Attention%20Deficit%20Hyperactivity%20Disorder%20(ADHD)

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Attention Deficit Hyperactivity Disorder (ADHD)

• Tips for Understanding and Managing ADHD in the
  Home
• Presented by Brett L. Patterson, M.A.

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Goals for This Presentation

• Provide a basic understanding of what ADHD is,
  and what it is not.
• Attempt to answer any questions and dispel any
  myths that many people have regarding ADHD.
• Introduce some guiding principles for dealing
  with ADHD behaviors.

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ADHD Exposed

• ADHD is identifiable via behavioral, not physical
  characteristics, making it more likely to be
  misunderstood.
• Misperceptions
• Behaviors that directly result from ADHD are not
  primarily attributable to poor parenting, lack of
  discipline, low motivation, or intentional
  trouble making.
• Not everything that fidgets and/or behaves
  defiantly is ADHD.

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What Is ADHD?

• Neurobehavioral disorder marked by
• Inattention
• Difficulties controlling impulses
• Excessive motor activity (hyperactivity)
• Be awarethe mere presence of these behaviors
  does not mean the child has ADHD.

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Indicators of ADHD as a Developmental Disorder
(Barkley, 1995)

• Seen in early child development
• Behaviors clearly distinguish child from non-ADHD
  children
• Occurs across several situations (though not
  necessarily in all of them)
• Behaviors persistent over time

• Child not able to perform at age-appropriate
  levels
• Not accounted for by environment of social causes
• Related to brain function
• Associated with other biological factors that can
  affect brain function (i.e. head injuries,
  genetics)

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Things We Can See (aka, Common Complaints)

• Difficulties sustaining attention
• Daydreaming
• Child doesnt listen
• Always losing things
• Forgetful
• Easily distracted
• Needs constant supervision
• Child doesnt finish anything he/she starts

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Common Complaints (contd)

• Problems with impulse control
• Impatient/Difficulties waiting for things
• Always interrupting others
• Blurts out answers
• Doesnt take turns
• Tries to take shortcuts on many tasks (including
  chores, homework, etc.)

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Common Complaints (contd)

• Hyperactivity
• Always on the go
• Squirmycant sit still
• Talks too much
• Frequently hums or makes odd noises
• Unable to put the brakes on motor activity
• Child has two speeds asleep and awake

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What Do These Behaviors Have in Common?

• Problem isnt as much sustaining attention as it
  is sustaining inhibitionthis is the hallmark of
  ADHD
• Inhibition a mental process that restrains an
  action (behavior) or emotion
• Problems of inhibition are not a matter of
  choice, but are instead a result of what is (or
  is not) going on in the childs brain

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ADHD and the Human Brain

• Portions of brains frontal lobe are responsible
  for Executive functions
• Consolidating information from other areas of the
  brain
• Considers potential consequences and
  implications of behaviors
• Puts brakes on (inhibits) impulsive reactions
• Initiates appropriate response to environment

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ADHD and the Brain (contd)

• Research suggests that in in children with ADHD,
  these executive areas of the brain are
  under-active
• Increasing the activity level in these areas of
  the ADHD brain have been shown to decrease
  behavioral symptoms. This is the logic behind
  using Stimulant medications as a first line
  treatment for the disorder.

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Common Stimulant Medications

• Methylphenidate (Ritalin)
• Dextroamphetamine (Dexedrine)
• Amphetamine/ Dextroamphetamine (Adderall)
• Pemoline (Cylert)

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Things That Look Like ADHD

• Depression
• Anxiety
• Hearing problems
• Visual problems
• Seizure disorder
• Oppositional defiant disorder
• Autism

• Learning disabilities
• Parenting problems
• Substance use
• Medication side-effects
• Lead poisoning

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Ten Guiding Principles for Raising a Child with
ADHD (Barkley, 1995)

1. Give your child more immediate feedback and
   consequences
2. Give more frequent feedback
3. Use larger and more powerful consequences
4. Use incentives before punishment
5. Strive for consistency

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Ten Guiding Principles for Raising a Child with
ADHD (contd)

1. Act, dont yak!
2. Plan ahead for problem situations
3. Keep a disability perspective
4. Dont personalize your childs problems or the
   disorder
5. Practice forgiveness

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In Using These Principles, It Is Important That
the Parent

• Pause before reacting to the child
• Use the ensuing delay to remember all 10 guiding
  principles (post them around the house if
  necessary)
• Choose a response that is consistent with the
  principles

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Additional Tips for Managing ADHD Behaviors

• Pay positive attention to your childcatch them
  being good
• Give effective commands
• Short, sweet, and straightforward
• Limit the number of tasks to 1-2 per command
• Maintain clear and consistent expectations
• Communicate realistic consequences for inability
  to meet expectations

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Tips for Managing ADHD (Contd)

• Manage the childs environment
• Limit distracting influences during times when
  child is asked to be on task (i.e. homework)
• Maintain a regular and predictable daily
  schedule
• When eliciting childs input, limit (but dont
  eliminate) the number of choices available to
  him/her to 2-3 options

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Tips for Managing ADHD (Contd)

• Be patient
• Be persistent
• Be understanding
• Most importantly, remember to differentiate the
  behaviors from the child
• Bad behaviors are not synonymous with a bad child

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Resources Available to Parents

• Children and Adults with ADD (CHADD) a family
  support organization that provides a variety of
  services. (www.chadd.org or the Central OK
  chapter phone number is 405-722-1233
• There is a plethora of readings available to
  those interested in obtaining more information on
  ADHD. One that I have found particularly useful
  in working with parents is Taking Charge of ADHD
  The Complete Authoritative Guide for Parents, by
  Russell A. Barkley, Ph.D. (1995)