Managing ADHD
There are three main ways to help manage ADHD in children:
- behavioural strategies, including strategies for the classroom and for promoting good sleep, diet and exercise habits
- medication
- a combination of both.
It’s important for you to choose your management strategy or plan based on sound professional advice and what suits your child and family. Management plans should consider all aspects of your child’s life – your child’s needs and responsibilities at home, at school and in other social settings.
Whatever you decide, it’s a good idea to discuss your strategy with your child’s family, carers and teacher. Your child’s specialist might assist in providing information to these people, so that they also understand your child’s diagnosis. This way, your child will get consistent messages about behaviour in all settings – home, school, or other care settings.
Behavioural strategies
Behavioural strategies focus on increasing your child’s appropriate behaviours and decreasing the inappropriate, disruptive ones. You can start learning about and using these strategies even if your child hasn’t received an official diagnosis yet.
Help your child to follow verbal instructions by:
- keeping instructions clear and brief, and limiting the number of steps involved in tasks
- maintaining eye contact with your child
- asking your child to repeat instructions back to you to make sure she has understood.
Reduce over-activity and fatigue by:
- providing healthy food options for sustained energy and concentration
- building rest breaks into activities
- alternating learning tasks, such as reading or homework, with brief stretches of physical exercise
- keeping handy a few fun but low-key activities – your child can do these if he starts to become over-excited
- helping your child keep regular sleep and wake times for adequate rest and recuperation.
Keep changes in routine to a minimum. Help your child know what to expect by:
- letting her know in advance about changes. For example, you can say, ‘In five minutes, you will need to brush your teeth and get ready for bed’
- talking to your child about her daily schedule. You can also ask teachers if they can keep a copy of the school schedule where your child can see it
- limiting the number of choices your child has to make.
Help your child develop his social skills by:
- rewarding him for positive behaviours such as sharing and being gentle with others
- teaching him strategies to use if provoked by another child, such as walking away or talking to a teacher
- reminding him about the consequences of certain actions. A short prompt such as ‘stop, think, do’ will help him learn to monitor his own behaviour.
Praise and encourage
your child by:
- introducing her to activities where she will experience success
- acknowledging successes, even small ones at first. Bigger successes can be celebrated with special items such as notes or certificates
- reviewing your child’s accomplishments at the end of the day. You can also talk through things she might have had trouble with.
Specific strategies that can be used in the classroom include:
- offering one-on-one assistance whenever possible
- assigning a ‘buddy’ to help provide guidance and direction
- planning the classroom setting so that children with special needs can be seated near the front of the room and away from distractions
- keeping daily activities as ‘routine’ or predictable as possible
- making a visual checklist of tasks that need to be completed
- scheduling more difficult learning tasks at the best times for concentrating (usually in the mornings)
- allowing some extra time to complete assigned tasks.
Medications
Stimulant medications are used to treat some children diagnosed with ADHD. Many parents have heard of the stimulant Ritalin. Others include Attenta, dexamphetamine and Concerta.
Stimulants help children with ADHD with their self-control. They help to filter out unnecessary information that can overwhelm a child with ADHD. This helps to focus the child’s attention.
These medications can cause some side effects. One of these is reduced appetite, which can then affect weight gain. The medications can also affect some children’s growth, so treatment needs to be carefully monitored. Most side effects are mild and short-lived. Changes in the dose or timing of medication can help alleviate side effects that don’t go away on their own.
Further research is required to assess the long-term effects of stimulant medication. When used appropriately, however, medication generally leads to better long-term outcomes. Of course, a child prescribed stimulant medication should always be closely monitored by a health professional.
Seeking professional help
If you’re concerned that your child might have ADHD, the first step is to visit your child’s primary care provider (either her GP or paediatrician). If your child is not already seeing a paediatrician, his GP might refer him to one or to a child psychologist or psychiatrist for further assessment and diagnosis.
If your child is diagnosed with ADHD, you and the specialist can work together to develop a management plan. Usually, behaviour strategies are trialled first, before medication is considered.
Support for parents
Parents of children with ADHD have been found to experience higher stress than parents of children with physical disabilities. For example, going on outings with children with ADHD can be highly stressful. You might feel your parenting is being judged when your child acts inappropriately in public.
You’ll be better placed to help your child if you seek help and support for yourself if needed. You might find it helpful to:
- seek help from family members and friends. If your child relates well to a particular family member, such as an aunt or grandparent, that person might be able to go shopping with you, or spend some time with your child while you get some chores done
- speak to your child’s teacher about behavioural strategies used in the classroom and try these out at home
- participate in a support group for parents of children with ADHD
- talk to your child’s health professional about any difficulties you are having
- learn about stress and how it can be reduced.
Remember that your child’s challenging behaviour is related to the condition – it’s not usually intentional. This can make it easier to respond to your child in positive and supportive ways.
