ADHD is a condition about which much has already been written, both fact and myth. However, we will address the situation when our child has already been diagnosed by specialists with attention deficit hyperactivity disorder, or ADHD.
ADHD – the case of Kuba
Kuba brought a lot of joy to his parents. He was a typical “living silver”, everywhere he went, his mouth was always open and he was curious about everything around him. However, the older he got, the more difficult it became to control this. During lessons, all the teachers’ attention had to be focused on him, when he got up and walked around the classroom, chatting to his classmates, going to the window, answering questions before anyone had time to finish them. More and more remarks were made about being unprepared for lessons: forgetting his outfit for PE class, losing his notebook, not finishing work he had started. At home, sitting down to dinner at the same time, he managed to play with the cat, then see what was going on outside the window, and fetch his favourite toy. Although if something caught his interest, he could keep at it. He would interject himself into a conversation and always had something to say. He did not respond to commands.
This “temper” of Kuba, as it seemed to his parents, was becoming more and more of a problem for them. The teacher at the school recommended that they see a psychologist or child psychiatrist, suspecting that Kuba had ADHD. On the basis of what the boy’s parents had told the doctor, feedback about him from school and the exclusion of other somatic illnesses, the specialist confirmed this suspicion. From that moment, the long road of coping with ADHD symptoms began for Kuba and his relatives. As it turned out, everything was new to them, and each of Kuba’s behaviours took on a different meaning.
This is the ‘textbook’ picture of a child with ADHD. Often the disorder is accompanied by others, such as: conduct disorders, mood disorders, specific school difficulties, and substance abuse and dependence in older children. This makes timely and appropriate management of such a child so important.
Understanding ADHD
The basic information to start with is that ADHD is not the fault of the parents or the child. The treatment of ADHD is a multi-pronged approach involving both the doctor, the family and the school. Before the whole family begins to face the condition, it is helpful to know your opponent well.
ADHD treatment
The first step in treatment is psycho-education of the patient’s parents, carers, as well as teachers and educators. Information about the disorder can be obtained primarily from specialists and from many brochures and guides on the subject. An important, if not one of the most important elements of therapy are workshops for parents of children with ADHD, where they learn how to deal with their child differently and how to deal with their child’s typical problems. Depending on the symptoms and comorbidities, the patient’s participation in aggression replacement training, social skills training or cognitive behavioural therapy may also be considered.
ADHD – an innocent child?
It is important to understand at the outset that many of the child’s behaviours are due to the symptoms of ADHD and not to the child’s ill will. We cannot punish a child for symptoms, just as we do not punish someone for having high blood pressure! It would be important to be able to distinguish between the symptoms of ADHD, and unwanted, intentional behaviour that is not due to the disorder, e.g. Kuba has trouble finishing a task, but gets back to it when you give him attention and bring him back to work. This is a symptom of attention deficit disorder. However, it is not a behaviour in which Kuba does not follow the teacher’s instructions, claiming that he will not do it because he does not want to. This is a deliberate violation of a rule that requires consequences.
“Glasses” for ADHD symptoms
Just as in the case of a visual impairment we wear glasses to help us see better and to “neutralise” the symptom in the form of blurred vision, so too do we put them on for the symptoms of ADHD. In this case, the ‘glasses’ are the methods and techniques that facilitate the functioning of a person with symptoms of attention deficit disorder, impulsivity and hyperactivity. These methods work when they are applied, just as glasses work when we wear them on our noses.
We cannot cure ADHD. We can only make the problems associated with the condition, much less impair the child’s functioning and life. Kuba’s problems included being distracted while doing homework. Kuba’s parents applied the ’empty desk’ technique: they removed all unnecessary objects from the desk, the walls, and the boy’s surroundings in the area where he does his homework. And they moved the table itself, which used to be against the window, against the wall so that the boy would not be distracted by what was going on outside. At school, Kuba was moved to the first bench, close to the teacher, so that the boy’s attention could be focused first on the lesson and not on what was going on in the classroom. Kuba’s parents, when they wanted him to do something, started talking to him with short, single commands. They also had to learn to anticipate situations where the boy’s impulsiveness could be dangerous for him, e.g. during bicycle trips along routes that ran close to streets. The parents tried to plan activities so that Kuba had plenty of time for physical activity, including at the pool and playing football. These are examples of putting ‘glasses’ on the symptoms of ADHD.
ADHD? Don’t panic!
Many symptoms need our acceptance, not our control. It is possible not to pay attention to a child squirming in a chair as long as he is not disturbing our conversation. If he wants to do his homework lying on the floor, why shouldn’t he? As long as the homework is done and the child is working it is not a problem. You may find that it helps him and makes his work more efficient, rather than disrupting it. If, while watching TV, your child wants to play with a ball at the same time – let him. Acceptance means calmly observing the child, seeing the positives, praising him and not lecturing him. As long as he doesn’t endanger himself or others by what he does, it is worth expressing acceptance to the child by not interfering in his activities.
We can’t count on the fact that if we explain to a child one day that they can only play after they’ve done their homework, they will remember to do it every day from then on. Children with ADHD do not remember the rules. Let’s keep this in mind before we get frustrated the next day when Cub starts playing his favourite game the day after school and feel that all our efforts are in vain. Children will demand repetition of the rules you have agreed upon. And in following them, it is worth praising your child for this. Praise is never too much, for every – for us the slightest, but for a child with ADHD not necessarily – activity well done, for fulfilling a command, for what went better than before. Just because we praised Kuba for eating his lunch efficiently one day, doesn’t mean that when it happens to him more often we can stop doing it and consider it normal behaviour. Each time it will be his success, which is worth emphasising.
ADHD at school
Once the diagnosis of ADHD in a child has been established, specific recommendations on how to work with a student with ADHD should be given to teachers and educators, which will be developed by the child’s treatment team. The diagnosis should be explained and the symptoms to be expected should be discussed. It is a good idea to give the teacher a brochure on ADHD, which you can get from your doctor or psychologist.
Children with ADHD forget what homework is due, when a test is, what to bring for the next art lesson. Such problems are a common reason why they get worse grades and are less successful in school. It might be a good idea to create a correspondence notebook in which the teachers can write down, after each lesson, Kuban’s grades, praise (it is advisable not to write negative comments in the notebook; if there is no praise, that will be enough for the parents to know), homework, test dates and extent of tests and other important information (e.g. dates of class trips to the cinema, excursions, school events).
Children and adolescents with ADHD need parental support for a longer period of time than their peers. When your child goes to middle school, don’t stop helping him or her, even though it seems like he or she should already be coping on their own at that age. And simply reminding your child to sit down for homework is not enough to say that homework is done together. This, by definition, also requires discipline on the part of the parent – to have time set aside at a certain time each day to help the child. If this is not possible, it is worth finding someone to help you. Homework should be finished by packing the school bag together and preparing the things needed for the next day’s school.
A frequent question from parents is whether their child with ADHD should attend an inclusive class. This is a good solution, mainly because such classes are smaller than traditional classes and because the class is often accompanied by a support teacher. This allows for better control of what happens to the child during the lesson. However, the reason for this should not be the false belief that it is a severe illness that prevents learning and normal functioning among peers.
Medication for ADHD
ADHD is a condition in which medication can only have an auxiliary function. They will not replace other, non-pharmacological interventions. It is important to remember that receiving a prescription from your doctor does not end your actions. The doctor may decide to include medication when other methods of therapy and modification of parenting methods do not have sufficient effect, or when ADHD symptoms are very severe at the time of diagnosis.
In a simple understanding of the disease, it seems that if a child is hyperactive then he or she needs ‘calming’ medication. Parents ask whether ADHD medication will ‘suppress’ their children, whether they will be ‘lethargic’ after it. Contrary to popular belief, ADHD patients do not need ‘tranquilising’ medication to ‘calm’ them down or reduce their activity.
Preparations used to treat Attention Deficit Hyperactivity Disorder are often psychostimulants, e.g. methylphenidate, which modify the level of excitation of parts of the brain responsible for attention control, inhibition processes and activity. They enable children to get more work done, the drugs lengthen attention spans and dampen impulsivity. However, they do not cure ADHD like antibiotics cure tonsillitis. Rather, it can be compared to treating hypertension or diabetes, where medication helps control symptoms and lower the risk of complications of the disease. Medication in ADHD will, among other things, help the child to concentrate better and work longer, but it will not affect the fact that they still do not want to do their homework.
ADHD – alleviating symptoms
These drugs only work when they are administered! Methylphenidate works between 4 and 12h – depending on the type of preparation. This has its disadvantages, as symptoms reappear every day after this time. However, this feature of the drug can also be an advantage. When a child needs help primarily with school functioning, he or she takes the medicine only on school days, with a break during weekends, holidays and holidays. After the holidays, the child’s school functioning and the presence of symptoms are reassessed in the first month of the school year. It may be that continuing pharmacotherapy is no longer necessary, as ADHD symptoms may diminish as the child grows up. The most common side effects of these medications include sleep disturbances, decreased appetite, gastrointestinal disturbances and headaches.
Another drug registered in Poland for the treatment of ADHD is atomoxetine, used most frequently in cases of intolerance to methylphenidate or the existence of contraindications to taking it. It differs from methylphenidate mainly in that its effect is visible only after about 2 weeks of regular use, and the full effect after 4-6 weeks of treatment. Atomoxetine works around the clock.
Tricyclic antidepressants, clonidine, et al. are also used in the treatment of ADHD. Each medication has its limitations, advantages and disadvantages. It is up to your doctor to decide which medication may be best for your child.
It is also important to report at each doctor’s appointment about changes in your child’s behaviour at school and at home, and how teachers and carers perceive this. This will help tailor treatment to the patient’s needs.
A child with ADHD is a normal child and adolescent. He has his own passions, interests and character. Therefore, it is important that Kuba continues to be Kuba and not a group of symptoms and problems. It is worth finding a moment each day to talk to your child and praise him for specific and even the smallest successes of the day. A diagnosis of ADHD in a child can be life-changing for a family. Children and teenagers with this disorder require much more parental support and care than other peers. It’s about building a relationship together and cheering on the smallest achievements. Over time, you will find that for your child, this has been the most important factor in their success.
Source
- https://www.medonet.pl/ciaza-i-dziecko/choroby-dzieciece,adhd-u-dzieci—objawy–leczenie,artykul,1647449.html
