If it seems as though more and more kids are being diagnosed with ADHD, or attention deficit hyperactivity disorder, that's because they are. Some 11 percent of children between ages 4 and 17 have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention (CDC), and that's up from 7.8 percent in 2003, a 41 percent increase. The average child is diagnosed at age 7, and it is the most common behavior disorder in school-age children. If your child has been diagnosed with ADHD, here's what you should know.
ADHD is a complex disorder that requires complex treatment -- and it's not always obvious what that should be. "Our physicians and psychologists don't always do a very good job of pointing parents to the right resources," says Lee Ann Grisolano, Ph.D., a pediatric neuropsychologist in Hershey, Pennsylvania. "As a parent, the first thing you need to do is talk more and ask more questions. 'What type of therapy and what type of treatment and what type of resources do I need to seek out in order to help my child?'"
There are three types of ADHD -- mostly inattentive, mostly hyperactive and impulsive, and a combination of both -- and children present symptoms in different ways. Treatment for a child with primarily inattentive qualities will be different from treatment for a child who is also hyperactive and impulsive. It's also easier to miss inattentive ADHD, which is the form most commonly seen in girls with the disorder.
Once your child has been diagnosed with ADHD, you should ask your health-care provider what other problems or weaknesses he might have. "It's really important that the parents and teachers know about that because treating ADHD alone is often an incomplete treatment." Make sure you've had your child screened for learning disabilities, cognitive processing weaknesses, and other conditions so you're addressing the complete picture.
Roughly 70 percent of children with ADHD are on medication, according to the CDC, and it can dramatically reduce symptoms. The good news is that your child may not need medication forever -- as with asthma, there's a wide range of severity in ADHD disorders, and many children have less need for medication as they get older. But that's no reason to turn medicine down today. "The vast majority of children with ADHD who take medicine don't need it for the rest of their lives, but right now your child is having difficulties, so it can help right now," Dr. Stein says. "Every year we have to answer that question again."
"What our research tells us is that parents are most satisfied when they get a combination of medication and other treatments," Dr. Stein says. "Medicines have side effects and always wear off. And they don't teach skills." Behavioral treatments such as classroom-based behavior modification, parent training, and peer-based programs can be beneficial, particularly when combined with medication.
Many of the symptoms of ADHD get better with time, especially those of hyperactivity. But because of their symptoms, children with ADHD tend to have significant problems at school. "They fall behind, and it affects them socially and it affects their self-esteem," Dr. Stein says. "You don't want your child to dig herself into a hole she can't get out of."
Because of their struggles at school and the resulting loss of self-esteem, putting a lot of focus on school and academics can worsen a child's situation. It's helpful for your child to try different activities so you can find one that he likes and can perform well in. Although some kids with the disorder are talented athletes, many aren't, so more individualized sports are a better bet -- swimming and martial arts, for instance. Think carefully about the timing of those activities, as well -- signing your child up for something that begins at the time of day when his medication starts to wear off is not a recipe for success.
When you have other children without ADHD, their siblings' disorder affects them as well, as your child with ADHD likely gets more attention. Remember that your non-ADHD child's successes are just as much a cause for celebration, and be mindful of how often you enlist his help with your child with ADHD, because it may cause resentment over time.
All children thrive on routine, but for the child with ADHD, it is even more important to establish a predictable schedule for as many things as possible -- playtime, bedtime, meals, and homework. Timers and clocks are helpful tools for helping your child manage his time and transition from one activity to another. And keeping your home in order can help a great deal with your child's organization.
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