of Child & Adolescent Psychopharmacology, Vol. 12, No. 1, 2002, Copyright Mary An Liebert, Inc. Pp 55-61 Study: Methlyphenidate Increases Heart Rate, Blood Pressure and Plasma Epinephrine in Normal Subjects Authors: P.R. Joice, M.G. Nicholls, and R.A. Donald Journal Publication: Life Sciences, Vol. 34, No. 18, 1984, pp 1701 - 1711, Pergamon Press Study: Psychotic Side Effects of Psychostimulants: A 5-Year Review Authors: Esther Cherland, M.D, FRCPC, Renee Fitzpatrick, MB, MRCPsych, FRCPC, Journal Publication: Canadian Journal of Psychiatry, Vol. 44, October 1999. Study: Prospective Study of Tobacco Smoking and Substance Dependencies among Samples of ADHD and Non-ADHD Participants Authors: Nadine M. Lambert and Carolyn S. Hartsough Journal Publication: Journal of Learning Disabilities, Vol. 31, No. 6, November /December 1998, Pp 553-554
What is Brain Mapping? Quantitative EEG brainmapping (QEEG) or quantitative electroencephalogram is a cutting edge diagnostic procedure that can actually pinpoint the abnormal brainwaves in ADD patients. By itself, the QEEG does not diagnose ADD, but carefully correlating the QEEG information with other clinical findings, it can support the diagnosis of ADHD or suggest otherwise. Because of different subtypes of ADD, we feel that a QEEG is important in complex cases or patients with comorbidities such as anxiety, depression, high functioning autism, obsessive-compulsive disorder, tics, overly aggressive or explosive behavior, and oppositional-defiant disorder. The QEEG can identify the specific pattern of the brainwave abnormality and help in developing the most effective neurofeedback protocols for the patient. It is similar to doing a bacterial culture and determining which antibiotic would work best for that infection. We do not feel that every patient requires a brainmapping but more complex cases do.
