Taking Charge of ADHD

ADHD is probably among the best studied of all psychological disorders of childhood. Still, our understanding of the psychology of ADHD is far from complete.

Executive functioning deficit. ADHD is primarily a disorder of self-control and executive functioning, rather than just attention. This involves difficulties with:

• Inhibiting behavior

• Sustaining attention

• Controlling impulses

• Self-regulating activity level

• Working memory

• Planning and organizing

• Emotional self-regulation

Children with ADHD struggle to manage their behavior relative to time and future consequences. They often live in the "now" and have trouble considering long-term implications of their actions.

The evidence that ADHD is a valid disorder is not only abundant but of a long-standing nature and has been considered to be such by clinical scientists for decades if not centuries.

Biological basis. ADHD has a strong genetic component and is associated with neurological differences:

• 70-80% of ADHD risk is attributable to genetic factors

• Brain imaging studies show structural and functional differences in individuals with ADHD

• Key brain regions affected include:

  • Prefrontal cortex

  • Basal ganglia

  • Cerebellum

  • Anterior cingulate cortex

Environmental factors like maternal smoking or alcohol use during pregnancy may increase risk in some cases, but are not the primary cause for most individuals with ADHD.

ADHD is real: a real disorder, a real problem, and often a real obstacle. It can be heartbreaking and nerve-wracking when not treated properly.

Pervasive impacts. ADHD affects various domains of a child's life:

• Academic performance: Difficulty completing work, lower grades, higher retention rates

• Social relationships: Trouble making and keeping friends, social rejection

• Family dynamics: Increased stress and conflict at home

• Emotional well-being: Lower self-esteem, higher rates of anxiety and depression

• Behavior: Higher rates of oppositional behavior and conduct problems

• Future outcomes: Increased risk of substance abuse, job instability, and relationship difficulties

Understanding the wide-ranging impacts of ADHD is crucial for developing comprehensive treatment plans and support strategies.

To claim that ADHD is a real developmental disorder, scientists must show that (1) it arises early in child development; (2) it clearly distinguishes these children from normal children or those who do not have the disorder; (3) it is relatively pervasive or occurs across many different situations, though not necessarily all of them; (4) it affects a child's ability to function successfully in meeting the typical demands placed on children of that age in various major life activities; (5) it is relatively persistent over time or development; (6) it is not readily accounted for by purely environmental or social causes; (7) it is related to abnormalities in brain functioning or development, which is to say that there exists a failure or deficit in the natural functioning of a mental ability that occurs in all normal humans; and (8) it is associated with other biological factors that can affect brain functioning or development (that is, genetics, injuries, toxins, etc.).

Executive parenting. Parents of children with ADHD must adopt a strategic, principle-centered approach:

1. Understand ADHD as a developmental disorder

2. Develop realistic expectations and a coping attitude

3. Establish clear rules and consistently enforce them

4. Communicate positively and effectively

5. Use problem-solving strategies for disagreements

6. Implement behavioral management techniques

7. Collaborate with schools and professionals

8. Maintain a sense of humor and practice self-care

This approach helps parents navigate the challenges of raising a child with ADHD while maintaining a positive relationship and promoting the child's growth and development.

The treatment programs suggested here will need to be combined with medication to treat the school problems of a child with ADHD. Recent research shows that the combination of behavioral programs and medication produces improvements that are superior to either treatment used alone.

Behavior modification. Effective strategies for managing ADHD behaviors include:

• Positive reinforcement: Praise, token systems, and rewards for desired behaviors

• Clear consequences: Consistent, immediate responses to misbehavior

• Time-out: Brief removal from rewarding activities for serious misbehavior

• Home-school communication: Daily report cards to coordinate efforts

• Self-monitoring: Teaching children to track and evaluate their own behavior

Key principles:

• Provide frequent, immediate feedback

• Use more powerful consequences than for typical children

• Implement rewards before punishments

• Maintain consistency across settings

Combining these behavioral techniques with medication (when appropriate) often yields the best results for children with ADHD.

The single most important ingredient in your child's success at school is your child's teacher.

Classroom accommodations. Effective strategies for supporting students with ADHD include:

• Seating arrangements: Close to teacher, away from distractions

• Task modifications: Breaking assignments into smaller chunks, providing extra time

• Visual aids: Posting schedules, rules, and reminders

• Active learning: Incorporating movement and hands-on activities

• Organizational support: Helping with materials management and planning

Teacher characteristics that promote success:

• Knowledge of ADHD and its impact on learning

• Willingness to implement accommodations and behavioral strategies

• Positive attitude towards students with special needs

• Ability to collaborate with parents and other professionals

Parents should advocate for appropriate classroom supports and work closely with teachers to ensure their child's needs are met.

A parent's relationship with a child is a sacred bond and trust and ultimately must be appreciated by both parents and teachers as having a higher priority to and serving as a fundamental underpinning of any academic priority.

Balanced approach. While academic success is important, it should not come at the expense of the parent-child relationship:

• Set realistic expectations for academic performance

• Limit homework time to age-appropriate levels

• Prioritize positive interactions and bonding activities

• Seek professional help for tutoring when needed

• Communicate with teachers about balancing school demands and family life

Remember that a strong, supportive parent-child relationship provides the foundation for long-term success and well-being. Overemphasis on academics can damage this crucial bond and potentially lead to negative outcomes in other areas of the child's life.