Attention Deficit Hyperactivity Disorder 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)

• Give your child more immediate feedback and
  consequences
• Give more frequent feedback
• Use larger and more powerful consequences
• Use incentives before punishment
• Strive for consistency

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

• Act, dont yak!
• Plan ahead for problem situations
• Keep a disability perspective
• Dont personalize your childs problems or the
  disorder
• 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)