ADHD

Understanding ADHD and ADD (Attention-Deficit/Hyperactivity Disorder)

Attention-deficit/hyperactivity disorder (ADHD) and Attention-deficit disorder (ADD) – both now referred to as ADHD- are conditions of the brain that make it hard for children to control their behavior.  It is one of the most chronic conditions of childhood.  All children have behavior problems at times.  Children with ADHD have frequent, severe problems that interfere with their ability to live normal lives.

A child with ADHD may have one or more of the following behavior symptoms:

  • Inattention– has a hard time paying attention, daydreams, is easily distracted, is disorganized, loses a lot of things.
  • Hyperactivity- seems to be in constant motions, has difficulty staying seated, squirms, talks too much.
  • Impulsivity– acts and speaks without thinking, unable to wait, interrupts others.
  • Immature social skills making it difficult for children to interact with peers and adults, particularly as they get older
  • Emotional sensitivity– meaning children react more strongly when they feel anxious, challenged or in a complex social situation.
  • Behaviors typically are seen prior to the age of 7, and have lasted at least 6 months.

How can I tell if my child has ADHD?
Your pediatrician will assess whether your child has ADHD using standard guidelines developed by the American Academy of Pediatrics.  Keep in mind the following:

  • These guidelines are for children 6 to 12 years of age.  It is difficult to diagnose ADHD in children who are younger than this age group.
  • The diagnosis is a process that involves several steps.  It requires information about your child’s behavior from you, your child’s teacher, and/or other caregivers.
  • Your pediatrician will also look for other conditions that have the same types of symptoms as ADHD.  Some children have ADHD and other (coexisting) conditions, i.e. conduct disorder, depression, anxiety, or a learning disability.
  • There is no proven test for ADHD at this time.

If your child has ADHD, the symptoms will:

  • Occur in more than one setting, such as home, school, and social settings.
  • Be more severe than in other children the same age.
  • Start before your child reaches 7 years of age.
  • Continue for more than six months.
  • Make it difficult to function at school, at home, and/or in social settings.

What does treatment for ADHD involve?
As with chronic conditions, families must manage the treatment of ADHD on an ongoing basis.  In most cases, treatment for ADHD includes the following:

  1. A long-term management plan. This will have
    1. Target outcomes (behavior goals, ie, better school work
    2. )Follow-up activities (i.e. medication, making changes that affect behavior at school and at home.)
  2. Monitoring (checking the child’s progress with the target outcomes)
  3. Medication– for most children, stimulant medications are a safe and effective way to relieve ADHD symptoms.
  4. Behavior therapy– this focuses on changing the child’s environment to help improve behavior.
  5. Parent training– training can give parents specific skills to deal with ADHD behaviors in a positive way.
  6. Education– all involved need to understand what ADHD is.
  7. Teamwork- treatment works best when doctors, parents, teachers, caregivers, other health care professionals, and the child work together.  It may take some time to tailor your child’s treatment plan to meet his needs.
  • Treatment may not fully eliminate the ADHD-type behaviors.  However, most school-aged children with ADHD respond well when their treatment plan includes both stimulant medications and behavior therapy.Is there a cure for ADHD?
    There is no proven cure for ADHD at this time.  The cause of ADHD is unclear, although it is clearly somewhat genetic in origin.  Research is ongoing to learn more about the role of the brain in ADHD and the best ways to treat the disorder.

Easy Interventions for Executive Function Deficits (these will help you start organizing your chid’s work at school and home):

  • Problems initiating work:  Break long assignments into chunks, review the “big picture”
  • Problems with attention regulation:  Eliminate distractions- use bright light in work area and clear surrounding area of potential distractions such as electonics, TV, siblings
  • Problems with attention shifting:  Plan transitions, institute 5 minute warnings, use a timer
  • Problems with organization:  Minimize clutter, color-code materials, establish a daily routing, create templates for writing assignments, use graphic organizers and visual charts placed strategically.
  • Problems with time management:  Schedules, calendars, planners, to-do lists, intermediate deadlines, watch with alarms and timers.
  • Problems with working memory:  Written directions from teachers/tutors, teach highlighting, note-taking, outlining, circling important key words.

For further information, visit this link to “Understanding ADHD:  Information for Parents about Attention-Deficit/Hyperactivity Disorder,” a booklet from the American Academy of Pediatrics:
Here is the booklet.

How do to proceed if you suspect your child has ADHD/ADD:
New ADHD evaluations will not be scheduled until the parent and teacher(s) have completed online ADHD questionnaires.  These will be assigned to your online CHADIS account by our office on request.  Once completed, we will schedule a visit with the parent(s), and then with the parent and child.  Please supply the office with any school evaluations or testing done prior to your appointment for review by the physicians.  We may additionally refer you to a psychiatrist or for further neuro-developmental testing as needed.

Recommended Books on ADHD: * books are “must reads

  • *8 Keys to Parenting Children with ADHD, Cindy Goldrich (also has an associated website with executive function coaching resources/webinars at www.PTScoaching.com)
  • *All About Attention Deficit Disorder, Tom Phelan
  • *Taking Charge of ADHD:  The Complete, Authoritative Guide for Parents, Russell A. Barkley
  • Driven To Distraction, Edward M. Hallowell, M.D.
  • Smart but Stuck: Emotions in Teens and Adults with ADHD, Thomas E. Brown, PhD
  • Your Kid’s Gonna Be Okay: Buildig the Executive Function Skills your Child Needs in the Age of Attention, Michael Delman, M.Ed.
  • Parenting Children with ADHD:10 Lessons, Vincent Monastra
  • The Survival Guide for Kids With ADD or ADHD, John Taylor
  • ADHD and the College Student: The Everything Guide to Your Most Urgent Questions, Patricia O. Quinn
  • Survival Guide for College Students with ADHD or LD, Kathleen Nadeau
  • College Confidence with ADD: The Ultimate Success Manual for ADD Students, from Applying to Academics, Preparation to Social Success and Everything Else You Need to Know, Michael Sandler
  • Learning Outside the Lines: Two Ivy League Sutdents with Learning Disabilities and ADHD Give You the Tools for Academic Success and Educational Revolution, Cole D. Mooney
  • The Stimulus Driven Brain: The Essential Guide for The ADD/ADHD College Student, George H. Glade
  • Coaching College Students with AD/HD: Issues and Answers, Patricia O. Quinn
  • Late, Lost, and Unprepared: A Parents’ Guide to Helping Children with Executive Functioning, Joyce Cooper-Kahn, Ph.D. & Laurie Dietzel, Ph.D.
  • Making the Grade with ADD: A Student’s Guide to Succeeding in College with Attention Deficit Disorder, Stephanie Sarkis
  • Joey Pigza Swallowed the Key (and other series books), Jack Gantos- for KIDS to read
  • Straight Talk about Psychiatric Medications for Kids, Timothy E. Wilens, M.D.
  • Putting on the Brakes- Understanding and Taking Control of Your ADD or ADHD, Patricia O. Quinn, M.D. & Judith M. Stern, M.D.
  • The Work-Smart Academic Planner, Peg Dawson and Richard Guare 
  • Organizing Solutions for People with ADHD, Susan C. Pinsky

Teen/Adult ADHD books/Planners:

  • Taking Charge of ADHD, Russell Barkley
  • Smart but Scattered Teens: The Executive Skills Program for Helping Teens Reach Their Potential, Peg Dawson & Richard Guare
  • The Work-Smart. Academic Planner, Revised Edition: Write it Down, Get it Done, Peg Dawson & Richard Guare
  • The Planner Pad, www.plannerpads.com
  • SkedPal, www.skedpal.com/howitworks
  • UseMotion, www.usemotion.com

POMODORO APPS–

The Pomodoro Technique is a time management method developed by Francesco Cirillo in the late 1980s. The technique uses a timer to break down work into intervals, traditionally 25 minutes in length, separated by short breaks. Each interval is known as a pomodoro, from the Italian word for tomato, after the tomato-shaped kitchen timer that Cirillo used as a university student.

Six steps in the technique:

  1. Decide on the task to be done.
  2. Set the pomodoro timer (traditionally to 25 minutes)
  3. Work on the task.
  4. End work when the timer rings and put a checkmark on a piece of paper.
  5. If you have fewer than four checkmarks, take a short break (3–5 minutes), then go to step 2.
  6. After four pomodoros, take a longer break (15–30 minutes), reset your checkmark count to zero, then go to step 1.

Motivation

Great video on how to create intrinsic motivation to start/complete tasks.

Valuable links:

Lurie Childrens Hospital Handouts on ADHD and Executive Functioning Skills:

https://ramp.luriechildrens.org/globalassets/ramp/reference/executive-functioning-handout.pdf

https://ramp.luriechildrens.org/globalassets/ramp/reference/adhd-handout.pdf

Students with ADHD and Section 504: A Resource Guide 

School Resource Guide for Students with ADHD (504 plan, IEP)

Child Mind Institute also has a comprehensive series of articles on ADHD:

What is ADHD
Parents Guide to ADHD Medications
How to get your Child Organized
ADHD and Behavior Problems
ADHD and College

(articles referenced below available for free download via the NICHQ 2002 toolkit– )