Attention Deficit Hyperactivity

Disorder (ADHD)

Tips for Understanding and

Managing ADHD in the Home
Presented by: Brett L. Patterson, M.A.
 Goals for This Presentation
• Provide a basic understanding of what
ADHD is, and what it is not.
• Attempt to answer any questions and
dispel any myths that many people have
regarding ADHD.
• Introduce some guiding principles for
dealing with ADHD behaviors.
 ADHD Exposed
• ADHD is identifiable via behavioral, not physical
characteristics, making it more likely to be
misunderstood.
• Misperceptions:
– Behaviors that directly result from ADHD are not
primarily attributable to poor parenting, lack of
discipline, low motivation, or intentional “trouble
making.”
– Not everything that fidgets and/or behaves defiantly is
ADHD.
 What Is ADHD?
• Neurobehavioral disorder marked by:
– Inattention
– Difficulties controlling impulses
– Excessive motor activity (hyperactivity)
• Be aware…the mere presence of these
behaviors does not mean the child has
ADHD.
 Indicators of ADHD as a Developmental
Disorder (Barkley, 1995)
• Seen in early child • Child not able to perform
development at age-appropriate levels
• Behaviors clearly • Not accounted for by
distinguish child from environment of social
non-ADHD children causes
• Occurs across several • Related to brain function
situations (though not • Associated with other
necessarily in all of them) biological factors that can
• Behaviors persistent over affect brain function (i.e.
time head injuries, genetics)
 Things We Can See (aka,
Common Complaints)
• Difficulties sustaining attention
– Daydreaming
– Child doesn’t listen
– Always losing things
– Forgetful
– Easily distracted
– Needs constant supervision
– Child doesn’t finish anything he/she starts
 Common Complaints (cont’d)
• Problems with impulse control
– Impatient/Difficulties waiting for things
– Always interrupting others
– Blurts out answers
– Doesn’t take turns
– Tries to take shortcuts on many tasks
(including chores, homework, etc.)
 Common Complaints (cont’d)
• Hyperactivity
– Always on the go
– Squirmy…can’t sit still
– Talks too much
– Frequently hums or makes odd noises
– Unable to “put the brakes on” motor activity
– Child has two speeds; asleep and awake
What Do These Behaviors Have
in Common?
• Problem isn’t as much sustaining attention
as it is sustaining inhibition…this is the
hallmark of ADHD
• Inhibition: a mental process that restrains
an action (behavior) or emotion
• Problems of inhibition are not a matter of
choice, but are instead a result of what is
(or is not) going on in the child’s brain
 ADHD and the Human Brain
• Portions of brain’s frontal lobe are
responsible for “Executive” functions:
– Consolidating information from other areas of
the brain
– “Considers” potential consequences and
implications of behaviors
– Puts “brakes” on (inhibits) impulsive reactions
– Initiates appropriate response to environment
 ADHD and the Brain (cont’d)
• Research suggests that in in children with
ADHD, these “executive” areas of the
brain are under-active
• Increasing the activity level in these areas
of the ADHD brain have been shown to
decrease behavioral symptoms. This is the
logic behind using Stimulant medications
as a first line treatment for the disorder.
 Common Stimulant
Medications
• Methylphenidate (Ritalin)
• Dextroamphetamine
(Dexedrine)
• Amphetamine/
Dextroamphetamine (Adderall)
• Pemoline (Cylert)
 Things That Look Like ADHD
• Depression • Learning disabilities
• Anxiety • Parenting problems
• Hearing problems • Substance use
• Visual problems • Medication side-
• Seizure disorder effects
• Oppositional defiant • Lead poisoning
disorder
• Autism
 Ten Guiding Principles for Raising a
Child with ADHD (Barkley, 1995)
1. Give your child more immediate
feedback and consequences
2. Give more frequent feedback
3. Use larger and more powerful
consequences
4. Use incentives before punishment
5. Strive for consistency
 Ten Guiding Principles for Raising a
Child with ADHD (cont’d)
6. Act, don’t yak!
7. Plan ahead for problem situations
8. Keep a disability perspective
9. Don’t personalize your child’s problems
or the disorder
10. Practice forgiveness
 In Using These Principles, It Is
Important That the Parent:
• Pause before reacting to the child
• Use the ensuing delay to remember all
10 guiding principles (post them
around the house if necessary)
• Choose a response that is consistent
with the principles
 Additional Tips for Managing
ADHD Behaviors
• Pay positive attention to your child…catch
them being good
• Give effective commands
– Short, sweet, and straightforward
– Limit the number of tasks to 1-2 per command
• Maintain clear and consistent expectations
• Communicate realistic consequences for
inability to meet expectations
 Tips for Managing ADHD
(Cont’d)
• Manage the child’s environment
– Limit distracting influences during times when
child is asked to be on task (i.e. homework)
• Maintain a regular and predictable daily
schedule
• When eliciting child’s input, limit (but
don’t eliminate) the number of choices
available to him/her to 2-3 options
 Tips for Managing ADHD
(Cont’d)
• Be patient
• Be persistent
• Be understanding
• *Most importantly, remember to
differentiate the behaviors from the child
– Bad behaviors are not synonymous with a bad
child
 Resources Available to Parents
• Children and Adults with ADD (CHADD): a family
support organization that provides a variety of
services. (www.chadd.org or the Central OK
chapter phone number is 405-722-1233
• There is a plethora of readings available to those
interested in obtaining more information on ADHD.
One that I have found particularly useful in
working with parents is Taking Charge of ADHD:
The Complete Authoritative Guide for Parents, by
Russell A. Barkley, Ph.D. (1995)