Transcript Attention Deficit Hyperactivity Disorder (ADHD)

Attention Deficit Hyperactivity
Disorder (ADHD)
Tips for Understanding and
Managing ADHD in the Home
Presented by: Brett L. Patterson, M.A.
Goals for This Presentation
• Provide a basic understanding of what
ADHD is, and what it is not.
• Attempt to answer any questions and dispel
any myths that many people have
regarding ADHD.
• Introduce some guiding principles for
dealing with ADHD behaviors.
ADHD Exposed
• ADHD is identifiable via behavioral, not physical
characteristics, making it more likely to be
misunderstood.
• Misperceptions:
– Behaviors that directly result from ADHD are not
primarily attributable to poor parenting, lack of
discipline, low motivation, or intentional “trouble
making.”
– Not everything that fidgets and/or behaves defiantly is
ADHD.
What Is ADHD?
• Neurobehavioral disorder marked by:
– Inattention
– Difficulties controlling impulses
– Excessive motor activity (hyperactivity)
• Be aware…the mere presence of these
behaviors does not mean the child has
ADHD.
Indicators of ADHD as a Developmental
Disorder (Barkley, 1995)
• Seen in early child
development
• Behaviors clearly
distinguish child from
non-ADHD children
• Occurs across several
situations (though not
necessarily in all of them)
• Behaviors persistent over
time
• Child not able to perform
at age-appropriate levels
• Not accounted for by
environment of social
causes
• Related to brain function
• Associated with other
biological factors that can
affect brain function (i.e.
head injuries, genetics)
Things We Can See (aka,
Common Complaints)
• Difficulties sustaining attention
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Daydreaming
Child doesn’t listen
Always losing things
Forgetful
Easily distracted
Needs constant supervision
Child doesn’t finish anything he/she starts
Common Complaints (cont’d)
• Problems with impulse control
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Impatient/Difficulties waiting for things
Always interrupting others
Blurts out answers
Doesn’t take turns
Tries to take shortcuts on many tasks
(including chores, homework, etc.)
Common Complaints (cont’d)
• Hyperactivity
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Always on the go
Squirmy…can’t sit still
Talks too much
Frequently hums or makes odd noises
Unable to “put the brakes on” motor activity
Child has two speeds; asleep and awake
What Do These Behaviors Have
in Common?
• Problem isn’t as much sustaining attention
as it is sustaining inhibition…this is the
hallmark of ADHD
• Inhibition: a mental process that restrains
an action (behavior) or emotion
• Problems of inhibition are not a matter of
choice, but are instead a result of what is
(or is not) going on in the child’s brain
ADHD and the Human Brain
• Portions of brain’s frontal lobe are
responsible for “Executive” functions:
– Consolidating information from other areas of
the brain
– “Considers” potential consequences and
implications of behaviors
– Puts “brakes” on (inhibits) impulsive reactions
– Initiates appropriate response to environment
ADHD and the Brain (cont’d)
• Research suggests that in in children with
ADHD, these “executive” areas of the
brain are under-active
• Increasing the activity level in these areas
of the ADHD brain have been shown to
decrease behavioral symptoms. This is the
logic behind using Stimulant medications
as a first line treatment for the disorder.
Common Stimulant
Medications
• Methylphenidate (Ritalin)
• Dextroamphetamine
(Dexedrine)
• Amphetamine/
Dextroamphetamine (Adderall)
• Pemoline (Cylert)
Things That Look Like ADHD
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Depression
Anxiety
Hearing problems
Visual problems
Seizure disorder
Oppositional defiant
disorder
• Autism
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Learning disabilities
Parenting problems
Substance use
Medication sideeffects
• Lead poisoning
Ten Guiding Principles for Raising a
Child with ADHD (Barkley, 1995)
1. Give your child more immediate
feedback and consequences
2. Give more frequent feedback
3. Use larger and more powerful
consequences
4. Use incentives before punishment
5. Strive for consistency
Ten Guiding Principles for Raising a
Child with ADHD (cont’d)
Act, don’t yak!
Plan ahead for problem situations
Keep a disability perspective
Don’t personalize your child’s problems
or the disorder
10. Practice forgiveness
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In Using These Principles, It Is
Important That the Parent:
• Pause before reacting to the child
• Use the ensuing delay to remember all
10 guiding principles (post them
around the house if necessary)
• Choose a response that is consistent
with the principles
Additional Tips for Managing
ADHD Behaviors
• Pay positive attention to your child…catch
them being good
• Give effective commands
– Short, sweet, and straightforward
– Limit the number of tasks to 1-2 per command
• Maintain clear and consistent expectations
• Communicate realistic consequences for
inability to meet expectations
Tips for Managing ADHD
(Cont’d)
• Manage the child’s environment
– Limit distracting influences during times when
child is asked to be on task (i.e. homework)
• Maintain a regular and predictable daily
schedule
• When eliciting child’s input, limit (but
don’t eliminate) the number of choices
available to him/her to 2-3 options
Tips for Managing ADHD
(Cont’d)
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Be patient
Be persistent
Be understanding
*Most importantly, remember to
differentiate the behaviors from the child
– Bad behaviors are not synonymous with a bad
child
Resources Available to Parents
• Children and Adults with ADD (CHADD): a
family support organization that provides a
variety of services. (www.chadd.org or the
Central OK chapter phone number is 405-7221233
• There is a plethora of readings available to those
interested in obtaining more information on
ADHD. One that I have found particularly useful
in working with parents is Taking Charge of
ADHD: The Complete Authoritative Guide for
Parents, by Russell A. Barkley, Ph.D. (1995)