Attention Deficit
Hyperactivity Disorder (ADHD) is a condition in
which there is developmentally inappropriate attention, hyperactivity and/or
impulsive behaviour. These difficulties
are so pervasive and persistent as to significantly interfere with a child’s
daily life. In the second article of a
three-part series on the condition, the Learning Assessment & Neurocare
Centre discusses how to manage this condition.
Managing Attention Deficit Hyperactivity Disorder in
children
It is very
important that as parents you and your child become empowered in the management
of your child’s condition. This means
that you must become well informed on the condition, able to make management
decisions within parameters that will be spelled out for you by your
consultant, and able to act as your child’s advocate so that all members of the
team, including the school and the physician, are able to work together in your
child’s best interests.
There are a wide
range of books available. There are also
a number of websites from where you may obtain further information. It is
important, however, to note that on the internet there are also a number of
websites with fallacious and misleading information.
Many parents feel
somewhat helpless and confused in the initial weeks following a diagnostic
assessment. There has been a great deal
of misinformation in the media about the condition and it is important that you
obtain factual information. There are
now clear international guidelines on the existence and management of
ADHD.
International guidelines on managing ADHD
In the UK the
guidance from the National Institute of Clinical Excellence 2000 is
particularly informative. European
guidelines on the management of ADHD have now been published and there are
guidelines from the American Academy of Pediatrics. These will help reassure you that the
approaches taken by your consultant are very much in keeping with international
opinion on the management of this condition and are based on research and
clinical practice which enables your child to be helped to the fullest.
Alternative therapies to treat Attention Deficit
Hyperactivity Disorder
There are a range
of management options available, and most experts agree that the combination of
treatments that are best suited to the individual child should be used. Before starting effective management, many parents
have trialled alternative therapy.
Whilst there is no objection to this, benefits of these treatments have
generally not been scientifically evaluated or proven to be helpful in the
treatment of ADHD.
You will be
advised to discuss such treatments with your consultant in an informed way
before proceeding. Such treatments could include biofeedback, dietary
restrictions or supplemental diets, mega-vitamins, herbal supplements, sensory
integration therapy, and allergy treatments.
Parent education and ADHD
Becoming informed
about the facts of ADHD and avoiding the misunderstandings and misinformation
is a critical part of overall management.
Parents must be able to distinguish between fact and fiction, and
between good and bad advice. This is a
never-ending process – there is an enormous amount of information available
about ADHD and the co-existing conditions.
The field continues to develop rapidly on an ongoing basis.
Managing the behaviour of children with Attention Deficit
Hyperactivity Disorder
Behavioural
management has been shown in controlled studies to be an effective treatment
available for AD/HD. Behavioural modification therapies include social skills
training, behavioural therapy and parent training. Such strategies can also be useful at school
and information is available for teachers.
At home, it is
often difficult for parents as well as others to view a child’s apparently
willful misbehaviour as being due to a valid medical disorder. It is important
to emphasis that ADHD is not an excuse – rather an explanation. Having a ‘disability perspective’ is often
helpful. Protecting and enhancing
self-esteem is always essential and it is important to avoid being
overly-critical and to emphasise the child’s ‘islets of competence’. A supportive
and empathetic communication style is helpful. Behavioural management
strategies are very helpful and help parents feel better prepared to deal with
the daily challenges of parenting a child with ADHD.
Educational strategies for children with ADHD
It is important
that as a parent you develop a good rapport with the school. Generally schools are recognising ADHD as a
valid condition. In situations where
this is not the case, attempts should be made to introduce an evidence-based
approach to the school. It is important
that as a parent you become an information source on ADHD so that you are able
to work with the school in your child’s best interests.
Not only is
feedback from the school essential in helping to guide effective management,
but an understanding of schooling strategies, behavioural management and the
reasons why a child with ADHD, especially if there are complications, may act
in a certain way at school, must be understood.
For example, ongoing detentions for a child who is always late or who
does not turn in his homework can be counter-productive. It would be much better to help the child to
perform adequately in these areas with a resulting improvement in
self-esteem.
Counselling children with Attention Deficit Hyperactivity
Disorder
Although this has not been shown to treat the core symptoms of ADHD, it
may help the child better understand the disorder and its affect on those
around him/her. It can be particularly
helpful if there are issues relating to self-esteem or social skills, or
overall family issues. Siblings
frequently suffer also because of the other child’s ADHD and may need help in
their own right.
