What is ADHD?

Does your child have trouble sitting still and paying attention? You may have been told that ADHD may be the cause. A child with ADHD might have a hard time staying focused. He or she may also have trouble controlling impulses. A child with one or both of these problems struggles daily to perform and behave well. ADHD is no one's fault. But if left untreated, ADHD can deprive a child of self-esteem and limit success.

Which of the following Describe your Child?

A partial list of symptoms common to attention deficit and hyperactivity disorder appear below. Your child may show traits from one or both groups.

Attention Deficit:

• Lacks mental focus
• Performs inconsistently
• Is distracted easily
• Has trouble shifting between tasks or settings
• Is messy, or loses things
• Forgets

Hyperactivity/Impulsive

• Has trouble controlling impulses; might talk too much, interrupt, or have a hard time taking turns
• Is easy to upset or anger
• Is alway moving (sometimes without purpose)
• Does not learn from mistakes

What happens in the brain?

The brain controls your body, thoughts and feeling. It does so with the help of neurotransmitters. These chemicals help the brain send and receive messages. With ADHD, the level of these chemicals often varies. This may cause signs of ADHD to come and go.

When messages are not received

With ADHD, chemicals in certain parts of the brain can be in short supply. Because of this, some messages do not  travel between nerve cells. Messages that signal a person to control behavior or pay attention aren't passed along. As a result, traits common to ADHD may occur.

Diagnosing ADHD

Many tools are used to diagnose ADHD. Parents, family, and teacher describe the child's behavior. Health care providers and educators may also observe and evaluate the child. This process can also help rule out other problems.

Adults describe the child

If your child's doctor suspects ADHD, he or she will ask you to fill out a questionnaire. We use the Vanderbilt which is the American Academy of Pediatrics standard. You also will be asked to describe your child's attention and behavior patterns. Think about your child's past as well as the present. other adults who know your child well can also share what they have observed.

Experts Evaluate

Your child's teacher may be asked to complete a Vanderbilt as part of the evaluation. your child's attention may be tested by a specialist. He or she may also observe your child in the classroom. ADHD seems to run in families. Tell the doctor if any other family members show signs of ADHD. The doctor and specialists will look at all the information. If ADHD is diagnosed, treatment can be planned.

Treating ADHD: Medication

In many cases, medication is part of a child's treatment plan. These medications provide a steady supply of chemicals needed to send and receive messages within the brain.

Sending Messages

Certain stimulants cause some sites in the brain to send stronger messages. When the messages are stronger, the child has better control  over attention and activity. Stimulants work quickly and can last from 4-10 hours, depending on the preparation.

Receiving Messages

Some antidepressants help the brain receive messages better. Used to treat depression and inattention, these medications are taken daily.

Be Aware.

It may take a few tries to find the best medication for your child. The amount and time of use may also need to be adjusted. In some cases, your child may need to be check for side effects. If medication doesn't help, think about having your child reevaluated.

Parent's Role:

• Learn about the medication your child takes, any side effects that might occur, and what results you can expect.
• Seek a second opinion if you have concerns about how your child's treatment is being managed.
• Make sure you, the school staff, and other caregivers follow all directions for giving your child medication.
• Watch your child for positive changes both at home and in school. keep track of any side effects. Tell your doctor what you or others observe.
• Avoid running low on medication. Some prescriptions are special and need time to fill.

Child's Role:

• How do you feel after you take your medication? Tell your parents and doctor how you feel.
• Your medication comes in a pill or granules (if you can't swallow the pill).
• Learn when to take your pill. Remind your parents or teachers when it is time.
• If someone teases you about taking medication, talk to your parents or teacher. They can help you decide what to tell that person.

Treating ADHD: Learning New Behaviors

A child with ADHD often acts up and tunes out. but you can show your child new ways to react to the world.  This process takes time and practice. Working with a counselor may help.

Coping Skills

What things upset your child? Perhaps having to do chores or share toys sparks poor behavior. Try to work with your child each day. Assign a simple task. Or talk with your child about the tips below. Show your child how to respond to frustration and anger in useful ways. This can help him or her learn self-control.

Reinforcing Success

Children with ADHD have trouble learning from past events. Positive feedback helps make lessons stick. Offer praise when a job is well done. This helps your child mark the moment in his or her mind. Place a sticker on a reward chart to celebrate each success.

Parent's Role:
Here are some ways you can help:

• Teach coping skills after your child has taken a dose of medication. Learning is more likely to occur at such times.
• Praise your child's success. Offer a smile and a hug, a positive comment, or a small reward.
• Set clear rules. Explain what will be taken away if those rules are not followed. Then, follow through.
• Try to stick to a routine. Prepare your child for any change in that routine.
• Help your child stay focused. For instance, avoid crowded, noisy places if they bother your child. Also, limit choices.

Child's Role:
Here are some hints for your child:

• Try out new ways of dealing with people and places that bother you. When you are upset, you might talk, draw, write, throw a ball, or spend some time alone.
• Act like a STAR: Stop, Think, Act, and then Review

Treating ADHD: Learning More

Before you can help your child, you must understand what ADHD is. Although ADHD is not a learning problem, it can interfere with learning. With the proper help, your child will find it easier to learn both at school and at home.

Learning about ADHD

One of the best ways to help your child is by learning about ADHD. You can start by believing that your child is not lazy or stupid. Once you understand the special needs that ADHD creates in your child, share what you learn with others. Some people may resist the diagnosis or deny the problem. Even so, let them know how they can help your child.

Learning with ADHD

Except in rare cases, there is nothing wrong with intelligence of a child with ADHD. To make learning easier, work with your child's teacher. Share the tips for teachers below. Keep in mind, federal law supports your child's right to receive the help he or she needs.

Parent's Role:
Here are some ways you can help your child:

• Stay informed. Read about ADHD. Join a local ADHD parent support group.
• Reassure your child that ADHD is not his or her fault.
• Request a teacher who can help your child. Stay in touch.
• Create a tidy, quiet study space for your child at home.

Teacher's Role:
Here are a few tips the teachers can try:

• Seat the child near the front of the room, away from any distractions such as windows or noisy radiators.
• Find the best way to "reach and teach" the child. Use tape recorders, computers, or games if they promote learning.
• Encourage the child to pursue favorite subjects. Offer special projects to boost self-esteem.

Child's Role:
Here are some hints for your child:

• Tell your parents and teachers when you need their help.
• Set aside one place at home and another at school to store your books, folders and projects.
• Make a list of your assignments and their due dates. Marking dates on a calendar can help.
• Take short breaks between homework assignments. Set a timer to signal when to end th break and return to homework.

Problems linked to ADHD

Any child can suffer from depression, anxiety or learning problems. These problems can exist along with ADHD or by themselves., Only through careful diagnosis can the true cause of a child's symptoms be found.

Depression

A depressed child may feel sad most of the time. He or she may have low self-esteem and show little interest in life. The child may hear or sleep more or less in the past. He or she may withdraw from the rest of the work

Anxiety

It is normal for children to have fears. But extreme anxiety can make a child scared and too sensitive. He or she may be obsessed with upsetting thoughts. The child may be restless, overactive, or withdrawn.

Learning Problems

A child with a learning problem may not fully process certain types of information. Some have trouble with what they see. Others have problems with what they hear. For instance, even if a teacher gives clear oral instructions, the message may not register in a child's mind. As a result, the child may struggle with one or more school subjects.

J. Stephen Robinson, MD