Adapting a Style of Communication with Your Child with ADHD

							         Adapting a Style of Communication with Your Child with ADHD




         Children with ADHD frequently experience difficulty participating in elements of
         sustained and focused day-to-day conversation. But adapting your own style of
         communication to your child’s needs can help him maintain a connection.

         When necessary, pause to get your child’s attention (call his name before giving a
         command), maintain eye contact, and perhaps have him repeat back or explain what
         you have told him to be sure he has heard and understands. This approach works
         well not only when issuing commands but also when beginning any sort of
         conversation with your child. If he tends to interrupt, help him out by keeping your
         sentences brief and focusing only on what needs to be said. Avoid interrupting him
         frequently because he may not be able to stay engaged in this type of interaction. If
         you sense that his attention is wandering, touch his arm, take his hand, or otherwise
         make physical contact. Some parents find that conversation flows more smoothly if
         they are also involved in a physical activity with their child, such as washing dishes
         or making dinner. Finally, if you are telling your child something that you want him to
         remember, write it down in simple terms or encourage him to write it down himself.

         Introducing concepts such as “consequences,” “rewards,” and “positive and negative
         behavior” into the family vocabulary can go a long way toward clarifying
         communications. Where you might have previously instructed your child to “Go to
         your room!” following an unacceptable behavior, you can now inform him that his
         behavior has led to a “time-out”—and by the time you give this command, he will
         know the exact rules that apply to this term.

         Specific behavior therapy language strategies, such as when/then statements
         (“When you finish your homework, then you can go play baseball.”) may also prove
         useful when interacting with all of your children and can improve
         communication and morale in the family as a whole.

         ADHD and Homework




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         Our eleven-year-old daughter, who has been diagnosed with inattentive-type
         ADHD, has been doing better since she began treatment with stimulant
         medication. However, we still have trouble getting her organized around
         homework. We have tried setting up an office in her room, taking away all the
         distractions, keeping the area quiet, and not allowing the television to go on
         until all her homework is done. We don’t seem to be making much progress
         and, in fact, we are all getting even more frustrated because nothing seems to
         work. Her teachers still complain that work is not getting turned in, and her
         grades are still suffering in spite of her teacher always telling us how bright
         she is.


         There is no one-size-fits-all solution to the ideal homework setting. Some children
         with ADHD work inefficiently in an isolated, quiet setting like their room, and do
         better in the midst of some action, like at the kitchen table with a radio playing. You
         might need to try a few different settings until you find the most efficient one.

         In addition, you might need to figure out if any other factors are making homework
         difficult. Think about all the steps involved. Does your child know what all the
         assignments are? Does she bring the materials home that are necessary for doing
         the work? Does she have a nightly work plan that fits with her learning style? (She
         might need to schedule breaks between math and English, or between outlining the
         report and writing the first 3 paragraphs.) Does she have a system to check on
         whether all the nightly work is done? Is there a system for checking that her
         completed work gets turned in on the due date? How does she or you know that work
         is late? Have you or her teacher set up rewards for progress or consequences for
         late work? Is there a system for her teacher to communicate with you about late
         work?

         Once you have gone through this type of systematic list of questions, you can begin
         to solve the problem in an organized way—and you might discover some simple and
         obvious solutions. If she is taking stimulant medication and she does her homework
         primarily at a time after it has worn off, you could consider a short-acting extended
         dose of medication for the early evening.

         ADHD Basics




         Update posted June 19, 2008: The American Academy of Pediatrics (AAP) recently
         released new recommendations about the use of heart tests–including an
         electrocardiogram (ECG)–for children with attention deficit hyperactivity disorder
         (ADHD) before starting treatment with stimulant drugs. The AAP currently




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         recommends that children with ADHD have a thorough patient history , family
         history, and physical exam before starting treatment with stimulant drugs. The AAP
         does not recommend that children have an ECG unless the patient history, family's
         history, or physical examination raises concerns. Parents with questions or concerns
         about the use of ECGs should consult their child's pediatrician.

         What do I need to know about ADHD?
         Almost all children have times when their behavior veers out of control. They may
         speed about in constant motion, make noise nonstop, refuse to wait their turn, and
         crash into everything around them. At other times they may drift as if in a daydream,
         failing to pay attention or finish what they start.

         However, for some children, these kinds of behaviors are more than an occasional
         problem. Children with attention-deficit/hyperactivity disorder (ADHD) have behavior
         problems that are so frequent and severe that they interfere with their ability to live
         normal lives.

         The following are some common questions parents have about ADHD.

         Will my child outgrow ADHD?
         ADHD continues into adulthood in most cases. However, by developing their
         strengths, structuring their environments, and using medication when needed, adults
         with ADHD can lead very productive lives. In some careers, having a high-energy
         behavior pattern can be an asset.

         Why do so many children have ADHD?
         The number of children who are being treated for ADHD has risen. It is not clear
         whether more children have ADHD or more children are being diagnosed with ADHD.
         Also, more children with ADHD are being treated for a longer period. ADHD is now
         one of the most common and most studied conditions of childhood. Because of more
         awareness and better ways of diagnosing and treating this disorder, more children
         are being helped. It may also be the case that school performance has become more
         important because of the higher technical demand of many jobs, and ADHD
         frequently interferes with school functioning.

         Are schools putting children on ADHD medication?
         Teachers are often the first to notice behavior signs of possible ADHD. However, only
         physicians can prescribe medications to treat ADHD. The diagnosis of ADHD
         should follow a careful process.

         Are children getting high on stimulant medications?
         When taken as directed by a doctor, there is no evidence that children are getting
         high on stimulant drugs such as methylphenidate and amphetamine. At therapeutic
         doses, these drugs also do not sedate or tranquilize children and do not increase the
         risk of addiction.

         Stimulants are classified as Schedule II drugs by the US Drug Enforcement
         Administration because there is abuse potential of this class of medication. If your



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         child is on medication, it is always best to supervise the use of the medication
         closely. Atomoxetine and guanfacine are not Schedule II drugs because they don’t
         have abuse potential, even in adults.

         Are stimulant medications “gateway” drugs leading to illegal drug or alcohol
         abuse?
         People with ADHD are naturally impulsive and tend to take risks. But those patients
         with ADHD who are taking stimulants are not at greater risk and actually may be at a
         lower risk of using other drugs. Children and teenagers who have ADHD and also
         have coexisting conditions may be at higher risk for drug and alcohol abuse,
         regardless of the medication used.




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