Attention-Deficit/Hyperactivity Disorder

ADHD is primarily a deficit in self-control. Children with this disorder may have a hard time controlling their attention, their body movements, reactions to frustration, emotions, or impulses. It appears that this condition is related to decreased activity in specialized parts of the brain. Their behaviors are not purposeful but due to a lack of activity in important (executive) areas of the brain. To help your child, it is important that you provide some accommodations to your parenting as well as serve as their missing self-control at times. Below are some specific interventions which many parents of ADHD children have found helpful. Instructional strategies for teaching children with add/adhd can be found at http://www.ed.gov/about/offices/list/osers/osep/index.html.

Attention to Task

	Break tasks down into smaller chunks.
	Reduce the amount you say when explaining.
	Be as succinct as possible.
	Reduce multiple directives. Ask one thing at a time.
	Gain eye contact before offering instructions.

Impulsivity

	Prepare yourself and them for transitions.
	Discuss expectations of behavior.
	Involve them in something productive when waiting.

Hyperactivity

	Ignore motor activity that is not interfering or dangerous.
	Provide opportunity to burn off energy.
	Involve them in high energy sports or activities.
	Narrow space.
	Give them something to do with their hands.

General Tips

	Give them more immediate and frequent feedback on their behavior.
	Use positive reinforcement and incentives before punishment.
	Find opportunities to praise small improvements, accomplishments, strengths, etc.
	Increase the novelty, stimulation, or fun involved in tasks.
	Be as consistent as possible.
	Control your anger.
	Use external, objective assistants (e.g., egg timer, cue cards, agreed upon prompts, checklists, etc.).
	Plan ahead. Be prepared for situations you know are problematic.
	Don't take their behavior personally.

Medication

Medication is the most widely used and debated treatment for ADHD. The most commonly prescribed medications for ADHD are stimulants (e.g., Ritalin, Adderall, Cylert, and Dexedrine). These medications seem to exert their effect by increasing certain chemicals in the prefrontal cortex of the brain, thus allowing the child greater ability to inhibit impulses and focus attention. Research shows that these modifications can be very helpful for many children and adolescents. Some children and adolescents do not respond well to this class of medications. They may be prescribed certain antidepressants, Clonidine, Risperdal, or Effexor. It is important that you work with a child psychiatrist or physician with expertise in child/adolescent medicine. It is also important to work with someone who will answer your questions and with whom you feel comfortable. Medication use is most effective if used in conjunction with behavior management programs/techniques and family therapy.

Therapy

Therapy or Counseling can be effective in helping children and parents learn individualized ways to deal with their child's specific difficulties and consequently improve the child's attention and behavior. Counseling will be most effective if it involves the parents and if the parents are willing to learn and try some new parenting techniques. If your child has difficulties in addition to ADHD, play therapy may be indicated. Play therapy allows the child to explore their concerns and feelings in a safe and child-centered environment; helping them learn effective coping mechanisms and social skills. As with physicians, it is important that you choose a psychologist or other mental health professional with experience working with children or adolescents. Because parenting a child with ADHD can be very stressful, it can often be helpful for the parents of a child with ADHD to receive their own counseling and/or learn and practice effective methods of stress management for personal renewal.

EEG Biofeedback/Neurofeedback

EEG Biofeedback is a relatively new treatment option for ADD/ADHD. Simply put, this treatment involves using sensitive computerized equipment to read a person's brain wave patterns. Persons with ADD or ADHD tend to have dysregulation with specific frequencies of brain waves in certain locations of the brain. The EEG information is then presented to the student in the form of a computerized game. As the student learns to "win" the game, they are teaching their brain to utilize a more productive pattern of brain waves. For many students, this re-training leads to desired behavior changes and increases in attention. This treatment typically requires 20-50 sessions and appears to be very promising as an alternative treatment for ADHD.

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Attention-Deficit/Hyperactivity Disorder

Last modified: September 17, 2008