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How Parenting Plays a Role in ADHD Treatment

Children diagnosed with attention-deficit hyperactivity disorder (ADHD) can learn how to manage the disorder with help from parents who have been trained in behavioral strategies.

The estimated number of U.S. children with ADHD is about 6 million, according to a 2016 national parent survey, and reported by the U.S. Centers for Disease Control and Prevention (CDC). Young boys are more likely to be diagnosed than girls.

The CDC also states that “behavior therapy is an effective treatment for attention-deficit/hyperactivity disorder (ADHD) that can improve a child’s behavior, self-control, and self-esteem.”

Parents are the best resources for helping children work through the challenges of ADHD. They can attend behavior management therapy with the child and learn positive strategies to manage the child’s self-control, impulsivity, and behavior. Children younger than age 12 benefit most from behavior management therapy.

What Is ADHD?  

The National Institute of Mental Health defines attention-deficit hyperactivity disorder (ADHD) as “a disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.”

According to KidsHealth from The Nemours Foundation, a children’s pediatric health system, ADHD is diagnosed after a visit with the doctor where they ask questions about the child’s health, behavior, and activity. The doctor will ask parents what they have noticed about the child, ask the parents to go through a complete checklist on the child’s behavior, and possibly ask parents to give a checklist to the child’s teacher also.

Once all this information is collected, the doctor can diagnose ADHD if it is definite that:

  • The child’s hyperactivity, distractibility, or impulsivity goes beyond what’s normal for their age.
  • The behaviors have been happening since the child was young.
  • Hyperactivity, distractibility, and impulsivity are affecting the child at home and school.
  • A health check indicates that another health or learning issue isn’t the cause.

Diagnosing ADHD in Young Children

The CDC notes that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-V) states that six of the nine symptoms of inattention and/or hyperactivity/impulsivity before age 12 must be demonstrated. The symptoms also must impair the person’s functioning in more than one setting – home, school, or work.

Note that six or more of these symptoms need to be observed for at least six months and that they are not appropriate for their developmental age:

Inattention

  • They often do not pay close attention to details or make careless mistakes in schoolwork, at work, or with other activities.
  • They have difficulty holding attention on tasks or play activities.
  • They usually do not seem to listen when spoken to directly.
  • They do not follow through on instructions and fail to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
  • They have trouble organizing tasks and activities.
  • They avoid, dislike, or are reluctant to do tasks that require mental effort over a long time (such as schoolwork or homework).
  • They often lose things necessary to perform tasks and activities (e.g., school materials, pencils, books, paperwork.).
  • They are often easily distracted.
  • They are often forgetful in daily activities.

Hyperactivity and Impulsivity

  • They often will fidget with or tap hands or feet or squirm in a seat.
  • They will often leave their seats when remaining seated is expected.
  • They will often run about or climb in situations where it is not appropriate. 
  • They will often be unable to play or take part in leisure activities quietly.
  • They seem “on the go”  or act as if “driven by a motor.”
  • They will often talk excessively.
  • They will often blurt out an answer before a question has been completed.
  • They will often have trouble waiting their turn.
  • They will often interrupt or intrude on others (e.g., butts into conversations or games).

Based on these symptoms, the DSM-V lists three types of ADHD that can be diagnosed:

  1. Combined Presentation: if enough symptoms of both criteria of inattention and hyperactivity-impulsivity were present for the past six months.
  2. Predominantly Inattentive Presentation: if enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months.
  3. Predominantly Hyperactive-Impulsive Presentation: if enough symptoms of hyperactivity-impulsivity, but not inattention, were present for the past six months.

It is essential for parents to talk with the child’s health care provider before assuming their child has ADHD. Most young children exhibit some degree of inattentiveness and hyperactivity. An experienced medical and/or mental health professional can be beneficial in determining if the child has ADHD. 

Behavior Management Strategies

Children with ADHD can be stressful to manage. They are more likely not to pay attention in class and, therefore, miss assignments. It is possible that their hyperactivity and impulsiveness can deter their peers. They tend to get hurt more often.  Parents can be a strong, positive influence on their children. This is how parenting plays a role in ADHD treatment.

Behavior modification strategies that parents can learn and practice at home help keep children with ADHD on target. Some of the strategies utilized are:

  • Positive attention. Parents provide positive attention and feedback, which reduces attention-seeking behavior.
  • Effective instructions. Eliminate any distractions before giving the child instructions. Turn off the TV or digital devices, establish and maintain eye contact, and gently put a hand on the child’s shoulder before giving them instructions, such as “please pick up your toys.” Give only one direction at a time, and ask the child to repeat it back.
  • Praise the effort. Praise the child when they follow an instruction or do something good, such as cleaning their room or finishing their homework. Praise is a good positive motivation for everyone, and more, the child with ADHD.
  • Create a reward system. List target behaviors that can be rewarded.
  • Be consistent with consequences. If using time-outs as a consequence, use them when needed but consistently. Taking away privileges is another effective consequence.

How to Find Help for Parents

The CDC recommends talking first to the child’s doctor to help find a qualified therapist for parent behavior management training and child behavior management training, both of which are evidence-based.

There is no doubt that a child with ADHD can be more than a handful to raise. Fortunately, there is help available and professionals to speak with to gain an understanding of the behavior and how to work with a child with ADHD.

Sources

(n.d.) U.S. Centers for Disease Control and Prevention. Attention-Deficit / Hyperactivity Disorder (ADHD). Data and Statistics About ADHD. Facts about ADHD. Retrieved from https://www.cdc.gov/ncbddd/adhd/data.html

(September 2019). The National Institute of Mental Health. Attention-Deficit/Hyperactivity Disorder. Retrieved from https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml

(November 2017). KidsHealth. The Nemours Foundation. ADHD. How Is ADHD Diagnosed?. Hasan, S. MD. Retrieved from https://kidshealth.org/en/parents/adhd.html

Symptoms and Diagnosis of ADHD. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. American Psychiatric Association (2013). from https://www.cdc.gov/ncbddd/adhd/diagnosis.html

(August 5, 2019). VeryWellMind. ADHD in Children Symptoms and Treatment. Low, K., Gans, S. MD. Retrieved from https://www.verywellmind.com/adhd-in-children-20844

(September 26, 2019). U.S. Centers for Disease Control and Prevention. Children's Mental Health. Therapy to Improve Children’s Mental Health. National Center on Birth Defects and Developmental Disabilities. Retrieved from https://www.cdc.gov/childrensmentalhealth/parent-behavior-therapy.html#finding-therapy

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