Attention-deficit/hyperactivity disorder (ADHD) in children

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Coping and support

By Mayo Clinic staff

Caring for a child with ADHD can be challenging for the whole family. Parents may be hurt by their child's behavior as well as by the way other people respond to it. And the stress of dealing with ADHD can lead to marital stress. These problems may be compounded by the financial burden that ADHD can place on families.

Siblings of a child with ADHD also may have special difficulties. They can be affected by a brother or sister who is demanding or aggressive, and they may also receive less attention because the child with ADHD requires so much of a parent's time.

Resources
There are no easy answers for struggling families, but many resources are available that may help. Parents can get advice on raising a child with ADHD from a social worker or other mental health care professional or from a support group. Support groups don't appeal to everyone, but they often can provide excellent information about coping with ADHD from people who know.

There also are excellent books and guides for both parents and teachers, and Internet sites dealing exclusively with ADHD.

Techniques for coping
Many parents notice patterns in their child's behavior as well as in their own responses to that behavior. For instance, your child might throw a tantrum every night before dinner, and you might routinely give him or her a snack so that you can finish preparing the meal in peace. Although you don't mean to, you end up encouraging your child's behavior. Both you and your child need to act differently. But substituting new habits for old ones isn't easy — it takes real awareness and a lot of hard work. It's important to have realistic expectations and not ask more of your child than is physically or mentally possible. Set small goals for both yourself and your child and don't try to make a lot of changes all at once. 

Here are a few things that can help you and your child manage ADHD:

  • Structure your child's life. You can help make change easier by ensuring that your child has the right kind of structure. For children with ADHD, structure doesn't mean rigidity or iron discipline. Instead, it means arranging things so that a child's life is as predictable, calm and organized as possible. Children with ADHD don't handle change well, and having predictable routines can make them feel safe as well as help improve behavior. Give your child a few minutes warning — with a countdown — when it's necessary to change from one activity or location to another.
  • Provide positive discipline. One of the best ways to instill new habits is to provide firm, loving discipline that rewards good behavior and discourages destructive actions. Children with ADHD usually respond well to positive reinforcement, as long as it's genuinely earned. It's best to start by rewarding or reinforcing a new behavior every time it occurs. After a short time, this probably won't be necessary, but you need to continue to let your child know that you're serious about encouraging new habits. Some parents object to rewards because they seem like bribery. But changing old habits is extremely hard, and rewards are simply a concrete way of recognizing your child's efforts.
  • Stay calm and set a good example. You also need to set a good example by acting the way you want your child to act. Try to remain patient and in control — even when your child is out of control. If you speak quietly and calmly, your child is more likely to calm down, too.
  • Strive for healthy family relationships. Finally, the relationship among all the family members plays a large part in managing or changing the behavior of a child with ADHD. Couples who have a strong bond often find it easier to face the challenges of parenting than do those whose bond isn't as strong. That's one reason it's important for partners to take time to nurture their own relationship.
  • Give yourself a break. If you're the parent of a child with ADHD, be sure to give yourself a break now and then. Don't feel guilty for spending a few hours apart from your child. You'll be a better parent if you're rested and relaxed. And don't hesitate to ask friends, grandparents and other relatives for help. Make certain baby sitters or alternative caretakers are knowledgeable about ADHD and mature enough to be prepared for the task.
References
  1. Attention-deficit/hyperactivity disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Jan. 21, 2009.
  2. Attention deficit/hyperactivity disorder. National Institute of Mental Health. http://www.nimh.nih.gov. Accessed Jan. 21, 2009.
  3. Plizska S. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. Journal of the Academy of Child and Adolescent Psychology. 2007;46:894.
  4. Vitiello B. Understanding the risk of using medications for attention deficit hyperactivity disorder with respect to physical growth and cardiovascular function. Child and Adolescent Psychiatric Clinics of North America. 2008;17:459.
  5. Perrin JM. Cardiovascular monitoring and stimulant drugs for attention-deficit/hyperactivity disorder. Pediatrics 2008;122:451.
  6. Overview of Section 504. Council of Educators for Students with Disabilities. http://www.504idea.org/504overview.html. Accessed Jan. 26, 2009.
  7. Weber W, et al. Complementary and alternative medical therapies for attention-deficit/hyperactivity disorder and autism. Pediatric Clinics of North America. 2007;54:983.
  8. Jensen PS, et al. The effects of yoga on the attention and behavior of boys with ADHD. Journal of Attention Disorders. 2004;7:205.
  9. Peck HL, et al. Yoga as an intervention for children with attention problems. School Psychology Reviews. 2005;34:415.

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Feb. 13, 2009

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