Monday, April 9, 2012

ADHD Management Tips for Parents


Kyla Boyse, R.N.
What are some tips for parents of kids with ADHD?
  • Try to focus on your child's good qualities. "Catch" your child behaving well at least three times a day and tell them you noticed. Work up to more than three times a day.
  • When you catch your child , simply describe to them the behavior you saw that you'd like to see more of. For example, “You really stayed with me at the mall today.”
  • Tell your kid what you want them to do, instead of what you don't want them to do. (Say "Walk." instead of "Don't run.")
  • Your child with ADHD will need lots of feedback from you. Provide immediate, constructive feedback often throughout the day. Again, keep it brief, specific and descriptive.
  • Kids with ADHD sometimes have trouble eating well because of their medications and trouble sitting still. Make sure your child gets regular meals and snacks of healthy food.
  • Vigorous exercise is also very helpful for your child, but make sure they stay safe. Kids with ADHD may need to be watched more closely than other kids their age because they can be active and impulsive. There are certain things you should do to keep them safe, like make sure they wear a helmet when biking or roller-blading.
  • Help your child develop good social and communication skills, which will help him or her form fulfilling friendships with other kids.
  • Make sure your child's other caregivers are also familiar with daily routines and behavioral goals. This will ensure that your child gets consistency throughout the day.

How can I help my child improve their behavior?
  • Don't try to change many behaviors at once. Target one to three behaviors at a time to work on.
  • Talk about the behavioral goals with your child.
  • You'll probably want to focus closely on target behaviors for tracking and feedback for an hour a day or for limited time periods on a regular routine. Doing this all day long is too grueling for both you and your child.
  • Reward your child with privileges and special activities like a trip to the park or a family picnic for successfully meeting behavioral goals.
  • Keep a few rules and enforce them consistently. (Choose your "battles" carefully.)
  • Offer choices, but keep them simple.

How should I set up the house and our routine to help my child?
  • Keep a regular routine and provide lots of structure, so your child knows what to expect.
  • Post lists and reminders for the routines in key places around the house. For example, you might keep a list of things to bring to school by the front door or in your child's backpack.
  • Keep your home organized. Store things as close as possible to where they are used, and have “a place for everything, and everything in its place.”

How do I get my child's attention?
  • No more yelling a laundry list of instructions from the other room while you're doing something else. You already know that doesn't work anyway.
  • To get your child's attention, get down on the floor in front of him or her and put your hands on his or her shoulders. When they make eye contact with you, say, “There you are.” and then tell them what you need to say.
  • When you give directions, give them one at a time. Break down big jobs into several smaller jobs.
  • Repeat your directions, and make lots of good eye contact. Expect to have to repeat yourself over and over.
  • Try writing a checklist for multiple tasks and break big jobs down into do-able chunks.

What are some tips for parents of younger kids with ADHD?
  • For young children, routines are especially important.
  • Post picture lists of routines in key places around the house. For example, the steps to get ready for bed on your child's bedroom wall or over the bathroom sink.
  • Strike a balance between high energy and quieter activities throughout the day. Follow some restful, quiet reading and snuggle time with a trip to the park to get the wiggles out, and vice versa.
  • Choose your battles—focus on one behavior you want to change at a time.
  • Frequently, throughout the day, offer choices between two alternatives that are both acceptable to you. For example, “Do you want to wear your red jacket or your yellow sweatshirt?”
  • Plan ahead to be sure your child is not overtired or hungry during shopping trips or other potentially “risky” outings.
  • Before going out, review the “behavior guidelines." For example, keep your hands to yourself and use inside voices.
  • You might want to take “practice trips.” Go out somewhere you don't mind leaving so you can leave if your child does not follow the behavior guidelines.

How can we cope with the challenges of raising a child with ADHD?
  • Teachers will change each year, but parents are always there. That's why you are your child's best and most important teacher.
  • Plan for one-on-one time with your child each day. Even just 10-15 minutes every day will go a long way in letting your child know they are special to you. Follow your child's lead during this special time. This will help both of you feel connected and loving toward each other.
  • Stay calm and in control of yourself. You can't force your child to behave the way you want them to, but you are in complete control of your own behavior.
  • Act the way you want your child to act. Be a good role model.
  • Get support. There are a lot of other parents out there going through the same thing as you, and you can help each other with ideas and just by listening. (See the last section, which lists contact information for CHADD, a support group with local chapters.)

How can I help my child do better in school?
Keep in close touch with your child's teacher and work together to make things as consistent as possible between school and home. Get involved and help the teacher as much as possible.

 Sometimes your child's teachers will be very knowledgeable and helpful, and sometimes they will not. Either way, it helps a lot if you learn as much as you can about ADHD, and share with your child's teacher what works best for your child. You may want to share the tips for teachers in the next section (below) with your child's teacher.

What can teachers do to help kids with ADHD?
A teacher who understands ADHD and how to work with kids with ADHD will make a big difference in your child's school experience. Teachers need to understand how to use a program of academic instruction, behavioral interventions and classroom accommodations to help kids with ADHD. You may need to help your child's teacher learn more about how to work best with your child at school. Some basic tips for modifying the classroom include:
  • Seating the child near the teacher
  • Repeating instructions
  • Not putting time limits on test and quizzes
  • Helping the child organize
  • Boosting the child's self-esteem
  • Having consistent consequences for unacceptable behavior.

Where can we get information and support?
Websites:
YourChild: Learning DisabilitiesYourChild: Getting involved in your child's educationYourChild Special Feature: A Look at Biofeedback
Books:
This resource list features books for professionals, parents, adults with ADHD, and books for young people with ADHD.

Organizations:
CHADD (Children and Adults with ADD) is an advocate and information source that sponsors support groups with local chapters. There are over 20 chapters in Michigan. Call or email for one near you. Call 1-800-233-4050.
National Attention Deficit Disorder Association supports education, research and public advocacy for adults with ADHD.
NICHCY (National Information Center for Children and Youth with Disabilities) publishes free, fact-filled newsletters, arranges workshops and speakers, and advises parents on the laws entitling children with disabilities to special education and other services. Call 1-800-695-0285 (Voice/TTY) or (202) 884-8200 (Voice/TTY) or e-mail to nichcy@aed.org with your questions. Spanish language assistance is available.
All Kinds of Minds is a non-profit Institute that helps students who struggle with learning measurably improve their success in school and life by providing programs that integrate educational, scientific, and clinical expertise. The Web site offers helpful information for parents.
Council for Exceptional Children is a professional organization that provides publications for educators, and can also provide referral to ERIC (Educational Resource Information Center Clearinghouse on disabilities and gifted education). Call 1-703-620-3660.
LD Online is an educational service of public television station WETA in Washington, D.C., and has a wealth of information about learning disabilities and ADHD for parents, kids, and teachers, including Spanish language materials.
ADD Warehouse is a catalog of books, videos, and other products to help parents, educators and health professionals understand and treat all developmental disorders, including ADHD and related problems. Call 1-800-233-9273 (1-800-ADD-WARE).

Reviewed by John O'Brien, M.D.

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