Treatment of A.D.H.D.
If you find out your child has ADHD, don't be in too
big a rush to run out and make all sorts of changes. First, take
some time to process your own feelings and reactions. Let God know
how you feel and talk to some trusted friends or family members.
There is “a time to weep and a time to laugh, a time to mourn
and a time to dance” (Ecclesiastes 3:4). There is every reason
to have hope, but before you can start helping your child, you need
a little time to come to peace with your own questions and reactions.
Remember that there are no quick fixes for attention disorders.
In spite of claims to the contrary, special diets, electronic gadgets,
or singular environmental alterations have not been proven to be
helpful with significant numbers of ADHD children. The good news,
however, is that there are many strategies and procedures that
improve your child’s behavior, self-esteem and overall quality
of life. Here are five categories of interventions, each with some
Understanding and parenting an ADHD child
parenting an ADHD child begins by increasing your understanding
of ADHD. Books, tapes, seminars, support groups, and professional
and mental health professionals are sources of information to help
you broaden your awareness of how ADHD impacts your child’s
behavior. Here are 12 specific tips for successfully parenting
your ADHD child:
- Provide consistency and structure. Above
all, ADHD children need clear structure, definite descriptions
they are being asked to do, specific consequences for their
behavior, and consistent enforcement of these principles. They
need an organized
environment where the demands are clearly identified ahead
of time. Surprises and the unexpected mean trouble. Try to keep
like bedtime, meals, and homework on a definite schedule. Be
firm about limits and enforce them consistently. Limit the amount
TV since that brings even more distracting stimuli. Lots of
rewards and praise for successful and appropriate behavior are
- Be sensitive to your child. Most children will
be confused, discouraged, or upset when they learn their ADHD diagnosis.
They might think there is something terribly wrong with their bodies
or brains. Or they may want to use their diagnosis as an excuse,
saying, “I can't help myself. I have ADHD.” Just
like you, they will need time to adjust to the diagnosis. Your
needs a lot of special understanding and encouragement at this
most children feel relieved, because now they know why they have
struggled so much, they will also need hope for their future.
ADHD simply. One of your most difficult tasks is to explain ADHD
to your child. Without an explanation he will conclude he is either “bad,” “dumb,” or “inferior.” He
needs to know that you realize he has a difficult time sitting
still, stifling interruptions, and keeping his mind on a job;
he needs to
know his academic problems are not his fault. Tell him you know
he is doing the best he can, but that he has a problem which
hard for him to concentrate and get his work done.
your explanation in word pictures your child can understand. Tell him that every person is unique and that we all have strengths
and weaknesses. Some people have vision problems so that they
very well. These people wear glasses to allow them to view
their world more clearly. Other kids have teeth that need straightening.
They wear braces and retainers to correct their teeth so they
eat correctly, play the horn, or whistle.
- Let your child
know he is not the only one with this problem. There are lots
of others in his school who also have attention deficit. If someone
else in his extended family has the same problem, share this
also. Let him know there are many parents, teachers, and very
successful people who have attention problems.
- Focus on what your
child can do, not on his or her limitations. Your child may
concentrating while reading to himself, but does much better
when listening to someone read aloud. Rather than force silent
which leads to frustration, let your child learn new information
by reading to him, listening to a book on tape, or watching a
the big picture. Schoolwork is important, but a child's emotional
and social adjustment and love for God are more important.
Be thankful for all the things that are going well in these parts
of your child's
- Teach and show by your life that mistakes don't
equal failure. An ADHD child may tend to see his or her mistakes
failures. You can model, through good-humored acceptance of
your own mistakes, that errors can be useful and can lead to new
Mistakes and problems are not the end of the world.
that this is a team effort. Yes, your child has to take responsibility
for doing his or her chores, completing homework, and putting
out his or her best effort. However, your child is not in this
Everyone will work together to make school and home life as
successful as possible.
- Pray together and work on projects as a family. Emphasize family traditions, stories, and legacies to help
keep the problem of attention deficit in perspective. In the larger
of things, family, faith, and loving relationships are truly
- Do not compare your child with his or her
brothers and sisters or classmates. Accept your ADHD child
as s/he is. Be the best cheerleader your child will ever see!
care of yourself. Most ADHD children are high-maintenance kids.
The constant advocacy, attention to details, remediation efforts
patience needed for a child with attention disorders can easily
wear you down. There will be days when you are at your wit's
end and you
will feel like giving up and trading in the family minivan
for a one-way ticket to New Zealand! Find time for yourself. Talk
a friend and maintain your sense of humor. Laughter is good
soul. Your home needs to be safe, supportive, and fun. Do all
you can to become that kind of parent and your child can learn
great about himself in spite of his attention problem!
self-control and social behavior
Once you have the basic parenting
it’s time to help your child develop better social skills
and self control. While most children can sit through a meal without
a major incident, an ADHD child will wiggle, rock, and squirm his
way from appetizer to desert. And while most children can consciously
focus their attention and resist the urge to move around, your
youngster must learn how to do this. Let him know that he can still
choose his behavior. It’s just a little harder for him than
for his siblings or friends. And he will need your help to do it.
ADHD children need very specific, step-by-step instructions on
how to control their actions. It will help if you can enlist the
of your child’s teachers, school bus drivers, and recess
monitors. Instruction in self-control in one situation will not
to a new setting unless the child’s caretakers are very involved
in the effort. Learn how to communicate your child’s problem
to others in simple, practical terms and ask them to help you set
limits and teach your child self control. You can also use games
and activities like Statue and Beat the Clock to help your child
learn to ignore distractions and develop impulse control. (For
more details on these activities, see Dr. Martin’s book What
You Need to Know About Attention-Deficit/Hyperactivity Disorder — Facts,
Myths, and Treatment.)
Since the majority of ADHD children have
experienced some social problems, immaturity or aggression, you
also need to help your child develop better social skills. Two
of the major goals of social skills training are that ADHD children
will become more knowledgeable about appropriate and inappropriate
social behavior, and that they will learn how to behave in socially
sensitive ways with their peers and classmates. Many schools and
clinics provide social skill training that can be a great help
ADHD children. These programs usually help children learn (1) how
to enter or begin a social interaction, (2) conversational skills,
(3) conflict resolution and problem solving, and (4) anger management.
Seeking medical support
More children receive medication to manage
ADHD than any other childhood disorder. And more research has been
conducted on the effects of stimulant medications on the functioning
of children with ADHD than any other treatment modality for any
childhood disorder. Unfortunately, a great deal of misinformation
perpetuated by the sensationalist, popular press. This extensive
research, however, helps us to be fairly definitive about the benefits
and liabilities of medication.
In general, we can say medication
intervention is a significant help to ADHD children. Between 70-80
percent of children with ADHD respond positively to medication.
Attention span, impulsivity and on-task behaviors improve, especially
environments. Some children also demonstrate improvements in frustration
tolerance, compliance and even handwriting. Relationships with
parents, peers and teachers may also improve. Medication will not
child behave perfectly, nor will it make him smarter. What it can
do is reduce many of your child’s attention difficulties
so that he can tackle his problems more successfully.
National Institute of Mental Health released the Multimodal Treatment
Study of Children with Attention Deficit Hyperactivity Disorder
(MTA). This study is the longest and most thorough study ever completed
comparing treatments for ADHD. The study found that medication
combination with intensive behavioral therapy was significantly
superior to all other types of treatment.
Although medication alone
to be more effective than intensive behavioral treatment alone,
the combination of the two was necessary to produce a variety of
and also led to the use of somewhat lower dosages of medication.
Also, for the improvement of social skills and anger management,
behavioral treatment was found to be very beneficial and necessary.
Medication alone, in other words, does not help a child make friends
or know how to resolve conflict in appropriate ways.
benefits of the combined use of medication and therapy are improvement
of the core problems of ADHD — hyperactivity, impulsivity,
and inattentiveness. Attention span seems to improve and there
is a reduction of disruptive, inappropriate and impulsive behavior.
Compliance with authority of figures is increased, and children’s
peer relations may also improve, primarily through reduction in
aggression. If the dosage is carefully monitored and adjusted,
been found to enhance academic performance. Medication by itself
will not rectify learning disabilities. If a child has visual or
auditory processing deficits, for example, medication will probably
not change the learning problem. But it may well help your child
pay better attention, so that he can better apply his educational
The most important finding to emerge from the vast
amounts of research about ADHD is that no one treatment approach
is successful alone. Neither medical, behavioral, psychological
nor educational intervention is adequate by itself. We must be
of treating the whole child or adolescent.
Some parents feel guilty
about having their child take medication because they mistakenly
think they are tranquilizing him. This is simply not true. Medication
actually helps stimulate the parts of the brain that are needed
to concentrate. The decrease in external movement does not mean
been tranquilized. It means he is able to focus more effectively.
All medical decisions, of course, need to be based on the comparison
of the benefits and alternative treatments available, and any possible
side effects. Although your physician can give you more details,
here are a few of the possible side effects of medication.
primary side effects noted for stimulant medication are insomnia,
or loss of appetite, weight loss and irritability. Most of these
appear at the beginning of treatment and only last for about a
Appetite suppression is another possible side effect.
child may be less hungry for a time. This affect may be less noticeable
if the drugs are taken with or after meals, as the effects wear
off before the next meal. Adjusting the dosage can usually alleviate
this symptom over a week or two.
Other mild, but less common side
effects, can include sadness, depression, fearfulness, social withdrawal,
sleepiness, headaches, nail biting, and stomach upset. These symptoms
will usually resolve spontaneously with a decrease in dosage. Some
of these symptoms are mild and can be considered acceptable side
effects in light of clinical improvement. You and your child’s
physician will need to make the decision regarding the advantages
of decreased distractibility versus side effects such as nail biting.
Alternatively, a trial of a different medication can be initiated.
are no reported cases of addiction or serious drug dependence to
date with these medications. Studies have also examined the question
of whether children on these drugs are more likely to abuse other
substances as teenagers, compared to children not taking stimulant
medications. Recent studies document a decreased risk of later
substance abuse if ADHD children are treated for their condition.
long-term side effect that has been considered has been the suppression
of height and weight gain. Presently, it is believed that suppression
in growth is a relatively transient side effect of the first year
or so of treatment and has no significant effect on eventual adult
height and weight for most children. However, suppression of growth
is a problem for a very small percentage of children. It is wise
for your physician to monitor your child’s growth while they
are receiving stimulant medications.
In ending this section, remember
that medication is never the sole treatment program for ADHD. What
you do after the start of medication, and the other therapy and
training he receives along with the medication will determine the
benefits. Medication is a very important aspect of a balanced treatment,
but it cannot do it all.
Ensuring appropriate educational assistance
no wonder an ADHD student has problems with school. Nowhere else
is your child required to concentrate so long in the face of so
many powerful distracters. Students must learn class routines,
to teachers’ rules and inhibit their impulses to do otherwise.
And they must control their body movements, maintain an appropriate
level of arousal and delay gratification until report cards are
issued. You can see why the ADHD child experiences so much frustration
failure at school. This also explains why it is often the classroom
teacher who raises questions that bring about referrals for an
evaluation for ADHD.
Unfortunately, while the teacher knows your
child has a
problem, he or she may not realize the problem is ADHD and may
not know what to do about it. Consequently, it may be up to you
a thorough assessment and treatment plan, including seeing that
some modifications are made in your child’s learning environment.
Here are a few guidelines for making educational interventions
with your child:
- Be sure your child’s school staff accepts
the legitimacy of ADHD.
- See that your child is in a classroom that
and predictable, but not punitive or sterile. The ADHD student
needs clear rules and consistent scheduling. Assignments should
communicated, both to the child and to the parent. Instruction
should be stimulating, clear, and uncomplicated.
- Distractions should
This may mean seating your ADHD child close to the teacher
and away from obvious distracters such as windows, active classmates,
cages or pencil sharpeners.
- Immediate and frequent feedback is required.
Your child will periodically need to be given directions or
instructions so that long periods of unproductive activity are
ADHD student needs both verbal and tangible positive consequences
attention to tasks and completing assignments. Other meaningful
positive and negative consequences will be needed to assist
the student in
learning appropriate classroom behavior.
- Directions and instructions
must be clear, concrete and concise. Give only a few directions
at a time and use as much visual, auditory and hands on demonstration
- The curriculum needs to be adjusted to allow the ADHD
student to be successful. This is done by modifying the instruction
methods to accommodate the child’s difficulty in paying attention
and concentrating. Help with organizational skills is necessary.
Some flexibility is needed to allow for the student’s low
frustration tolerance. Assignments may need to be shortened.
Computers can be
used to compensate for poor handwriting ability. Assignments
might be divided into smaller parts to help the student feel
and to give more frequent opportunity for feedback.
- It is crucial
for the entire team of educators, mental health professionals,
medical personnel, and parents to maintain regular communication.
must work together toward the common goal of ensuring your
student the best educational experience possible.
- Maintain an advocate status
with your child’s school. There are many other students to
take up the school personnel’s time. Don’t wait for
the six-week progress reports. Become very familiar with your child’s
teacher and the classroom routine. Be courteous and tactful, but
maintain a constant vigil on your child’s behalf.
of ADHD students
The Federal Government has established several
provisions that affect the education of children with Attention-Deficit
Disorder. One of these is the Individual’s with Disabilities
Education Act (IDEA), and the other is Section 504 of the Rehabilitation
Act of 1973. These laws require schools to make modifications or
adaptations for students whose ADHD results in significant educational
impairment. Qualifying children with ADHD must be placed in a regular
classroom to the maximum extent appropriate to their educational
needs, but they must also receive supplemental aids and services,
Sustaining spiritual support
Not long ago a little
boy with ADD asked his mother, “Mom, why can’t something
be wrong with my arm and not my brain?” Later he added, “My
broken arm will get better but you can’t fix my brain.”
may have had the same kind of questions, along with, “Why
my child?” or “Why would God allow this to happen?” I
certainly don’t have the answers to these “why?” questions
any more than I would claim to understand the mind and long range
plans of God.
I do, however, believe ADHD children have potential
to live very creative and fulfilled lives. There is every reason
to be optimistic about their abilities to mature, yield fruit in
season and prosper in whatever they do (Psalm 1:3).
difficult with any child, and even more challenging for a child
needs. That is why the spiritual resources of a Christian parent
can make all the difference in the world. You don’t face
this task with only your own strength and understanding. You have
promises of direction and power.
Pray regularly for your child.
God has made some rather remarkable promises – He will answer
our prayers (Mark 11:24); God has never failed to keep His promises
Kings 8:56). He does not lie. Remember these promises and claim
them as you pray for and parent your ADHD child. God will not miraculously
remove your child’s ADHD, but He will help you grow in patience,
sensitivity and other parenting skills.
If part of God’s purpose
is to help a parent develop patience and long-suffering, then blessing
you with a child who has attention deficit is a guaranteed way
to meet that goal! And, if parenting any child is worth a college
then raising an ADD child should give you a Ph.D.! The task is
continuous and the challenge is great. Put a solid spiritual foundation
the Christian father and mother additional resources and a basis
for hope even when some progress reports will be temporarily discouraging.
God can provide encouragement and guidance for you and your child.
And He can lead you and your child to rich, rewarding and successful
“Trust in the Lord with all your heart and lean not
on your own understanding; in all your ways acknowledge Him and
make your paths straight” (Proverbs 3: 5-6). These verses
capture the essence of every parent’s need.
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