ADHD is a disorder characterized by an inability to pay attention, being overly active, impulsive behaviors (where the child acts without thinking about what the consequences will be. Some level of inability to pay attention is normal in children, but an inability to focus on activities a child likes can be an indication of something deeper. Further, ADHD often occurs in all areas of a child’s life: home, school, playing with friends, etc.
Symptoms (From the DSM-V)
Six or more symptoms of inattention for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:
Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
Often has trouble holding attention on tasks or play activities.
Often does not seem to listen when spoken to directly.
Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
Often has trouble organizing tasks and activities.
Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
Is often easily distracted
Is often forgetful in daily activities.
Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16 years, or five or more for adolescents age 17 years and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:
Often fidgets with or taps hands or feet, or squirms in seat.
Often leaves seat in situations when remaining seated is expected.
Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
Often unable to play or take part in leisure activities quietly.
Is often “on the go” acting as if “driven by a motor”.
Often talks excessively.
Often blurts out an answer before a question has been completed.
Often has trouble waiting their turn.
Often interrupts or intrudes on others (e.g., butts into conversations or games)
How to treat it
I use a variety of techniques for treating ADHD. There are many things you can do, but I try to focus on three ideas.
For inattention, we work on mindfulness
For impulsivity, we set boundaries and create structure. Boundaries and structure can be rules or routines. These are important because they help children feel safe, like the grown-ups in their lives are in charge. When children have ADHD, rules and routines help them focus.
A few tips:
· For rules—keep it simple. Too many rules
o When a rule gets broken, enforce a consequence.
o Make the consequence something easy for you to enforce. Don’t go for something that will be more painful for you than the child.
o Make it a consequence that doesn’t carry over for days. You will forget to enforce it, and they will feel like there is no point to changing their behavior because they will be punished forever.
· For routines—keep it simple
o Awake at the same time
o Keep before school routines fairly consistent
o Keep after school routines consistent
o Dinner at the same time
o Bedtime routines
§ Utility—getting dressed, brushing teeth, etc.
§ Bonding—story time, kiss goodnight, etc.
For hyperactivity, we work on focusing for a few minutes at a time.
· Kitchen Timer—For regular, routine tasks, I get a timer and set it for two or three minutes at a time. For those minutes, we focus on one task. After the timer goes off, we do something else. Then we set another timer and try another task. Gradually, I increase the amount of time for each task, which helps kids focus for longer.
· Special Time—Delaying gratification is a technique we try to teach kids with ADHD. Often, time with parents is a great reward for kids. Set aside 15 minutes
· Launchpad—This one works particularly well for kids who have a hard time remembering things in the morning. Before they go to bed at night, have them set out everything they will need for the next day: backpack, homework, shoes, mask. That way, morning isn’t a mad dash to get out the door.