Attention deficit/Hyperactivity Disorder help sheet

The Hout Bay Attention Deficit / Hyperactivity Disorder Support Group are an organization that provide help and guidance to parents (and caregivers) of children diagnosed with the disorder.

Being the parent or caregiver of a child with AD/HD is not easy. Nobody should have to go it alone. Among the many things that the group does to help parents is to produce a guide to dealing with AD/HD. It was put together with the help of child psychologists and paediatricians and we have included it below. It is an awesome resource for any parent or caregiver, and is worth a read even if your child is not AD/HD.

Attention Deficit Hyperactivity Disorder

AD/HD in brief

A child (or partner!) with AD/HD can be a challenge as well as a joy. The good news is that with proper assessment and treatment anyone can lead a happy, successful life. Learn as much as you can about AD/HD so you can make informed decisions as you guide your child into adulthood.

“AD/HD is one of the best researched disorders in medicine, & the overall data on its validity are far more compelling than that for most mental disorders & many medical conditions.”(June1997 AMA study).

While the exact causes of AD/HD remain illusive current research indicates a genetic & neurobiological basis involving the dopamine transporter (DAT) gene and D2 & D4 dopamine receptor genes. The D4 gene is also associated with AD/HD in families & has been found in adults with AD/HD.

AD/HD is usually noticed before the age of 6 and may continue throughout adolescence into adulthood. It may exist alone or with learning disabilities, depression, anxiety, poor self-esteem, Oppositional Defiant Disorder or Conduct Disorder, which all complicate identification and treatment.

Early diagnoses & treatment can make all the difference to a child, the family, friends, teachers etc. Learn what you can do to help your child and you will benefit too) If you suspect your child has AD/HD it is recommended that an educational psychologist or a paediatrician who specialise in AD/HD assess them.

Information will be gathered from parents, teachers or other professionals involved with the child.

Other possible causes of the child’s behaviour are ruled out. To be identified with AD/HD, at least 6 symptoms listed in the diagnostic criteria of the OSM-1V. should be identified.

The DSM1V identifies 3 subtypes of AD/HD.

  1.  AD/HD predominately inattentive type.
  2.  AD/HD predominantly hyperactive impulsive type.
  3.  AID/1-4D combined type.

AD/HD is a syndrome characterized by attention skills that are developmentally inappropriate, impulsion and sometimes Hyperactivity. Here are a few characteristics that you may have noticed.

Poor attention span

  • The child is easily distracted
  • Has a hard time following instructions and completing work(this is not due to being oppositional or failing to understand)
  • Leaves one unfinished task for another
  • Doesn’t seem to listen
  • loses books, pencils, and clothes
  • Daydreams
  • Has a short attention span
  • Has difficulty organizing tasks and activities

Weak Impulse Control

  • The child has difficulty waiting his/her turn in games
  • Acts without thinking often regretting the actions afterwards
  • Engages in physically dangerous activities without considering consequences
  • Often interrupts other in conversations and games.

Hyperactivity

  • The child seems to squirm and fidget constantly
  • Has difficulty remaining seated of playing quietly
    talks excessively

It’s when these characteristics cause problems at home, school and in social situations that the difficulties the child is experiencing need to be tended to.
The solutions must be carefully structured for success to enable the child’s strengths and self-esteem to develop.

In spite of their difficulties children/teens and adults with AD/HD have many strengths and talents they can develop. They are often creative, intelligent, gifted and the risk takers in the business world. Discover and nurture these treasures.
Becoming fully informed on AD/HD, combined with the right treatment can help children and adults reach their potential.

A child/teens environment can affect AD/HD. What happens at home, school, or socially may make the symptoms more of less severe.

AD/HD Can Be Treated
There is no cure. Having said that we can learn ways of coping with difficulties that arise thus making like easier.

Recommended treatment requires medical, psychological and educational intervention as well as behaviour management techniques.

The results of the 1999 NIMH, Multimodal Treatment Study reported that the most successful treatments were medication and behaviour therapy.

This is how we can make a drug free difference:

  • Parent training in behaviour management
  • implementing an appropriate educational program. Working hand in hand with the teacher is imperative and the results far more successful than each one working on their own. Parents are usually well informed and a useful resource for teachers to tap into.
  • Individual and family counselling.

More often than not the above goes hand in hand with medication (when required).

What Medication Can (and can’t) Do

What Medicines Can Do

Decrease activity level

  • sit still longer
  • less running around

Allow child to focus longer

  • Do more accurate work
  • Improve attention span
  • Listen to people longer

Decrease impulsivity

  • Follow rules better
  • May think before acting

Decrease reactivity

  • less aggression

Some children/adults with AD/HD need medication before the above and other therapies work effectively

The child’s self esteem and confidence improve when all the above work

What Medicines Can’t Do

Teach good behaviour

  • Remove old behaviours
  • Teach reflective thinking
  • Teach positive self talk

Teach skills they missed

  • Teach old school work
  • Teach social skills
  • Teach what to focus on

Teach dealing with feelings

  • Control anger
  • Deal with frustration
  • Make a child happy

Motivate the children

  • Make them try new skills

Some children/adults with AD/HD just need to be taught the above to help them cope with the symptoms of AD/HD

It is imperative that treatment be monitored and adjusted when necessary. If something is not working it’s an alarm bell calling for change! Parents and teachers need to get those behaviour rating scales done to measure the effectiveness of treatment.

Parents and teachers don’t need to cope on their own. Share your feelings and experiences with a trusted friend or relative or join a support group. Sharing what works with others facing similar challenges can be a valuable source of support.

Some Guidelines for parents from CHADD

Provide clear, consistent expectations, directions and limits. Children with AD/HD need to know exactly what others expect from them. They do not perform well in ambiguous situations that require determining “shades of grey” or “reading between the lines”.

Set up an effective discipline system. Parents should learn proactive discipline methods that teach and reward appropriate behaviour and respond to misbehaviour with alternatives such as “time out” or loss of privileges.

Create a behaviour modification plan to change the most problematic behaviours. Behaviour charts and other behaviour modification techniques will help you focus on and address problems in systematic, effective ways. You will learn to use behaviour modification principles to reinforce positive behaviours and to eliminate or reduce negative behaviours that create problems for your child.

Assist your child with social issues. Children with AD/HD may be rejected by their peers because of hyperactive, impulsive or aggressive behaviour. Parent training can help you assist your child in making friends and learning to work cooperatively with others.

Identify your child’s strengths in areas such as the arts, computers, mechanical ability and build upon these strengths so that your child has a sense of pride and accomplishment. This is vital and its importance cannot be overestimated.

Set aside a daily “special time” for your child. Constant negative feedback can erode a child’s self-esteem, while a daily dose of TLC whether a special outing or just time spent in positive interaction can help fortify your child against assaults to self-worth.

Tell your child that you love and support him or her unconditionally. There will be days when you may not believe this yourself. Those will be the days when it is even more important that you acknowledge the difficulties your child is facing on a daily basis, and express your love. Let your child know that you will get through the smooth and rough times together.

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