Mon Aug 01, 2005
Order within the Disorder of ADHD: Acknowledging and Understanding ADHD in Children
As parents we are all familiar with the 'hyper' child in the class. Perhaps that child is yours or maybe YOU were that child. Impulsiveness and lack of focus are common characteristics of children and something that usually fades as children grow older. However, sometimes these traits do not fade. As parents we are often at a loss when we learn that our child has ADHD.
How do we handle a defiant or disorderly child? ADHD is a disorder that affects 5 to 8% of school age children, with boys being three times more likely to have ADHD. Children will start showing symptoms before the age of seven. It is important to recognize the creativity and 'genius' in some children with ADHD. The double edge of this sword has resulted in many famous people having struggled with ADHD, including Albert Einstein, Mozart, Emily Dickinson, actor Jim Carrey, Bill Gates, Presidents Bill Clinton and Abraham Lincoln, actor/comedian Robin Williams and even our current President George W. Bush.
At 12 years old I was kicked out of school, suspended many times before being expelled in the fifth grade. My parents were humiliated to have a defiant child, but in the 1960's ADHD was not recognized as commonly as it is today. I struggled with my ADHD over the years, simply from feeling that I was so different from the others. I was the kid least likely to be successful though I managed to graduate college, go to Medical School and become Chief Resident in my advanced training. The one thing that really put me on track was having a teacher who truly cared about me. Mr. Poster, in the seventh and eighth grades, took the time to structure me and address my behavior rather than simply dismissing me as another annoying problem student, as many of my teachers had done previously. He accepted me without being judgmental.
Over the years I have inadvertently learned how to handle my ADHD. For example, I had trouble absorbing information in books, so I ended up coping with my ADHD by listening to lectures on tape while driving or skiing. Even today, I can read a book but it is much easier to listen to a book on tape (or CD) while driving.
What are the symptoms?
Children with ADHD tend to act more impulsively, often it seems without thinking, have trouble focusing or staying on task and can be hyperactive. They may lose things or have trouble finishing homework or chores. They may seem like a 'race car,' talk a lot or be more
likely to get in trouble at school for defying classroom rules. Children with ADHD manifest continual patterns of inattention, hyperactivity and impulsivity that is more recurrent and severe than children at comparable levels of development and age. Conversely, it is important to know that symptoms of restlessness and lack of focus can also be caused by depression, anxiety or another learning disability (dyslexia for example). That is why it is very important that your child has a thorough examination with a Psychiatrist to rule out other common causes of the above mentioned symptoms.
ADHD is something that is managed well with parental/family involvement, therapy, classroom management and/ or medication. Physicians have been successfully treating ADHD with medication for over 50 years. They may prescribe stimulants, anti depressants or non-stimulants along with behavioral therapy. It often takes some time to find what medication works effectively for your child and sometimes children with mild ADHD can be successfully treated without medication. It is also essential to understand that your child may need different tools to learn. As I mentioned in my own experience above, I learn better through listening to lectures and books on tape versus actually sitting down and reading them. Combinations of stimuli help most.
Behavior Strategies:
Create a schedule. Try to follow a schedule or routine with your child.
Teach your child how to organize: Have you child put items in areas where they can find them, so they are less likely to lose important items such as homework. Labeling items and using bins and plastic drawers is an inexpensive way to help your child feel more comfortable and confidant. For younger children, pick out school outfits and organize their book bag the night before the school day.
Limit choices. Avoid over stimulation by limiting choices. Your child is less likely to feel over
stimulated if they have 2-3 options in an activity. Use directed simple language Use clear, brief directions to remind your child of his or her responsibilities.
Use goals and rewards. Use a chart to keep tract of your child's accomplishments and encourage them to stay on track. It may also be helpful to make a list that your children can check off on their own each day.
Take away distractions, like excessive TV watching or Video Games and encourage your child to read quietly or play educational games. Take them to a bookstore or an educational store and encourage them to find items that they may enjoy doing or books they might enjoy reading. Puzzles are also an effective tool for children because it teaches them coordination and patience.
Find your Child's talent and encourage it Children may feel frustrated with their ADHD or lack of focus. Helping them find a talent in sports, music, writing or art will encourage them to feel comfortable with themselves. For example, as a child, playing the piano and learning to read music taught me how to handle mistakes as well as explore music. The immediate feedback I got from making musical mistakes may have provided me with a kind of "left-handed
biofeedback system" unachievable elsewhere. Being fluent in both left and right brain skills may matter in some vocations, negotiations, academic paths, and relationships far more than many realize. Even more importantly may be the relationship between the two sides, almost like our houses of Congress. ADHD doesn't stop at the end of childhood, because it becomes a part of us, and becomes who we are. One reason this disorder seems over-represented in the mental health field may be that these right brain skills favor recognizing patterns, reading between the lines, reframing, and thinking by analogy. As a psychiatrist, this is right up my alley, and are the tools of my trade. I also recommend reading Directed from Distraction by Ed Hallowell and John Ratey, an excellent book that examines the way children and adults with ADHD think and respond to the world around them.
It is critical for parents and family to be supportive and patient with children. Remember that ADHD in children is manageable especially when parents educate themselves about this disorder and work in conjunction with the child's teachers and physician.
Article by Ron Rubin M.D. Dr. Rubin is the father of two young daughters, and husband of jewelry designer, Elana Rubin. He has practiced medicine and psychiatry for over 20 years and is Board Certified by the American Board of Psychiatry and Neurology.
