Parents Zone

Coping with ADHD

Attention Deficit Hyperactive Disorder affects more than 50,000 Australian children in varying degrees of severity.  While the exact cause of the disorder is not known, it has been linked to imbalances in the brain of certain neurotransmitters such as dopamine – which regulates movement, emotion, motivation and the feeling of pleasure – and noradrenaline – which regulates and attempts to control behaviour, alertness and attention.  It is believed that is the lack of these chemicals to the frontal lobe that causes a child suffering from ADHD to become inattentive, over/hyper-active and/or impulsive.

The 3 Key Features Of ADHD

Inattention
A child suffering with this feature may have difficulty following instructions or a set of tasks.  They tend to be easily distracted and move from activity to activity without actually finishing it or learning anything from it.  Simple things that we take for granted like reading a book may be too hard for an individual and they may be reluctant to participate in any activities requiring sustained mental effort.  Due to their inability to maintain concentration and pay attention to detail, they often make careless mistakes, can be rather forgetful and appear not to be listening.

Symptoms
• Difficulty with concentration
• Makes careless mistakes
• Doesn't appear to be listening
• Avoids difficult or detailed tasks
• Easily distracted
• Is forgetful and disorganised
• Is unable to follow instructions or complete tasks/activities
• Loses things

Hyperactivity
Children who are hyper or overactive tend not to take note of social situations and acceptable behaviour therein.  They tend to run around, fidget or squirm when they should be sitting quietly.  They appear to always be on the go not just physically but also within their speech.  They seem to be unable to occupy themselves happily.

Impulsivity
Most children display an impulsive tendency, but for those with ADHD it is difficult for them to understand the need to or even how to stop those impulsive desires.  They find it impossible to wait in line or stop themselves from interrupting someone when they are talking.  Usually a child with a propensity for impulsiveness will also be hyperactive.  It is their hyperactivity that creates the impulse as they rush around without a thought for safety or social etiquette.

Symptoms Of Hyperactivity/Impulsivity
• Fidgety or squirmy
• Moves about when should be sitting
• Runs about or climbs in situations where it is inappropriate
• Finds it difficult to play quietly
• Often interrupts others
• Finds it difficult to wait their turn
• Always on the go
• Talks excessively
• Blurts out answers to questions before the question has been completed

There are 3 types of ADHD

1. Combined Type or Hyperkinetic (HKD) which is a combination of all 3 features, and the most common form.

2. Hyperactive/Impulsive Type show these 2 features but are still able to concentrate.

3. Inattentive Type formerly known as ADD (Attention Deficit Disorder) these kids are not disruptive and are usually not overly active.

How Is It Diagnosed?
All children have periods when they are inattentive, appear to be hyperactive or are impulsive – seeming to have no fear or regard – but when these sorts of behaviour occur at a heightened rate or more persistently than is considered the norm, this is when a child may be suspected of having ADHD.  Many times the signs or symptoms of ADHD go unnoticed until the child enters school and begins to have learning difficulties due to any or all of the key features associated with the disorder.

When diagnosing a child a professional may ask themselves or you the following questions:

1. Are these behaviours excessive, long-term and pervasive?
2. Do they occur more often than in other children of the same age?
3. Are they just a response to a temporary situation or is it continuous?
4. Do the behaviours only pertain to one setting or environment, like the classroom, or do they occur in several?

How Do I Cope?
While there are many therapeutic treatments and medications which will help your child – usually found to be best in a combination of the 2 – there are some things you can do yourself which may help you and your child learn and cope.

Anger
We all feel angry at some time, which can be healthy, but the way we express that anger can be very unhealthy.  Many children with ADHD are unable to regulate or control their anger and therefore express it in such a way that can be frightening and/or destructive.  They hit, kick, punch, bite, throw things or even bang there heads against the wall or floor. 

Some children adopt this method of venting because they don't know any other way of expressing it, or letting you know how they feel.  Children with ADHD are capable of being taught less destructive and less dangerous ways of expressing their anger and how to control it.

Most children don't always know the words to explain how they feel, but you can help them develop a vocabulary of feelings by creating a “find-a-word” of synonyms to specific emotions.  This can be used for any emotion and can be a fun and constructive way for you and your child to spend some quality time together.  Once you have created the find-a-word, sit down with your child and help them do it.  Make a game out of it and encourage them to find as many as they can.

Also giving your child alternative “safe” outlets for their anger can help.  Sometimes just saying it isn't enough and you need something physical to do in order to vent it. 

Suggest your child does one of the following

• Hitting or punching a pillow
• Screaming into a pillow
• Running around the back yard
• Scribbling with crayons
• Tearing up the junk mail or old newspaper
• Stamping their feet

Control

Teaching your child to control their anger can be a tricky task, but it can be done.  We all have warning signs that tell us we're getting angry – it's our body's way of keeping us out of trouble.

The first thing you need to do is explain to your child that there are warning signs that their body gives them that will tell them when they are starting to get frustrated.  Tell them that they need to listen to these warning signs because it will help keep them safe and out of trouble.

Next you will need to help your child identify what their warning signs are. 

Here's some examples to help you

• Do they clench their fists?
• Do they feel hot, especially their cheeks or face?
• Do they raise their voice?
• Does their breathing or heart beat speed up?

Once you have identified them, you need to point them out to your child whenever you see them present themselves.  “You have clenched your fist, are you starting to feel angry?”  The more often you are able to point them out to your child and make them aware of them, the better they will be able to calm down and learn to control the feeling.

Exercise
While you may believe that your hyperactive child exercises quite enough because they are always on the go, they are not actually doing the right kind of exercise.  Most kids with ADHD are actually reluctant to exercise and because the stress hormones don't increase during exercise for them, they actually require more than any other kid.

At least 40 minutes vigorous exercise is required for children with ADHD in order to increase the levels of the neaurotransmitters dopamine, serotonin and noradrenaline which are necessary for emotional regulation, the ability to focus, mental alertness and calmness.  It has been proven that 40 minutes a day of vigorous exercise in kids with ADHD has made significant behavioural improvements.  They have been:

• Less hyperactive
• Less impulsive
• More co-operative
• Reduced aggression
• Improved sleep patterns
• Better appetite
• More even-tempered
• Fewer angry outbursts
• Better team-playing skills
• Improved attention

Exercise doesn't need to be done all at once, you can break it up into 2 parts.  Do 20 minutes in the morning and another 20 minutes in the afternoon.  For some forms of exercise you may need to become creative to keep your child's interest and attention.

Some examples of vigorous exercise are

• Aerobics
• Skating
• Bike riding
• Jumping on the trampoline
• Walking briskly

Time Out

Time Out has been used by many parents to correct unwanted, unacceptable or inappropriate behaviour and it can be very effective if used in the right way.  If you have used this technique before without success, it is possible you have either not been consistent, or you have used Time Out for all instances of “bad” behaviour.  Time Out was designed as a way of correcting “targeted behaviour”, meaning one specific behaviour.  It is not effective when used for every little thing they do wrong.  To use Time Out effectively, try the following the steps below:

1. Choose you target behaviour – an “action” behaviour like hitting will benefit more from this technique than something verbal like swearing or screaming.
2. Choose the place of Time out – eg. A room or an object such as a chair or mat
3. Ensure the location is boring and safe.
a) Room – remove all breakables or anything your child can hurt themselves with.  Also remove any toys or fun things they may play with.
b) Chair/Mat – Place the object somewhere that is away from other kids, activities and things that could amuse them.
4. Prepare you child – You will need to explain how Time Out works and also put a positive spin on it. For example you could say, “ We are going to introduce the Time Out system because is not acceptable and we want you to behave better so that you will feel better about yourself.” 
Then you will need to explain how it works.  “ Every time you you will have to go to for __ minutes (1 minute per year of age – 3 years old = 3 minutes), and you won't be able to play.”
5. Don't warn, just do it! - ADHD children require immediate consequences for their actions. You have already explained to your child what is going to happen so the next time they do it don't say, “ The next time you........”  Just take their hand, escort them to wherever the Time Out is to take place, say, “You will stay here for __ minutes because you . Then walk away.  Do not continue to talk to them.
6. If they scream and yell, ignore it.  If they keep getting up/off or coming out of the room, calmly but firmly place them back and walk away.  If you like, you can add 1 minute to their time for every instance they move from their Time Out location.  If you do this make sure you explain that this will happen at step 4.  Another good idea is to set a timer to the amount of time they are required to stay there and give it to your child to watch.
7. Once their time is up make sure you give them positive reinforcement and then let them go back and play.  Don't harp on their bad behaviour.

Praise

Praise is probably something that kids with ADHD don't hear enough of, instead they are constantly bombarded with critical comments, put downs and negativity.  Kids with ADHD need more praise than other child, usually once every hour.  When they hear nothing but negative reinforcement or very little positivity they lose their self-esteem and the confidence to control their behaviour.

When you see your child attending well to an activity or person, not acting impulsively, doing something that requires a lot of concentration or persevering with something, try to make a point of telling them that you like that  and why.  For example:  “ I was really proud of the way you sat still while you ate your lunch.”  “Thank you for playing so quietly”, etc.

Confidence
To help build your child's confidence and self-esteem, here's a great game for them to play.  It's called Animal Mania.  All you have to is get you child to fill in the blanks.

“If I were an animal I would be a ________, because it's good at ______________, just like me!

Eg: If I were an animal I would be an elephant, because it's good at remembering, just like me!

Another way to help build your child's confidence as well as their memory and attention is to play Memory.  Place a deck of cards, it doesn't matter what sort as long as it has pairs, face down in rows on a flat surface.  Then have your child turn over 2 cards during their turn to see if they have a pair.  The idea is to remember where each card is so that when they eventually find the pair to one they turned over earlier, they will be able to find it again.  Don't forget Praise!

Reward Charts

Reward charts can be used for a variety of things.  It can be used as a form of praise and also as a way of correcting behaviour or improving skills in your child such as attention and impulsiveness.  It is an excellent form of positive reinforcement, even for the negative things.

Begin by timing your child to see how long they can typically perform certain tasks or do certain things, like:

• Playing quietly
• Wait in line
• Read a book
• Do their homework, etc

Draw up a chart which incorporates all of these areas.  Each time your child completes a task for their usual amount of time, allow them to put a sticker beside that task and tell them why they are receiving it.  Example - “You get a sticker because you did your homework for 5 minutes.”

By the 4th day they should begin to get the idea of the reward chart and will be motivated to perform the tasks.  It is now time to increase the time you expect them to do whatever it is you have listed.  Add a minute or 2 to the time.  Try to pick different times of the day for each task achievement so as not to confuse them.  You can also give them a tangible reward once they have collected a certain amount of stars which will motivate them even more.  Be careful not to add too much time to the expectations so that your child is actually performing the task for shorter periods.

These are but a few of the ways to help improve your child's condition and help you and your family create a less stressful and more cooperative environment.  Patience and understanding by everyone will go a long way in teaching your child how to be more attentive, how to have more control over temper and impulsive actions and how to become a less disruptive member of the family.

For More Information
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Books

• Calm Your Hyperactive Child
http://www.fishpond.com.au/product_info.php?ref=1354&products_id=11676360&affiliate_banner_id=1" target="_blank">Calm Your Hyperactive Child: Coping with ADHD and Other Behavioural Problems (52 Brilliant Ideas)

• ADHD & Autism Cookbook
http://www.fishpond.com.au/product_info.php?ref=1354&products_id=13617985&affiliate_banner_id=1" target="_blank">The Kid-Friendly ADHD & Autism Cookbook, Updated and Revised: The Ultimate Guide to the Gluten-Free, Casein-Free Diet

Websites

• Living With ADHD
http://www.livingwithadhd.com.au/

Ebooks

• Control ADD/ADHD, Control Your Life!
http://98bfdj0q85yott93tlrrrpm4pz.hop.clickbank.net/