Both the sufferers and their families feel the deleterious effects of ADHD/ADD. Parents of children with ADHD/ADD feel stressed and find that their usual approaches to dealing with “normal” children do not work well with children who have the disorder. If they are fortunate, they may be able to refer to professionals or friends who have experience with ADHD/ADD to get help. If not, they may succumb to the stress of dealing with the problems this disorder presents.
The characteristics of an ADHD/ADD child or adolescent
The classical triad of ADHD/ADD is distractibility, impulsivity, and overactivity. Sufferers of ADHD/ADD may have one or more of the symptoms from the triad.
- Concentration difficulty.
- Loses things.
- Inability to complete tasks.
- Calling out and interrupting.
- Does not wait for instructions.
- Acts before thinking.
- Inability to stop.
- Restless and fidgety.
- Fiddles with things.
- Constantly on the move.
- Hates being confined to a small space.
- Difficulty coping with being confined indoors.
Other associated features
Children and adolescents with ADHD/ADD are more likely to have the following problems:
- Difficulty making and maintaining friendships.
- Does not take turn in games.
- Bullying behavior.
- A sore loser in games.
- Active avoidance of work.
- Poor handwriting.
- Poor grammar.
- Reading difficulty.
- Writing difficulty.
- Expressive or receptive language difficulty.
- Major depression with disturbance in sleep, energy levels, eating habits, body weight, concentration, motivation and self-esteem.
- Chronic low grade depression.
- Performance anxiety, which may manifest as procrastination and/or active avoidance of work.
- Social anxiety.
- Lacking in self-confidence.
- Learned helplessness (i.e., a constant feeling that one is unable to effect any changes with one’s efforts and that external help is inevitable).
There is no single, foolproof test for diagnosing ADHD/ADD. Psychiatrists, psychologists and doctors use a number of tests, checklists, questionnaires, clinical assessments and investigations to arrive at the diagnosis. A comprehensive examination and assessment will help to confirm the diagnosis and exclude other disorders, such as oppositional defiant disorder, which have a similar presentation to ADHD/ADD.
Seeking professional help
ADHD/ADD is best managed with a combination of complementary treatments including medication and psychological therapies. The two commonly prescribed medications are Methylphenidate and Dexamphetamine. Generally, the impulsive symptoms respond better to medication than the inattention symptoms. For those people who suffer from ADHD/ADD with inattention symptoms, a Tricyclic antidepressant such as Imipramine may be effective.
Cognitive behavioural therapy is useful for ADHD/ADD sufferers, especially when they are young because the problems are not too entrenched. Through the therapy, sufferers learn to deal with and control their impulsiveness and hyperactivity.
It is important to note that ADHD/ADD sufferers have a higher risk of developing an anxiety disorder and depression than the general population. As such, it is useful to include anxiety and stress management in their treatment plan. When their anxiety and depression go untreated, ADHD/ADD sufferers tend to self-medicate with alcohol or other harmful drugs to calm their nerves.
The treatment approaches for anxiety or depression problems in ADHD/ADD sufferers are similar to those recommended for anxious and depressed people who do not have ADHD/ADD.
Helping children with ADHD/ADD
The following are some useful suggestions that work:
Helping your child attend to verbal interactions:
- Maintain eye contact with your child whenever you talk to him or her.
- Give short, concrete directions that consist of no more than three separate parts.
- Get your child to repeat directions back to you if you think he or she has difficulty remembering.
- As far as possible, use various sensory inputs to help your child to remember information. For example, use cards and drawings to enhance visual inputs in addition to providing the auditory inputs of verbal instructions.
Helping your child to remember:
- Teach your child to use a personal organiser or diary.
- Teach your child the art of using mnemonics to cue recall.
- Use songs, poems or funny stories to enhance recall.
- Use different colour codes to highlight the content of written notes to improve memory.
Helping your child to overcome impulsiveness:
- Teach your child the skills of Stop, Think and Do, as represented by the three traffic light colours of Red, Yellow and Green respectively. Before your child does anything, he or she has to Stop (represented by the colour Red), then Think (represented by Yellow) about the consequences of the behaviour to ascertain whether there are any negative consequences. If there are no negative consequences, then your child may proceed to Do whatever he or she wants (represented by the colour Green).
- Use positive reinforcement to encourage non-impulsive behaviour.
Helping your child to stay on task with study:
- Remove all distractions from the work area or the study room.
- Use colour codes to highlight salient points in the school work.
- Give your child frequent small breaks to overcome mental fatigue.
- Provide activities that are consistent with the intellectual and developmental level of your child.
- Initially, alternate short independent tasks with other more difficult tasks that require your input. Then, ease your child into becoming more independent by having him or her attempt more difficult tasks alone before offering your help.
Helping your child to harness excessive energy constructively:
- Ensure your child has regular sporting activity.
- Schedule a time for physical exercise before he or she attends to any mental activity, such as homework, as this will enhance concentration ability.
- If your child is good at sports, provide ample opportunity to develop sporting prowess as this will help to nurture and strengthen your child’s self-esteem.
Helping your child deal with stress:
Helping your child’s self-esteem:
- Nurture your child’s self-esteem by helping him or her to build up self-confidence.
- Teach your child self-assertiveness.
- Teach your child how to deal with negative and irrational beliefs that impact adversely on self-esteem.
If you want to know more about how to build up your child’s self-esteem, refer to the self-help program, Building Your Child’s Self-Esteem, available in the Management Toolkits Section
In conclusion, ADHD/ADD is best managed by a combination of different modalities. Parents should not just leave treatment to the ‘experts’ — the paediatricians, psychologists, social workers and child psychiatrists. You can do a great deal to help your child. Through the combined efforts of professionals and parents, children with ADHD/ADD have a better outcome and better opportunity to achieve their full potential in life.