If you’re raising a child with ADHD (attention deficit hyperactivity disorder), you and your child are likely to encounter numerous challenges. Licensed clinical psychologist and certified school psychologist, Dr. Liz Matheis offers advice on how to cope with three common issues parents with ADHD kids face: (1) Considerations on to medicate or not to medicate an ADHD child; (2) Helping your ADHD child get things done; and (3) Helping Your Child Manage ADHD at School.
With the goal of helping parents understand ADHD, and helping both parents and children manage ADHD,
To Medicate or Not To Medicate ADHD?
This is a question that parents struggle with once they receive an ADHD diagnosis for their child. For some parents, it is out of the question. Some are open to the idea, while others may want more than just medication.
What is the ‘right’ thing to do? Is there a ‘right’ thing? The answer, unfortunately or fortunately, is no. There are several variables to consider when deciding the appropriate course of treatment for your child and your family, as this decision is a family affair.
What Is the Impact on My Child’s Daily Functioning?
This question refers to how much your child is affected by poor focus, hyperactivity or impulsivity. That is, is your child able to establish and maintain friendships? Is your child able to take in class lessons and learn? Is your child distracting himself or others in the classroom?
Is your child able to participate in a family dinner at home by remaining seated and following a conversation? Is your child able to be in a restaurant and follow general behavioral etiquette? Is your child able to play with another child in her home without breaking things/toys? Is your child clumsy or accident prone?
Your decision will be based on how severe the level of impact is on your child’s ability to participate in daily activities and events as an individual, and for you as a family.
How to Help a Child Focus without Medication
Yes, there are. You can begin to implement behavioral strategies regarding homework, for example, by creating a space for your child to complete homework that is not at the kitchen table – as your kitchen is likely the “Grand Central Station” of your house, as it is in many.
It is also helpful to implement a no phone or iPod/iPad rule in your house while homework is being completed. All electronics are to be turned in to a central place in your home where you can monitor their presence during homework time.
Consistency, consistency, consistency is also helpful as a strategy. Used on a regular basis, it will ultimately become habit. Good habit.
There are many strategies to choose from, but the ones that you’ll be implementing will be based on the areas of need for your child and for you as a family. Start small and expand the behavioral expectation as your child is experiencing success.
What Types of Medications Are out There?
Do your research. Ask questions. If you are interested in trying medication, do so for a month’s duration. Don’t go based on your observations alone, but ask others to help you notice if there is an improvement. For example, get your cub scout leader, your soccer coach, your child’s teacher(s) to offer their feedback. Also, ask your child about his experience.
In terms of the types of medications, there are stimulants, non-stimulants, short-acting and long-acting. There is also a patch as a route of administration for medication. There are advantages and disadvantages to all of these medications if you choose to go that route.
Here is what I’ve seen used for children in middle school and high school: a long acting medication during the school day, and then a short-acting medication to get through homework and after school activities. Timing is set just right so that the medication wears off 1-2 hours prior to bedtime and your child is able to settle down and fall asleep.
Another key point I want to make here is that medication is only one form of treatment, but it doesn’t teach your child the skills that he needs to succeed in life. Even though you may be facing pressure from your child’s teacher or Child Study Team Case Manager to start a course of medication to help manage inattention, hyperactivity or impulsivity, the medication alone will not help your child to organize school materials or manage time.
The other part of helping your child is to find a Psychologist or ADHD Coach who can help teach your child the executive functioning (EF) skills she needs to slow down, self monitor, and use strategies to help remember homework assignments and after school activities.
You, the parent(s), are also part of the treatment. If you are an organized person who is able to begin and complete a task without hesitation, you are likely struggling in understanding why your child just can’t sit down and complete three math problems, or put on her shoes without being distracted multiple times.
I’ve seen many parents become frustrated, despite being very sympathetic towards their child. However, by providing you, the parent, with small short-term goals for your child and for you as a family, you will experience success as a whole and work towards finding a balance between what your child needs to succeed and what your family needs to function.
Whether or not to give your child medication following an ADHD diagnosis is a tough decision. Ask yourself the questions listed above and answer honestly. Whatever your decision for your child’s treatment, keep in mind that no decision is final. If you so choose to try medication, you can decide to come off of it if you feel that it isn’t working. You can also take a ‘holiday’ where you don’t give your child medication on weekends or during school breaks. You may also wish to pursue behavioral modification strategies with the help of a Psychologist or ADHD Coach, with or without medication.
Whichever course of treatment you choose, you will need to assess and re-assess and re-assess again continuously as your child’s academic, social and physiological needs will change. Don’t do this alone – work closely with a Psychologist or ADHD Coach to help you make those decisions along the way.
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Getting Things Done: Developing a Routine for an ADHD Child
If you have a young child with ADHD, you know that getting through non-preferred tasks – that is, anything that is not a video game, iPad, running outside, or watching TV – is difficult. How many times have you wanted to pull you hair out trying to get homework done, or get through the morning or bedtime routine?
On one hand, your child doesn’t want to engage in something so boring. But, on the other hand, your child struggles with sustaining attention and focus long enough to complete the three tasks you just asked him to do (1- go upstairs, 2- put on your pajamas, 3- brush your teeth). Even though tasks may be routine and familiar, your child is so easily distracted by all of the other things in the bathroom and his bedroom, or a thought about a game, that it just doesn’t get done.
In the classroom, I’m sure you’ve gained feedback from your child’s teacher that getting through a worksheet is hard. She is able to complete a few problems, but then gets involved with the other child walking in the hall, or distracted by the fact that a peer’s pencil just rolled on the floor.
So, what can you do to help your child get through everyday life routines and tasks that just have to be done?
Pair Up Tasks
Not like a pair of shoes, but pair up a preferred task with a non-preferred task. For example, “Brush your teeth and get dressed, and then you can go downstairs and watch a TV show while you eat breakfast.” Or, “Get 5 problems done on your math worksheet and you can have a snack.”
Pairing up something pleasant with something unpleasant gives your child an immediate reward for completing a task. Giving a reward at the end of the day after following a long list of rules and routines is just not immediate enough. A short-term reward for a short-term task is the way to go.
Turn Day-To-Day Tasks into a Game
Putting dirty laundry into the washing machine is tedious, but playing a quick game of baseball using dirty laundry is much better! Cleaning up toys by setting a 30-second clock and asking your child to get as many cars into the toy bucket is far more enjoyable than saying, “Time to clean up your cars.”
Homework can also be turned into a game. For example, “Let’s see how many spelling words you can write in one minute!” or “Today’s theme for writing spelling sentences is soccer. Your first spelling word is slow. Tell me the sentence out loud and then write it down – go!”
Build on Your Child’s Strengths
Your child clearly has areas of strength. It may be math or visual reasoning. In fact, those areas of strength can be used to work on other tasks. For example, if your child is good at understanding math concepts, then liken other academic subjects to math. If you are trying to teach about a particular war in Social Studies, draw numbers on a whiteboard to represent soldiers, years, places, etc. to help her visualize and understand the war using numbers, which are reinforcing and motivating.
If your child is strong in a particular academic area, encourage his teacher to allow him to re-teach or help other peers in the classroom who are not grasping concepts as easily. This serves to build your child’s self esteem as well as build his identity and social persona with peers as the one who is really good at math or being the math helper!
Trying to get through the daily boring tasks of life with a child with ADHD can be tough because of the lack of interest your child has with that particular task, and/or because of poor sustained attention. However, by using some of these strategies, you may be able to get through your child’s day with a little bit more ease… and maybe even some fun!
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Helping Your Child Manage ADHD at School
Our children with ADHD are wonderful and intelligent people who need our help with creating a learning environment that allows them to use their strengths to compensate for their weaknesses.
On a daily basis, students with ADHD work very hard to take in information from their environment while filtering out the irrelevant, but this is difficult and consumes a lot of energy. By the time they get through their school day, they are spent because they have processed so much information that you and I are able to translate into background noise. We don’t actively process all the sounds and sights in our environment, but the student with ADHD does.
Your child may also have the urge to get out of her seat to look at something of interest, or speak out the answer because of excitement, or become distracted by her thoughts about that game of Mine Craft she started last night.
You want your child to gain the best education possible, but how can that be achieved if your child needs to be re-focused often? Or, how can you best help your child with ADHD who struggles to express his thoughts in writing, or sit through a task that requires sustained attention?
Well, there are supports in school to help your child. There are three types of plans and here is how they differ:
Intervention and Referral Services Plan (I&RS Plan)
This plan can be gained if you don’t have a diagnosis, but you and your child’s teacher have noticed that concentration, focus and fidgety-ness are an area of weakness. Accommodations can be provided by the classroom teacher.
504 Accommodation Plan
This plan is gained once you have an ADHD diagnosis and your child needs statewide testing (NJASK or now, the Parrcc Assessment) accommodations, such as extended time or small group administration. Once again, accommodations can be provided by the classroom teacher
Individualized Education Plan (IEP)
This is a plan that can provide a special education program and related services. There are many eligibility classifications, but the one(s) that your child will likely qualify under is Other Health Impaired (OHI), or Specific Learning Disabled (SLD) if your child has a comorbid learning disability.
A special education program allows for your child to have in-class assistance in which there is a paraprofessional available to your child with re-focusing and re-directing to task due to attentional weakness, hyperactivity or impulsivity.
In-class resource support allows for a general education and a special education teacher to co-teach. The special education teacher is able to modify work and tests for your child.
Pull out replacement resource support (which is often referred to as Resource Room) allows for modification of the curriculum by a special education teacher because your child is functioning at a level in that subject that is behind his same-aged peers.
Related services are services such as Occupational Therapy, Physical Therapy and Speech Therapy. These services can be gained with an IEP only.
Statewide testing accommodations are available to your child via an IEP as well as accommodations within the classroom, lunch, recess and specials.
The goal is to provide your child with the least restrictive environment (LRE) or the class environment that allows your child to be with her general education peers for as much of the day as possible.
With that said, here are some accommodations you can request for your child via an I&RS Plan, 504 Accommodation Plan or IEP:
- Allow [insert your child’s name here] movement breaks
- Re-direct and re-focus as needed
- Cue [your child’s name] prior to providing instructions in order to ensure attention
- Ask [your child’s name] to repeat back directions in order to ensure accuracy of comprehension
- Provide study guides and/or class notes
- Encourage use of visual graphic organizers prior to a writing assignments
- Break down a large assignments into smaller tasks
The list of possible accommodations is vast and dependent on your child’s needs. If you find that a particular strategy is helpful at home, make sure to ask for it to be a part of your child’s support plan.
Navigating the school system in order to give your child access to the best education possible can sometimes be confusing, but here is some information to help you de-mystify the process.
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Dr. Liz Matheis is a licensed clinical psychologist and certified school psychologist who specializes in treating children with ADHD, Autism, Anxiety, and learning disabilities. She created the ACHIEVE program to coach students with ADHD to create organizational systems that work for them. Dr. Liz serves as Parent Coach, in which she helps parents develop boundaries and maintain consistency in the home environment. She has been effective in helping to decrease anxiety in children, adolescents, and adults using Cognitive Behavioral Therapy techniques. She is also a sought-after contributor to numerous publications, blogs and radio shows!
The views and opinions expressed on this blog are purely the blog contributor’s. Any product claim, statistic, quote or other representation about a product or service should be verified with the manufacturer or provider. Writers may have conflicts of interest, and their opinions are their own.