Managing your child’s ADHD

The start of a new school year has arrived, and getting your child into their school routine after a summer of sleeping late and enjoying the freedoms from strict schedules and homework can be stressful, especially for children with learning or behavioral disorders.

Attention deficit hyperactivity disorder (ADHD), formerly referred to as attention deficit disorder (ADD), is a common childhood disorder that can continue into adulthood. Children with ADHD can be impulsive, hyperactive and have trouble focusing, making it difficult to discern if your child has ADHD or is simply “being a kid.”

“It is normal for children to have trouble focusing and behaving at one time or another; however, children with ADHD do not just grow out of these behaviors,” said Rebecca Burns, D.N.P. (c), M.S.N., R.N., clinical assistant professor at Texas A&M Health Science Center College of Nursing, who specializes in pediatric-related health and wellness.

The good news is that by working with a pediatrician to identify proper treatment, children with ADHD don’t have to been negatively impacted by the behavioral disorder. Burns offers the following advice for recognizing and managing your child’s disorder.

Establish a relationship with your child’s teacher

Being involved with your child’s school life can keep you aware of their behaviors outside the home and will help you determine whether or not they are exhibiting traits associated with ADHD at school.

“During the school year, it’s not uncommon for teachers to see your child more than you do in a day,” said Burns. “They will recognize if your child is having trouble concentrating or sitting still during class.”

If you are concerned that your child may have ADHD you can work with your school counselor, who will be able to guide you through the testing process or refer you to a specialist and work with your physician.

Understand the examination process

Diagnosing ADHD involves a comprehensive examination.  In order to get the correct referrals, contacting your primary care physician or pediatrician, who will then guide you through the process of testing and diagnosing your child, is an important first step. According to Burns, the examination will include interviews with the parents and the teachers separately and an evaluation of the child. If both parties report the same behaviors and symptoms in the child, the physician will then determine the type of ADHD your child has and what treatment plan is best for him or her.

The physician may first conduct a physical exam and gather family history, inquiring about any medications your child is currently on, their past health concerns, along with previous familial health concerns. Since some emotional conditions such as stress, depression and anxiety can cause the same behaviors in your child, the physician may ask you to fill out a questionnaire to rule out those conditions. During this process, it is important to be as honest as possible so that your child can be accurately diagnosed and treated.

There are three ways ADHD can manifest itself:

1. Predominantly hyperactive-impulsive: These are the children that just can’t seem to sit still. They engage in impulsive behaviors such as interrupting people or talking during inappropriate times.

2. Predominantly inattentive: Children who have this kind of ADHD are considered the “daydreamers.” They find it difficult to organize and finish a task. Children who are predominantly inattentive will find it harder to remember and complete daily routines, because they are easily distracted.

3. Combined presentation: As its name suggests, a child with combined presentation will display symptoms from both the hyperactive-impulsive and the inattentive types of ADHD.

Find the right treatment

ADHD can’t be cured, but it can be successfully managed. Finding the best way to manage your child’s ADHD is possibly the most time-consuming and exhausting part of the journey, but once the right treatment is found, it can be a great stress reliever. Medication is the most common form of treatment that may help your child focus in and out of the classroom.

There are three kinds of medications that are generally prescribed to treat ADHD:

• Stimulants have a wide range of dosages; some may require multiple doses per day, while others can last up to 12 hours. The side effects associated with stimulants are decreased appetite, stomachache, irritability and insomnia.
• Nonstimulants are an alternative to stimulants or may be used with stimulants. The dosages typically last longer than stimulants and are associated with fewer side effects.
• Antidepressants are sometimes used to treat ADHD. However, antidepressants can pose an increased risk to suicide in children and teens. Be sure to discuss the side effects with your physician if antidepressants are considered to treat your child’s ADHD.

Be prepared for many trials and errors as you work with your pediatrician on the path to finding the correct medication. While your child is trying a new medication or dosage, be sure to monitor their behavior. If they become more hyperactive or start sleeping most of the day, contact your physician about trying a different medication. “The correct medication and dosage should leave your child in a happy medium between overactive and lethargic,” Burns advised.

Aside from medication, psychotherapy is another way to help your child manage their disorder. “Psychotherapy allows children to organize their thoughts and gives them the tools necessary to remember tasks and ultimately help them manage their ADHD,” Burns said.

Therapy won’t “cure” your child, but it may help them better manage their condition. Behavioral therapy can teach your child how to create a routine, and utilize different strategies for organizing and provide tools to avoid distractions. Therapy can also give you tips on how to organize your house and other tactics to help manage your child’s ADHD.

Typically, the most effective treatment is a combination of medications and therapy. Work with your physician to see what kind or balance of treatment is right for your child.

Remember, no one knows your child better than you, so be active about finding the best treatment plan.

Be your child’s advocate

“Having ADHD is far from the end of your child’s academic and professional career. There are many successful individuals—doctors, musicians and celebrities—who have ADHD and are able to manage their condition,” Burns said. Your child will still be able to pursue whatever aspirations they develop, but they will need your help finding the right tools to keep their ADHD under control.

Whether it’s making sure your physician finds the right treatment option, or ensuring that your child is receiving proper accommodations in the classroom, you are your child’s primary advocate. “Parents need to make sure that their child is getting the right treatment and given fair opportunities in the classroom,” said Burns. “Especially early on, when they can’t stand up for themselves.”

Be active in your child’s life and establish relationships with your child’s physician, therapist and teachers. See if your area provides and support groups or parent education courses that can give you better insight on how to help your child succeed.

For more information on ADHD symptoms, testing and treatments, please visit the National Institute of Mental Health.