Psychologically Speaking: Life with a child with ADHD

Treatment often consists of cognitive behavioral therapy, and for many medication has been successful.

By DR. BATYA L. LUDMAN
adhd child 88 (photo credit: )
adhd child 88
(photo credit: )
Dear Dr. Batya, I was recently told by the school that they think my son has ADHD (attention deficit hyperactivity disorder). I'm wondering if you can tell me what types of issues children with ADHD face and if he'll outgrow it as he gets older. - P.M., Herzliya The first step you may want to take is to see your family doctor or pediatrician, who may then refer you, if necessary, to a neurologist, child psychiatrist or clinical psychologist. All provide assessment and treatment in this area. There is no one test for ADHD and no two kids look exactly alike. That said, some of the hallmarks of ADHD are impulsivity, inattention, low frustration tolerance and for some, but not all, hyperactivity. These children may also be inconsistent in carrying out tasks and as a result they get accused of not trying, being poorly motivated to succeed or are told they are lazy. Many children with ADHD have learning problems and may have social difficulties, be disruptive in class, have poor organizational skills and have trouble paying attention to detail. As children move into the teen years and adulthood, their problems may appear to change. Younger children get identified because of problems related to inattention, impulsivity and hyperactivity, whereas adolescents start to have more social issues and present with concerns around self-esteem. Adults may have mood swings, difficulty completing tasks and issues related to stress. While children don't always outgrow ADHD, once an accurate diagnosis is made, one can begin to put into place all that is necessary to enable a child to feel good about himself. With support from both home and school, a child with ADHD can do very well. Treatment for ADHD often consists of cognitive behavioral therapy, and for many children medication has been a very successful adjunct. In addition to psychotherapy, educational help, family counseling and other supportive measures are often quite helpful. There have been lots of issues raised about the use of stimulants in children, and this is something that should be discussed with your doctor. That said, I've seen quite dramatic changes for those children who have responded well to medication. Parents with an ADHD child come to me for several reasons. Perhaps their child doesn't pay attention, has difficulties listening, or gets into fights with his siblings and friends. Maybe he gets distracted, interrupts, has problems making transitions or is inappropriate in school. Perhaps he has difficulty completing homework and this too has become a struggle or maybe his room doesn't get cleaned or he gets sent to get dressed and is found playing instead. As you can see from the list I've presented, many children who don't have ADHD have similar problems. Whatever the problem, there are strategies that can be individualized for your child, taking into account both his strengths and his weaknesses. The goal is to enhance your child's self-esteem and improve, among other things, his interpersonal relationships.may feel sad or angry? Children with ADHD can benefit from help in several areas. Here are just a few suggestions in some of the areas addressed above. 1) Help children get organized - for example, by making it easier to keep track of their belongings and assignments, determining priorities, managing time, creating routines, keeping an assignment or homework notebook, using schedules, calendars, maps, color coding and making lists, keeping a well organized work space, using timers and setting time limits. 2) Teach children to be less impulsive by having them role play situations where they could use a "stop-think" paradigm which can help them to better examine their actions and the consequences. Teach them how to stop, count to 10, step back and rethink a scenario to make things work. 3) Teach attention strategies such as memory games, reading things out loud, asking questions, writing things down and using a tape recorder. Help children feel less overwhelmed by focusing on one aspect of a problem, keeping directions clear and short, providing repetition and presenting information in more than one way. 4) Teach social skills such as how to deal with teasing or feeling embarrassed and ways to make and keep friends. Learning about eye contact, "I" statements, verbal and non-verbal cues and assertiveness are all important ways to improve self-confidence and self-esteem. Helping a child to keep a journal to record feelings works well for many children and can lower stress levels as well. 5) Help children get along better at home through improving their communication skills, taking refueling breaks, practicing relaxation strategies, anger management skills and keeping busy with hobbies or activities. Parents may benefit from learning which battles to pick, how to contract for success, and helping their child with consistency. 6) Get help in school, maximizing strengths and communicating with home. As parents, you know your child better than anyone and you'll have many opportunities through the years to be the best advocate you can be for your child. If you are able to put in the hard work, you'll be pleasantly surprised by the many blessings you'll receive in return. The writer is a licensed clinical psychologist in private practice in Ra'anana. ludman@netvision.net.il