Psych 101: Attention Deficit/Hyperactivity Disorder (ADHD)

I work with a lot of children (and a few adults) who suffer from ADHD. It's very important, when possible, for a parent to participate also. The diagnosis doesn't concern me as much as the behavior, and how it is interfering with the child and family's life. This condition is often misdiagnosed, as many of the symptoms could be the result of other problems (for example, depression, anxiety, stress, difficult adjustment to life changes, grief, etc.). So I focus on the behavior, what triggers it, what happens in response to it, as well as what's going on in the child's life.

The DSM-IV-TR describes ADHD as "a persistent pattern of inattention and/or hyperactivity-impulsivity" that is displayed more frequently, and is more severe than what is considered normal for kids their age. "It must have been present before age 7," however many individuals are not diagnosed until later. "It must be present in at least two settings," and must clearly interfere with their functioning in those settings. These individuals usually don't pay close attention to things, are messy, don't finish tasks, are sometimes careless, and may appear to be daydreaming. They are usually impulsive (though don't always show hyperactivity; this is called ADD).

Family's typically have to adjust their life style to accommodate the member with ADHD/ADD. Unfortunately, often anger and defiance accompany this condition. The home of a person with ADHD can be very stressful for all. It doesn't have to be. The changes that you make in response to your child's needs should be oriented towards helping him to control the interfering behaviors, as well as facilitating his strengths. So, for example, don't call her from the kitchen to save a few steps, but go to where she is, look her in the eyes and give the direction. Flexibility is helpful. Controlling your own anger, and giving lots of positive feedback (when appropriate), and clearly defined consequences given consistently. Help them label, understand, and appropriately express their emotions (all of them). And never give up on your optimism, and confidence that your child can and will be successful and happy as an adult, having learned to cope with whatever obstacles confront them.

When Should We Get Help? (Final Back-To-School Lesson)

If you have implemented the Back-To-School lessons of my blog the past few weeks, without getting the results that you want, then you should call or come in. I can help you figure out how to do things differently, and let you know if therapy is necessary. You and your child are not "failures" if change doesn't occur quickly enough, or the way that you expected it to. Habits are hard to break.

When children have problems behaving in class, or are not able to get their work done, then they need help from you. Don't wait until he or she gets suspended, or until they get D's and F's on their report card. Don't wait until the teacher labels your kid as a troublemaker. Once they start treating you child as the class "problem," it is VERY hard to break them of that habit. Your child may end up with that label sticking with them year after year, no matter how hard he tries to change it. Too many parents don't bring their child in for treatment until after everyone's given up. By that time the habits have gotten stronger, and the labels have gotten worse. ADHD (Attention Deficit Hyperactivity Disorder). Oppositional Defiant Disorder. Depression. These are serious labels. At this point school personnel often start recommending medicine. PLEASE come in for an initial consultation before considering medication for your child (and before you get too attached to any of these labels). Unfortunately, there are some children who require medication to help them break some of the bad school habits that they've developed, but this should be considered only after you've really tried everything else.

The majority of the children, and adolescents that I counsel make substantial improvement in their school performance, especially if their family participates. And the younger the child is, the more quickly they respond, usually. So, my final back-to-school recommendation is this: if you need help for your child to be successful in school, GET IT!