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Join psychiatrist and former public school teacher Hal Kronsberg, M.D., August 10, 2021 at 7 p.m. EDT, as he discusses the signs of anxiety that children may be feeling about returning to school after a tumultuous year of virtual learning. The webinar is presented as part of A Woman’s Journey Conversations That Matter webinar series.
What Is Adhd Or Add
Its 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 attention deficit hyperactivity disorder , sometimes known as attention deficit disorder or ADD.
ADHD is a common neurodevelopmental disorder that typically appears in early childhood, usually before the age of seven. ADHD makes it difficult for children to inhibit their spontaneous responsesresponses that can involve everything from movement to speech to attentiveness. We all know kids who cant sit still, who never seem to listen, who dont follow instructions no matter how clearly you present them, or who blurt out inappropriate comments at inappropriate times. Sometimes these children are labeled as troublemakers, or criticized for being lazy and undisciplined. However, they may have ADHD.
Gender Differences With Adhd
ADHD is more commonly diagnosed in boys than girls, but research into ADHD in adulthood suggests an almost equal balance between men and women. A lower diagnosis rate among females in childhood can result because girls with ADHD are more likely than boys to have the inattentive form of ADHD and less likely to show obvious problems.
More than half of children who experience ADHD in childhood continue to have symptoms as adults. Some women only recognize their ADHD after a child has been diagnosed and the woman begins to see similar behavior in herself. Other women seek treatment because their lives spin out of control, financially, at work or at home.
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Inattentiveness Signs And Symptoms Of Adhd
It isnt that children with ADHD cant pay attention: when theyre doing things they enjoy or hearing about topics in which theyre interested, they have no trouble focusing and staying on task. But when the task is repetitive or boring, they quickly tune out.
Staying on track is another common problem. Children with 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. Kids with ADHD also have trouble concentrating if there are things going on around them they usually need a calm, quiet environment in order to stay focused.
School Tips For Children With Adhd
ADHD, obviously, gets in the way of learning. You cant absorb information or get your work done if youre running around the classroom or zoning out on what youre supposed to be reading or listening to. Think of what the school setting requires children to do: Sit still. Listen quietly. Pay attention. Follow instructions. Concentrate. These are the very things kids with ADHD have a hard time doingnot because they arent willing, but because their brains wont let them.
But that doesnt mean kids with ADHD cant succeed at school. There are many things both parents and teachers can do to help children with ADHD thrive in the classroom. It starts with evaluating each childs individual weaknesses and strengths, then coming up with creative strategies for helping them focus, stay on task, and learn to their full capability.
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How Is Adhd Diagnosed In Preschoolers
It is usually hyperactive and impulsive behavior that leads to an ADHD diagnosis in preschoolers. They may have been kicked out of preschool or banned from playdates. Their parents worry constantly that they will run into the street or hurt themselves in some other impulsive way.
From 2 to 6 percent of preschoolers are estimated to have the disorder a much lower percentage than school age kids. Boys are twice as likely as girls to be diagnosed.
But Dr. Stein, who is also a professor of psychiatry and behavioral science at the University of Washington, emphasizes that diagnosing ADHD at this age should be done with great care, since all preschool children exhibit some hyperactivity, impulsivity and inattention, the key symptoms of ADHD.
Observing a childs behavior in the doctors office is not sufficient for a diagnosis, as symptoms may not be present in that environment. Pediatricians are encouraged to collect screening questionnaires filled out not only by a parent but by at least one other adult who spends time with the child. Symptoms must be present in more than one setting ie at home, at preschool or daycare, with relatives or family friends.
As Dr. Stein notes, its harder to evaluate children who are not yet in a structured environment like preschool, where their behavior is easier to observe and compare to that of other kids.
Allow For Natural Consequences
When disciplining a child with ADHD, pick your battles wisely. You dont want your child to feel as though they cant do anything right or that they are constantly getting into trouble. Allowing some behaviors to slide can help both of you.
Sometimes, allowing for natural consequences makes more sense than trying to convince a child to make a better choice. For example, if your child refuses to take a break from playing to eat lunch, simply put the food away.
The natural consequence is that they will likely be hungry later and will have to wait until dinner to eat. Tomorrow, they will be more motivated to eat lunch when it is served.
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How Is Hyperactivity Diagnosed
If you or your child is experiencing hyperactivity, speak with your doctor.
Your doctor will ask about symptoms, including when they began. Theyll ask about recent changes in your overall health and about any medications you might be taking.
Answering these questions will help your doctor determine the type of hyperactivity youre experiencing. Itll help them learn if the hyperactivity is caused by a new or existing condition, or a side effect of medication.
Your doctor may also take a blood or urine sample to check your hormone levels. This will help them learn if you have a hormonal imbalance. For example, a thyroid hormone imbalance may be causing the hyperactivity.
Its important to get a proper diagnosis in order to effectively treat your condition.
Behavioral Treatment For Adhd
Parent training for behavioral management techniques is the recommended treatment for preschoolers with ADHD. Through these programs, parents learn how to more effectively shape the behavior of young children, and the children usually show marked improvement in their ability to comply with direction and rein in their impulsivity.
Why parent training, rather than therapy delivered directly to the child? Dr. Adesman explains that children are often referred for play therapy, but this is not a very helpful intervention for ADHD. At its worst its like an expensive play date. At its best its a well-intentioned intervention that doesnt have any evidence to support it. What families should be pursuing is parent training in behavior management techniques.
Intuitively one would think that if the child has the problem, the therapy should be focued on the child. The reality is that, while its the child who has the problem, what we want to do is change the environment so we can set the child up for success. And that typically involves working with parents and teachers, he explains. If a child has allergies the problem is with the child but the solution is in working with the environment. You might get rid of the carpet or the drapes or find a new home for the cat. We can do things with the environment to help kids behave better.
- because of the childs behavior
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Symptoms Of Inattention In Children
Your child may:
- Have trouble staying focused be easily distracted or get bored with a task before its completed.
- Appear not to listen when spoken to.
- Have difficulty remembering things and following instructions not pay attention to details or makes careless mistakes.
- Have trouble staying organized, planning ahead, and finishing projects.
- Frequently lose or misplace homework, books, toys, or other items.
Adhd Symptoms At Different Ages
Because we expect very young children to be easily distractible and hyperactive, its the impulsive behaviorsthe dangerous climb, the blurted insultthat often stand out in preschoolers with ADHD. By age four or five, though, most children have learned how to pay attention to others, to sit quietly when instructed to, and not to say everything that pops into their heads. So by the time children reach school age, those with ADHD stand out in all three behaviors: inattentiveness, hyperactivity, and impulsivity.
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Discipline Strategies For Kids With Adhd
When you have a child with ADHD, you may need a different approach to discipline. A few simple changes to your parenting strategies could give your child the tools they need to manage their behavior more effectively.
Kids with ADHD may have trouble sitting still, completing tasks, managing impulses, and following directions. These discipline strategies can be instrumental in helping a child with challenging behaviors to follow the rules.
How Is Hyperactivity Treated
If your doctor thinks the hyperactivity is caused by an underlying physical condition, they may prescribe medications to treat that condition.
Hyperactivity may also be caused by a mental health condition. In that case, your doctor may refer you to a mental health specialist. The specialist may prescribe medication, therapy, or both.
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Plan To Support Your Kid In School And At Home
Symptoms should be present for at least six months and interfere with your child’s functioning before you consider seeking treatment, Gorelik says.
If diagnosed, there are ways you can support your child in school, socially and at home.
” this could look like setting up accommodations including giving extra time on tests, different classroom settings, and behavior plans,” Gorelik says.
“Group based counseling, such as social skills groups, can also help to learn effective strategies to interact with peers.”
And if you put your child in therapy, be sure to have regular consultations with the therapist too, she says.
Adhd Parenting Tip : Stay Positive And Healthy Yourself
As a parent, you set the stage for your child’s emotional and physical health. You have control over many of the factors that can positively influence the symptoms of your child’s disorder.
Maintain a positive attitude. Your best assets for helping your child meet the challenges of ADHD are your positive attitude and common sense. When you are calm and focused, you are more likely to be able to connect with your child, helping him or her to be calm and focused as well.
Keep things in perspective. Remember that your child’s behavior is related to a disorder. Most of the time it is not intentional. Hold on to your sense of humor. What’s embarrassing today may be a funny family story ten years from now.
Don’t sweat the small stuff and be willing to make some compromises. One chore left undone isn’t a big deal when your child has completed two others plus the day’s homework. If you are a perfectionist, you will not only be constantly dissatisfied but also create impossible expectations for your child with ADHD.
Believe in your child. Think about or make a written list of everything that is positive, valuable, and unique about your child. Trust that your child can learn, change, mature, and succeed. Reaffirm this trust on a daily basis as you brush your teeth or make your coffee.
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Who Is Affected By Attention
Estimates suggest that about 4% to 12% of children have ADHD. Boys are 2 to 3 times more likely to have ADHD of the hyperactive or combined type than girls.
Many parents of children with ADHD experienced symptoms of ADHD when they were younger. ADHD is commonly found in brothers and sisters within the same family. Most families seek help when their child’s symptoms begin to interfere with learning and adjustment to the expectations of school and age-appropriate activities.
About The Kennedy Krieger Institute
Internationally recognized for improving the lives of children and adolescents with disorders and injuries of the brain and spinal cord, the Kennedy Krieger Institute in Baltimore, MD serves more than 18,000 individuals each year through inpatient and outpatient clinics, home and community services and school-based programs. Kennedy Krieger provides a wide range of services for children with developmental concerns mild to severe, and is home to a team of investigators who are contributing to the understanding of how disorders develop while pioneering new interventions and earlier diagnosis. For more information on Kennedy Krieger Institute, visit www.kennedykrieger.org.
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Im Afraid To Medicate My 4
Behavior therapy, as mentioned, is actually the first type of treatment the AAP recommends for 4-year-olds. If behavior therapy has been tried and found not to work, then the doctor can consider putting a 4-year-old on ADHD medication, which the guidelines say is also effective and safe for children in this age group. Many children ultimately end up with both therapy and medicine.
Medication at any age is never a magic bullet, says Michael Reiff, M.D., professor of pediatrics at the University of Minnesota, who served on the committee that developed the 2011 AAP guidelines. However, if your child exhibits dangerous behaviors that significantly impair his daily living, it seems reasonable to consider the possibility of medication management.
Parents should ask, Would it be helpful to my child to explore what medications have to offer? says William Dodson, M.D., a retired psychiatrist who practiced in Colorado. As one pediatrician said, Were not talking about a tattoo on your childs face. We are going to see what medication has to offer and then decide, based on knowledge rather than fear.
What Causes Attention
ADHD is one of the most researched areas in child and adolescent mental health. However, the precise cause of the disorder is still unknown. Available evidence suggests that ADHD is genetic. It is a brain-based biological disorder. Low levels of dopamine , which is a neurotransmitter , are found in children with ADHD. Brain imaging studies using PET scanners show that brain metabolism in children with ADHD is lower in the areas of the brain that control attention, social judgment, and movement.
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A Note About Language
In this article, we use male and female and boy and girl to refer to sex assigned at birth. This reflects existing research on childhood ADHD, which mainly uses gender to refer to sex assigned at birth.
That said, at Healthline we recognize gender as a spectrum, not a male-female binary. We also realize that gender identity doesnt always align with sex assigned at birth.
Parents and other caregivers might begin to suspect ADHD in boys who:
- cant sit still in school
- disrupt learning by constantly calling out of turn
- spend hours playing video games but get frustrated after a few minutes of homework
They might not notice or look for similar behaviors in girls, but girls often dont show those signs, either.
Instead, maybe your daughter:
- reads far ahead in the novel assigned for class but consistently fails to do the homework questions
- spends hours working on math homework but often forgets to turn it in
- sits quietly in class, doodling in her notebook instead of paying attention and taking notes
- constantly seems lost in her own thoughts
- is often called a chatterbox by teachers and other adults
In short, girls with ADHD might seem distracted, dreamy, or forgetful instead of outwardly disruptive. As a result, caregivers often dont make the connection, especially in the absence of hyperactive or disruptive behavior.
Girls are also more likely to compensate for symptoms with coping strategies like:
Some key signs of ADHD in girls include:
Helping A Child With Adhd Improve Social Skills
It’s hard for children with ADHD to learn social skills and social rules. You can help your child with ADHD become a better listener, learn to read people’s faces and body language, and interact more smoothly in groups.
- Speak gently but honestly with your child about their challenges and how to make changes.
- Role-play various social scenarios with your child. Trade roles often and try to make it fun.
- Be careful to select playmates for your child with similar language and physical skills.
- Invite only one or two friends at a time at first. Watch them closely while they play and have a zero-tolerance policy for hitting, pushing and yelling.
- Make time and space for your child to play, and reward good play behaviors often.
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How Adhd Is Diagnosed
A diagnosis of ADHD requires more than the key symptoms of inattention, hyperactivity, or impulsivity.
Not only do children need to have 6 or more symptoms for at least 6 months, they also need to:
- have some symptoms before the age of 12
- show symptoms in at least two different settings, including at school, home, work, with friends, or during other activities
- have symptoms severe enough to interfere with function at school, work, or in social situations and affect quality of life
Before making a diagnosis of ADHD, a mental health professional will also rule out other mental health conditions, including:
Research from 2020 notes, for example, that inattentive symptoms often go unrecognized, especially in girls, since these symptoms generally dont disrupt others. A child with inattentive ADHD might seem dreamy or distant. They might also seem intently focused on what looks like class notes when theyre actually doodling or zoning out.
If you dont get a diagnosis in childhood, you might not seek support unless you begin to have problems at work or school, or in your relationships with friends and romantic partners.
Many people with ADHD find their symptoms improve with age. That said, if you never get the right diagnosis or treatment, you might continue to find those symptoms difficult to cope with. As a result, you might feel as if theyre getting worse over time.