Mario is 10 years old. When he was 7, his family learned he had ADHD. At the time, he was driving everyone crazy; he couldn’t stay in his seat or keep quiet in school, and at home, he didn’t finish his homework or do his chores. What he did do was climb out of his window onto the roof and run across the street without looking, scaring his mother half to death.
Fortunately, things are much better now. Mario was tested by a trained professional to find out what he does well and what gives him trouble. His parents and teachers came up with ways to help him at school. For example, since he has trouble sitting still, he now does some of his work standing up. He’s also the student who tidies up the room and washes the chalkboard. His teachers break down his lessons into several parts, and have him do each part one at a time. This helps Mario keep his attention on his work.
Things have changed at home, too. Now his parents know why he’s so active. They are careful to praise him when he does something well, and even have a reward program of good-job points to encourage good behavior. After earning 10 points, Mario gets to choose something fun he’d like to do. Having a child with ADHD is still a challenge, but after getting the help they needed, things are looking up for this family.
What is ADHD?
Attention-Deficit/Hyperactivity Disorder (ADHD) is a condition that can make it hard for a person to sit still, control their behavior, and pay attention. These difficulties usually begin before the child is 7 years old, but may not be noticed until years later.
Doctors don’t quite know what causes ADHD. But researchers who study the brain are coming closer to an answer. They believe that some people with ADHD are lacking in certain brain chemicals called neurotransmitters, which help the brain control behavior.
While parents and teachers do not cause ADHD, there are many things they both can do to help a hyperactive child.
How Common is ADHD?
As many as 5 out of 100 children are predicted to have ADHD, with boys three times as likely to have the disorder as girls.
What Are the Signs of ADHD?
There are three main signs or symptoms of ADHD:
- problems with paying attention
- being overly active (called hyperactivity)
- acting before thinking (called impulsivity).
More information on these symptoms is listed in the book The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (1994). Based on the aforementioned symptoms, three distinct types of ADHD have been identified:
- inattentive type, in which the person can’t seem to get or stay focused on a task or activity
- hyperactive-impulsive type, in which the person is very active and often acts without thinking
- combined type, in which the person is inattentive, impulsive, and hyperactive.
Many children with ADHD have problems paying attention. Inattentive children often
- do not pay close attention to details
- can’t stay focused on play or school work
- don’t follow through on instructions
- don’t finish homework or chores
- can’t seem to organize tasks and activities
- get distracted easily
- lose things such as toys, homework, and books (APA, 1994, pp. 83-84)
Hyperactivity is probably the most visible sign of ADHD. The hyperactive child is always on the go (though as he or she gets older, the level of activity may go down). These children also act before thinking (impulsivity). For example, they may run across the road without looking or climb to the top of very tall trees, and are then surprised to find themselves in dangerous situations.
Hyperactivity and impulsivity tend to go together. Children with the hyperactive-impulsive type of ADHD may often
- fidget and squirm
- get out of their chairs when they’re not supposed to
- run around or climb things
- have trouble playing quietly
- talk too much
- blurt out answers before questions have been completed
- have trouble waiting their turn
- interrupt others when they’re talking
- butt in on games others are playing (APA, 1994, p. 84)
Children with the combined type of ADHD have symptoms of both types described above. They have problems with paying attention, being too active, and controlling their impulses.
Of course, from time to time, these are characteristics of most children. But with children who have ADHD, these behaviors are the rule, not the exception, and can cause a child to have significant problems at home, at school, and with friends.
As a result, many children with ADHD feel anxious, unsure of themselves, and depressed. These feelings are not symptoms of ADHD, but come from having problems again and again at home and in school.
Does Your Child Have ADHD?
When a child shows signs of ADHD, he or she needs to be evaluated by a trained professional. This person may work for the school system or a private practice. Regardless, a complete evaluation is the only way to know for sure if a child needs psychological help. It is also important to
- rule out other reasons for the child’s behavior
- find out if the child has other disabilities along with ADHD
There is no quick treatment for ADHD. However, the symptoms can be managed. It’s important that the child’s family and teachers
- learn more about ADHD
- learn how to help the child manage his or her behavior
- create an educational program that fits the child’s individual needs
- use medication if necessary
Tips for Parents
- Learn about ADHD. The more you know, the more you can help yourself and your child. See the list of resources and organizations at the end of this publication for more info.
- Praise your child when he or she does well, and build up your child’s abilities. Talk about and encourage his or her strengths and talents.
- Be clear, consistent, and positive. Set clear rules for your child. Tell your child what he or she should do, not just what he shouldn’t do. Be clear about what will happen if your child does not follow the rules. Have a reward program in place for good behavior. Praise your child when he or she behaves.
- Have strategies for managing your child’s behavior. Possibilities include: charting, having a reward program, ignoring behaviors, natural consequences, and logical consequences. These strategies and more may lead to more positive behaviors and cut down on problem behaviors. You can read about these techniques in many books; see Resources at the end of this publication.
- Talk with your doctor about whether or not medication will help your child.
- Pay attention to your child’s mental health (and your own!). Be open to counseling; it can help you deal with the challenges of raising a child with ADHD, and help your child deal with frustration, feel better about themselves, and learn social skills.
- Talk to other parents whose children have ADHD; they can give you practical advice and emotional support. Call NICHCY to find parent groups near you.
- Meet with the child’s school and develop an educational plan to address their needs. Both you and your child’s teachers should get a written copy of this plan.
- Keep in touch with your child’s teacher. Tell the teacher how your child is doing at home, and ask how they are doing in school. Offer support.
Tips for Teachers
- Learn more about ADHD. The resources and organizations at the end of this publication will help you identify behavior support strategies and effective ways to help the student educationally.
- Figure out what specific things are hard for the student. For example, one student with ADHD may have trouble starting a task, while another may have trouble ending one task and starting the next. Familiarize yourself with these distinct needs.
- Post clear rules, schedules, and assignments. Clear rules and routines will help a student with ADHD. Have set times designated for specific tasks, and call attention to changes in the schedule.
- Show the student how to use an assignment book and a daily schedule.
- Teach them study skills and learning strategies, and reinforce these regularly.
- Help the student channel his or her physical activity (e.g., let the student do some work standing up or at the board). Provide regularly scheduled breaks.
- Make sure directions are given step by step, and that the student is following the directions. Give directions both verbally and in writing. Many students with ADHD also benefit from doing the steps as separate tasks.
- Let the student do work on a computer.
- Work together with the student’s parents to create and implement an educational plan tailored to meet the child’s needs. Regularly share information about how the student is doing at home and at school.
- Have high expectations for the student, but be willing to try new ways of doing things. Be patient. Maximize the student’s chances for success.
What About School?
School can be hard for children with ADHD. Success in school often means being able to pay attention and control behavior and impulse. These are the areas in which children with ADHD have trouble.
There are many ways the school can help students with ADHD. Some students may be eligible to receive special education services under the Individuals with Disabilities Education Act (IDEA). Under the newest amendments to IDEA passed in 1997, ADHD is specifically mentioned under the category of Other Health Impairment (OHI). We’ve included the IDEA’s definition of OHI below. Other students will not be eligible for services under IDEA, however, they may be eligible for services under Section 504 of the Rehabilitation Act of 1973. In both cases, the school and the child’s parents need to meet and talk about what special help the student needs.
Most students with ADHD are helped by routines or changes in the classroom (called adaptations). Some common changes that help students with ADHD are listed under Tips for Teachers above. More information and helpful strategies can be found in NICHCY’s publication “Attention-Deficit/Hyperactivity Disorder”. The resources listed below will also help families and teachers learn more ways to help children with ADHD.
IDEA’s Definition of Other Health Impairment
Many students with ADHD now may qualify for special education services under the Other Health Impairment category within the Individuals with Disabilities Education Act (IDEA). IDEA defines other health impairment as…
…having limited strength, vitality or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, and sickle cell anemia; and adversely affects a child’s educational performance.
34 Code of Federal Regulations 300.7(c)(9)
Alexander-Roberts, C. (1994). ADHD parenting handbook: Practical advice for parents from parents: Proven techniques for raising a hyperactive child without losing your temper. Dallas , TX : Taylor Publishing. [Telephone: 1-800-677-2800.]
Barkley, R. (1995). Taking charge of AD/HD. New York : Guilford Press. [Telephone: 1-800-365-7006.]
Dendy , S.A. Z. (1995). Teenagers with ADD: A parents’ guide. Bethesda , MD : Woodbine House. [Telephone: 1-800-843-7323.]
Fowler, M. (1994). Attention-deficit/hyperactivity disorder. NICHCY Briefing Paper, 1-16. [Telephone: 1-800-695-0285. Also available on NICHCY’s Web site: www.nichcy.org]
Fowler, M. (1999). Maybe you know my kid: A parent’s guide to identifying, understanding, and helping your child with ADHD (3rd ed.). New York : Birch Lane Press. [Telephone: 1-800-447-2665.]
Fowler, M. (1992). CH.A.D.D. educators manual: An in-depth look at attention deficit disorders from an educational perspective. Plantation , FL : CH.A.D.D. [Telephone: 1-800-233-4050.]
Wodrich, D.L. (1994). Attention deficit hyperactivity disorder: What every parent wants to know. Baltimore , MD : Paul H. Brookes. [Telephone: 1-800-638-3775.]
Source: National Information Center for Children and Youth with Disabilities
Update: August 1999