Coping with ADHD in the family

David Coleman on coping strategies for dealing with Attention Deficit & Hyperactivity Disorder

I often get queries from parents about Attention Deficit Hyperactivity Disorder (ADHD). Many parents wonder if their child has ADHD because of their behaviour which is often perceived as extremely bold, willful and impetuous. Indeed, the key signs or symptoms of ADHD are hyperactivity, inattentiveness and impulsivity. So children with ADHD will often appear fidgety and squirmy in their seats, be restless, and be always on the go and up running or moving. Their inattentiveness can be seen in distractibility, making careless mistakes, forgetfulness in daily activities and an inability to sustain their attention on tasks. Also, because of their impulsivity they will find it hard to wait their turn, they will be impatient and interrupt others.

Children with ADHD may also engage in potentially dangerous activities without considering the consequences. So you may find that they regularly injure themselves in falls or other avoidable accidents. Of course, many of these symptoms occur from time to time in youngsters without ADHD. However, in children with ADHD they occur frequently -- at home and at school or when visiting with friends. They also interfere with the child's ability to function normally. Sometimes you may also find that children with ADHD can fall into a pattern of negative, hostile and defiant behaviour, where they frequently lose their temper and argue. They may refuse to obey rules, intentionally annoy others and appear generally angry and resentful.

ADHD needs to be assessed and diagnosed by a Child and Adolescent Mental Health team. They will use a range of interviews, questionnaires and sometimes observations of your child to determine if the symptoms are all present. Children must have had the symptoms of ADHD for over 6 months and show them in more than one setting for a diagnosis to be confirmed.

Diagnosis is only the start...

Of course diagnosis is only the start; as the bit that parents are most interested in is what to do about managing their child. Sometimes medication is suggested and this can be very helpful for some children. The medication helps to reduce inattentiveness and impulsivity, and this gives your child a better chance of acting in positive ways that can be praised and rewarded.

The importance of structure, routine and predictability

Usually, various behaviour management strategies are also suggested. I think the really important strategies to consider are those that encourage structure, routine and predictability. It is also really important for parents to try to find ways of positively reinforcing their child’s good behaviour whenever it is present. This combats the intensely negative cycle of interaction which can often develop between parents and their child who, on the face of it, appears so willfully disobedient, disorganised and defiant.

So much of the behaviour that emanates from a child with ADHD is unconscious and unintentional. Understanding this can help to increase your patience and even tolerance of some behaviours. This means you can avoid arguing and disagreeing with your child because you know they don’t mean to act in bold ways. It is also really helpful to set up a plan with the crèche, preschool or school that your child attends. This means that everyone can be trying to use the same positive reinforcers for good behaviour and also applying the same consequences for negative behaviour. This means your child will get a consistent message from all the adults about what is okay and not okay.

Hard as it may be to stay calm, the least helpful response to your child with ADHD is to get angry and resentful with them. When we get cross and angry we tend to make irrational and inconsistent responses and this only antagonises and confuses your child. It is much more effective to be clear calm but firm with them, letting them be in no doubt about what the rules are and how they can stick by them. Because of the nature of their behaviour, being the parent of a child with ADHD can be wearing and exhausting. There are other parents out there who are experiencing similar struggles with their child and it can be very supportive to meet and talk with those who understand what you are going through.

So keep an eye out for ADHD parent support groups or parenting courses specifically aimed at dealing with ADHD for exactly that kind of support