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Child ADD / ADHD
Other Issues >> Child ADD / ADHD

Now and again, every child gets restless or absent-minded. It’s normal for children to occasionally forget their homework, daydream during class, act without thinking, or get fidgety at the dinner table. But inattention, impulsivity, and hyperactivity are also signs of ADD or ADHD. ADD and ADHD can lead to problems at home and school, and affect your child’s ability to learn and get along with others. So it’s important to know what the signs and symptoms are and get help if you spot them in your child.
You know these kids: the ones who can’t sit still, who never seem to listen, who don’t follow instructions no matter how clearly you present them, who blurt out inappropriate comments at inappropriate times. Sometimes these children are labeled as troublemakers, or criticized for being lazy and undisciplined. But the correct label may very well be ADHD.

Attention-deficit hyperactivity disorder (ADHD) is a chronic disorder that appears in early childhood. You may know it by the name attention deficit disorder, or ADD, which is what it used to be called. ADD / ADHD makes it difficult for people to inhibit their spontaneous responses—responses that can involve everything from movement to speech and attentiveness. The National Institute of Mental Health estimates that between 3 and 5 percent of children in the United States have ADHD. This means that in a classroom of 25 to 30 children, at least one is likely to have ADHD.

ADD or ADHD can cause many problems if left untreated. Children with ADD / ADHD may struggle in school, get into frequent trouble, and find it hard to make friends. They may develop low self-esteem as a result of failures, frustrations, and criticism. Their symptoms can also lead to friction and stress for the whole family. But treatment can make a dramatic difference in ADD / ADHD. With the right support, your child can overcome the obstacles of ADD / ADHD and get on track for success in all of areas of life.

Myth #1: All kids with ADHD are hyperactive.
Some children with ADHD are hyperactive, but many others with attention problems are not. Children with ADHD who are inattentive, but not overly active, may appear to be spacey and unmotivated.

Myth #2: Kids with ADHD can never pay attention.
Children with ADHD are often able to concentrate on activities they enjoy. But no matter how hard they try, they have trouble maintaining focus when the task at hand is boring or repetitive.

Myth #3: Kids with ADHD choose to be difficult. They could behave better if they wanted to.
Children with ADHD may do their best to be good, but still be unable to sit still, stay quiet, or pay attention. They may appear disobedient, but that doesn’t mean they’re acting out on purpose.

Myth #4: Kids will eventually grow out of ADHD.
ADHD often continues into adulthood, so don’t wait for your child to outgrow the problem. Treatment can help your child learn to manage and minimize the symptoms.

Myth #5: Medication is the best treatment option for ADHD.
Medication can help the symptoms of ADHD when prescribed properly. But an effective treatment plan also includes education, behavior therapy, support at home and school, exercise, and proper nutrition.

When many people think of ADHD, they picture an out-of-control kid in constant motion, bouncing off the walls and disrupting everyone around. But this is not the only possible picture. Some children with ADD/ADHD are hyperactive, while others sit quietly with their attention miles away. Some put too much focus on a task and have trouble shifting it to something else. Others are only mildly inattentive but overly impulsive.

The 3 primary characteristics of ADD / ADHD are inattention, hyperactivity, and impulsivity. The signs and symptoms a child with ADD / ADHD has depends on which characteristics predominate. Children with ADD / ADHD may be:
  • Inattentive, but not hyperactive or impulsive.
  • Hyperactive and impulsive, but able to pay attention.
  • Inattentive, hyperactive, and impulsive (the most common form of ADHD).
The signs and symptoms of ADD / ADHD typically appear before the age of 7. However, it can be difficult to distinguish between ADHD and normal “kid behavior.” If you spot just a few signs, or the symptoms appear only in some situations, it’s probably not ADD / ADHD.

On the other hand, if your child shows a number of disruptive ADD / ADHD signs and symptoms that are present across all situations–at home, at school, and at play–it’s time to take a closer look. One good way to assess your child’s behavior is to look at other kids his or her age. If your child is significantly more impulsive, hyperactive, or inattentive than his or her classmates or friends, it’s a good idea to see a mental health professional for an ADHD evaluation.

Which one of these children may have ADD / ADHD?
A. The hyperactive boy who talks nonstop and can’t sit still.
B. The quiet dreamer who sits at her desk and stares off into space.
C. Both A and B

The correct answer is “C.”

Children with ADD / ADHD can pay attention under the right circumstances. When they’re doing things they enjoy or hearing about topics in which they’re interested, they have no trouble focusing and staying on task. For example, children with ADHD may have no problem paying attention when playing a favorite game or listening to a story (The hard part may be pulling them away to the next activity). But when the task is repetitive or boring, they quickly tune out.

Not paying close enough attention is another common problem. Children with ADD / ADHD often bounce from task to task without completing any of them, or skip necessary steps in procedures. Organizing their schoolwork and their time is harder for them than it is for most children. They also tend to be easily distracted. Kids with ADD / ADHD have trouble concentrating if there are things going on around them; they usually need a calm, quiet environment in order to sustain attention.

Children who only have inattentive symptoms of ADD / ADHD are often overlooked, since they’re not disruptive. However, the symptoms of inattention have consequences: getting in hot water with parents and teachers for not following directions; underperforming in school; and clashing with other kids over not playing by the rules.

Symptoms of inattention in children:
  • Doesn’t pay attention to details or makes careless mistakes
  • Has trouble staying focused; is easily distracted
  • Appears not to listen when spoken to
  • Has difficulty remembering things and following instructions
  • Has trouble staying organized, planning ahead, and finishing projects
  • Frequently loses or misplaces homework, books, toys, or other items
The most obvious sign of ADD / ADHD is hyperactivity. While many children are naturally quite active, kids with hyperactive symptoms of ADD / ADHD are always moving. They may try to do several things at once, bouncing around from one activity to the next. Even when forced to sit still–which can be very difficult for them–their foot is tapping, their leg is shaking, or their fingers are drumming.

Symptoms of hyperactivity in children:
  • Constantly fidgets and squirms
  • Often leaves his or her seat in situations where sitting quietly is expected
  • Moves around constantly, often running or climbing inappropriately
  • Has difficulty playing quietly
  • Talks excessively
  • Is always “on the go,” as if driven by a motor
The impulsivity of children with ADD / ADHD can cause problems with self-control. Because they censor themselves less than other kids do, they’ll interrupt conversations, invade other people’s space, ask irrelevant questions in class, make tactless observations, and ask overly personal questions. Children with impulsive signs and symptoms of ADD / ADHD also tend to be moody and to overreact emotionally. As a result, others may start to view the child as disrespectful, weird, or needy.

Symptoms of impulsivity in children:
  • Blurts out answers without waiting to be called on hear the whole question
  • Has difficulty waiting for his or her turn
  • Often interrupts others
  • Intrudes on other people’s conversations or games
  • Inability to keep powerful emotions in check, resulting in angry outbursts or temper tantrums
ADD and ADHD gets in the way of learning. Children can’t absorb information or get their work done if they’re running around the classroom or zoning out when they’re supposed to be reading or listening. But schoolwork isn’t the only thing that suffers. The symptoms of ADHD can also affect the child’s relationships with family members and peers. For example, a kid with ADHD may be mentally playing a video game while the ball is flying over his head in center field, and daydreaming while Mom is asking him to clean up his room. As a result, the other team just scored three runs, the bedroom is still a mess, and everyone’s exasperated and frustrated.

Effects of ADD / ADHD on memory
Children with ADD / ADHD tend to have problems with working memory. Working memory is the ability to remember several thoughts or facts you’ve just heard long enough to use it to solve a problem or perform a task. When you stop and ask for directions, working memory is what helps you remember to go five blocks, make a right at the stop sign, continue for about a mile until you pass Oak Street, and then make a left about two and a half blocks past Oak into a driveway with a red mailbox out front. Obviously, problems with working memory can be a big obstacle if you’re trying to do a math problem in your head, follow the teacher’s instructions, or take a pop quiz. For a child struggling with ADD / ADHD, retaining three or four consecutive tasks can be difficult; it’s better to ask them to only do one or two things at a time.

Problems with working memory often express themselves as:
  • Forgetting instructions
  • Difficulty memorizing facts, figures, or dates
  • Difficulty summarizing information
  • Forgetting one part of the problem while working on another

Effects of ADD / ADHD on planning and judgment
ADD / ADHD impairs the area of the brain responsible for executive function. Executive functioning includes the abilities to plan, prioritize, organize, move toward a goal, delay gratification, and monitor your own behavior. Instructions like “Be patient” and “Just wait a little while longer” are extremely difficult for children with ADD / ADHD to follow. The problems with executive function also make it difficult for many kids with ADD / ADHD to recognize personal boundaries and read social cues such as body language and facial expressions. This can lead to rebuffs and even ostracism by other children.

Problems with executive function often express themselves as:
  • Poor sense of time and timing
  • Poor problem solving
  • Inconsistency
  • Difficulty waiting for an outcome
  • Low tolerance for frustration
  • Poor judgment

Positive effects of ADD / ADHD
In addition to the challenges, there are also some positive traits associated with people who have ADD or ADHD:
  • Creativity – Children who have ADD / ADHD can be marvelously creative and imaginative. The child who daydreams and has ten different thoughts at once can become a master problem-solver, a fountain of ideas, or an inventive artist. Children with ADD may be easily distracted, but sometimes they notice what others don’t see.
  • Flexibility – Because children with ADD / ADHD consider a lot of options at once, they don’t become set on one alternative early on and are more open to different ideas.
  • Enthusiasm and spontaneity – Children with ADD / ADHD are rarely boring! They’re interested in a lot of different things and have lively personalities. In short, if they’re not exasperating you (and sometimes even when they are), they’re a lot of fun to be with.
  • Energy and drive – When kids with ADD / ADHD are motivated, they work or play hard and strive to succeed. It actually may be difficult to distract them from a task that interests them, especially if the activity is interactive or hands-on.
Keep in mind, too, that ADD/ADHD has nothing to do with intelligence or talent. Many children with ADD/ADHD are intellectually or artistically gifted.

Just because a child has symptoms of inattention, impulsivity, or hyperactivity does not mean that he or she has ADD or ADHD. Certain medical conditions, psychological disorders, and stressful life events can cause symptoms that look like ADD / ADHD. Before an accurate diagnosis of ADD / ADHD can be made, it is important that you see a mental health professional to explore and rule out the following possibilities:
  • Major life events or traumatic experiences (e.g. a recent move, death of a loved one, bullying, divorce).
  • Learning disabilities or problems with reading, writing, motor skills, or language.
  • Psychological disorders including anxiety, depression, and bipolar disorder.
  • Behavioral disorders such as conduct disorder and oppositional defiant disorder
  • Medical conditions, including thyroid problems, neurological conditions, epilepsy, and sleep disorders.
At present, no laboratory or imaging test exists to determine if your child has ADD / ADHD. Clinicians base their diagnosis on the signs and symptoms they observe and by ruling out other disorders. In order to get an accurate diagnosis, it is important to have a full medical and psychological evaluation. The doctor should interview you, your child, and any adults who can provide insight, such as teachers or nannies.

When choosing a specialist to diagnose your child, it’s a good idea to get recommendations from other doctors, therapists, and parents. You can also call your insurance company for referrals and information about what is covered by your insurance plan. Mental health professionals who can diagnose ADD / ADHD include psychologists, pediatricians, and psychiatrists.

Criteria for an ADD / ADHD diagnosis
A diagnosis of ADD / ADHD requires the following:
  • Early onset – Symptoms must have been present before age 7.
  • Duration – A combination of symptoms must have been present for at least 6 months.
  • Settings – The symptoms must be present in two or more settings, such as home, school, and other social settings.
  • Impact – The symptoms must have a negative impact on the individual’s school, family, and/or social life.
  • Developmental level - The symptoms are not due to the child’s normal developmental level or young age.
  • Alternative explanation - The symptoms are not caused by another physical or mental disorder.
If you have a child with the symptoms of ADD / ADHD, the energy required to get your child to listen, finish a task, or sit still can be daunting. The constant monitoring can be frustrating and exhausting. Power struggles can flip parent-child relationships upside down and disrupt family harmony. Sometimes you may feel like your child is running the show. But there are steps you can take to regain control of the situation, while simultaneously helping your child make the most of his or her abilities.

If you feel embarrassed or responsible for your child’s inattentive or hyperactive behavior, try to remember that ADHD is no one’s fault. Your child has a disorder. Children with ADD / ADHD act this way because a part of their brain is lacking the ability to “put the brakes on.” It’s not because of willful disobedience on your child’s part, nor is it because of bad parenting.

That said, good parenting strategies can go a long way in dealing with problem behaviors related to ADD / ADHD. Children with ADHD need structure, consistency, clear communication, and rewards and consequences for their behavior. They also need lots of love, support, and encouragement.

There are things parents can do to reduce the signs and symptoms of ADHD–without sacrificing the natural energy, playfulness, and sense of wonder unique in every child.

Read Parenting a child with ADD / ADHD

If your child struggles with symptoms of hyperactivity, inattention, or impulsivity, don’t wait to seek treatment. You don’t have to wait for a diagnosis of ADD / ADHD to get your child into therapy, start him or her on a better diet and exercise plan, or modify the home environment to meet your child’s needs.

Once you have a diagnosis, you can pursue the full range of treatment options for ADD / ADHD. Effective treatment for childhood ADD / ADHD involves behavioral therapy, parent education and training, social support, and assistance at school. Medication may also be used, however, it should never be the sole ADD / ADHD treatment.

Read ADD & ADHD Treatment

Melinda Smith, M.A., Ellen Jaffe-Gill, Deborah Cutter, Psy.D., and Robert Segal, M.A., contributed to this article. Last modified on: 7/10/08.

Reprinted with permission from http://www.helpguide.org/. C 2008 Helpguide.org. All rights reserved.

You can find the original article at

SOURCE: www.helpguide.org

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