ADHD / ADD/ Attention/ Impulse/ Emotional Regulation

For Parents

While ADHD is believed to be hereditary, managing your child’s symptoms can affect both the severity of the disorder and development of more serious problems. Early intervention holds the key to positive outcomes for your child.

The earlier you address your child’s problems, the more likely you will prevent school and social failure and associated problems such as underachievement and poor self-esteem that may lead to delinquency or drug and alcohol abuse.

Although life with your child may seem challenging, as a parent you can help create home and school environments that improve your child’s chances for success.

Here are some ways to get started.

- Don’t waste your limited emotional energy on self-blame. ADHD is a disorder in certain areas of the brain and is inherited in the majority of cases. It is not caused by poor parenting or a chaotic home environment, although the home environment can make the symptoms of ADHD better or worse.
- Learn all you can about ADHD. While a great deal of information on the diagnosis and treatment of ADHD is available, not all of it is accurate or based on scientific evidence. It is up to you to be a good consumer and learn to distinguish the accurate information from the inaccurate. How can you sort out what will be useful and what will not? It is good to be wary of ads claiming to cure ADHD. There is no cure for ADHD, but you can take positive steps to decrease its impact. In addition, pay attention to the source of the information. If you’re using the Internet, stick with reputable websites such as government (for example CDC), nonprofit (such as CHADD) or university resources (those that end in .edu).
- Make sure your child has a comprehensive assessment. To complete the diagnostic process, make sure your child has a comprehensive assessment that includes medical, educational and psychological evaluations (involving input from your child’s teacher) and that other disorders that either mimic or commonly occur with ADHD have been considered and ruled out.

How to help your child succeed at school

- Become an effective case manager. Keep a record of all information about your child. This includes copies of all report cards, teacher notes, disciplinary reports, evaluations and documents from any meetings concerning your child. You might also include information about ADHD, a record of your child’s prior treatments and placements and contact information for the professionals who have worked with your child.
- Form a team that understands ADHD and be the team captain. Meetings at your child’s school should be attended by the principal’s designee as well as a special educator and a classroom teacher that knows your child. You, however, have the right to request input at these meetings from others that understand ADHD or your child’s special needs. These include your child’s physician, the school psychologist, and the nurse or guidance counselor from your child’s school. If you have consulted other professionals, such as a psychiatrist, psychologist, educational advocate or behavior management specialist, the useful information they have provided should also be made available at these meetings. A thorough understanding of your child’s strengths and weaknesses and how ADHD affects him or her will help you and members of the team go on to develop an appropriate and effective program that takes into account his or her ADHD.
- Become your child’s best advocate. You need to represent and protect your child’s best interest in school situations, both academic and behavioral. Become an active part of the team that determines what services and placements your child receives.
- Communicate regularly. Adopt a collaborative attitude when working with your child’s team—after all, everyone has the same goal, to see your child succeed! Let your child’s teachers know if there are some major changes going on in your family since your child’s behavior can be affected. Invite the teachers to contact you with any issues or concerns before they become a problem. Having open lines of communication between you and the school will help your child.

How to make life at home easier

Join a support group.
- Seek professional help. Ask for help from mental health professionals, particularly if you are feeling depressed, frustrated or exhausted. Helping yourself feel less stressed will benefit your child.
- Work together. It is important that all the adults that care for your child (parents, grandparents, relatives, and babysitters) agree on how to handle your child’s problem behaviors. Working with a professional, if needed, can help you better understand how to work together to support your child.
- Learn the tools of successful behavior management. Behavioral techniques have been widely established as a key component of treatment for children with ADHD. Parent training will teach you strategies to change behaviors and improve your relationship with your child.
- Find out if you have ADHD. Since ADHD is often inherited, many parents of children with ADHD discover that they have ADHD when their child is diagnosed. Parents with ADHD may need the same types of evaluation and treatment that they seek for their children in order to function at their best. ADHD in the parent may make the home more chaotic and affect a parent’s ability to be proactive rather than reactive.

Parent training will help you learn to:

- Provide clear, consistent expectations, directions and limits. Children with ADHD need to know exactly what others expect from them. They do not perform well in ambiguous situations that don’t specify exactly what to expect and that require them to “read between the lines.” Working with a professional can help narrow the focus to a few specific behaviors, help you set limits and consistently follow through with consequences.
- Set up an effective discipline system. Parents should learn proactively—not reactive—discipline methods that teach and reward behavior and respond to misbehavior with alternatives such as time outs or loss of privileges. Communicate with the other people who care for your child and work to be as consistent with behavioral techniques across settings and caregivers as possible.
- Help your child learn from his or her mistakes. At times, negative consequences will arise naturally out of a child’s behavior. However, children with ADHD have difficulty making the connection between their behaviors and these consequences. Parents can help their child with ADHD make these connections and learn from his/her mistakes.

How to boost your child’s confidence

- Set aside a daily special time for you and your child. Constant negative feedback can erode a child’s self-esteem. A special time, whether it’s an outing, playing games or just time spent with your child in positive interaction, can help fortify your child against assaults to self-worth.
- Notice your child’s successes, no matter how small. Attempt to notice when your child is paying attention well or doing what s/he is supposed to be doing. Tell your child exactly what she/he did well. This can improve your child’s self-esteem and teach him/her to notice gradual improvements, rather than being too hard on him/herself.
- Tell your child that you love and support him/her unconditionally. There will be days when you may not believe this yourself. Those will be the days when it is even more important that you acknowledge the difficulties your child constantly faces and express your love. Let your child know that you will get through both the smooth and rough times together.
- Assist your child with social skills. Children with ADHD may be rejected by peers because of hyperactive, impulsive or aggressive behaviors. Parent training can help you learn how to assist your child in making friends and learning to work cooperatively with others.
- Identify your child’s strengths. Many children with ADHD have strengths in certain areas such as art, athletics, computers or mechanical ability. Build upon these strengths, so that your child will have a sense of pride and accomplishment. Make sure that your child has the opportunity to be successful while pursuing these activities and that his strengths are not undermined by untreated ADHD. Also, avoid, as much as possible, targeting these activities as contingencies for good behavior or withholding them, as a form of punishment, when your child misbehaves.

Set routines- review the linked article.

References

Barkley, R. (2008). Classroom Accommodations for Children with ADHD. ADHD Report.

Dendy, C., Durheim, M., & Ellison, A. (2006). CHADD Educator’s Manual. Lynchburg, VA: Progress Printing.

Parker, H. (2012). Accommodations Help Students with Attention Deficit Disorders. A.D.D. WareHouse.

Zentall, S. (2006). ADHD and Education Foundations, Characteristics, Methods, and Collaboration. Upper Saddle River, NJ: Pearson Education.

Chaban, P., McAuley, T., & Tannock, R. (2009). ADHD and Social-Emotional Abilities. www.AboutKidsHealth.ca.

Recommended Readings:

The Misunderstood Child, Dr. Larry Silvers

Children with learning difficulties — like ADHD, dyslexia, or sensory processing disorder — struggle to explain what’s going on in their head, and why they feel “different” from their peers. In The Misunderstood Child, Dr. Larry Silver starts to explain what these “atypical” children might be feeling — from the genetics of learning disabilities to the most recent neurological research behind his claims. Armed with this timely resource, parents can work to understand their child’s difficulties and become effective advocates for them, in school and in life.

For Teachers and IAs

Classroom Management

Good classroom managers have efficient classrooms that meet the educational and psychological needs of their students. Classrooms are structured so that rules and routines are well known by the students and consistently followed. Transitions among lessons and activities are smooth. The teacher can give the impression that he or she is aware of all activities by students in the classroom. Teachers with good classroom management skills meet the educational and personality needs of their students, regardless of their students’ abilities and special needs. Student misbehavior especially misbehavior related to ADHD symptoms can be prevented by careful attention to the following:

the physical environment of the classroom (including minimizing distracting classroom displays)
establishing and practicing with the students rules and procedures for routines and classroom tasks
organizing lesson plans and instruction in a way that minimizes interruptions
increasing teacher awareness in the classroom by letting students know you are aware of their actions at all times

Accommodations are intended to help students with ADHD learn the same information as other students. They are changes to the structures and/or the environment that provide support to help students access the curriculum. Accommodations work best when they are tailored for the individual needs of the student based on the severity and symptoms of their ADHD and any other co-occurring conditions. It is important to observe the student to see which accommodations are effective – and the effectiveness of accommodations can change over time. Students can also be enlisted in figuring out what helps them the most. This will also ensure that the accommodations are seen as support instead of punishment. Teachers, parents, and students should partner together to address needs and supports.

The Diagnostic and Statistical Manual, Fifth Edition lists two categories of symptoms of ADHD—inattentive and hyperactive-impulsive. Students may have only one type, or they may have both types of symptoms. The accommodations that are appropriate for each student depending on the symptoms and on how much they impact the student.

Social Skills

Besides creating academic challenges, ADHD also affects social skills. Students may have trouble controlling their emotions, and younger kids especially may have difficulty keeping their hands to themselves. They might not interpret social cues effectively. They could also struggle with conversational skills. These challenges often cause students with ADHD to have difficulty making and keeping friends.

As a teacher, you can help by providing a positive learning environment. You can also teach, show, and support appropriate behavior in the following ways:

Praise the student for good behavior more often than punishing for bad. Give encouragement and reassurance. Let the student hear they are succeeding. Frequent but brief feedback that lets the student know they are on the right track is often very effective.
Work with students to set up a private signal, either visually or verbally, to help them recognize when their behavior is bordering on inappropriate. When prompting behavior you want it to be a reminder rather than a reprimand.
Promote self-awareness. Ask students to describe the problem or issue they are having. Ask them why they think it is happening and how they can change their behavior.
Give opportunities for group or paired learning. The opportunities provide a structured setting for students to interact with classmates.
Provide opportunities for other students to see them in a positive light. You might ask the student to help you with a task or give him or her a leadership role in the classroom for a day―anything to help the student feel connected to the classroom and the school.
Provide feedback in one-on-one settings. Not only do you preserve self-esteem by providing feedback privately, but you also can help reinforce positive behavior and have the student practice having a conversation with you to improve social skills.

Accommodating ADHD in the Classroom

ADHD: Inattentive Symptoms

Students with inattentive symptoms are easily distracted and have trouble focusing. Everything competes for their attention. They often struggle to follow through with instructions and have difficulty with organization.

To help students with managing inattentive symptoms, the following accommodations can be effective:

Seating the student in an area with fewer distractions where he or she can focus on the lesson. For example, near the teacher’s desk, away from windows and the doorway, or in another area that has few distractions.
Seating the student next to positive role models, peers who are less likely to provide distractions and can help them stay on task.
Breaking long assignments into smaller parts. This allows students to see both the start and end of the task.
Making sure all assignments are clear and provided in writing in addition to giving them out loud.
Checking with the student before they complete an assignment to see if they heard and understood instructions. Ask them to repeat it back to verify understanding.
Allowing them to take tests in a different room, one that is quiet and has few distractions. Or using aids such as headphones or privacy boards to create quiet spaces in the classroom.
Giving more time to complete assignments, projects, and tests.
Using a timer or alarm to help with time management.
Providing breaks. Depending on the student, these could include stretching, walking to the board to complete a task, or handing out assignments or materials.
Limiting repetitive assignments, particularly those the students has already mastered, or tasks that are too far above the student’s level. Students are most able to pay attention to tasks that present some challenge but are within their current learning zone.
Making sure that the student has the opportunity for physical activities because active movement increases the ability to focus. Recess should never be taken away as a punishment for misbehavior.
Providing tools to help with organization, such as different colored folders, a notebook with dividers, or a homework assignment book.
Using computers or tablets for work. Computers are visually stimulating and allow for more engagement and also help students organize their thoughts.

ADHD: Hyperactive-Impulsive Symptoms

Students with hyperactive-impulsive symptoms move a lot. They fidget, squirm, and have difficulty staying seated. They often talk excessively, blurt out answers, and have trouble taking turns.

To help students manage their hyperactive-impulsive symptoms, the following accommodations can be effective:

Seating the student in an area of the room where there will be the least disruption. This might be towards either side of the classroom rather than the center.
Allowing for the student to move around. You could allow the student to do their work while standing, sitting on the floor, or moving between desks.
Pairing the student with a peer who is a good role model and can model behavior.
Providing activity breaks. Depending on the student, these could include stretching, walking to the board to complete a task, or handing out assignments or materials.
Ignoring minor misbehavior.
Allowing the student to move or fidget in a non-distracting manner. They might tap their foot in the air or rotate their pen back and forth in their hands. Asking the student to offer suggestions is always a great way to get more ideas.
Allowing them to take tests in a different room. One that is quiet, has few distractions and lets them move around without interrupting other students.
Praising when they exhibit appropriate behavior such as raising their hands and waiting to be called.
Limiting repetitive assignments, particularly those the students has already mastered, or tasks that are too far above the student’s level. Fidgeting is often a symptom of boredom or overstimulation.
Making sure that the student has the opportunity for physical activities. Recess should never be taken away as a punishment for misbehavior.
Using a speaking stick or other object that gets passed around during class discussions as a cue to indicate whose turn it is to speak.

ADHD: combined symptoms

Many students with ADHD show a combination of inattention and hyperactive-impulsive behaviors. You can use a combination of accommodations from both lists. One of the best ways to identify which accommodations might work best is to observe the student’s natural behavior.

Some sample behaviors and accommodations include:

The Explosive Child, Ross Greene

In Ross Greene's excellent book, The Explosive Child, he introduces a paradigm for understanding children with ADHD, sensory processing challenges, oppositional defiant behavior, and similar conditions: When children misbehave, it's often because the demands of the situation exceed what they are developmentally able to handle. To help these "inflexible" kids, Greene developed Collaborative & Proactive Solutions (CPS), a parenting method in which parents and kids solve problems together. The book is easy to follow and the system straightforward to implement; many parents who struggled with their child's defiance describe Greene's book as a "lifesaver," providing hope when they were at the end of their parenting rope.

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