ADHD Help

There are many who believe that there is a positive relationship between ADHD and creativity and ADHD and high intelligence. Unfortunately, research does not support this belief. There are brilliant people with ADHD and also retarded ones. Some are artistically or creatively gifted, and others are not. ADHD is a disorder and not an advantage. The good news is that we are becoming progressively more successful treating ADHD. With good treatment, ADHD does not need to interfere with relationships, occupational success, or overall life quality.

As a child psychologist, I find that it is much easier to suggest
strategies to others than to successfully manage your own family. When
dealing with others, you can be much more objective and dispassionate.
Your emotions don’t interfere nearly as much. With your own children,
however, it’s an entirely different ballgame.

I also believe that the tricky part of being a therapist isn’t coming up
with suggestions but rather helping the parents figure out what to do
after your initial recommendations don’t work. Children with ADHD are
quite good at playing adults against each other. They also appear to be
good at learning your plan and figuring out how to work it to their
advantage in ways you probably never imagined. That is why you need to
be flexible, able to change the strategy as needed. Raising
psychologically healthy children is still an art rather than a science.

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A high percentage of children with ADHD , particularly boys, also have Oppositional Defiant Disorder (ODD). ADHD alone can create friction within the family. ADHD, when combined with ODD, can make family life much more challenging. I have known parents who did not want to go home after work and face the frequent conflicts. Some were also concerned that if they did not go home, the problems might escalate even more. Family life with ADHD and ODD can become quite unhealthy for children and parents alike.

It is better to act than to react. In order to improve the situation it is a good idea to have a plan in place to improve family communication and cooperation. Consequences need to be clearly stated, and parents must follow through. I also want families to have fun together and accomplish goals as a team. I want people in families to treat each other with respect.

I have created a program specifically designed to encourage more peaceful families. The program takes into account the special needs of children with ADHD. I will be presenting the program in the near future in a series of teleconferences. I hope you will be able to attend.

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Behaviors tend to be cyclical. We deal with the same problems over and
over again.  This means that we don’t necessarily need to have good
skills thinking on our feet.  If we don’t get it right the first time,
we can plan how to handle the problem the next time around.

A general principal is that it is better to act than to react. If a
problem occurs and you are unhappy with your response, sit down with
your spouse or some other trusted adult, discuss what happened, and come
up with a plan regarding how to respond if and when the problem recurs.

Look at management of problem behaviors as problem solving. If a
particular response is not effective, come up with another one.
Eventually you will get the problem under control.

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The majority of medications used to treat children with ADHD are stimulants. Most mental health providers prefer sustained release preparations rather than short acting ones. With the short acting ones, you have to take them every 4 hours. Sometimes there are symptoms rebounds when the medication wears off. A symptom rebound is when the symptoms return, possibly even worse than normal.

The sustained release medications do not appear to have significant problems with symptom rebounds. Because you have to take them every 4 hours, more energy is put into the act of taking the short acting medication. I like to deemphasize the medication if at all possible. It is also more likely that you might forget to give some of the doses if you need to give the medication 3 times a day. Finally, the child will have to take the medication at school, thus increasing the child’s stigma or possible embarrassment. As you can see, there are many advantages to the sustained release preparations.

Sometimes less is more.

This is a counterintuitive statement (goes against intuition) which is often true when dealing with misbehavior in children. Conventional wisdom is that the more you yell at your child for a wrong deed, the better. However, I usually do not find this to be true. What you do when you yell is give your child lots of negative
attention. Sometimes this rewards the behavior instead of punishing it.
The more you yell the more powerful your child might feel.

It is better to deal calmly and efficiently. Tell your child the
consequence and move on.

We define a punishment as anything which follows a behavior and
decreases the probability for recurrence.
A reward is anything which follows a behavior and increases the
probability for recurrence. If you are yelling over and over regarding
the same type of misdeed, you are probably not punishing the problem.

Regarding less is more, shorter consequences tend to work better than
longer ones. When we use long consequences we have a difficult time
following through and can easily end up burying our child in
punishments. Better to use shorter punishments and follow through.
That way children also learn that we mean what we say.

If you overemphasize to your child the importance of the medication, you very well might tap into his/her oppositionality. A high percentage of children with ADHD are oppositional. They do not want to do what you tell them to do.

If they think that you are trying to control them with medication, they might try their best to do the opposite. It is very important that you avoid falling into this potential trap. That is why you emphasize that the child is doing better because (s)he is trying.

When medication helps, the effects can often be remarkable. It is easy to fall into the trap of putting all of the responsibility for the improvements on the medication and forgetting that the child is responsible for her/his own behavior.

Obviously the medication is an important part of the treatment. However you have to remember that children improve because they try to change. The medication does not make them act appropriately. It just makes it easier for them to improve if they try.

When we put all of the emphasis on the medication, the child can stop taking responsibility. Remember to emphasize that your child is doing better because he or she is trying rather than just focusing on the importance of the medication.