ELEMENTARY PARENT GUIDE TO ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) Chesterfield County Public Schools
Overview of ADHD Attention Deficit Hyperactivity Disorder is characterized by poor attention, impulsivity, and, with some children, over-activity. It is believed to be a neurobiological disorder that exists throughout life and across a variety of settings. Its symptoms can range from mild to severe and can be easily confused with other conditions that have similar behaviors. ADHD affects boys and girls of all ages, races and socio-economic classes. Short attention span, high activity level and impulsive behaviors are among the most common difficulties identified by teachers as interfering with student learning. They result in frequent referral to Child Study Committees and are reported to be of increased concern in mental health clinic settings. ADHD is estimated to affect approximately 3-7 out of every 100 school-age children [American Psychological Association (APA), 2000]. It is a disorder that not only exists in children, but most often persists through adolescence and adulthood. Many children show some signs of being distracted, fidgety, and/ or impulsive. For children with ADHD, however, these behaviors are the rule and not the exception. Children with ADHD can experience significant school problems, suffer from low self-esteem, have difficulty relating to peers and encounter problems in complying with rules at home leading to conflict with parents. Children with ADHD tend to be 30 percent or more behind in social skills and organization. This delay also affects the ability to control impulses, plan ahead and inhibit physical activity; therefore, overall behavior may be somewhat immature when compared to same-aged peers. Some children with ADHD also have learning disabilities, conduct disorders (destructive and/or antisocial behaviors) or mood disorders, including depression and anxiety. 2
Overview of ADHD, Con t One must consider ADHD look-alikes when determining whether this condition exists, as some psychological and medical problems may be manifested as attentional difficulties in young children. Examples are depression, bipolar disorder, anxiety disorders, schizophrenia, stressful environmental circumstances and medical disorders such as lead poisoning, thyroid malfunctions or sleeping problems. It is important to identify the cause of attentional difficulties, as treatment methods vary. While there is no known cure for ADHD, it can be successfully treated in most instances using psychostimulant medication, as well as behavior modification, a structured classroom setting, parent training, and counseling as needed. There is no known cause of ADHD, but it is thought to result from biochemical imbalances in areas of the brain that are responsible for attention, planning and motor activity. There are several types of psychostimulant medication that address attention deficits by stimulating areas of the brain that help us control impulses and filter out distractions, enhancing the ability to attend to the task at hand. A common myth is that people who take medication for ADHD are more likely to use illegal drugs; however, research shows that substance abuse is less likely to occur in those who have taken psychostimulant medication to treat ADHD. More recent theories view ADHD as an inability to stop the urge to move on to a task more interesting than the one at hand. 3
Intervention Principles Behavioral interventions for children with ADHD include: Rules and instructions for ADHD children must be clear and brief. Visual presentation may help when communicating expectations. Incentive/reward plans should be implemented in order to encourage and reinforce appropriate behaviors before applying punishments. Consequences and behavioral feedback must be immediate. Consequences must also occur more frequently due to motivational deficits. (Be consistent!!) The types of incentives and consequences may need to be more extreme in order to impact ADHD children. Reinforcers should be changed or rotated more frequently with ADHD children in order to keep their interest. Alternate reward selections every 2-3 weeks. Plan ahead and prepare ADHD children during periods of transition so that they understand expectations in new situations. Other interventions that may enhance attentional and organizational skills include: Provide a balanced breakfast and eliminate allergens and foods high in sugar. Break big projects down into short-term goals. Set specific time limits in which tasks should be completed. Limit television and video games. Discover and tap into your child s interests and personal learning style. Use color to highlight information. Use background music to focus and calm. Provide opportunities for physical movement Provide hands-on activities. Give your child real-life responsibilities. Teach problem-solving skills. 4
When To Ask About Help It is time to get help when you feel that your child s attentional problems have an impact on school performance, peer socialization and overall behavior. If you have concerns regarding whether your child may have ADHD, consult with your child s teacher about behavior and ability to focus at school. You can discuss this further with the school psychologist at your child s school as well as your pediatrician. The school can be instrumental in providing information which may be useful to the physician in making a diagnosis of ADHD. Sources for This Document Barkley, R.A. (1998). Attention Deficit Hyperactivity Disorder (ADHD): A handbook for diagnosis and treatment, second edition. New York: Guilford Press. Armstrong, T. (1995). The Myth of the A.D.D. Child: New York: Penguin Group. Carroll, S. (1998). ADHD Look-Alikes: NASP Communiqué: Guidelines for Parents. Contributors: Kathy W. Douglas, School Psychologist, Senior Writer Angie Calhoun, School Psychologist, Senior Editor Kenneth S. Roach, School Psychologist Harry P.A. Knight, School Psychologist Dave Topf, School Psychologist Susan K. Horger, School Psychologist 5
Books for Parents Barkley, R.A. (1995). Taking Charge of ADHD: The Complete, Authoritative Guide for Parents. New York: The Guilford Press. Fowler, M.S. (1990). Maybe You Know My Kid: A Parent s Guide To Identifying, Understanding and Helping Your Child With Attention Deficit Disorder. New York: Birch Lane Press. Lynn, G.T. (1996). Survival Strategies For Parenting Your ADD Child. Grass Valley, CA: Underwood Books. Paperback, 268pp. Phelan, T.W. (1195). 1-2-3-Magic: Training Your Children To Do What You Want. Books for Children Nadeau, K., & Dixon, E. Learning To Slow Down And Pay Attention. Paperback, 70pp. Parker, R.A. (1992). Making The Grade: An Adolescent s Struggle With A.D.D. Plantation, FL: ADD Warehouse. Quinn, P. (1992). Putting On The Brakes. New York: Magination Press. Paperback, 64 pp. Websites and Organizations www.chesterfield.k12.va.us/instruction/psych_services/adhd.htm www.nasponline.org www.chadd.org Resources for Families www.add.org www.adhd.com Children & Adults with Attention Deficit Disorders (C.H.A.D.D.) Parent Resource Center, CCPS (743-3703) Chesterfield Community Services Board Prevention Services, Services for Families of Children with ADHD (768-7204) The Chesterfield County public school system does not unlawfully discriminate on the basis of sex, race, color, age, religion, disabilities, or national origin in employment or its educational programs and activities. 6