Advice on overcoming ADHD challenges


Brenda McCreight
Focus on Adoption magazine

There are a variety of techniques you can employ  to help your child and your family cope with attention deficit disorder(ADD) or attention deficit hyperactivity disorder(ADHD). Medication is helpful in many cases, but there are techniques that can help your child learn how to better manage his behaviour.

Consider medication
There are differing opinions on the value of medicating children. Before ruling it out, consider whether it could allow your child to have a more successful home and school experience. Make sure that the pediatrician assessing your child’s need for medication is well trained in ADD/ADHD, and considers the viability of not medicating.

Dietary management
Experiment. Find out which foods cause an increase in your child’s energy. Not all children increase activity with sugar and dyes.

Some techniques will work for a while and then become less effective. That’s a sign that it’s time to switch to something else. But just because something stopped working a year ago, does not mean it cannot be tried again.

Use appropriate therapy 
Many of the therapies commonly used with children, such as play therapy and nondirected talk therapy, are not effective with this condition. Behavior modification, cognitive behavioural therapy (CBT), biofeedback, and relaxation training can be effective for some children and youth. You may also benefit from stress management counselling for yourself.

When to drop the issue
When your child cannot focus on a task, leave it and return to it later. Over time, she may develop her own strategies for lengthening her attention span. However, while she is young, it is likely that when she appears finished, she really is finished and needs to move on. Respect this. Later, guide the child back to the task. Chores, such as cleaning the bedroom, can be broken into small tasks that are undertaken throughout the day. While this method will never result in a completely clean room, it will  mean that parts of the cleaning is done each day so that neither the child nor you are over-whelmed by a mess. It also allows her to see that she is able to contribute toward organizing her own life.

Avoid long explanations
Children and youth who have attention problems often also have co-existing memory problems (or they easily forget what they have been told because they cannot stay focused enough to listen). Explain things in as few words as possible. Keep the explanation basic and short. If the issue is complicated, try explaining it over a period of time. And remember to re-explain frequently.

Difficult points of the day
Make note of which parts of the day or week are the most difficult for your child and plan around them. If he is always a problem right after school, make sure that this is never the time you take him shopping or to an appointment. If he has problems on Fridays, then this is a goof day for the family to go to the local swimming pool or to undertake some other activity that involves extensive use of the body’s larger muscles. If he is always scattered and has had serious problems at school for the last two months of the year (nine or 10 months of school is too long for most children with ADHD), then try to work out an agreement with the school so that he only attends four days a week. A proactive approach to this problem, can give him a better school record.

The child with ADD/ADHD can manage her share of the chores just as well as the other children. However, she will most likely complete chores that can be done quickly and which have a clear finish like emptying the dishwasher. Sweeping a floor may not be a good choice—it is too easy to miss spots and to ignore major parts of the floor.

Reduced homework load
Try to negotiate with the teacher for a reduced homework load.  Your child or teen will have trouble focusing by the end of the day; too much homework requiring parental supervision can set the stage for intense daily parent/child conflict. If the homework load cannot be reduced, try to break it up into smaller time chunks. Your child can do one part right after school and another right after supper.

Swimming is excellent because it uses the large muscle groups and leads to sports as a recreational activity. Complicated team work may not be fitting for children with ADD/ADHD since the kids may become frustrated with the rules, causing conflict with their teammates.

Educate your child
Your child needs to understand what it means to have ADD OR ADHD, how it impacts his life, and how he can learn to manage it.  This will help him to take control of his own symptoms and to become responsible for his behavior.

Give lots of encouragement
Your child will hear enough criticism, so make sure she also feels encouraged as she goes through the day.

Avoid overstimulation
If you know that he cannot tolerate a grocery store with all the people and all the things he likes to touch, then don’t take him shopping when you don’t have to. As he gets older, there will be time and opportunity to teach him how to manage his behaviour despite distractions.

There will be situations that are impossible to avoid (family weddings, school events, shopping, etc). Find something that can help your child to focus at such events, and teach him how to do this. For example, you can take a hand-held video game for him to play when his attention jumps and his energy escalates. He can learn to play with the game as a means of rechanneling his thoughts and energy and of temporarily shutting out the overwhelming input coming from his environment.

Stop, think, and plan
Since impulse control is a major issue, teach him to stop, think, and plan. While he is growing up, you will have to be the person who tells him to stop, then helps him to consider what is going on around him, to look at what others are doing, and then to plan what he can do that will not make everyone mad at him. This takes a year or two to become a successful habit, but the payoff is worth the time. 

He can learn to write out, or to use symbols for, daily activities, chores or reminders of what he has to do. This is likely something that he will have to rely on all his life. Starting young can ingrain the habit. He can carry the list in his pocket, put it on the fridge door, or on the mirror in his bedroom. He can make the list each morning, or he can make a list for the next day before he goes to bed each evening.

Learning how to prioritize
Your child with ADHD cannot determine what is important and what is not. Help him consider what needs to be done right away versus what can be done later.

Attention span
Your child will have difficulty staying with one task from beginning to end. For example, he may repeatedly jump up from the dinner table to phone a friend, watch TV or play with  the dog. Each time he does this, bring him back to the table immediately, and have him resume his meal. No matter how tired you are, don’t make exceptions. And do this with a friendly tone of voice.

Mood fluctuations
Mood fluctuations may be from medication or environmental stimulation and can change within seconds. Help him refocus or redirect him to something that will not cause frustration, letting his mood pass.

Monitoring behaviour
Your child cannot monitor his own behaviour, but he can learn to watch other people to see how they are reacting to him. Teach him to notice when his friends are trying to stop playing, or whether the teacher is starting to look mad. He can learn to use these signals and try to slow down and refocus. This process will take several years to learn, but when used successfully will continue to be useful into his adults years.

Adapted with permission from Parenting Your Adopted Older Child.