As any parent knows, children say and do some pretty baffling stuff.
While sudden outbursts in the park or an adamant refusal to bathe are understandably annoying, there’s solace to be found in the fact that most children grow out of those behavioral problems eventually.
In about 10 percent of children, however, those puzzling personality traits and temper tantrums aren’t just growing pains. They’re symptoms of attention deficit hyperactivity disorder (ADHD).
Found in both children and adults, ADHD is a neurodevelopmental disorder that causes individuals to have trouble paying attention, listening, and following instructions. Children with ADHD might lose things easily and avoid tasks that require focus, especially schoolwork. They might also be hyperactive and act impulsively.
But how can a parent differentiate between what’s considered normal childhood behavior and ADHD? Children are normally inquisitive and active, but if these characteristics interfere with a child’s ability to function in social and school situations, then it might be worth discussing this with your child’s doctor.
“All children push boundaries and social limits,” explains Max Wiznitzer, MD, a pediatric neurologist at University Hospitals Rainbow Babies and Children’s Hospital. “But it becomes an issue when their behavior is beyond what is considered normal because they have so much trouble self-regulating.”
In addition, you should also take note of your child’s mood since studies suggest comorbidity—or disorders that appear together—occur in about 60 percent of ADHD cases, according to the Centers for Disease Control and Prevention. These disorders often include anxiety, depression, obsessive-compulsive disorder (OCD), bipolar disorder, and oppositional defiant disorder.
Children with ADHD and anxiety, for example, may have have symptoms of both. They may be prone to fidgeting and acting out, but also appear fearful or sad. In fact, symptoms due to anxiety or depression can often mask the underlying issue of ADHD.
For parents struggling with a child’s behavioral problems, getting a child evaluated as soon as possible is critical. If left untreated, disorders like these will likely get worse and can progress into adulthood, Dr. Wiznitzer says.
Here’s how to help your child with ADHD, according to experts.
1. Demand the Right Diagnosis
Although getting your child evaluated is a necessary first step in determining if ADHD is present, it’s important to do your homework before arriving at the appointment.
Take note of any behavioral oddities or issues you’ve witnessed, and be prepared to discuss them with your child’s pediatrician or mental health clinician. While a certain trait might not be tied directly to a disorder, it’s important to note regardless.
“Behavior that is not normal tends to put a child in harm’s way,” says Dr. Wiznitzer. For example, a child who is developing normally will be very active. But children who may have ADHD or other disorders that affect impulse control will also be active—so much so that they may run out of the house or into the street at night.
Dr. Wiznitzer also notes that children who are among the youngest in their class may be misdiagnosed with ADHD or other behavioral issues because they are simply less mature than their classmates.
Another clue that your child may be experiencing a psychiatric disorder: Normal parenting techniques don’t work. For example, if you want to discipline a child for bad behavior, time-out is often an effective strategy to help them cool off. That doesn’t work for kids with ADHD, who feel compelled to move around and won’t calm down if forced to be still.
2. Assemble Your Support Team
Managing ADHD and other mental health issues should be a team effort.
Too many parents think the burden of care is theirs alone. Parents should get connected with a mental health clinician, such as a psychologist or psychiatrist, who knows about ADHD in children.
A psychologist or psychiatrist can also help with therapy or medication, both of which have been shown to be very helpful for ADHD symptoms.
A professional evaluation of your child will involve the following:
- A complete family history because ADHD tends to run in families
- A thorough history of your child’s health and a physical examination to rule out other causes of the condition, such as developmental issues
- A questionnaire about the child’s behavior
- Behavioral observation in different contexts: at home, at school, and with friends and family
- Referrals to other experts
- Treatment, which may include therapy or medication
If your child’s clinician recommends medication, ask how pharmacogenetic (PGx) testing can help personalize ADHD treatment.
3. Dole Out Rewards Instead of Punishments
The golden rule when dealing with children with ADHD? Honey over vinegar.
“Punishment never works,” says Dr. Wiznitzer, who pushes for rewards and incentives for positive behavior versus scolding and time-outs. “If my child is a baseball fan and I want him to be polite to his Aunt Sadie, I may say, ‘Aunt Sadie is coming over tonight. If that goes well, then afterwards we’ll go to a baseball game.’ It is much more likely they will behave.”
Praise and opportunities for positive relationships with parents, friends, and teachers are powerful tools for managing disruptive behavior.
4. Structure Your Child’s Day
Children with ADHD often need more structure than other kids, such as set bedtimes, places to put their things, and order in their environment, according to Dr. Wiznitzer.
“Presenting kids with ADHD with new and different choices isn’t always a good idea,” he explains. “They do better with a consistent daily routine.”
5. Recognize That They’re Trying
Although behavioral episodes when parenting a child with ADHD are understandably frustrating, it’s important to trust the treatment process. One of the most important ways to help your child with ADHD is to acknowledge your child’s progress.
Kids want to do well. They want to be loved by their families and liked by their teachers and friends. If that’s not happening, then there’s something wrong.
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