Some 11 percent of children ages 4-17 have been diagnosed with ADHD, according to 2011 statistics from the federal Centers for Disease Control and Prevention, which also says diagnostic criteria and treatments are constantly changing as scientists learn more about the disease.
“Every three years we finally figure out what ADHD is,” said Jennifer Gruenert, a speech and language pathologist and learning specialist at the Sendan Center in Bellingham, where psychiatrists, psychotherapists and clinicians treat a variety of child and adolescent mental and behavioral conditions, including ADHD.
According to the National Institute Of Mental Health, ADHD — for attention-deficit/hyperactivity disorder — affects parts of the brain that handle so-called executive functions, such as thinking, planning and the ability to pay attention. Children without these skills run the risk of falling behind in school and often lack the savvy to socialize with other children, leaving them “different” and ostracized.
“It affects learning and communication, but it’s a chemical problem in the brain,” Gruenert said. “It’s a medical condition.”
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With all the research dedicated to it, new discoveries are made that sometimes change the way ADHD is treated, she said.
“You could argue it’s a form of developmental disability,” she said. “Talk to your doctor and find out what they think and what they think you should do.”
Some physicians recommend medication right off the bat, but “we’re moving past that now,” Gruenert said. “What you really need is to learn ‘What else I can do?’”
With a physician’s diagnosis in hand, parents can talk to their child’s teacher about classroom options, said Terry Pauls, a special-education teacher at Kulshan Middle School who works mostly with sixth-graders who have qualified for special services for a broad range of health issues. Pauls taught in a regular classroom for 18 years in Carbondale, Ill., then came to Bellingham 21 years ago to focus on special education.
School officials will develop basic strategies for the child’s education, such as breaking up the instruction time if a child has difficulty focusing for long periods, Pauls said.
“It depends on what we see in the medical report,” Pauls said. “Maybe the student needs movement,” noting that a lack of exercise can affect children’s ability to focus in class — a sentiment echoed by Gruenert.
“Even the highly capable kids have their own entry spot,” Pauls said. “My biggest goal is to help with whatever skills they need.”
With that in mind, here are 10 things parents should know about ADHD.
1. Be observant. Watch your child. Does the behavior you suspect could be ADHD occur at a certain time of day or under a certain type of circumstances? Keep a journal of issues you suspect could be ADHD.
2. Talk to your doctor. Rule out a hearing deficit and other problems, such as sleep disorders, and dietary issues or a learning disability, such as dyslexia.
“(ADHD) can take so many forms,” Gruenert said. “Think about what could be causing those problems, could it be something else? Learning disabilities can look like attention problems. Maybe this is a learning disability that looks like an attention problem.”
Medication is not a silver bullet, she said, noting that doctors often suggest tutoring to help with learning issues; counseling for the anxiety that can go hand in hand with ADHD; and language therapy because speech and language disorders are often present with ADHD.
Doctors today encourage parents to address ADHD with good medication and good counseling, Gruenert said.
“The meds get you into a ready-to-learn state,” she said.
3. Enlist the school’s help.
Pauls said that because ADHD is a medical diagnosis, “it would be inappropriate” for teachers to tell parents that they suspect their child may be struggling with ADHD — or even for a teacher to recommend seeking professional help. But he said a teacher might ask, “What does your doctor say?” in response to parental concerns.
But he said teachers will make observations about the child’s specific behavior and offer solutions.
“(A medical diagnosis) would give us a bigger picture of the child. It doesn’t necessarily mean they’ll be in special ed. Just because a child is diagnosed with ADHD doesn’t mean they will be in special ed. There are lots of kids who have ADHD who are not in special ed,” Pauls said. “It’s not so much about ADHD, it’s about what the student needs.”
Teachers can initiate an Individualized Education Program that outlines educational goals or obtain a 504 plan, part of the Americans with Disabilities Act that spells out specific accommodations that students with disabilities might need — such as allowing more time to complete homework or providing a student with note-taking assistance.
“(But) if they’re successful students, they might not need school support,” Gruenert said.
4. Learn about ADHD and what it means.
“Connect with other parents and educate yourself,” Gruenert said. “(ADHD is) a label that is used for a lot of different people. You need to figure out what works for you and your kids.”
Gruenert said parents must accept that helping their child cope with ADHD will be a lifelong task.
“It’s not going to happen overnight,” she said. “Be patient with yourself and your kids. Take time to enjoy each others’ company. It’s a long road.”
She suggested parents read “Smart But Scattered” by Peg Dawson and Richard Guare and “All Kinds of Minds” by Melvin D. Levine, as well as books that address executive function.
5. Connect with other parents.
Talking with a parent whose child has similar issues can ease the strain of coping, Gruenert said. She suggested using social media to seek friends’ help.
“A lot of people get connected at the waiting room of their psychiatrist’s office,” Gruenert said.
6. Help your child eat right, get enough exercise and sleep.
Physical movement is now being emphasized as part of an overall strategy that includes encouraging good diet and adequate sleep.
“Creative, self-directed play is what grows our frontal lobes,” Gruenert said.
She suggested individual sports such as gymnastics, swimming and rock climbing, rather than organized team sports that require discipline, attention and teamwork — athletic skills that a child with ADHD might not possess.
“Playgrounds — let them go play in the creek and get muddy. At Squalicum Park they have some really good spinners “ which kids love, she said.
7. Help your child manage anxiety.
“Our No. 1 goal is to help their own locus of control,” Pauls said. “The second you think you’ve lost control, you start to doubt yourself. If there’s one thing that’s pretty challenging for ADHD students — (anxiety) can lead to stress. All of us have stress.”
Gruenert agrees, suggesting that parents seek professional counseling for companion issues such as anxiety and depression.
8. Be encouraging.
“ADHD, it’s not the defining thing about them. Don’t let the diagnosis overpower them,” Pauls said. “I think that what’s helping in a huge fashion is for students to realize that learning is a process, to know that learning to manage ADHD is a process. Parents need to realize that every single student is unique. We all have different strengths and different challenges. There’s not some ideal. They’re all individuals. We all have a different way of getting from A to B.”
Children with ADHD often act impulsively and outside the social norms, he said.
“You start to feel like you can’t trust yourself,” Pauls said. “Don’t look at success or failure; that’s not real life. Real life is process. I’ve never met any two ADHD students who are alike in every way.”
9. Don’t let them use the diagnosis as an excuse.
Pauls said it’s helpful to emphasize small successes as they struggle with their disability.
“Things don’t have to be perfect,” he said, noting that it’s easy to let frustration get in the way.
“You’re not going to get on the bike the first time without falling over,” he said. “That’s not learning. Learning in saying ‘Oh I fell down, I’ll get up and try again.’ ”
10. Help them take risks.
Students don’t like to draw attention to themselves, Pauls said, but parents should urge their children to push the limits of their abilities.
“Don’t compare your child to other students,” he said. “The most successful ADHD kids I see are ones who are encouraged at home that it’s OK, it’s part of who I am. Students with that attitude by far are best. It keeps the anxiety down.”