‏إظهار الرسائل ذات التسميات pediatrics. إظهار كافة الرسائل
‏إظهار الرسائل ذات التسميات pediatrics. إظهار كافة الرسائل

ADHD in Children: Better Parenting

What Is ADHD ?

ADHD often affects children learning in school.

Attention Deficit Hyperactivity Disorder (ADHD) is a common disorder seen in children. ADHD symptoms in children include the inability to focus on tasks or pay attention, impulsiveness, and/or hyperactivity. The American Psychiatric Association estimates 5% of children have ADHD, though some studies believe the incidence may be higher.

ADD Vs. ADHD

The term “ADD” was used by the American Psychiatric Association in the Diagnostic and Statistical Manual (DSM), third edition, first published in 1980. At that time scientists believed attention difficulties are sometimes independent from impulse problems and hyperactivity. By the release of DSM-IV in 1994, the name of the disorder had been replaced with “ADHD.” Today, “ADHD” is considered the current term, while “ADD” is considered outdated.

ADHD Symptoms in Children

ADHD symptoms in children are commonly noticed in the classroom.
ADHD Symptoms in children include unusual hyperactivity, impulsivity, and inattentiveness. While these behaviors are normal in children at times, children with ADHD have symptoms that are more frequent and severe.

ADHD Symptoms: Hyperactive Kids

  • Fidgeting and squirming
  • Inability to sit still
  • Nonstop talking
  • Difficulty with quiet or calm activities

ADHD Symptoms: Impulsiveness

  • Impatience
  • Difficulty waiting their turn
  • Saying inappropriate things
  • Interrupting others
  • Acting without regard for consequences

ADHD Symptoms: Inattention

  • Being easily distracted
  • Difficulty focusing on tasks
  • Difficulty staying organized
  • Trouble completing homework or other activities
  • Struggle to follow instructions

How ADHD Is Diagnosed

ADHD is emotionally taxing.

Most children show signs of inattention, hyperactivity, and impulsiveness as part of normal behavior and development. In children with ADHD these behaviors are more severe and frequent.

Guidelines for Diagnosing ADHD in Children

Diagnosing ADHD requires several steps. To diagnose ADHD in children, associated ADHD behaviors must persist for six months or more, be observed in multiple settings (such as home, school, and other places), and interfere with the child's schoolwork or relationships.

Where ADHD Guidelines Come From

Healthcare professionals use guidelines from the current edition of the American Psychiatric Association's DSM to help diagnose ADHD. By using this standard, professionals seek to assure that children are appropriately diagnosed and treated for ADHD. Only trained health care providers can diagnose or treat ADHD.

After an ADHD Diagnosis: Types of ADHD

If an ADHD diagnosis is deemed appropriate, one of three types of ADHD may be determined:
  • Combined Presentation: If enough symptoms of both inattention and hyperactivity-impulsivity were present for the past six months.
  • Predominantly Inattentive Presentation: If enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months.
  • Predominantly Hyperactive-Impulsive Presentation: If enough symptoms of hyperactivity-impulsivity but not inattention were present for the past six months.
ADHD symptoms can change over time, and so can ADHD diagnosis. The average age of onset for ADHD is 7 years old.

Is it ADHD ?

A mom shows concern for her daughter.

The first step in determining if a child has ADHD is to talk to the child's pediatrician about the behaviors observed and concerns you have. Often you will be referred to a mental health specialist who has experience in childhood disorders such as ADHD. There is no single ADHD test.

Other Conditions Similar to ADHD in Children

The first step is to try to rule out other conditions that may have similar symptoms to ADHD. ADHD may be suspected when a child actually suffers from seizures, hearing or vision problems, learning disabilities, or anxiety or depression.
Here are other conditions that share the symptoms of inattention, hyperactivity and/or impulsiveness with ADHD:
  • Malnutrition: Improper nutrition can harm brain development in growing children, especially in the first year of life.
  • Stress: Major life stress like divorce or death of a loved one can cause changes in children's behavior that may sometimes mimic the symptoms of ADHD.
  • Ineffective parenting: If parents are inconsistent or unsure of themselves, children without ADHD may develop behavior problems.
Many other conditions may be responsible for symptoms that resemble ADHD. That's why a doctor must take a close look at other possibilities before diagnosing a child with ADHD.

Raising a Child with ADHD: Think Positively

Raising children with ADHD can be challenging.
An important part of helping a child with ADHD to overcome their challenges is to provide positive support and encouragement. Many children with ADHD are bright and creative and can use those strengths to their advantage.

Opportunities to Notice Positive Behavior

When parents, teachers, and coaches find something children with ADHD are good at, it is important to praise them and encourage those positive traits. Remember that your child is not behaving badly on purpose, and know that your child can learn and grow.
Here are some opportunities for recognizing and appreciating your child with ADHD:
  • Observe them with arts and crafts. Praise them as they work, or let them know you appreciate what they've created once they've finished.
  • When your children with ADHD help with chores, make sure to recognize their contribution. Let them know they are valued.
  • Many children with hyperactivity need a lot of exercise. Organized sports can be a great way for them to blow off steam, and sports also give you opportunities to recognize their talents.

Parenting for ADHD: Define Schedules and Routines

ADHD is common in both boys and girls.

Children with ADHD often benefit from well-defined schedules and routines. Knowing what to expect helps the child manage daily tasks.

Tips to Create Manageable Routines for Kids with ADHD

Set routines for getting ready for school, doing homework, and chores around the house so a child with ADHD can complete them in a timely manner. Here are three tips to get you started with setting appropriate schedules for your child with ADHD:
  • Understand Your Routine: Pay attention to the things that need to be done every day, and when they need to be done. Set aside time for meals, chores and play.
  • Be Prepared to Stick to the Schedule: Make the schedule you establish a priority. This can be tricky in daily life, so prepare ahead of time. For example, you can get breakfast items ready the night before, or pack a day trip bag for your beach trip the day before.
  • Know When to Make Changes: Nobody can be perfectly consistent, but if you find yourself slipping out of your set routine several times in a row, be prepared to re-establish the schedule. Make sure to sell the change enthusiastically to your child with ADHD in terms he or she will understand.

Tips for Setting Schedules for Children

Children with ADHD benefit from schedules.

When setting schedules for kids with ADHD, there are a few organizational tips that can make life easier. Here is a partial list of ways to set schedules for your child with ADHD:
  • Charts and checklists can also be used to help the child know what has been done and what tasks need to be completed. As the child finishes each task, he or she can check them off the list.
  • Time management skills and cues can help them, such as timers for homework or play time.
  • Create a family calendar and either put it on the wall or keep it organized online. This will help you plan more effectively, as well as recognize scheduling conflicts before they become problems.

Parenting for ADHD: Set Clear Rules and Expectations

Setting boundaries can help children with ADHD.

Clear-cut rules with reasonable expectations are important for children with ADHD. Write down
the rules and post them if this is helpful. Children with ADHD often respond well to rewards and consequences. Make sure your child understands the rules that are set, and stick to them. When the child follows the rules, provide positive feedback and rewards. If the rules are not followed, there needs to be fair and consistent consequences.

Helpful Phrases for Instructing a Child with ADHD

Change the way you talk to kids with ADHD.

Make sure instructions are clear. Children with ADHD may have difficulty following vague requests. Instead of telling your child to "clean the mess," tell him to "make the bed and put your clothes in the closet." Instead of saying, "play nicely," ask your child to "give your friend a turn to play with the video game." Give step-by-step instructions for larger tasks. Stay calm and speak clearly, and make eye contact to keep your child focused on you. Ask your child to repeat instructions back to you to make sure they are understood.

How to Discipline a Child with ADHD

Learn to discipline a child with ADHD.

A clear-cut system of rewards and consequences helps children with ADHD to manage behavior. Use positive rewards such as praise or privileges when the child behaves well. Avoid rewards such as food or toys. Consequences for negative behaviors may include time-outs or removal from activities.
Consequences must be consistent and fair. A child with ADHD should know in advance what the consequences of negative behaviors are, and those consequences must be predictable and acted upon immediately. Delayed consequences are less effective. Consequences may include time-outs, withdrawing the child from the situation where they are acting inappropriately, or restricting privileges. Every time the child exhibits negative behaviors, consequences should be implemented.

Rewarding a Child with ADHD

Try to praise your child with ADHD, even for small things. Children with ADHD often hear a lot of criticism and it is important for them to know they can do things well.

Using Effective Time Outs

A time-out may help calm down children with ADHD.

One type of effective consequence for children with ADHD can be time-outs. These can be particularly useful for younger children and can remove the child with ADHD from the situation that may be stressful or over-stimulating. Time outs should be immediate (at the time of the behavior) and should last no longer in minutes than the child's age in years (for example, a 6-year-old should get a time out for no longer than 6 minutes).

Learn to Ignore Negative ADHD Behavior

Ignore negative ADHD behaviors when children act out.

Often, children with ADHD may whine, nag, yell, or argue for attention. Ignoring these undesirable behaviors may be an effective consequence when done consistently. Another way to respond to these attention-seeking behaviors is telling children with ADHD in a calm and quiet tone that they will be listened to when they are calm and quiet themselves. If a child's behavior could injure themselves or others, this should not be ignored.

Keep Your Child Organized

Organization for children with ADHD.

ADHD in children can manifest as having difficulty organizing tasks and belongings (also referred to as executive functioning skills). Doing homework and performing in a classroom may be stressful for children with ADHD. Parents and teachers often find using color-coded binders and notebooks for each subject along with a checklist of homework for the day to be helpful. Having a second set of textbooks at home may help the child who forgets to bring books home. Create an organizing system for your child and help him or her follow it.

Ways to Remove Distractions for Children with ADHD

Eliminate distractions for ADHD children.
Children with ADHD can easily become over-stimulated, so quiet spaces are important. There are many distractions at home from televisions, computers, video games, and siblings. If your child has ADHD, make sure to have a space free of distractions so they can complete homework assignments and other tasks.

Overcome ADHD: Set Small, Realistic Goals

Set real goals to overcome ADHD.

Set small, gradual, and attainable goals. It is unrealistic and stressful for a child to be expected to change overnight. Just as with losing weight you cannot expect to lose 25 pounds overnight and need small increments along the way, your child needs small steps to accomplish behaviors that are important.
If you want your child to sit still when you go out to dinner, break up the meal into small, attainable segments such as not interrupting conversations for five minutes, then remaining seated for ten minutes. Offer praise and rewards for each goal met.

Slowing Kids Down: One Thing at a Time

Slowing kids with ADHD down.

Take it one step at a time as far as attempting to change challenging ADHD behaviors in children. Remember that your child is not behaving this way purposefully. Changing will take time and patience. Expecting change all at once is stressful and frustrating for the child. Pick just one or two things to change such as not interrupting, or putting toys away, or not arguing about homework. Changes may be gradual and it is important to praise your child for every positive accomplishment along the way.

Ways to Help Your Child Shine

Help out your student with ADHD.

All children are good at something. Children with ADHD are often criticized for their negative behaviors. That means their positive behaviors and accomplishments are often overlooked. Help your children with ADHD find out what they are good at, whether it's a sport, a musical instrument, a class at school, art, or any other activity. It doesn't matter what the hobby is – having something they can be successful at and receive praise for will improve self-esteem.

Helpful Phrases for Praising Your Child

Here are a few handy phrases you can use in recognizing the talents and capabilities of children with ADHD:

  • “I am so proud of you!”
  • “You set such a good example when you...”
  • “You can do this.”
  • “I really enjoy how much you like to ask questions.”
  • “You're making great progress.”
  • “I believe in you.”

ADHD Treatments & Nutrition

Better nutrition can help kids with ADHD.

Physical and emotional health is also important. Many children with ADHD are so distracted or disorganized they neglect to eat proper balanced meals. Limit sugary and junk foods, as many parents find they worsen ADHD symptoms. In addition, many of the medications used to treat ADHD can cause decreased appetite so it is important to make sure your child eats regularly. Make healthy choices for yourself and your children will follow your example.

ADHD Treatments & Exercise

Exercise can help kids with ADHD be healthier.

Children with ADHD often have a lot of excess energy and regular exercise can help them release their pent-up energy in healthy and constructive ways. Organized sports can provide regular exercise, a predictable schedule, and an area for your child to receive positive rewards and praise. Activities such as martial arts or yoga can be beneficial for children with ADHD as these emphasize the mental and physical aspects of activity. For some children with hyperactivity, highly active sports where there is more constant motion such as running track may be better than sports with a lot of 'down time' such as baseball.

ADHD Treatments & Sleep

Sleep can enhance ADHD treatments.

Lack of sleep can make it more difficult for children with ADHD to focus and pay attention. Falling asleep is often a challenge for children with ADHD who are frequently over-stimulated to begin with. A scheduled and consistent bedtime should be part of your child's schedule. Also coming up with a bedtime routine where the child is calm and quiet before bed can help them relax. Children with ADHD should avoid caffeine, and the television, computer, and cell phones should be turned off well before bed time so they don't interfere with the child's sleep.

Show Your Unconditional Love

A mother kisses her son.

Like all children, kids with ADHD need to know they have their parent's unconditional love and support. Even if you are angry or frustrated at your child's behaviors remember to tell them you love them no matter what.

Tips for Self-Care While Raising an ADHD Child

Parents of ADHD children needs to take care of themselves too.

It can also be stressful and frustrating as the parent or caregiver of a child with ADHD. Remember to take care of yourself. It can help to remember your child cannot control his behaviors and they are due to a disorder. Take a break if you need one, and don't be afraid to ask for help. You will be a more effective parent if you take care of yourself.

Quick Tips for Self-Care

  • Make sleep a priority
  • Stay in touch with friends
  • Spend time outdoors with fresh air and natural light
  • Ask for help and be willing to accept support when it is offered
  • When overwhelmed by stress, take a step back and breathe deeply

Back-to-School Health Checklist

Remember Your Child’s Health as School Starts

Keep your kids healthy for the start of a new school year.

You've got the pens, the notebooks, and a few fresh new pairs of clothes. But what have you done to look after your children's health as they head off to school? Follow this checklist and discover the problems and solutions that impact the health of your star students, including overloaded backpacks, bullying, and back-to-school separation anxiety.

Be a Lunchbox Hero

Healthy lunches are essential to kids’ success.

Little changes can make a big difference over time. Changing the way you pack your kids' lunches can make them healthier over the long term. Plus, you're helping them appreciate what healthy food tastes like. Try filling their lunchboxes with colorful fruits and vegetables. Grapes, apples, mangoes, berries, and thin slices of red bell peppers and carrots are often popular, or mix in a few of your kid's favorites. Switch juices and sodas for water. And consider substituting white bread for whole grains to add more fiber to their diets.

Prepare With Good Sleep Hygiene

Reading a book at bedtime is much healthier than iPad screen time.

Sometimes the long days of summer throw sleep routines out of whack. Your kids will be more alert and focused in class if you start to get them ready for their school schedule ahead of time. School-aged children need at least 10 hours of sleep every night. Teens need between nine and 10 hours. For good sleep hygiene, get kids accustomed to the same bedtime every night. Also, try removing screen devices from their rooms at night, like cell phones, tablets, computers, TVs, and other gadgets.

Immunize, Immunize, Immunize

Get your kids vaccinated before classes begin.

Polio was once one of the most dreaded childhood diseases in the United States, causing paralysis and even death. In 1955 a vaccine was created and widely implemented. Today polio has been nearly wiped out worldwide.
Vaccinations save children from unnecessary pain, illness, and death. That's why all 50 states require school-aged children to be immunized against diseases like measles, mumps, rubella, pertussis, and chickenpox. Be sure your child's immunizations are up-to-date for their safety, and for the safety of others.

Flu Shots

Flu shots can keep both you and your children virus-free.

Every year, kids in school are at risk of contracting the flu virus, which interferes with learning and in certain cases can be deadly. To reduce the risk for your children and their classmates, make sure to get them immunized. Everyone above 6 months old should be vaccinated every year to control the spread of flu, according to the CDC. Ideally, get your family vaccinated before October, the start of the flu season.

Staying Physically Fit

Teach your kids to play outside and exercise daily.

Kids need at least an hour a day to exercise. Making sure they get enough exercise is a matter of balancing their priorities. For instance, setting limits on TV-watching, video game time, and similar low-energy activities can give kids the encouragement they need to pick up a ball or a jump rope or go out and explore their surroundings. Doing so helps kids maintain a healthy weight, sleep better, and feel less stressed out.

Teach Them the Rules of the Road

Teach your kids to safely cross the street and wait for a crossing guard.

As the school year starts, remember to teach your children about walking and bicycling safely. These statistics show how important it is to teach schoolchildren to stay safe:
  • In 2014, car crashes in the U.S. killed 4,884 pedestrians and 726 bicyclists and injured many more.
  • In 2013, one in five U.S. children under the age of 14 killed in an auto crash was a pedestrian.
  • Children ages 5-14 are the most likely pedestrians to be injured in car crashes.
Be sure your kids know to always walk on a sidewalk when available. When there is no sidewalk, always walk on the shoulder of the road facing traffic. And whenever possible, cross the road at intersections with clearly marked crosswalks.

Battling Backpack Burdens

Lighten up your children’s backpacks.

Most experts say that carrying any more than 10-15 percent of a child's body weight in backpacks can cause problems. Heavy backpacks can cause significant pain in children's backs, necks, and shoulders. Girls are particularly prone to back pain from overburdened backpacks. Lightweight backpacks with waist belts and padded backs can help. Using both shoulder straps is also a good idea. Finally, finding ways to reduce the extra weight like using lockers more frequently between classes can help prevent unnecessary pain.

Sick at School? Have a Plan

Have a plan for your kids if they get sick while at school.

Now that most parents work, getting a call from the school nurse can be a major disruption. Caring for your child when they come down with a flu or other illness takes preparation when you're away from home. Your backup plan can include a trusted family member or family friend who can care for your child for the day, or bring them to a babysitter or child care facility flexible enough to take sick kids. Or you could start a parent network at your school for support during challenging situations like this.

Prepare for Emergency Medication

Get a doctor’s note for your child if they require medication.

When your child needs medication, the law may prevent schools from administering it without your written consent and a note from a doctor. School staff is not allowed to administer medications as needed, so you need to give them specific instructions on how to medicate your child. Also consider asking your pharmacist to put your child's medication into two labeled bottles - one for use at home, the other to be kept at school. And remember that when it comes to transporting medication, make sure adults are in charge until your child is mature and responsible enough to handle the job.

Keep Clear of Colds

Teach your kids to prevent the spread of germs.

Don't let colds and other infectious diseases stand in the way of your child's success. Teach your kids the basics of cold prevention. Wash your hands frequently for at least 20 seconds, avoid touching your face, sneeze into tissues or sleeves, and throw tissues away after using them. Finding ways to lower your kids' stress can help them keep colds at bay, too.

Allergy Awareness

Chalk dust can make allergies worse.

The new school year can also bring new allergy concerns. Common classroom allergy triggers include mold, dust mites, and chalk dust. Food allergies present another challenge. Try talking with teachers, coaches, and other school staff about your child's allergy needs. If your child has hay fever, pay attention to local pollen counts and plan accordingly with allergy-fighting medicine. If your child has a life-threatening food allergy, make sure school staff know how to administer auto-injectable epinephrine.

Beware of the Heat

Keep kids hydrated when it’s hot outside.

It's easy to forget that for most students in the U.S., the beginning of the school year is the hottest time of the year. One of the most important ways to protect your child's health in the heat is to be sure they're staying hydrated. For kids aged 4-8, about two quarts of water should be enough on a hot day. The amount increases for each age group, leveling out as teenagers at about 3.5 quarts for boys and 2.4 quarts for girls each day.

Get Them in for a Checkup

Make an appointment with your kid’s pediatrician for a back-to-school checkup.

It's a good idea for kids to have a yearly checkup to keep up with their growth progress and other health concerns. From birth until early adulthood, doctors recommend that children be seen annually to check on their progress. Let the first day of school be a reminder each year that the annual checkup is an important time to assure your child's health and wellness.

Time for Glasses?

Make sure to get your child’s vision checked to see if they need eye glasses.

As children head to school, some of them will begin to notice trouble with their vision. Nearsightedness, farsightedness, astigmatism, and many other vision problems may create barriers to learning. Yet young children often do not tell their parents about their vision problems or even recognize that they have problems with their sight. A yearly eye exam can help. Also, watch for signs of vision problems like squinting, rubbing eyes, sitting too close to the television, frequently losing their place while reading, closing one eye to see better, and frequent headaches.

Stop Bullying

Only you can stop bullying.

Bullying is a complicated social problem in our schools. Bullies have the potential to hurt children physically, socially, and emotionally. It can lead to academic problems, later substance abuse, and even death in extreme cases. However, there are many ways to fight bullying at school. Teach your children to tell you and other trusted adults if they are being harassed or see harassment of others, and to be kind to bullied kids. Teach them to speak up for themselves by telling the bully clearly to stop, or, if that seems unsafe, to walk away and stay away. Experts do not recommend fighting back.

Overcoming Separation Anxiety

Learn to send your kids off to school without getting upset.

It's common for both parents and children to feel anxious over being apart as the school year starts. But there are ways to relieve this separation anxiety. Try practicing separation ahead of time by leaving kids with caregivers for short periods. Developing a simple goodbye ritual can help reassure children. Make goodbyes short and sweet—don't stall! And realize that your own trouble saying goodbye may feed into your kid's anxiety. Forging a good relationship with the teacher can help you and your child both feel better about saying goodbye for the day.

Building a Healthy Future

Keep your children safe and healthy this school year.

Little eyes are watching. By taking steps to secure your child's health at school, you are leading by example. Children learn how to take better care of themselves when you take them to get annual checkups, teach them how to face bullying, make preparations to manage their allergies, and follow the other steps listed here. What's more, those lessons can last a lifetime, setting them on the right track to become and remain healthy adults.

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