What is ADHD or ADD?

It’s normal for children to occasionally forget their homework, daydream during class, act without thinking, or get fidgety at the dinner table. But inattention, impulsivity, and hyperactivity are also signs of attention deficit hyperactivity disorder (ADHD), sometimes known as attention deficit disorder or ADD (ADD is now an outdated term).

ADHD is a common neurodevelopmental disorder that typically appears in early childhood, usually before the age of seven. ADHD makes it difficult for children to inhibit their spontaneous responses—responses that can involve everything from movement to speech to attentiveness. We all know kids who can’t sit still, who never seem to listen, who don’t follow instructions no matter how clearly you present them, or who blurt out inappropriate comments at inappropriate times. Sometimes these children are labelled as troublemakers or criticized for being lazy and undisciplined. However, they may have ADHD.

Is it normal kid behaviour or is it ADHD?

It can be difficult to distinguish between ADHD and normal “kid behaviour.” If you spot just a few signs, or the symptoms appear only in some situations, it’s probably not ADHD. On the other hand, if your child shows a number of ADHD signs and symptoms that are present across all situations—at home, at school, and at play—it’s time to take a closer look.

Life with a child with ADHD can be frustrating and overwhelming, but as a parent there is a lot you can do to help control symptoms, overcome daily challenges, and bring greater calm to your family.

What does ADHD look like?

When many people think of attention deficit disorder, they picture an out-of-control kid in constant motion, bouncing off the walls and disrupting everyone around. But the reality is much more complex. Some children with ADHD are hyperactive, while others sit quietly—with their attention miles away. Some put too much focus on a task and have trouble shifting it to something else. Others are only mildly inattentive, but overly impulsive.

Which one of these children may have ADHD?

1. The hyperactive boy who talks nonstop and can’t sit still.
2. The quiet dreamer who sits at her desk and stares off into space.
3. Both.

The correct answer is “3.”

The signs and symptoms a child with attention deficit disorder has depend on which characteristics predominate.

Children with ADHD may be:

• Inattentive, but not hyperactive or impulsive.
• Hyperactive and impulsive, but able to pay attention.
• Inattentive, hyperactive, and impulsive (the most common form of ADHD).

Children who only have inattentive symptoms of ADHD are often overlooked, since they’re not disruptive. However, the symptoms of inattention have consequences: getting in hot water with parents and teachers for not following directions; underperforming in school; or clashing with other kids over not playing by the rules.

Spotting ADHD at different ages

Because we expect very young children to be easily distractible and hyperactive, it’s the impulsive behaviours—the dangerous climb, the blurted insult—that often stand out in pre-schoolers with ADHD. By age four or five, though, most children have learned how to pay attention to others, to sit quietly when instructed to, and not to say everything that pops into their heads. So, by the time children reach school age, those with ADHD stand out in all three behaviours: inattentiveness, hyperactivity, and impulsivity.

Inattentiveness signs and symptoms of ADHD

It isn’t that children with ADHD can’t pay attention: when they’re doing things they enjoy or hearing about topics in which they’re interested, they have no trouble focusing and staying on task. But when the task is repetitive or boring, they quickly tune out.

Staying on track is another common problem. Children with ADHD often bounce from task to task without completing any of them or skip necessary steps in procedures. Organizing their schoolwork and their time is harder for them than it is for most children. Children with ADHD also have trouble concentrating if there are things going on around them; they usually need a calm, quiet environment in order to stay focused.

Symptoms of inattention in children

Your child may:

• Have trouble staying focused; be easily distracted or get bored with a task before it’s completed.
• Appear not to listen when spoken to.
• Have difficulty remembering things and following instructions; not pay attention to details or makes careless mistakes.
• Have trouble staying organized, planning ahead, and finishing projects.
• Frequently lose or misplace homework, books, toys, or other items.

Hyperactivity signs and symptoms of ADHD

The most obvious sign of ADHD is hyperactivity. While many children are naturally quite active, kids with hyperactive symptoms of attention deficit disorder are always moving. They may try to do several things at once, bouncing around from one activity to the next. Even when forced to sit still, which can be very difficult for them, their foot is tapping, their leg is shaking, or their fingers are drumming.

Symptoms of hyperactivity in children

Your child may:

• Constantly fidget and squirm.
• Have difficulty sitting still, playing quietly, or relaxing.
• Move around constantly, often running or climbing inappropriately.
• Talk excessively.
• Have a quick temper or “short fuse.”

Impulsive signs and symptoms of ADHD

The impulsivity of children with ADHD can cause problems with self-control. Because they censor themselves less than other kids do, they’ll interrupt conversations, invade other people’s space, ask irrelevant questions in class, make tactless observations, and ask overly personal questions. Instructions like, “Be patient” and “Just wait a little while” are twice as hard for children with ADHD to follow as they are for other youngsters.

Children with impulsive signs and symptoms of ADHD also tend to be moody and to overreact emotionally. As a result, others may start to view the child as disrespectful, weird, or needy.

Symptoms of impulsivity in children

Your child may:

• Act without thinking.
• Guess, rather than taking time to solve a problem; blurt out answers in class without waiting to be called on or hear the whole question.
• Intrude on other people’s conversations or games.
• Often interrupt others; say the wrong thing at the wrong time.
• Be unable to keep powerful emotions in check, resulting in angry outbursts or temper tantrums.

Understanding and helping your child with ADHD

Life with a child or teen with attention deficit hyperactivity disorder (ADHD or ADD) can be frustrating, even overwhelming. But as a parent you can help your child overcome daily challenges, channel their energy into positive arenas, and bring greater calm to your family. And the earlier and more consistently you address your child’s problems, the greater chance they have for success in life.

Children with ADHD generally have deficits in executive function: the ability to think and plan ahead, organize, control impulses, and complete tasks. That means you need to take over as the executive, providing extra guidance while your child gradually acquires executive skills of their own.

Although the symptoms of ADHD can be nothing short of exasperating, it’s important to remember that the child who is ignoring, annoying, or embarrassing you is not acting wilfully. Kids with ADHD want to sit quietly; they want to make their rooms tidy and organized; they want to do everything their parent says to do—but they don’t know how to make these things happen.

If you keep in mind that having ADHD is just as frustrating for your child, it will be a lot easier to respond in positive, supportive ways. With patience, compassion, and plenty of support, you can manage childhood ADHD while enjoying a stable, happy home.

ADHD and your family

Before you can successfully parent a child with ADHD, it’s essential to understand the impact of your child’s symptoms on the family as a whole. Children with ADHD exhibit a slew of behaviours that can disrupt family life. They often don’t “hear” parental instructions, so they don’t obey them. They’re disorganized and easily distracted, keeping other family members waiting. Or they start projects and forget to finish them—let alone clean up after them. Children with impulsivity issues often interrupt conversations, demand attention at inappropriate times, and speak before they think, saying tactless or embarrassing things. It’s often difficult to get them to bed and to sleep. Hyperactive children may tear around the house or even put themselves in physical danger.

Because of these behaviours, siblings of children with ADHD face a number of challenges. Their needs often get less attention than those of the child with ADHD. They may be rebuked more sharply when they err, and their successes may be less celebrated or taken for granted. They may be enlisted as assistant parents—and blamed if the sibling with ADHD misbehaves under their supervision. As a result, siblings may find their love for a brother or sister with ADHD mixed with jealousy and resentment.

The demands of monitoring a child with ADHD can be physically and mentally exhausting. Your child’s inability to “listen” can lead to frustration and that frustration to anger—followed by guilt about being angry at your child. Your child’s behaviour can make you anxious and stressed. If there’s a basic difference between your personality and that of your child with ADHD, their behaviour can be especially difficult to accept.

In order to meet the challenges of raising a child with ADHD, you must be able to master a combination of compassion and consistency.  Living in a home that provides both love and structure is the best thing for a child or teenager who is learning to manage ADHD.

Maintain a positive attitude 

Your best assets for helping your child meet the challenges of ADHD are your positive attitude and common sense. When you are calm and focused, you are more likely to be able to connect with your child, helping him or her to be calm and focused as well.

Keep things in perspective. Remember that your child’s behaviour is related to a disorder. Most of the time it is not intentional. Hold on to your sense of humour. What’s embarrassing today may be a funny family story ten years from now.

Don’t sweat the small stuff and be willing to make some compromises. One chore left undone isn’t a big deal when your child has completed two others plus the day’s homework. If you are a perfectionist, you will not only be constantly dissatisfied but also create impossible expectations for your child with ADHD.

Believe in your child. Think about or make a written list of everything that is positive, valuable, and unique about your child. Trust that your child can learn, change, mature, and succeed. Reaffirm this trust on a daily basis as you brush your teeth or make your coffee.

Parenting Strategies for children with ADHD

• Children with ADHD are more likely to succeed in completing tasks when the tasks occur in predictable patterns and in predictable places. Your job is to create and sustain structure in your home, so that your child knows what to expect and what they are expected to do.
• Follow a routine for meals, homework, play, and bed; have your child lay out clothes for the next morning before going to bed, and make sure whatever he or she needs to take to school is in a special place, ready to grab.
• Use clocks and timers; allow enough time for what your child needs to do, such as homework or getting ready in the morning. 
• Simplify your child’s schedule; it is good to avoid idle time, but a child with ADHD may become more distracted and “wound up” if there are too many after-school activities. 
• Create a quiet place: make sure your child has a quiet, private space of their own. 
• Do your best to be neat and organized; make sure your child knows that everything has its place. 
• Keep your child busy, but do not overwhelm them with too many activities.
• Try not to allow too many computer/video games as they may increase symptoms of ADHD.
• Children with ADHD often have energy to burn. Organized sports and other physical activities can help them get their energy out in healthy ways and focus their attention on specific movements and skills.  Find a sport that your child will enjoy and that suits their strengths.
• Help your child to get as much sleep as possible, eg with a consistent, early bedtime
• Eliminate caffeine from your child’s diet.
• Use lavender or other aromas in your child’s room. The scent may help to calm your child.
• Set clear expectations and rules; make the rules of behaviour for the family simple and clear. 
• Children with ADHD respond particularly well to organized systems of rewards and consequences. 
• Praise is especially important for children who have ADHD because they typically get so little of it. 
• Reward your child for small achievements that you might take for granted in another child but change rewards regularly as they can get bored if the reward is always the same.
• Help your child eat right; monitoring and modifying what, when, and how much your child eats can help decrease the symptoms of ADHD.
• All children benefit from fresh foods, regular mealtimes, and staying away from junk food. 
• Prevent unhealthy eating habits by scheduling regular nutritious meals or snacks for your child no more than three hours apart. 
• Teach your child how to make friends as children with ADHD often have difficulty with simple social interactions and they may struggle with reading social cues.
• Role-play various social scenarios with your child. Trade roles often and try to make it fun.  Invite only one or two friends at a time at first. Watch them closely while they play and have a zero-tolerance policy for hitting, pushing and yelling.

ADHD testing and diagnosis

There’s no single test that can tell if you or your child has ADHD.  If you suspect that you or your child has ADHD, talk to your doctor about getting an evaluation.  You can also talk to their school SENCO.  Schools regularly assess children for problems that may be affecting their educational performance.

For the assessment, provide your doctor with notes and observations about you or your child’s behaviour.

Strategies for teaching the student with ADHD

Seating

• Seat the student with ADHD away from windows and away from the door.
• Put the student with ADHD right in front of your desk unless that would be a distraction for the student.
• Create a quiet area free of distractions for test-taking and quiet study.

Information delivery

• Give instructions one at a time and repeat as necessary.
• If possible, work on the most difficult material early in the day.
• Use visuals: charts, pictures, colour coding.

Student work

• Create worksheets and tests with fewer items, give frequent short quizzes rather than long tests, and reduce the number of timed tests.
• Test students with ADHD in the way they do best, such as orally or filling in blanks.
• Divide long-term projects into segments and assign a completion goal for each segment.
• Accept late work and give partial credit for partial work.

Organisation

• Have the student keep a master binder with a separate section for each subject, and make sure everything that goes into the notebook is put in the correct section. Colour-code materials for each subject.
• Make sure the student has a system for writing down assignments and important dates and uses it.
• Allow time for the student to organise materials and assignments for home.

Starting a lesson

• Establish eye contact with any student who has ADHD.
• List the activities of the lesson on the board.
• In opening the lesson, tell students what they’re going to learn and what your expectations are. Tell students exactly what materials they’ll need.

Conducting the lesson

• Keep instructions simple and structured. Use props, charts, and other visual aids.
• Vary the pace and include different kinds of activities. Many students with ADHD do well with competitive games or other activities that are rapid and intense.
• Have an unobtrusive cue set up with the student who has ADHD, such as a touch on the shoulder or placing a sticky note on the student’s desk, to remind the student to stay on task.
• Allow a student with ADHD frequent breaks and let him or her squeeze a rubber ball or tap something that doesn’t make noise as a physical outlet.
• Try not to ask a student with ADHD perform a task or answer a question publicly that might be too difficult.

Ending the lesson

• Summarise key points.
• If you give an assignment, have three different students repeat it, then have the class say it in unison, and put it on the board.
• Be specific about what to take home.