What is ADHD? - Part 2
ADHD can't be cured, but it can be successfully managed. Your child's doctor will work with you to develop an individualized, long-term plan. The goal is to help a child learn to control his or her own behavior and to help families create an atmosphere in which this is most likely to happen.
In most cases, ADHD is best treated with a combination of medication and behavior therapy. Any good treatment plan will require close follow-up and monitoring, and your doctor may make adjustments along the way. Because it's important for parents to actively participate in their child's treatment plan, parent education is also considered an important part of ADHD management.
Several different types of medications may be used to treat ADHD:
- Stimulants are the best-known treatments — they've been used for more than 50 years in the treatment of ADHD. Some require several doses per day, each lasting about 4 hours; some last up to 12 hours. Possible side effects include decreased appetite, stomachache, irritability, and insomnia. There's currently no evidence of long-term side effects.
- Nonstimulants represent a good alternative to stimulants or are sometimes used along with a stimulant to treat ADHD. The first nonstimulant was approved for treating ADHD in 2003. They may have fewer side effects than stimulants and can last up to 24 hours.
- Antidepressants are sometimes a treatment option; however, in 2004 the U.S. Food and Drug Administration (FDA) issued a warning that these drugs may lead to a rare increased risk of suicide in children and teens. If an antidepressant is recommended for your child, be sure to discuss these risks with your doctor.
Medications can affect kids differently, and a child may respond well to one but not another. When determining the correct treatment, the doctor might try various medications in various doses, especially if your child is being treated for ADHD along with another disorder.
Research has shown that medications used to help curb impulsive behavior and attention difficulties are more effective when combined with behavioral therapy.
Behavioral therapy attempts to change behavior patterns by:
- reorganizing a child's home and school environment
- giving clear directions and commands
- setting up a system of consistent rewards for appropriate behaviors and negative consequences for inappropriate ones
Here are examples of behavioral strategies that may help a child with ADHD:
- Create a routine. Try to follow the same schedule every day, from wake-up time to bedtime. Post the schedule in a prominent place, so your child can see what's expected throughout the day and when it's time for homework, play, and chores.
- Get organized. Put schoolbags, clothing, and toys in the same place every day so your child will be less likely to lose them.
- Avoid distractions. Turn off the TV, radio, and computer games, especially when your child is doing homework.
- Limit choices. Offer a choice between two things (this outfit, meal, toy, etc., or that one) so that your child isn't overwhelmed and overstimulated.
- Change your interactions with your child. Instead of long-winded explanations and cajoling, use clear, brief directions to remind your child of responsibilities.
- Use goals and rewards. Use a chart to list goals and track positive behaviors, then reward your child's efforts. Be sure the goals are realistic (think baby steps rather than overnight success).
- Discipline effectively. Instead of yelling or spanking, use timeouts or removal of privileges as consequences for inappropriate behavior. Younger kids may simply need to be distracted or ignored until they display better behavior.
- Help your child discover a talent. All kids need to experience success to feel good about themselves. Finding out what your child does well — whether it's sports, art, or music — can boost social skills and self-esteem.
Currently, the only ADHD therapies that have been proven effective in scientific studies are medications and behavioral therapy. But your doctor may recommend additional treatments and interventions depending on your child's symptoms and needs. Some kids with ADHD, for example, may also need special educational interventions such as tutoring, occupational therapy, etc. Every child's needs are different.
A number of other alternative therapies are promoted and tried by parents including: megavitamins, body treatments, diet manipulation, allergy treatment, chiropractic treatment, attention training, visual training, and traditional one-on-one "talking" psychotherapy. However, scientific research has not found them to be effective, and most have not been studied carefully, if at all.
Parents should always be wary of any therapy that promises an ADHD "cure." If you're interested in trying something new, speak with your doctor first.
Parenting a child with ADHD often brings special challenges. Kids with ADHD may not respond well to typical parenting practices. Also, because ADHD tends to run in families, parents may also have some problems with organization and consistency themselves and need active coaching to help learn these skills.
Experts recommend parent education and support groups to help family members accept the diagnosis and to teach them how to help kids organize their environment, develop problem-solving skills, and cope with frustrations. Training can also teach parents to respond appropriately to a child's most trying behaviors with calm disciplining techniques. Individual or family counseling can also be helpful.
ADHD in the Classroom
As your child's most important advocate, you should become familiar with your child's medical, legal, and educational rights.
Kids with ADHD are eligible for special services or accommodations at school under the Individuals with Disabilities in Education Act (IDEA) and an anti-discrimination law known as Section 504. Keep in touch with teachers and school officials to monitor your child's progress.
In addition to using routines and a clear system of rewards, here are some other tips to share with teachers for classroom success:
- Reduce seating distractions. Lessening distractions might be as simple as seating your child near the teacher instead of near the window.
- Use a homework folder for parent-teacher communications. The teacher can include assignments and progress notes, and you can check to make sure all work is completed on time.
- Break down assignments. Keep instructions clear and brief, breaking down larger tasks into smaller, more manageable pieces.
- Give positive reinforcement. Always be on the lookout for positive behaviors. Ask the teacher to offer praise when your child stays seated, doesn't call out, or waits his or her turn instead of criticizing when he or she doesn't.
- Teach good study skills. Underlining, note taking, and reading out loud can help your child stay focused and retain information.
- Supervise. Check that your child goes and comes from school with the correct books and materials. Sometimes kids are paired with a buddy to can help them stay on track.
- Be sensitive to self-esteem issues. Ask the teacher to provide feedback to your child in private, and avoid asking your child to perform a task in public that might be too difficult.
- Involve the school counselor or psychologist. He or she can help design behavioral programs to address specific problems in the classroom.
Helping Your Child
You're a stronger advocate for your child when you foster good partnerships with everyone involved in your child's treatment — that includes teachers, doctors, therapists, and even other family members. Take advantage of all the support and education that's available, and you'll help your child navigate toward success.
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