Children and ADHD

ADHD: What Parents Should Know

What is ADHD?

Attention-deficit hyperactivity disorder (ADHD) is the name of a group of behaviors found in many children and adults. People who have ADHD have trouble paying attention in school, at home or at work. They may be much more active and/or impulsive than what is usual for their age. These behaviors contribute to significant problems in relationships, learning and behavior. For this reason, children who have ADHD are sometimes seen as being "difficult" or as having behavior problems.

ADHD is common, affecting 4% to 12% of school-age children. It's more common in boys than in girls. You may be more familiar with the term attention deficit disorder (ADD). This disorder was renamed in 1994 by the American Psychiatric Association (APA).

What are the symptoms of ADHD?

The child with ADHD who is inattentive will have 6 or more of the following symptoms:

• Has difficulty following instructions
• Has difficulty keeping attention on work or play activities at school and at home
• Loses things needed for activities at school and at home
• Appears not to listen
• Doesn't pay close attention to details
• Seems disorganized
• Has trouble with tasks that require planning ahead
• Forgets things
• Is easily distracted

The child with ADHD who is hyperactive/impulsive will have at least 6 of the following symptoms:

• Fidgety
• Runs or climbs inappropriately
• Can't play quietly
• Blurts out answers
• Interrupts people
• Can't stay in seat
• Talks too much
• Is always on the go
• Has trouble waiting his or her turn

What should I do if I think my child has ADHD?

Talk with your child's doctor. A diagnosis of ADHD can be made only by getting information about your child's behavior from several people who know your child. Your doctor will ask you questions and may want to get information from your child's teachers or anyone else who is familiar with your child's behavior. Your doctor may have forms or checklists that you and your child's teacher can fill out. This will help you and your doctor compare your child's behavior with other children's behavior.
Your doctor will do vision and hearing tests if these tests haven't been done recently.

Your doctor may recommend trying medicine to see if it helps control your child's hyperactive behavior. A trial of medicine alone cannot be the basis for diagnosing ADHD. However, it can be an important part of evaluating your child if ADHD is suspected.

It might be hard for your doctor to tell if your child has ADHD. Many children who have ADHD aren't hyperactive in the doctor's office. For this reason, your doctor may want your child to see someone who specializes in helping children who have behavior problems, such as a psychologist.

What causes ADHD?

Children who have ADHD do not make enough chemicals in key areas in the brain that are responsible for organizing thought. Without enough of these chemicals, the organizing centers of the brain don't work well. This causes the symptoms in children who have ADHD. Research shows that ADHD is more common in children who have close relatives with the disorder. Recent research also links smoking and other substance abuse during pregnancy to ADHD.

What can I do at home to help my child?

Children who have ADHD may be difficult to parent. They may have trouble understanding directions. Children who are in a constant state of activity can be challenging for adults. You may need to change your home life a bit to help your child. Here are some things you can do to help:

• Make a schedule. Set specific times for waking up, eating, playing, doing homework, doing chores, watching TV or playing video games, and going to bed. Post the schedule where your child will always see it. Explain any changes to the routine in advance.
• Make simple house rules. It's important to explain what will happen when the rules are obeyed and when they are broken. Write down the rules and the results of not following them.
• Make sure your directions are understood. Get your child's attention and look directly into his or her eyes. Then tell your child in a clear, calm voice specifically what you want. Keep directions simple and short. Ask your child to repeat the directions back to you.
• Reward good behavior. Congratulate your child when he or she completes each step of a task.
• Make sure your child is supervised all the time. Because they are impulsive, children who have ADHD may need more adult supervision than other children their age.
• Watch your child around his or her friends. It's sometimes hard for children who have ADHD to learn social skills. Reward good play behaviors.
• Set a homework routine. Pick a regular place for doing homework, away from distractions such as other people, TV and video games. Break homework time into small parts and have breaks.
• Focus on effort, not grades. Reward your child when he or she tries to finish school work, not just for good grades. You can give extra rewards for earning better grades.
• Talk with your child's teachers. Find out how your child is doing at school--in class, at playtime, at lunchtime. Ask for daily or weekly progress notes from the teacher.
  
• Resources : family doctor.org editorial staff.
  

Classroom accommodations for students with ADHD

As a teacher, you can make changes in the classroom to help minimize the distractions and disruptions of ADHD.

Seating

• Seat the student with ADD/ADHD away from windows and away from the door.
• Put the student with ADD/ADHD right in front of your desk unless that would be a distraction for the student.
• Seats in rows, with focus on the teacher, usually work better than having students seated around tables or facing one another in other arrangements.

Information delivery

• Give instructions one at a time and repeat as necessary.
• If possible, work on the most difficult material early in the day.
• Use visuals: charts, pictures, color coding.
• Create outlines for note-taking that organize the information as you deliver it.

Student work

• Create a quiet area free of distractions for test-taking and quiet study.
• Create worksheets and tests with fewer items; give frequent short quizzes rather than long tests.
• Reduce the number of timed tests.
• Test the student with ADD/ADHD in the way he or she does best, such as orally or filling in blanks.
• Show the student how to use a pointer or bookmark to track written words on a page.
• Divide long-term projects into segments and assign a completion goal for each segment.
• Let the student do as much work as possible on computer.
• Accept late work and give partial credit for partial work.

Organization

• Have the student keep a master notebook, a three-ring binder with a separate section for each subject, and make sure everything that goes into the notebook has holes punched and is put on the rings in the correct section.
• Provide a three-pocket notebook insert for homework assignments, completed homework, and “mail” to parents (permission slips, PTA flyers).
• Color-code materials for each subject.
• Allow time for student to organize materials and assignments for home. Post steps for getting ready to go home.
• Make sure the student with ADD/ADHD has a system for writing down assignments and important dates and uses it.

Teaching techniques for students with ADD/ADHD

Teaching techniques that help students with ADD/ADHD focus and maintain their concentration on your lesson and their work can be beneficial to the entire class.

Starting a lesson

• Signal the start of a lesson with an aural cue, such as an egg timer, a cowbell or a horn. (You can use subsequent cues to show much time remains in a lesson.)
• List the activities of the lesson on the board.
• In opening the lesson, tell students what they’re going to learn and what your expectations are. Tell students exactly what materials they’ll need.
• Establish eye contact with any student who has ADD/ADHD.

Conducting the lesson

• Keep instructions simple and structured.
• Vary the pace and include different kinds of activities. Many students with ADD do well with competitive games or other activities that are rapid and intense.
• Use props, charts, and other visual aids.
• Have an unobtrusive cue set up with the student who has ADD/ADHD, such as a touch on the shoulder or placing a sticky note on the student’s desk, to remind the student to stay on task.
• Allow a student with ADD/ADHD frequent breaks.
• Let the student with ADHD squeeze a Koosh ball or tap something that doesn’t make noise as a physical outlet.
• Try not to ask a student with ADD/ADHD perform a task or answer a question publicly that might be too difficult.

Ending the lesson

• Summarize key points.
• If you give an assignment, have three different students repeat it, then have the class say it in unison, and put it on the board.
• Be specific about what to take home.

School tips for parents

Success at school isn’t the sole responsibility of teachers. There are many things parents can do to help a child with ADHD thrive in the classroom.

How Parents Can Support Success at School
Communicating with teachers	Tell your child’s teacher(s) about the child’s ADD/ADHD issues and possible interventions as the school year begins. Take as a given that the teacher is acting in your child’s best interests; support the teacher’s efforts. Be available for regular conferences in person or on the phone. Educate yourself about how ADHD affects school performance. Check your child’s notebook every day for homework assignments, communiqués from the school, and items that need your signature.
Homework	Make sure your child has a quiet, uncluttered place to do homework. Help your child with homework, breaking down assignments into smaller tasks and keeping the child focused. Have a regular time for homework and allow for frequent breaks. Reinforce study skills such as highlighting, note taking, and reading out loud. Praise your child for work done well — and remember, “good” is not necessarily the same as “perfect.” Check that completed homework and other materials are where they’re supposed to be when your child leaves for school.
Behavior	Have a reward system for good days or weeks at school. Regularly praise your child for appropriate behavior at school. Help your child develop social skills. Collaborate with the teacher on behavior interventions. Involve the school counselor or psychologist if necessary.

Special education services

Students with ADD/ADHD may qualify for special education services, which address the unique needs of children in order to help them learn what other students learn. “Attention deficit disorder or attention deficit hyperactivity disorder” is listed in the “other health impairment” category of the federal Individuals with Disabilities Education Act (IDEA), which requires schools to provide special services for students who need them. Detailed information about how a child is found eligible for special education is available at the website of the National Dissemination Center for Children with Disabilities (NICHCY).

If one of your students is evaluated for eligibility as a special education student under IDEA, your school will be required to gather a good-sized body of information about the child and convene a group of people, including the parent(s), to discuss how the student is doing in school and what his or her needs are. If you’re the student’s primary classroom teacher, you’ll be part of that group; you may be invited to join it if you’re one of a middle- or high-school student’s classroom teachers. Whether or not you sit with the group, you’ll be asked to provide examples of the student’s behavior and how it impedes learning, along with information on interventions you’ve tried.

Once the student has been evaluated, one of the following outcomes will occur:

• The child is found eligible for special education. At that point, you’ll collaborate with parents, other school personnel, and other professionals involved with the child’s learning to develop what is known as an Individualized Education Program (IEP). The IEP will spell out how the child’s specific problems and unique learning needs will be addressed in the classroom. If you’re a member of the IEP team, you’ll help determine what services will address the student’s needs and where learning will take place.

• The child is found not eligible. Parents may appeal the decision or may ask to have the child evaluated under Section 504 of the federal Rehabilitation Act of 1973, which provides a broader definition of disability. It also provides fewer direct services for the student, but it can wind up mandating many of the accommodations for students with ADD/ADHD listed above.

Keep in mind that neither federal law allows school personnel to pressure parents to put children with ADD/ADHD on medication once they are identified as having an impairment, nor does identification necessarily mean the student will or should be pulled from your classroom. Being placed in a special ed classroom is likely to increase a student’s feelings of social alienation and may not give the student an outlet for the creativity and energy that’s often part of ADHD. As a teacher, your job is to help the student identified as disabled by ADD/ADHD to gain access to materials and services and to do whatever you can to assist the student in realizing his or her full potential.

Resources: http://www.helpguide.org