ADHD in children

Attention deficit hyperactivity disorder is a common neurodevelopmental disorder. Children with ADHD may be more active and more easily distracted than others. 

There are both strengths and challenges associated with ADHD. For example, children with ADHD may be creative thinkers with high motivation for activities that are interesting to them, but their difficulties with attention and planning may make it hard for them to begin or complete schoolwork and chores. Their behaviour may also be affected if they have trouble regulating their emotions or if they often act without thinking.

Diagnosis and treatment can help support children with ADHD to develop strategies, expand on personal strengths and learn specific skills for navigating these challenges.

Of course, all kids (especially younger ones) act in a busy, distracted and energetic way at times, particularly when they're anxious or excited. But the difference with ADHD is that symptoms are present over a longer period of time and occur most of the time. They affect the child's ability to function socially, at school, and at home.

In the past, we used the term ADD (attention deficit disorder) to describe children who had extreme attention challengers but were not hyperactive. ADD is now called “inattentive ADHD” and children with this condition may seem to be often lost in a daydream. In a classroom, these children are in danger of being overlooked, because the children who have hyperactivity within ADHD cannot fail to get noticed.

It is important to support children with ADHD to develop their self-esteem. Some children with ADHD experience negative comments from teachers or family/whānau regarding their behaviour or school achievement. This can make them feel “not good enough”. Adults can encourage children with ADHD by acknowledging and celebrating their unique talents, skills and efforts.

With proper treatment and support, kids with ADHD can learn to successfully live with and manage their symptoms.

A child with ADHD will have some or all of the following signs:

As babies and infants:

• being colicky, restless, and hard-to-cuddle babies and poor sleepers
• crawling or walking earlier than other children
• having lots of energy and being constantly on the go – they seem unable to sit still even if they are enjoying doing something
• having a short attention span and not following through what they set out to do.

 At school:

• tuning out or appearing to daydream, especially when being given instructions
• talking a lot, interrupting others and being unable to wait for their turn
• having trouble with the work and often giving the impression they have not heard the teacher's instructions
• having trouble starting a task on their own or completing one without regular one-on-one support
• frequently calling out in class or a group and being known as the ‘class clown’
• doing dangerous and impulsive things, like jumping from heights or running out onto the road without looking out for traffic
• acting before they think
• being easily upset
• getting angry and “exploding” quite easily
• finding it hard to make and keep friends, usually because they are seen as bossy.

Complementary therapies

Health and healing practices are varied and differ according to how people view illness. Any health-related practice that increases your child’s sense of wellbeing or wellness is likely to be of benefit.

The term complementary therapy is generally used to indicate therapies and treatments that differ from conventional western medicine and which may be used to complement and support it.

Complementary therapies can include using a number of herbal and other medicinal preparations to treat particular conditions. 

When considering taking any supplement, herbal or medicinal preparation, consult a doctor to make sure it is safe and will not react with other medication. 

Ways to support a child with ADHD at home

For family/whānau of someone with ADHD, the following strategies are useful:

• Make sure there are everyday routines in the home. Most children respond to predictability and structure. Routines help the child to know what the rules are around getting up, showering, mealtimes, homework, going to bed and playing. If a child has to navigate this themselves, it increases the demands placed on them, which can be overwhelming for someone with ADHD. Setting up clear structure can help by creating one routine, rather than several tasks to remember. To support this, your child may need a reminder list or picture chart for some things.
• Give instructions clearly and one at a time, so your child knows exactly what’s expected. It will be less time-consuming in the long run to look your child in the eye when you ask them to do something and check they have heard and understood the request by asking them to repeat what you've said. Instructions such as "please put these toys in your room" (a specific request) will work better than "tidy your room" (a general and, to the child, confusing request).
• Teach and encourage your child to insert a pause before acting. The act of stopping and breathing first will help your child to pause and think things through before acting. Consider what will work best for your child in teaching and practising this. For example, if your child likes cars, they could practise holding a small toy car in their pocket, slowly feeling the sides and wheels of it as they pause and breathe.
• Encourage your child to talk about their life – the good things and the not so good. You may be able to help them with a problem, and it’s important to keep the communication going. Build trust with your child by remaining calm and empathetic when discussing challenges. Problem-solve together and model useful conversations and strategies to use. On topics your child has more experience and confidence in, gradually step back so they can learn to problem-solve more independently, with support from you.
• Build on your child's strengths. Find something your child does well, is interested in or enjoys doing. It is vitally important for them to experience success. This may mean the whole family/whānau takes up rollerblading! Physical activities that can be done in short bursts may work out better than organised sports for the child with ADHD.
• Be positive about any successes, even if they don't complete a task. It is better for a child's self-esteem if you say that you noticed how hard they tried to do something, rather than to comment on how they didn't do it properly or finish it.
• If your child raises one of their challenges with you, assure them that everyone has things they find easier and harder. (You can point to examples of this in yourself to normalise and model acceptance of this.) Ask them if they would like more support in those areas, and problem-solve together how you can help them learn more in this area.
• Take care of yourself and other relationships. At times, a child with ADHD demands more time and attention, and siblings can feel resentful or left out. Try and make sure that their needs are met and use all the help you can get from extended family/whānau and community for babysitting, time-out, or having fun. Consider your own wellbeing, and create a self-care plan that supports your mental health. Marriages can be put under a lot of stress, so it may be helpful to consult a counsellor or family therapist to work out the best ways of living with a child with ADHD, keeping your partnership healthy and the rest of the family/whānau happy. 
  
  

Ways to support a child with ADHD at school

It’s best to keep up with your child's school programme and inform the teacher of any changes in behaviour or treatment. A home-to-school notebook is a good idea, in addition to meetings to create solutions to any current challenges. It’s important that the school understands your child’s strengths, interests, goals and areas for support. Some teachers know quite a lot about ADHD − others don't, so as a parent you may have to help with the teacher's education! 

Talk to the school about getting assistance from the Ministry of Education’s Learning Support Service for help with your child's classroom behaviour and learning needs.

The following strategies can be useful to support children with ADHD in school:

• have the child sit in an area with as little distractions as possible – not beside a busy window or at the back of the classroom 
• use lists, reminders and predictable schedules
• break tasks, information and instructions into small chunks 
• provide close support with each new task, gradually stepping back so the child can become more and more independent 
• set short, realistic time frames for how long the child is expected to focus for, and extend this time gradually where appropriate
• include the child’s personal interests in the curriculum as much as possible
• include “doing” activities like play-based activities and field-based learning
• provide lots of opportunities for physical exercise 
• if required, create a behavioural management programme with clear rules, goals and supports.  

As a parent or caregiver, you are your child’s best advocate at school and in dealing with health professionals, because you know your child best. Help teachers and health professionals understand your child, so the best solution can be worked out for them. Don't forget, too, that children themselves are often able to tell adults what is most helpful to them.