How to manage ADHD in Children?

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Meaning of  Attention Deficit Hyperactivity (ADHD)

The term ADHD means Attention Deficit Hyperactivity Disorder which is a brain disorder. There have other terms which indicate ADHD like “attention deficit disorder”, “Hyperkinetic disorder” “Hyperkinesias” and “minimal brain dysfunction”. ADHD syndrome is characterized by persistent hyperactivity, impulsivity, and difficulties in sustaining attention which may lead to poor attainment in school and difficulties making and maintaining appropriate peer relationship.

Inattention, impulsivity, and hyperactivity make it difficult for the teenager with this acknowledgment to confirm the parental expectations, so children with ADHD often involved in conflict type relationship with their parents. For child ADHD it may long 17 years of age and for adult, it occurs after 18 years of age.

For two-thirds of cases, the primary problems of ADHD occur into adulthood. Roughly a third develop significant antisocial behavior problems in adulthood including conduct disorder and substance abuse which may lead criminality, adjustment problems, and suicidal attempts.

The name ADHD was first introduced in 1980 at DSM (The Diagnostic and Statistical Manual of Mental Disorders). In 1994 ADHD is included in DSM 5 by defining the name “Attention Deficit Hyperactivity Disorder’ and the definition was changed by three main criteria.

  1. Inattention
  2. Hyperactivity
  3. Impulsivity

Parents can see some of the behavioral symptoms into their children during attention deficit hyperactivity disorder (ADHD):

          Diagnosis ADHD in Children

Diagnostic Symptoms of ADHD:

  • The children with ADHD may have a short attention span and they feel difficulty in continuing attention on activities.
  • Susceptibility to interruption by extraneous stimuli and internal thoughts.
  • Gives the impression that he/she is not listening well.
  • Frequently failure to follow instructions, finishing school assignment and other small activities
  • They may be forgetful, lack of attention in activities, and losing equipment essential for tasks.
  • They are Hyperactive with high energy level, agitation, the problem to sitting silent, or noisy or unnecessary conversation.
  • Impulsivity is shown by awaiting the turn in group situations,
  • Before finishing the question they go through the answer.
  • Frequent intrusions into others’ personal business.
  • Frequent disruptive, aggressive, or negative attention- seeking behaviors.
  • The tendency to engage in carelessness or potentially dangerous activities.
  • Difficulties to work accurately for complete the task effective way, frequently blame others for his/her own mistake, and most of the time they fail to work from experience.
  • Low self-esteem and poor social skills.

You can also see the symptoms of Inattention, Hyperactivity, and Impulsivity of children

Factors/causes for Attention Deficit Hyperactivity Disorder (ADHD)

The exact factors/causes of attention deficit hyperactivity disorder (ADHD) cannot be described in a word, but various combining factors may be influenced ADHD. These factors are personal, biological, contextual and psychological.

Predisposing factors:

  • Genetic vulnerability
  • Intrusive parenting
  • Parental psychological problem
  • Family disorganization
  • maternal smoking, alcohol use in pregnancy
  • Anorexia at birth
  • diseases in infancy
  • social disadvantage
  • Institutional upbringing
  • Minor physical abnormalities  at birth
  • Early neurological problem

 Maintaining factors:

  • Deregulation of dopamine, adrenergic and nor-adrenergic system
  • Co-morbid with various disability
  • Low self-efficacy
  • Dysfunctional coping strategy
  • Family deny problem
  • Lack of coordination involves professionals
  • Unhelpful parenting
  • Father absence
  • Low parental self-esteem
  • Poor social support network
  • High family stress
  • Confused communication patterns
  • Parental psychological problem or criminology
         Way to deal with  child’s ADHD

How parents can deal with a child’s ADHD?

Treatment/Management for Attention Deficit Hyperactivity Disorder (ADHD):

  1. Parents’ psychoeducation about the child ADHD:

    Parents require clear authoritative information about the syndrome of inattention, hyperactivity, and impulsivity. They need to learn the above symptoms and factors that caused ADHD. Parents need to know the rights of their child to appropriate educational resources, and local guidance on how best to access these resources.

  2. Psychological Test:

    Complete psychological testing to identify the child with a diagnosis of ADHD as well finds out the common emotional factors.

  3. Proper Medication:

    Take prescribed medication as a directive by the physician. Parents have to monitor child for psychotropic medication prescription compliance, side effects, and effectiveness; consult with the prescribing physician at regular intervals.

  4. Introduce an organized system:

    Parents need to develop and utilize an organized system to keep track of the child’s school assignment, chores, and household responsibilities.

  5. Communication with school:

    Parents should maintain communication with the school to increase the child complains of the completion of the school assignment.

  6. Discuss with the child’s teachers:

    Parents need to consult with the child’s teachers to implement strategies to improve school performance. For example:

    • sitting in the front row during class
    • using a prearranged signal to redirect the child back to tasks
    • providing frequent feedback
    • calling on the child often
    • arranging for listening buddy
    • implementing a daily behavioral report card
  7. Reinforcement:

    Ensure reward system/reinforcement for appropriate behavior and completion of his/her assignments.

  8. Teaching the child about task taking strategies:

    Teach the child more task taking strategies such as:

    • reviewing material regularly
    •  reading directions twice
    •  and rechecking work.
  9. Teaching the child about coping mechanism:

    Teach the child meditation and self-control strategies (e.g., “stop, look, listen and think”) to delay the need for instant gratification and inhibit impulses to achieve more meaningful, longer-term goals.

  10. Psychological training:

    Parents need to know from a psychological expert about “Parents management Training approach” where they will be able to implement:

    • a reward and punishment system
    • contingency contract
    • token economy
    • how parent-child behavioral interaction can reduce the frequency of impulsivity, disruptive, negative attention-seeking behaviors and
    • increased desired behavior through promoting and reinforcing positive behaviors
  11. Enhancement of parents and child bonding:

    Parents need to spend 10-15 minutes daily of one-on-one time with the child to create a closer parent-child bond. Allow the child to take the lead in selecting the activity to the task.

  12. Confrontation of the child’s disruptive behavior:

    Firmly confront the child’s impulsive behaviors, pointing out consequences for him/her and others.

  13. Coordination activities:

    Parents need to assign child the task of showing empathy, kindness or sensitivities to the needs of others (e.g., allowing sibling or peer to take first time to play a video game, helping with school fundraiser).

  14. Confront the child stalemates:

    Confront stalemates in which child blames others for his/her annoying or impulsive behaviors and fail to accept responsibilities for his/her actions.

  15. Identify the stressors:

    Parents need to identify stressful events or factors that contribute to an increase in impulsivity, hyperactivity, and destructibility.

  16. Stress management techniques:

    Parents and clients will develop a positive coping strategy (e. g., anger management techniques, and meditation with assertiveness techniques, positive self-talk) to manage stress more effectively.

  17. Group therapy session:

    Parents and child will regularly attend and actively participate in group therapy. Here, parents and child may be given their homework assignment.

The above strategies are not a complete treatment plan to handle ADHD child. There are many other methods which are used by expert clinical/counseling/educational psychologist. After proper diagnosis, disruptive behavior of a child with ADHD can be identified. As the ADHD child spend most of the time with their parents, so they have more role than teacher or psychotherapists for the child’s well-being.

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