Parent Resources

ADHD and Your School-Aged Child
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Parents, Provision and Policy
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School Report Perspective on ADHD
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Introduction

Living with ADHD, whether as the individual or a family member/caregiver is challenging.

Life is full of opportunities and these opportunities can often feel like they are being missed or aren’t available to the individual or family due to ADHD. The information on this part of the site has been brought together to serve as a resource to provide tools and resources for the family of an individual with ADHD, to help everyone get the most out of their daily lives.

Parenting a Child with ADHD

There is ongoing scientific research into the causes of Attention Deficit Hyperactivity Disorder (ADHD) but studies show that ADHD is caused by biological factors1 and can be linked to some external or environmental factors.2 As a parent, you are ideally placed to create a home environment that can help successfully manage your child’s ADHD alongside support from your child’s teachers and physician.

The earlier you address your child’s ADHD and resulting needs, the more likely your child will have the foundations to do well in school and life, and to develop rewarding social relationships.

ADHD Defined

ADHD is a neurobiological disorder attributed to a developmental delay in brain circuitry which impacts on a person’s sense of inhibition and self control.1 Inattention, hyperactivity and impulsiveness are the key symptoms3. A child with ADHD is easily distracted; may move and speak rapidly and excessively, and may often act inappropriately, as if without thinking. Exhibiting behavior that resembles that of younger children, a child with ADHD may often have problems forming friendships with other children or siblings and thinking through the social consequences of his/her actions. This can impact on the short term for example, the school situation, but can also have long term consequences and impact on your child’s potential for life success. If unrecognized and untreated, children and adolescents with ADHD are less likely to complete high school, further their education or remain employed, than their peers.4

Diagnosis

All children can be excitable and energetic at times. It is important to check whether your child’s behavior differs greatly from their peers or is unusual for their age. Children with ADHD exhibit combinations of the following behaviours:5

Inattention:

  • Failing to give close attention to details and avoiding careless mistakes
  • Difficulty sustaining attention in tasks or activities
  • Often does not seem to listen when being spoken to directly
  • Difficulty following through on instructions and in organizing tasks

Hyperactivity:

  • Fidgeting with hands or feet or squirming in their seat
  • Difficulty remaining seated when required to do so
  • Often runs about or climbs excessively in situations when it is inappropriate to do so
  • Difficulty in playing quietly

Impulsivity

  • Blurting out answers to questions before the questions have been completed
  • Difficulty in waiting for a turn in tasks, games or group situations
  • Often interrupts or intrudes on others (e.g. butts into conversations or games)

For more information see American Psychiatric Press: Diagnostic and statistical manual of mental disorders (DSM-IV).

The process for diagnosis varies from region to region. You may request that your physician evaluates your child for ADHD. A diagnosis of ADHD must be made by a healthcare professional. In many cases, a child’s teacher is best able to observe how a child with suspected ADHD acts in the classroom and is first aware of the impact of his/her behavior on his/her ability to learn.

To meet standard diagnostic criteria, some symptoms of ADHD must appear before the age of seven, cause impairment, and persist for at least six months to a degree that is unusual for the person’s age5.

Monitoring Treatment

Research has shown that medication alone can improve ADHD symptoms, the current ADHD treatment practices focus on management of symptoms through a multimodal approach which may include medical, educational and behavioral approaches6.

Treatment plans for ADHD should be tailored to each individual child7. A healthcare professional should regularly assess the treatment goals after speaking with your child’s teachers, counselors and yourself, to adapt the therapy as necessary.

It is also important to set realistic treatment goal targets that can be achieved and measured. For example7:

  • Improvements in relationships with peers and teachers
  • Increased self-esteem
  • Increased independence through self-monitoring and completion of assigned tasks
  • Improvements in academic performance.

As a parent you should work closely with your child’s teachers and physician or psychologist as they will also play a key role in monitoring the progress and behavior of your child during treatment.

Behavioral Support

Essentially, behavior modification is used to help improve not only a child's behavior but also his or her relationships with others by improving interactions with other children and adults. Therapists teach the techniques to parents and teachers, for use in daily life.7

The three areas in which behavior modification is used, also known as the "ABCs" of behavior modification, are8:

  • Antecedents – things that initiate or precede 'behaviors'
  • Behaviors – undesirable behaviors
  • Consequences – things that occur as a result of 'behavior'

The most important and effective behavioral technique is verbal reinforcement of appropriate behavior, that is praise when a child begins and completes an activity or exhibits a particular desired behavior9.

When your child displays positive behavior you should ensure that you give your child praise for that specific behavior. Praise should be specific for the positive behavior displayed by your child. Your comments should focus on what your child did right and should include exactly what part(s) of their behavior was desirable9. Rather than praising your child for not fighting with their sibling during a family meal, for example, you should praise him or her for sitting still while eating their meal.

Good parenting involves praising a child with ADHD frequently and looking for good behavior to praise before, and not after, a child gets distracted off a task.

Parenting Support

It is hard work raising children, especially a child with ADHD. As a parent, it is important to be aware of all available support. It can be good to talk to other parents who are experiences similar challenges with their own children. Other support may include parenting classes and/or joining local self help groups.

It is important to remember that siblings can also be affected by your child’s ADHD in several ways. For example they may feel jealous of the attention you give your child with ADHD or embarrassed by their behavior. Family counseling sessions can help all the family to gain more understanding of your child’s ADHD symptoms and resulting behaviors.

For more information see the links to advocacy groups and the ‘Further Reading’ provided below.

Medication

Medication can play an important role in the management of ADHD symptoms. It can help a child be less restless, more able to concentrate and more likely to think before acting.6

Medication works by changing the levels of chemicals in the brain responsible for our ability to concentrate, to control our impulses and to behave normally.6 These appear to be incorrectly balanced in children with ADHD.

When prescribing medication for ADHD, the doctor will check the dosage and type of medication to monitor it’s effectiveness in treating your child’s ADHD symptoms.6 The doctor will also explain any side effects specific to that medication.

What can you do to help your child?

A child with ADHD will have specific needs and display distinctive symptoms, however it is important to maintain simple parenting principles. Consistent discipline and a structured lifestyle will help you and your child manage ADHD effectively.

  • You should not attempt to get rid of all your child’s energy and hyperactivity but aim to bring it under control. It is important not to try and change your child into a quiet or faultless child, to get the best response from your child it is important to be tolerant and patient.10
  • Daily outdoor activities such as running, sports, and long walks are good outlets for a hyperactive child. A recreational room or safe outside space where your child can play with minimal restrictions and supervision can also be beneficial. Try to make sure your child does not have too many toys, as this can cause him or her to be more easily distracted from playing with any one toy. Encourage your child to play with one toy at a time.10
  • Daily household routines help a hyperactive child to get used to order and regulate your child’s responses. Keep the times for wake-up, meals, chores, and bed as regular as possible. A quiet home environment can also help encourage thinking, listening, and reading at home as well as school.10
  • Carefully plan how you discipline your child. A child with ADHD can tolerate fewer rules, so enforce a few clear, consistent, important rules. You can add to these in line with your child’s own pace. Rules should be formulated mainly to prevent harm to your child and to others. Avoid unnecessary or unattainable rules, for instance don't expect your child to keep his hands and feet still. Avoid constant negative comments like "Don't do this," and "Stop that." It can also help to develop a set of hand signals and use them rather than verbal reminders to tell your child to calm down or slow down.10
  • You can help stretch your child’s attention span by reading to your child and playing puzzles, dominoes, card games and dice games. Older children with ADHD may benefit from playing consequence games such as chess.10
  • Set a timer for 15 minutes (or 5 minutes for younger children). Ask your child to focus their efforts on completing one aspect of their homework for those 15 minutes.11 When the timer goes off, enjoy a short reward or break and repeat.
  • As a parent it can be difficult to understand how much of your child’s behavior is the nature of the condition and how much is oppositional behavior. Parenting approaches that include clear, concise instructions; structure without rigidity; nurturing a child's gifts and interests; and constant approval of positive behavior will help you feel better and help your child feel safe.11

For more information and ideas see Attention Deficit Hyperactivity Disorder available at www.aboutkidshealth.ca

Working with Teachers

It is important to work with your child’s teachers to ensure your child’s ADHD is correctly managed at school and that appropriate support services are made available for your child.

  • Be assertive regarding your child’s educational needs. Make sure you know exactly how the school will help meet your child’s specific needs, particularly in reference to any appropriate educational laws.
  • Ask for meetings with your child’s teachers whenever you think they're necessary to monitor your child's progress and make any necessary changes.
  • It can be useful to keep notes of all meetings.

Working with Physicians

It is important that you find a physician who will listen carefully to your concerns. You will need a physician that will seriously consider the possibility of ADHD and refer your child for possible diagnosis where appropriate. If your child is diagnosed with ADHD you should work closely with your physician to monitor your child’s symptoms and any subsequent treatment.

Further reading

  1. Parenting a child with ADHD. National Resource Centre on ADHD (CHADD) at www.help4adhd.org
  2. ADHD Fiction and Facts at www.adhd.com
  3. Without Boundaries report at www.wfmh.com
  4. American Psychiatric Press. Diagnostic and statistical manual of mental disorders (DSM-IV). Washington (DC): The Press; 1994
  5. Barkley R.A. Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, Guildford Press, 1998
  6. Parents, Provision and Policy – A Consultation with Parents. ADDISS, September 2003
  7. ADHD Background, ADDISS
  8. Attention Deficit Hyperactivity Disorder on www.aboutkidshealth.ca
  9. A Guide to Organising the Home and Office. National Resource Centre on ADHD (CHADD) at www.help4adhd.org
  10. Specific Learning Difficulties. Factsheets for parents and teachers. Royal College of Psychiatrists 2004.
  11. Educational Rights for Children with ADHD. National Resource Centre on ADHD (CHADD) at www.help4adhd.org
  12. What can I do to get help? www.adhd.com
  13. Barkley, R. A. Taking Charge of ADHD: The Complete Authoritative Guide for Parents (Revised Edition). New York:Guilford Press. 2000
  14. Green C and Chee K. Understanding ADHD – A Parent’s Guide to Attention Deficit Hyperactivity Disorder in Children. Vermilion; 2Rev Ed edition. 1997

References

  1. Durston S. 2003. A Review of the Biological Bases of SDHD: What Have We Learned From Imaging Studies. Ment Retard Dev Disabil Res Rev 9:184-95.
  2. Pineda DA, Palacio LG, Puerta IC, Merchán V, Arango CP, Galvis AY, Gómez M, Aguirre DC, Lopera F, Arcos-Burgos M. Environmental influences that affect attention deficit/hyperactivity disorder : Study of a genetic isolate. Eur Child Adolesc Psychiatry. 2007. Epub ahead of print. Access via www.pubmed.gov 6th August 2007
  3. Tannock R. 1998. Attention Deficit Hyperactivity Disorder: Advances in Cognitive, Neurobiological, and Genetic Research. J Child Psychol Psychiat 39: 65-99.
  4. de Boo GM and Prins PJM. 2007. Social Incompetence in Children With ADHD: Possible Moderators and Mediators in Social-Skills Training. Clin Psychol Rev 27:78-97.
  5. Barkley RA. 2003. Issues in the Diagnosis of Attention-Deficit/Hyperactivity Disorder in Children. Brain Dev 25:77-83.
  6. Greydanus DE, Pratt HD and Patel DR. 2007. Attention Deficit Hyperactivity Disorder Across the Lifespan: The Child, Adolescent, and Adult. Dis Mon 53:70-131
  7. American Academy of Pediatrics. Subcommittee on Attention-Deficit/Hyperactivity Disorder and Committee on Quality Improvement. 2001. Clinical practice guideline: treatment of the school-aged child with attention-deficit/hyperactivity disorder. Pediatrics 108:1033-44.
  8. National Resource Centre on ADHD (CHADD). Factsheet: Psychosocial Treatment for Children and Adolescents with ADHD. www.help4adhd.org/ Accessed 3 July.
  9. US Department of Education. 2004. Teaching Children with Attention Deficit Hyperactivity Disorder: Instructional Strategies and Practices.
  10. Attention Deficit Hyperactivity Disorder. www.aboutkidshealth.ca Accessed 21 June 2007.
  11. Smith SL. What do parents of children with learning disabilities, ADHD, and related disorders deal with? Pediatr Nurs. 2002. May-Jun;28(3)254-7