Young people with attention-deficit/hyperactivity disorder (ADHD) are usually overactive. They are not able to pay attention and can be hasty or clumsy. Children or adolescents with ADHD may not do well in school. They could even fail, even if they are very intelligent.
Hyperactive means “extra active.” But that word does not tell us very much. The activity level of children who are called “hyperactive” varies. For some children, the most obvious sign may be problems paying attention. For others, the problem is hyper or impulsive behavior.
There are two groups:
- Those who are mainly hyperactive or impulsive.
- Those who have problems paying attention.
Some will could fall into both of these groups.
What causes ADHD?
There are different thoughts about what causes ADHD, but many agree the problem might have to do with brain chemicals. The signs and symptoms of this condition can appear if there are not enough of these chemicals or if they are not doing their job.
Does ADHD run in families?
Yes, ADHD does run in families. At least 30 percent to 40 percent of children with ADHD have family members with the same problem. This doesn’t mean that all children in a family will have ADHD. There is usually only one child who shows the signs and symptoms in most families with ADHD.
How common is it?
ADHD is found in about one in every 20 children. About three times more boys have it than girls. Children with ADHD are at risk for many other disorders:
- About half also have a conduct disorder
- About a fourth have an anxiety disorder
- About a third have depression
- About a fifth have a learning disability
Sometimes a child will have two or more of these disorders along with ADHD. Children with ADHD might develop personality problems. They can also develop substance abuse disorders. This can happen when they are adolescents or adults.
ADHD is one reason why children are given mental health care. Boys are more likely to be put into treatment than girls. This is partly because many boys with this disorder also have a conduct disorder.
How is the diagnosis made?
Diagnosis is not easy. It can require more than one specialist. It is a mistake to make a quick diagnosis. It is not a good idea to make a diagnosis before all of the facts are known. Children should be looked at by:
- Pediatricians and/or neurologists (these doctors should have a background in behavioral and developmental problems)
- Licensed mental health professionals
- Specially trained family and general practitioners
- A team of professionals from the all of these specialties
Before diagnosing the child:
- Look at all of the possible reasons for the way a child is acting.
- Find out about other problems. These could include:
- Learning disabilities
- Conduct disorders
- Physical illnesses
- Know about the family and classroom situation. Also know about any special conditions or problems.
- Have a good idea of the child’s ability to think and how they do in school.
A complete exam is important. This helps rule out some medical problems. This includes a check of hearing and vision. It is also important to find out if the child has any problems with:
- Motor skills
- Remembering things in order
- Listening and speaking
- Recognizing and repeating pictures and symbols
Children with ADHD often have learning problems. Between 40 percent and 60 percent of children with this condition have problems in school. Many others have problems doing school work. This includes writing or timed tests and is a common cause of school problems. ADHD can affect people for their whole lives.
Common treatments include:
- Psychological approaches
- Behavioral approaches
What help is available for families?
There are many treatments for people with ADHD. The best are medication and behavior treatments.
The drugs used most often are stimulants. These increase activity in parts of the brain that are not active enough in people with ADHD. They lessen impulsive behavior and hyper or aggressive behavior. People might respond better to one medication than to another, so please consult with a medical professional.
Antidepressants may work for some patients. Calming drugs might also work. Care must be used with all medicines as all medications have side effects.
Some children might lose weight from these medicines. They might also have a smaller appetite or could grow more slowly for a short time. Others may have trouble falling asleep. Many doctors, however, think the benefits are worth the side effects. Side effects can often be fixed by lowering the amount of the drug used.
Behavioral treatments include:
- Teaching parents and teachers how to manage the behavior. This can include rewarding good behavior.
- A report card to connect home and school every day. For example, a parent rewarding a child for good school performance and behavior.
- Summer and Saturday programs
- Special classrooms that use behavior modification
- Specially trained classroom helpers
Stimulants and behavioral treatment can help for a few weeks or months. Research is being done on the benefits of different treatments. There is also research on new medicines.
Families might need to plan treatment or services for a child based on how bad the symptoms are and how long the symptoms last.
This plan should be developed with the family, service providers and a service coordinator or case manager.
The child is usually involved in decisions.
The support and services in a care plan is called a system of care. This system improves the child’s ability to function in all areas of life and includes life at home, at school and in the community.
Signs and symptoms of ADHD may last into the adult years. These can include:
- Being restless
- Not being organized
- Being impulsive
- Having trouble with friends.
Adults might still:
- Be distracted easily
- Be hyper or restless
- Have mood swings (this is often the main symptom in adults)
- Not be able to finish things
- Have a bad temper (they might not be able to handle a lot of stress)
- Have problems getting along with spouses, co-workers and other people in their lives
What else can parents do?
Parents should be careful not to jump to conclusions. A child having lots of energy does not mean that he or she has ADHD. The diagnosis depends on whether the child can focus enough to finish tasks. This will probably be noticed by a teacher, and input from teachers should be taken seriously.
If parents or other caregivers think a child has ADHD, they should:
- Get the child evaluated. Check with the child’s doctor for a referral to one of the following:
- Child neurologist
- Behavioral pediatrician
- Be patient if the child is diagnosed with ADHD. It might take a long time to improve.
- Let the child know that he or she is still able to do things. Recognize his or her strengths and talents. Give him or her feelings of self-worth.
- Remember that the following things can cause more problems than ADHD itself:
- Low self-esteem
- Get correct information from libraries, hotlines or other sources.
- Ask questions about treatments and services.
- Talk with other families in the community.
- Find family network organizations.
Adapted with permission from the National Mental Health Association.
Children with Special Needs
Finding good child care is hard. It is even harder to find good child care for children with special needs. The special needs label covers a wide group of children, including normal children who need special help and children who are severely developmentally or physically challenged. What comes next is a starting point that can help you figure out your needs and guide you to more resources.
Normal but difficult
Difficult children are hard to handle. They may show the following:
- Bad tempers
- Very aggressive behavior
- Problems with routines and change
- A lot of negativity
They may have a hard time with things other children find easy. For example, a child may get overly angry when a favorite shirt is lost. Whatever it is, a difficult child can be very hard to handle in a group care situation. The child can quickly alienate an in-home caregiver. Many day care centers say no to difficult children.
Make sure to factor your child’s behavior into your search at the start. Deal with issues head on to save you time later. Talk with the caregiver about your child’s behavior. Choose providers who will work with difficult children and make sure the provider has experience. It is good to ask a provider how he or she may handle a situation. Be part of any procedures that are supposed to help your child in his or her care situation. Be prepared to make changes at home.
Children with learning disabilities
A learning disability affects a child in many ways. It causes problems with the ability to process, read and understand what is going on around him or her. It can be very mild to very bad and most of the time it can be helped. Early detection is key.
How to detect a learning disability
Learning problems are often not noticed in a very young child, but signs can become apparent by the time your child is three or four years old. Your child may:
- Start talking later than other children.
- Have trouble finding the right words.
- Not be able to follow instructions.
- Have problems sitting still.
- Display poor behavior with peers.
- Show a lack of physical coordination.
By the school-age years, learning problems are easier to notice. Your child may:
- Have problems understanding letters and sounds.
- Confuse simple words.
- Mix up numbers and letters.
- Have difficulty following easy directions.
- Be impulsive and lack planning skills.
- Have very poor handwriting and/or have trouble holding a pencil well.
- Be unable to understand time.
- Speak more slowly than peers.
This list of the items above only show that there could be a problem. If you think that your child may have a problem, keep a record of his behavior and ask yourself the following questions:
- When does the behavior happen, alone or in a group?
- Where does the behavior happen, in the home, in the care situation or at a friend’s house?
- What other things could be a factor, peers, family members, hunger, anger and/or fatigue?
- How often does the behavior happen, every day, once a week?
- How long does the behavior last, a few minutes, 30 minutes?
Ask your child’s caregivers or teachers make notes of what they see. Their notes will help provide a full picture. A month of taking notes will help you decide if your child should have special testing. This is the only way to confirm a problem. Your child’s doctor is another great way to monitor progress. Also, vision and hearing tests may find problems. Please note, any stress in your child’s life may cause temporary problems that may seem like something more.
How to get testing
If you think that your child needs to be tested, ask your public school. You have a legal right to ask under the Individuals with Disabilities Education Act (IDEA). Your care provider or someone at the school may say your child should be tested. This can be upsetting. You may not think there is a problem, but take the information as just a suggestion. You know your child. Your consent is needed for the testing.
Contact special education at the school for testing. If your child is under three, ask for additional information on programs to help. If your child goes to a private school, you are still allowed free testing at the public school. Make all requests in writing and keep copies.
The school will have the child assessed when a request for testing is made. It will be determined if testing is needed. If they don’t think testing is needed, and you think it does, you may ask for the following:
- An informal hearing by other professionals to air your concerns
- An evaluation by a private doctor at the school system’s expense
- An administrative review of the assessment process
- A due process hearing if no resolution can be obtained at the school level (this is a last resort)
What happens when testing?
A doctor will meet with you if testing is needed. You will be asked about the following:
- Your child’s birth
- His or her physical development
- His or her emotional development
- Your family’s history that fits the situation
Then plans will be made to have your child tested.
School-age children will meet with a doctor several times during testing. A session may last from two to three hours. Children first grade and younger will have shorter sessions. Your child will be tested in the following areas:
- Language, reading, writing and math understanding
- Auditory processing
- Visual processing
- Physical coordination
These tests are not meant to be scary. It is important talk to your child before the test. Let him or her know what will happen. Make sure the child knows he or she is not in trouble. Explain to your child that these tests are just to help him or her learn more easily.
Test results… What’s next?
Your child’s tests will be scored and a diagnosis made. If your child in diagnosed, a team will work with you to create a plan. This plan generally has two parts, a clear description of your child’s problem and a set of steps to help him or her grow.
A meeting with this information needs to take place within 90 days of the initial request for testing.
Testing may not show a problem. If this happens, other things are looked into and recommended. You can also challenge the results.
It is very important for the parent to support the child in this situation. Your confidence in him or her is very important to create a life that is positive and fulfilling.
Children with handicaps
Children with handicaps is the largest group of children with special needs. It is also the hardest for which to give specific advice and information. Communities using state support are required to develop programs for children with special needs.
What are learning disabilities?
Learning disabilities affect the way people use spoken or written words. People may have trouble doing math, trouble with movements and/or trouble with direct attention. While very young children can have a learning disability, it is usually not seen until the child is school age.
Is there any treatment?
Yes, special teaching is the most common treatment. Trained teachers use a test to look at the child’s strengths. They will teach learning skills by building on the child’s current skills. The child’s strengths are used while fixing the problem. Speech and language therapists may also help. Some medications may help the child learn. Medication can also help the child’s attention and concentration. Psychological therapies may also be used.
What is the prognosis?
Learning disabilities can last a lifetime. Some may have overlapping learning problems. Other people may have one learning problem that does not bother them their whole life.
What research is being done?
Research is being done by:
- The National Institute of Neurological Disorders and Stroke (NINDS)
- National Institutes of Health
- National Institute of Child Health and Human Development
- National Institute of Deafness and Other Communication Disorders
- National Institute of Mental Health
Research is helping to find ways to diagnose learning disabilities. It also helps with the treatment and help people understand the disability.
CHADD – Children and Adults with Attention-Deficit/Hyperactivity Disorder
8181 Professional Place, Ste. 150
Landover, MD 20785
Tel: (301) 306-7070 or (800) 233-4050
Fax: (301) 306-7090
International Dyslexia Association
8600 LaSalle Road
Chester Building, Ste. 382
Baltimore, MD 21286-2044
Tel: (410) 296-0232 or (800) ABC-D123
Learning Disabilities Association of America
4156 Library Road, Ste. 1
Pittsburgh, PA 15234-1349
Tel: (412) 341-1515 or (412) 341-8077
Fax: (412) 344-0224
National Center for Learning Disabilities
381 Park Avenue South, Ste. 1401
New York, NY 10016
Tel: (212) 545-7510 or (888) 575-7373
Fax: (212) 545-9665
National Institute of Child Health and Human Development (NICHD)
31 Center Drive, Rm. 2A32 MSC 2425
Bethesda, MD 20892-2425
Tel: (301) 496-5133
Fax: (301) 496-7101
National Institute of Mental Health (NIMH)
6001 Executive Blvd. Rm. 8184, MSC 9663
Bethesda, MD 20892-9663
Tel: (301) 443-4513 or (301) 443-8431 or TTY (866) 615-NIMH
Fax: (301) 443-4279
Attention Deficit Disorder and Your Child
Children that have attention skills that do not grow the correct way have attention deficit disorder (ADD). Attention deficit hyperactivity disorder (ADHD) is when children also have hyperactivity.
You shouldn’t blame yourself if your child is diagnosed with either ADD or ADHD. Most studies link the cause of ADD and ADHD to a biological origin.
Medication can be used to treat ADD. It can greatly improve your child’s attention span and help with overall behavior. There are things you can do as a parent to help your school-age child with learning such as:
- Taking extra time to work with your child on his or her homework.
- Finding a tutor to help your child on any hard schoolwork.
- Talking with your child’s teacher.
- Making a plan where you and his or her teacher work together on your child’s learning problems.
- Look into counseling for your child. This may help your child learn to deal with his or her disorder better.
Parenting an ADD or ADHD child can be hard. Remember, your child may have an even harder time dealing with the disorder. It is important that you focus on finding the best ways to help your child.
Disciplining your ADD or ADHD child can be a major problem for parents. Your child doesn’t have the patience that other children have. They can let their anger explode. Bad behavior and the need for constant supervision are tiresome for both you and your child. The best way to discipline your ADD or ADHD child is to keep a regular schedule. This can help your child learn to complete tasks. Little things like reminder notes and alarm clocks will help with the schedule.
Remember to reward your child for good behavior. Do not allow yourself to get into a fight over power with your child. Talk with your child and you will get better results. Be very specific in your wishes. Time-outs and loss of rights seem to work well. Discipline also works well as it takes your child away from the situation and shows consequences for what he or she did.
For further informational resources on ADD and ADHD, you may find these organizations helpful:
Children with Attention Deficit Disorder
499 Northwest 70th Ave., Ste. 101
Plantation, FL 33317
(954) 587-3700 or (800) 233-4050
Children and Adults with Attention Deficit Disorder
5705 Oak Leather Drive
Burke, VA 22015
What is dyslexia?
A person with dyslexia is not able to learn the basic language skills of reading. At least 10 million children are poor readers. That’s about 17 percent of school-age children. Reading problems happen at the same rate in boys and girls.
Reading is made up of different language skills, including the:
- Ability to identify and remember sounds that go with words.
- Ability to quickly make sense of sounds within words.
- Ability to understand words.
- Hearing and recall of spoken language.
Having trouble with these basic skills can mean the person has reading problems. Some people with this condition might not be able to tell the difference between similar sounds in words. They may process language more slowly than others.
It is common for those with dyslexia to have trouble processing language. They might also have trouble learning, but the effects can be very different from person to person. Each person can have different symptoms and also have different degrees of severity, but most people with dyslexia read at levels that are lower than expected for people of their age.
What are the causes?
The causes are not known. Dyslexia is based in the brain, is a life-long condition and is often inherited. Other family members may have similar learning patterns. Some people may have a slight difference in brain structure; they might function differently in the areas connected with language learning. Some might also not be able to process speech quickly.
What are the characteristics?
- Reverses letters, words and numbers
- Confuses the order of letters in words
- Does not remember words previously learned
- Spells a word several different ways
- Does not recognize the correct spelling of words
- Does not hear differences in words (for example, writes “pin” for “pen”)
- Confuses left and right
- May write letters backwards
- Has poor reading comprehension
- Has a hard time carrying out directions in order
- Has a hard time saying thoughts in an organized way
- Has a hard time saying words
- May say words backwards
- Has a hard time remembering what he or she has recently read
- Has a hard time concentrating when reading or writing
- Is unable to determine what information matters and what does not
- Spells poorly
- Misspelling is not logical
- Has problems taking notes
- Has a hard time organizing and completing writing projects
Children might often show these characteristics while they are learning basic reading skills. Other teaching options should be considered when a child has a hard time learning basic reading skills and shows many dyslexic characteristics over a period of time.
How can educational evaluation help?
It is important to notice reading problems early. Poor reading skills can be improved if they are taken care of early. A person who is behind his or her peers in reading skills should be evaluated.
The results of the evaluation show where the person is strong and where he or she still needs work. A teaching method can then be suggested for the child. Children with dyslexia should work with a reading specialist. The specialist should have experience with reading disabilities. Good teaching and learning can help even the worst case.
What type of help is available?
People with dyslexia learn and process language differently. They need special programs to learn reading, spelling and writing skills. A structured phonetic method is the best. One-on-one teaching can also help.