(ADHD) Treatment

Medicine alone is not the answer. Because ADHD is an ongoing condition, your child also needs special interventions at home and school to help with impulsive behaviors. Work on structuring your child's home life and improving discipline. Behavior problems can be addressed at any time after 1 year of age. If your child also has a poor attention span, you can do activities to help him or her learn to listen and complete tasks.

Accept your child's limitations: Accept the fact that your child is active and energetic and possibly always will be. The hyperactivity is not intentional. Don't expect to eliminate the hyperactivity but merely to bring it under reasonable control. Any criticism or other attempt to change an energetic child into a quiet or model child will cause more harm than good. Nothing helps a hyperactive child more than having a tolerant, patient, low-keyed parent.

Provide an outlet for excess energy: Daily outdoor activities such as running, sports, and long walks are good outlets for excess energy. In bad weather your child needs a room where he can play as he pleases with minimal restrictions and supervision. Your child should not have too many toys. This can cause him to be more easily distracted from playing with any one toy. Encourage your child to play with one toy at a time.

Don't initiate roughhousing with your child. Forbid siblings to say, "Chase me, chase me," or to instigate other noisy play. Encouraging hyperactive behavior can lead to its becoming your child's main style of interacting with people.

Follow a structured daily routine: Household routines help the hyperactive child to accept order. Keep the times for wake-up, meals, snacks, chores, naps, and bed as regular as possible. Try to keep your environment relatively quiet because this encourages thinking, listening, and reading at home. Predictable daily events help your child's responses become more predictable. ADHD symptoms are made worse by sleep deprivation and hunger. Be sure your child has an early bedtime and a big breakfast on school days.

Try not to let your child become overexhausted: When a hyperactive child becomes overtired, his self-control often breaks down and the hyperactivity becomes worse. Try to have your child sleep or rest when he is exhausted. If he can't seem to "turn off his motor," hold and rock him in a rocking chair.

Maintain firm discipline: These children are usually difficult to manage. They need more carefully planned discipline than the average child. Rules should be made mainly to prevent harm to your child and to others. Aggressive behavior, such as biting, hitting, and pushing, should be no more accepted from the hyperactive child than any other child. Try to stop such aggressive behaviors, but avoid unnecessary or impossible rules. For example, don't expect your child to keep their hands and feet still. Enforce a few clear, consistent, important rules and add other rules at your child's pace. Avoid constant negative comments like "Don't do this," and "Stop that."

Enforce rules with nonphysical punishment: Physical punishment suggests to your child that physically aggressive behavior is OK. We want to teach hyperactive children to be less aggressive. Your child needs adult models of control and calmness. Try to use a friendly, matter-of-fact tone of voice when you discipline your child. If you yell, your child will be quick to imitate you.

Punish your child for misbehavior immediately. When your child breaks a rule, isolate him or her in a chair or time-out room if a show of disapproval doesn't work. The time-out should last about 1 minute per year of your child's age. Without a time-out system, overall success is unlikely.

Stretch your child's attention span: While the attention span may never be normal, it can usually be improved. Encouraging an increased attention span and persistence with tasks is helpful for preparing your child for school. Increased attention span and persistence with tasks can be taught at home. Don't wait and expect the teacher suddenly change your child. By age 5 he or she needs at least a 15-minute attention span to perform adequately in school.

Buffer your child against any overreaction by others: If your child is labeled by some adults as a "bad" kid, it is important that this image of your child doesn't carry over into your home life. At home the attitude that must prevail is that your child is a good child with excess energy. It is extremely important that you not give up. Your child must always feel loved and accepted within the family. As long as a child has this acceptance, his or her self-esteem will survive. If your child has trouble doing well in school, help them gain a sense of success through a hobby in an area of strength.

Medicine is usually helpful: Stimulant drugs can improve a child's ability to concentrate. If you and your child's teacher both feel that your child's short attention span is interfering with school performance, discuss the use of medicine with your child's health care provider. In general, medicine should not be prescribed before school age. It should also not be prescribed until after your child has been evaluated by a doctor, the school education team, you have a individualized education plan (IEP) at school, and you have followed the above suggestions. While medicine is helpful, it needs to be part of a broader treatment plan including special education and behavioral management.

Call your child's doctor for referral to a child psychiatrist or psychologist if:

• Your child shows unprovoked aggression and destructiveness.
• Your child has repeated accidents.
• Your child has been suspended or expelled from school.
• Your child can't make or keep any friends.
• You have "given up" hope of improving your child.
• You can't stop using physical punishment on your child.
• You are at your wit's end.