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MY CHILD HAS ADHD....WHAT DO I DO NOW ???
An Overview of ADHD for Parents
The diagnosis of Attention Deficit Hyperactivity Disorder or ADHD may confirm what you have known about your child for quite a while. Sometimes, putting a label on something may come as a relief. It is very unusual for a parent to be totally surprised about hearing that their child has this disorder. In your role as a parent, you are very familiar with your child's difficulties with attention, self-control, organization, doing what he/she is told, etc. Now that there is a "label", at least you know that this behavior has a name and that you are not the only parent with a child like this.
But there is another side to hearing the diagnosis. Your child has a problem... one that he or she will need to live with forever. It doesn't go away. So you may be feeling a sense of loss. You are losing the idea that your child is just fine and this problem will all go away. You are losing the idea that all parents have at one time ... my child is perfect. So this diagnosis brings a range of emotions - relief, sadness, anger (why our family?), anxiety (what will our child become?) and confusion.
ADHD is a neurobiological disorder. It did not come about because you did something wrong. Many parents feel very guilty about their child's ADHD and this guilt prevents them from making things better. Please remember that this disorder is not caused by bad parenting, working parents, or flying in an airplane when you were pregnant. These are some of the misconceptions that parents have about the cause of ADHD. We do not know what causes ADHD. We know that it often runs in families. We know that it has a lot to do with the chemicals that are in the brain. Please let go of any guilt that you might be carrying with you by thinking that you did something wrong. Put your energy into helping your child.
The ADHD diagnosis is the starting point for a journey. This is a journey through schools, doctors, therapists, parent groups, magazine articles, books, and questioning relatives. The journey can often be confusing. It will also be enlightening. It will challenge you; it will frustrate you. Your eyes and ears will become sensitive to any news about children with this disorder. You will hear stories about ADHD kids who turn out well, and those who do not. It is essential that you maintain your interest and curiosity. The most important thing you can do is to increase your knowledge about ADHD.
Let's take the first step. Today, you have reviewed the results of your child's evaluation. Dr. Starr has given you the results of the rating scales, the test data, and his observations of your child. You've had a chance to ask questions. You've probably talked about what can be done to help. Here is something important to remember : You have been given a lot of information in a short period of time. The human brain cannot remember all of this information especially when it is combined with strong emotions that parents experience when they learn that their child has a problem. Soon after you leave Dr. Starr's office you will forget something. Don't blame yourself. It's normal. You can always pick up the phone and call the office. Needing to have something explained again is not a sign of stupidity. Especially something that is so significant to your family. The most important part of this whole evaluation process is that you understand your child and what you can do to help.
MEDICINE
There is a lot of misinformation out there about medicine for ADHD. Much of this misinformation comes from cases where children have been poorly diagnosed or poorly monitored. For many ADHD children, medicine changes their lives dramatically. It is not a cure-all. There still needs to be educational interventions and family support. But for many children the medicine opens the door.
The most important thing about using medicine for ADHD is having a good working relationship with your doctor. These medicines require some trial-and-error work. In other words, we don't know exactly which medicine works with which child and at what dose. So your doctor will prescribe a low dose of one medicine and increase it (or change it) depending on how your child reacts. Your doctor needs to get regular information about your child's behavior. You are an important source of information. This working relationship between parent and doctor is absolutely essential for a successful outcome.
Guess who else can provide excellent information to your doctor ? The classroom teacher. Your child's teacher is able to observe behavior during the time when your child needs to pay attention and concentrate. The teacher knows how your child is able to attend to a math lesson, read a story, or finish classwork. Classroom teachers often have the most important information regarding the effects of medication. So make sure that your child's teacher is part of your team and can let the doctor know what's happening.
Make sure you understand when the medicine is to be given. Many of these medicines last for only a few hours. Missing a dose in the morning may lead to a bad start at school. So get into a routine of giving the medicine just as the doctor instructs you to do. Make sure you know what to do if you forget a dose. And keep track of the medicine, so you know when to get a refill. Don't wait until the last minute. The only person who will suffer will be your child.
Make sure you understand about side effects. While most medicines for ADHD have very minimal side effects (usually some loss of appetite or sleeplessness) discuss all possibilities with your doctor. If you notice any changes in your child that you think might be a side effect, call right away. " Better be safe than sorry."
NEUROFEEDBACK (EEG Biofeedback)
Neurofeedback is a new and exciting treatment for ADHD. It consists of training the brain to be more attentive through the use of specialized computers. Children with ADHD have certain brainwaves that are poorly developed. When they are able to increase the amount of these brainwaves, many of their symptoms disappear. Neurofeedback is a training program that increases the production of these brainwaves by providing the child with visual and auditory feedback almost like a video game. The more successful the child is in increasing the production of the correct brainwaves, the more points they earn. They earn prizes when their performance reaches a certain level.
Neurofeedback does not use any medicines and has no side effects. The training is intensive and there are two forty-minute sessions per week. Usually improvement is seen in twenty to thirty sessions. The child's progress is monitored by parent and teacher reports, measures of brainwave activity, and periodic testing. Many children who are treated with neurofeedback become almost symptom free and these effects last indefinitely. Dr. Starr is one of only two psychologists in Maine who use neurofeedback with ADHD children.
More information on neurofeedback can be obtained through the Internet. Go to the following website: WWW.EEGSPECTRUM.COM
SCHOOL
Many, but not all, children with ADHD have some type of learning disability. Sometimes it is in reading, math, or writing. Dr. Starr has screened your child for these types of learning problems and has given you an indication of whether there may be a disability in some academic area. If your child has ADHD or a possible Learning Disability, you need to find out what Special Education has to offer. Each school district must, by law, provide an adequate education for all educationally handicapped children. This includes children who have hearing or vision problems, physical handicaps, speech probems...there are a number of categories of handicapping conditions. Schools must provide special services to help these children learn in spite of their handicap. Services may include speech therapy or special help in reading or math. Sometimes this help is provided right in the regular classroom, or your child may spend some time in a resource room for more individualized work. Schools are responsible for determining your child's eligibility for these services.
The first step is to contact the Director of Special Education in your school district and obtain information about the procedures and services for handicapped children. You will be able to get a handbook that will inform you about all of this.
The Special Education process sometimes seems very complicated. In reality, it is a series of steps. The first step is the referral. Either the classroom teacher or you can refer the child. This step requires that a referral form be completed that indicates the nature of the problem and the things have been done to help the child. This form usually goes to the school principal and then a meeting is set up. This meeting is held at the school and includes the classroom teacher, a school administrator, a special education teacher and the parents. Others can be invited to the meeting. This group of people is called the Pupil Evaluation Team or PET. As parents, you are a very important part of the team. You have rights that are protected by law. The PET will discuss the reason why your child is being referred and will determine whether diagnostic testing will be done at school. Remember to tell the school that Dr. Starr has evaluated your child so that this information can be given to the PET. If additional testing is recommended, then your child will be tested and another PET meeting will take place to review the results and determine whether your child qualifies for special education services.
There is no specific special education category for ADHD. Sometimes ADHD children are eligible under a category called "Other Health Impaired." In determining whether your child is eligible for special education, the PET needs to determine whether the child's problem is having an "adverse effect" on his/her education. Often, the classroom teacher is in a good position to determine whether this is happening. If your child is learning well, then special education may not be needed. However, if his/her learning is being adversely effected by ADHD, then he/she may qualify for special services. If your child does qualify for special education, a written plan will be developed that specifies what type of help your child will receive. This is called an Individualized Educational Plan or IEP. This is essentially a contract between you and the school. You will have input into the development of the IEP and will need to sign it. Every year, your child's progress will be evaluated to determine if any changes need to be made in the IEP. Every three years, your child will be re-evaluated to see if he/she continues to need special education services.
If your child doesn't qualify for special education you can still expect the school to help the classroom teacher improve your child's situation. In fact, children who don't qualify for special education often qualify under Chapter 504. This is a law that ensures that all handicapped children are provided with assistance in their school programs. So if your child does not qualify for Special Education, specifically ask what is available under Chapter 504.
Your child's teacher plays a key role in this whole plan. Teachers cannot be everything to everyone. So ask the teacher if he/she has had experience with ADHD children. Can the teacher develop some behavior plans to help your child stay on task or complete his work ? Find out what kind of training has been provided to teachers in your school about ADHD. Is there a School Psychologist who can work with the teacher ? Just because a teacher doesn't know exactly what to do for an ADHD child doesn't mean that she doesn't care. Find out where help can be provided to the teacher. Dr. Starr has written a book for teachers so they can develop a behavior program right in the classroom. It is called "One Step at a Time." He also spends a great deal of time training teachers. Perhaps your school can use this type of training.
The parents of an ADHD child must learn to advocate for their child. This means getting to know your child's teachers, maintaining good communication with all school personnel, and knowing what your child needs and who is going to provide it. Trust and communication are the cornerstones. Being an advocate doesn't mean there has to be battles with the school. It means that you have to be clear about what you expect and support the efforts of the school that are in your child's best interest. It also means bringing up things that you are concerned about so that positive changes can be made. The dictionary defines advocate as "one that defends or maintains a cause or proposal." Your cause is your child. You are going to maintain your child's education so that he or she learns to the best of his ability.
CHILD MANAGEMENT
Most ADHD children are difficult to discipline. This is not because they are bad kids. It is because they don't pay attention to what you tell them to do and because they don't take time to think before they do things. This is part of their disorder. ADHD children learn best when their behavior leads to immediate and consistent consequences. Many of the traditional methods for disciplining children do not work so well for ADHD kids. You know the frustration of telling your child to do something over and over again and having him/her not do it. This leads to a lot of anger and you sometimes resort to punishments. Over time, these punishments lose their effectiveness.
In order to improve your family situation, you will need to learn some new ways of managing your ADHD child. The best way to learn is to take a parenting class or get involved in a child management training program. Some schools or community agencies offer this type of training. You will find that an investment of a few hours will lead to happier times in the future. Call your local school to inquire about a parent training program. Dr. Starr has also developed a "One Step at a Time" program for parents and you can purchase it directly from him.
Another way to learn is to read. There are a number of excellent books that provide strategies for living and loving ADHD children. Some of these books have been put on audio or video tape. The best resource for all of this material is the ADD Warehouse in Florida. You can call their 800 number (800-233-9273) and request a free catalog.
PARENT SUPPORT GROUPS
Raising an ADHD child can be a lonely job. Thankfully, there are groups of parents who meet on a regular basis to share their experiences, provide new ideas, and offer support to each other. There is even a national organization of parents of ADHD children. Joining either, or both, of these groups is an excellent way to feel part of a growing number of families who are experiencing similar situations. Many parents report that they feel less isolated and more optimistic when they participate in parent support groups. They can ask the questions that may have been bothering them for many years. They can listen to how other parents deal with various problems and learn new ways of coping. And most importantly, you will understand that you are not the only one who is trying to live with an ADHD child.
The local parent group meets monthly at the Thompson Community Center in Union.
The national organization is called Children With Attention Deficit Disorder (CHADD) They hold outstanding national conferences and publish a newsletter. CHADD is located at 1859 N. Pine Island Road, Suite 185 in Plantation, Florida. Their phone number is 305-384-6869. They are also on the Internet at WWW.CHADD.ORG.
COUNSELING FOR MY CHILD
Your child needs to know about his or her ADHD. Children who are educated do better than children who are not. If your child had diabetes or asthma, the doctor or nurse would explain the disease and the treatment. ADHD is no different. Your child must be given an explanation of their disorder and what is going to be done to help. Dr. Starr will begin this process by reviewing the evaluation results with your son or daughter. Children need to know the language of ADHD. Like the terms "impulsivity" and "hyperactivity." If they will be taking medicine, they need to know how it works. Believe it or not, many ADHD kids think they take medicine because they are bad ! The real reason (and even very young children can understand this) is to help them concentrate better. Dr. Starr can make available some reading or video tape materials to help your child understand ADHD. The ADD Warehouse also has information for children.
Counseling for ADHD children is not just talking about feelings. It's probably not at all what you might imagine from either watching TV or reading or your own personal experience. Counseling for ADHD children is more like training. Training the ADHD child to think before doing something, to learn ways of slowing down, to learn better ways of solving problems, to learn social skills so they can get along better with other children. Sometimes this type of counseling, either individual or in groups, can be provided through the school by the guidance counselor. Some schools even have social skills training groups. Dr. Starr will discuss your child's need for counseling during the review of the evaluation. These types of counseling/training services are very helpful for children. They are just as important as the medicine. Remember; when your child stops taking the medicine, it stops working. If he/she has this type of training, it never stops working!!!
So which is it ? Medicine or neurofeedback or training ? The best outcomes occur when children have access to all of these treatments in a coordinated manner. Medicine alone isn't the answer. The best treatment is what we call "multi-modal." This means providing a variety of services. In the ideal situation it might include medicine, neurofeedback, a good educational program, and training. As a parent, your role is to make sure that all of these areas are given attention.
NEW TREATMENTS FOR ADHD
As you become more tuned in to information about ADHD, you will hear about new programs and treatments. We are learning more about ADHD every day. Unfortunately, there are more and more "sure fire cures" for ADHD being described in magazines, newspapers, and on television. Some appear to offer everything to everyone and promise cures for this disorder. You will be encouraged and even excited about what you might read or hear. Be cautious. As of 1999, there is no "sure fire cure" for ADHD. There are some interesting new treatments that hold some promise and may be helpful.
There are other treatments that are being offered that have no scientific validity. Changing diets, which may be a good thing for children, does not have any proven impact on ADHD. Reducing sugar intake, again a good idea in general, does not cure ADHD. Food allergies do not cause ADHD but may cause behaviors that mimic it.
The best advice is to proceed cautiously. If you hear of a treatment program that seems to offer something, call Dr. Starr and discuss it with him.
THE FUTURE
What will happen to your ADHD child ? What does the future hold ?
Many parents, upon learning the diagnosis of ADHD, become pessimistic about their child's future. No college, dead end job, years of frustration. There is no need to think this way. Many ADHD children grow up to be successful adults. Some learn to channel their behavior in effective ways. Some end up being doctors, lawyers, teachers or executives. Others become carpenters, auto mechanics, or fisherman. The things that make the difference are a supportive family, a successful school experience, and appropriate medical/psychological treatment. Everything that you invest in your ADHD child now can have a payoff in the future. Don't hope that it goes away. Don't hope that things will work out. Take charge and get things done now. Advocate for your child. Communicate with teachers and your doctor. Learn new ways of disciplining. This journey that you're on isn't a smooth road. But it is a road that you can travel if you set your mind to it.
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