How to cope when your child has ADHD

Attention Deficit Hyperactivity Disorder (ADHD) has long been recognised as a legitimate disorder, according to NICE (The National Institute of Clinical Excellence). The estimated prevalence of all ADHD is around 5% of school-aged children, which equates to 1.5 children in an average class of 30 children.

There are no physical tests for ADHD and therefore it can only be identified through behaviours, which may be occurring to a much greater degree than the norm. The three main features consistent with the Disorder are moderate to severe inattention, hyperactivity and impulsiveness with associated oppositional and sometimes more extreme anti-social behaviours.

What parents can do
Parents should liaise with schools early in the process, prior to major problems emerging, to develop a partnership in order to make the lines of communication clear between all parties. Many of the issues and incidents that occur at home and at school can (but do not always) impact in both areas.

It is important to develop a relationship early in order to prevent potential antagonistic attitudes between school and home with the child with ADHD stuck in the middle of the situation. As it is likely that a child with ADHD will have an IEP in either an Action Plan or Action Plan plus stage on the school special needs register, the parent should have regular contact with both the child’s form tutor and the school SENCO, and should encourage review on short- and long-term academic and socialisation targets by a weekly report and at least a bi-weekly telephone conference.

Although the specifics of IEPs will differ depending on the needs of individual children, a strong IEP should address targets in both attainment and self esteem and have criteria for monitoring and assessment and realistic timescales for an overall review.

In terms of the home itself, having a child with ADHD can place a great deal of pressure on family relationships for both parents and siblings. This issue is compounded by the fact that ADHD is a condition with a strong hereditary link. If a family has one ADHD child, there is a 30-40% chance that another brother/sister will also have the condition and more than half of all parents with ADHD will have a child with ADHD.

There are numerous modification strategies which parents can use to help the ADHD child, and these methods do not necessarily require psychiatric inputs. However, it is essential that parents look after themselves particularly, as they need to give consistent discipline and a structured lifestyle to their children and to remember the when-then principle as in:
When you have put your toys away – Then you can have a story.

Parent training programmes
Parents of children with ADHD need support, and education about the Disorder is central to this. Parents can gain instruction in basic concepts, assessment procedures and the different treatment options, which are available for their child through parent training programmes. The training will encompass principles of effective child management, which will include attending skills, home token systems, punishment techniques, anticipating problems, communicating skills, problem solving skills and ignoring skills. To ensure that you (as parents of a child with ADHD) have on-going support, group therapy and social support should be made available.

What are the essential elements of parental training?

  • Family education about ADD 
  • Restoration of parental control
  • Maximising the impact of medication
  • Reframing/Restructuring
  • Problem solving skills
  • Tension reduction
  • Communication skills
  • Individual psychotherapy where indicated


Diet, ADHD and behaviour
About 5% of children with ADHD respond to particular substances in their diet in a direct and obvious way. However healthy eating, with regular varied food, which provides a constant blood sugar level through out the day, will be beneficial for all pupils. Children from a chaotic home where one or other parent may also have a degree of ADHD may well not be provided with a particularly nourishing lunchbox. It can be an ongoing challenge.

The thinking on Coke or Red Bull intake is variable. There are some children who respond in a very active way to the caffeine or the sugar load in these drinks but for the majority of children with ADHD although these drinks will not make the symptoms any better they do not in fact make them a great deal worse. Currently there is a great deal of media interest in the use of supplements containing fish oils which are often marketed ‘to improve brain function’. However the evidence to date is inconclusive and there are a number of studies ongoing to justify the claims of specific products. The balanced view appears to be that it may provide some improvement in brain functioning but not to the same degree as established treatments such as stimulant medications, commonly methylphenidate which allows the child to concentrate and pay attention; there are also non-stimulant medication options now available for the management of ADHD symptoms, for example, atomoxetine, which helps improve concentration and has a slight anti-anxiety effect. 

Guidelines for working with your child at home
Guidelines are in place to help direct a parent as to how best to work with an ADHD child in the home setting. It is crucial that a parent acknowledges and accepts their child’s weaknesses and strengths so that they are able to help their child’s confidence levels by designing activities around their strengths. Parents who have a child with the disorder should try to work out the times in the day when the child’s work is most productive and ensure that the task for the child begins and ends with an activity which the child enjoys. When working with a child, his/her self-esteem should continually be considered and in order to help the ‘whole child’ develop, the school and the home must maintain close contact to ensure that the child receives consistent messages.

Two final tips are as follows: do not personalise situations as it is the behaviour that you do not approve of, not the child. Never discipline in anger as often in these situations you say things in the heat of the moment you will regret because you will say things you both don’t mean and more importantly sometimes you can’t back up.

Finally have fun with your children and look at specific situations not as problems but as opportunities for developing your relationship.


THE IDEAL TEACHER (and PARENT) FOR A CHILD WITH ADHD

  • Thoroughly knowledgeable about ADHD and accepts legitimacy of the Disorder.
  • Tough as nails about rules but always calm and positive.
  • Ingenious about modifying teaching strategies and materials in order to match child's learning style.
  • Tailors learning materials to suit child’s abilities and skills.
  • Creates assignments that require as much activity on child's part as possible.
  • Mixes high and low interest tasks in tune with child's learning style.
  • Deals with homework in a pragmatic way.
  • Knows when to back off when STUDENT's level of frustration begins to peak.
  • Knows when to back off when TEACHER'S (PARENT'S) level of frustration begins to peak.
  • Speaks clearly in brief, understandable sentences.
  • Looks the child straight in the eye when communicating.
  • Runs an absolutely predictable and organised classroom.
  • Controls the classroom without being controlling.
  • Provides immediate and consistent feedback regarding behaviour.
  • Develops a private signal system with child to gently notify him when he/she's off task or acting inappropriately.
  • Maintains close proximity without being intrusive.
  • Ignores minor disruptions. Knows how to choose battles.
  • Has no problem acting as an auxiliary organiser.
  • Maintains an interest in the child as a person even after a trying day.
  • Willing to call and meet with parents/teachers. 
  • Has a sense of humour you wouldn’t believe.