What is ADHD? Does My Child Have It?
Attention deficit hyperactivity disorder (ADHD) is a brain disorder. There can be subtypes of ADHD such as ADHD combined (which includes both inattention and hyperactivity,
ADD (inattention mainly minus the hyperactivity and ADHD (hyperactivity mainly which includes being unable to sit still but otherwise having good attention).
It is important to remember that every individual’s brain chemistry is different and behaviors present themselves in different ways as a result of this.
However a doctor, developmental pediatrician or a psychiatrist can help pull apart where these behaviors may stem from biologically or neurologically.
Sometimes if there are more symptoms that are being seen beyond the ones associated with ADHD, another diagnosis is looked at and this is called a co-existing condition or co-morbidity.
Symptoms must begin by age six to twelve and persist for more than six months for a diagnosis to be made.
ADHD is a long term condition that can often continue into adulthood. The symptoms of ADHD include struggles gaining and sustaining attention, hyperactivity, distractibility or acting impulsively that are not typical for a person’s age.
Those symptoms often lead to difficulty staying focused, controlling one’s own behavior, social and academic deficits. The social and academic deficits stem from struggling to maintain peer and adult relationships, and also staying on task and completing school work.
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ADHD in Children
Children with ADHD also may struggle with low self-esteem, as their relationships are troubled and their performance in school is sometimes hindered.
But they can learn strategies to be successful. Early diagnosis and intervention can make a big difference in the positive outcomes of this disorder. It is best to teach children coping strategies early that work for them individually.
Within children, there may be a number of behavioral symptoms that are shown which will be addressed here with more concrete examples:
a) Trouble paying attention to things that may be considered boring for a child with ADHD e.g. some conversation, teaching, homework or chores.
On the other hand, when doing interesting things like their hobbies/interests, or video games, a child with ADHD can pay really great attention, sometimes to the point of being “hyper focused”.
b) The need for things to be exciting: Because the child with ADHD needs things to be very stimulating in order to pay attention, this can then lead to:
-the child may have trouble finishing tasks or rushing through them and making mistakes.
-trouble with organizing, often leading to disorganized writing or body movements
– losing and misplacing things
c) Hyperactivity is the need to move around or fidget which can cause problems in a setting where there is not enough opportunity for movement. Examples include:
-some children may need to constantly fidget with hands or feet, or need to shake legs
-some may be unable to sit still, and have to move frequently
-some children with ADHD may run around too much, or climb on things
d) Impulsivity, which is the tendency to act first, and think afterwards, which can lead problems with poor decisions. Examples of impulsivity in children diagnosed with ADHD include:
– blurting out answers in class
-troubles waiting his/her turn
-often interrupts others a lot, because of struggles with waiting
-doing things without thinking about them first, or without thinking through consequences, and later regretting it
e) Struggles to regulate effort and alertness/arousal level. Being able to complete short term-projects may be more successful then longer-periods of focus and attention.
Individuals often have troubles regulating sleep and alertness. When it is time to go to bed, one’s mind may be overly active, have trouble sleeping exhaustion sets in. When waking up, there may be difficulty in doing so.
f) Struggles with regulating emotions. Many individuals with ADHD report getting frustrated easily, and having strong emotions. On the flipside individuals can experience increased elation, excitement and happiness at times greater than the average individual.
Statistics for Children with ADHD
In the United States, according to national surveys, 5.1 million children (8.8% or 1 in 11 of this age group 4-17 years) have a current diagnosis of ADHD. The average age of current ADHD diagnosis was 6.2 years. 3.5 million Children (69% of children with current ADHD) were taking medication for ADHD. Boys (12.1%) continue to be more than twice as likely than girls (5.5%) to have a diagnosis of ADHD. Current ADHD prevalence rates vary between states, with Nevada having the lowest rate at 4.2% and Kentucky having the highest rate of 14.8%.
The most prevalent co-existing disorder with ADHD is Oppositional Defiance Disorder (ODD), occurring 41 % of the time, then Minor Depression/Dysthymia (MDDD), with a rate of 22%. Generalized Anxiety Disorder (GAD) was third, appearing 15% of the time.
Globally, the sum of prevalence of ADHD for persons age 18 and under was 5.29%, based on a review of 102 studies including 171,756 subjects from all world regions. In another study the global prevalence rate for males found was 2.2% as opposed to females at 0.7%.
On a global scale, ADHD affects about 6–7% of children when diagnosed via the DSM-IV (Diagnostic and Statistical Manual) criteria and 1–2% when diagnosed via the ICD-10 ( International Classification of Diseases) criteria.
Possible Natural Remedies
These techniques and strategies can help to build success in children and give them lifelong tools to cope with the lovely brain they have.
Diet-cutting down on preservatives, artificial sweeteners and sugar in diet may help lower the hyperactivity rate.
Check with your family doctor and complete a blood test for iron deficiencies. Research shows children with severe ADHD have some iron deficiencies associated.
Exercise-provide time for a child with ADHD to have exercise during the day, but not before bedtime as this can make the child overly alert and have trouble settling for bed.
This exercise may help to release energies and calm the body. The exercise can be in the form of outdoor play, an extracurricular activity or the simple use of a small trampoline in the home.
A just right scale—develop a scale for children six and up to show them what self regulation looks like. This scale offers a visual for children to follow along with to see how their system may be “too high” or “too low”.
The aim is to get the system to around “just right” by doing natural remedies and calming exercises.
This in no way should be a mode to fix the system or introduce any stigma to the child but to simply increase the child’s awareness a bit and provide a learning opportunity.
Please see Shellenberger on “how does your engine run” for more information.
Emotional literacy- discuss with your child how they are feeling on a daily basis. This will help to have them identify different emotions and label them.
Then when they feel a certain way they can tell you. You can then coach them through the feeling and provide outlets for them to help them get back to “just right”.
This eventually will give them the tools they need to succeed when you are not there and as they get older.
Accommodations in school-having a working space with just enough visual stimulation, but not too much that it is distractible. Avoid placing a child with ADHD close to windows as this is much too distracting.
Ear buds or headphones during tests can be suggested to the teacher and/or principal. This depends on many factors. ADHD is often in many states and provinces not considered an official ‘special need’ so may not be accommodated.
However, suggestions are always welcome to advocate for your child. A parent is a child’s biggest advocate and it never helps to ask. You also want to make sure your child is not stigmatized for wearing ‘extra gear’.
If they feel they stand out and this is embarrassing for them then it is probably not a good choice however may work in different environments.
Smell-sometimes certain essential oils are naturally calming to the body such as lavender or peppermint. These oils can be used around the home as a supplement.
Music – use instrumental or classical music in work environments as this is a calming choice. Use white noise or music at sleep time as well to help settle the body down for sleep.
Stories-using stories that are age appropriate are a fantastic way to engage children and increase awareness as well as give children something to identify with. Books such as “Peaceful Piggy meditation” by Kerry Lee Maclean may be effective.
Also if you would like to develop your own social story about what works for your child this is a great way to make your child feel special and remind them of things that work for them. Repetition is key…it takes many times of hearing, doing and learning before an idea gets solidified in a child’s mind.
Yoga-use yoga to teach mindfulness and breathing techniques to help regulate your child’s system. This teaches them to be in the moment, slow their body down and relieve stress. Use poses that require more movement and stretching.
Fidget toys—children can use these when sitting for long periods of time to help them sit and provide stimulation. There are various fidget toys available on the market or you can make your own at the dollar store.
This can be made with a plastic coil bracelet, a pen that can be retracted, a bracelet with charms on the end, etc. Those fidgets will also blend into the environment if you are afraid of your child standing out.
Explain to your child why the item is there and appropriate ways of using it. A fidget toy is just something that works for your child to help them to focus while sitting. Be careful this does not add to distractibility depending on the situation.
A lot of children find it helpful to keep them in their pockets so that when they need to, they put their hands in their pockets and fidget to help them regulate.
Add proprioceptive components to a child’s day—proprioception helps the body calm.
Such sensory input can be provided through stress balls, chewing on straws, weighted lap pads, deep pressure on back, joints, and legs. Encourage a child to help you around the house by carrying weighted boxes or baskets.
Push or pull can also be a form of proprioception. Pushing the cart at the grocery store is a great natural way to deliver more proprioceptive input to your system.
Taking breaks to regulate –encourage children to take physical breaks when possible while engaging in tasks that require a lot of focussing and attention.
Getting enough sleep-keep sleep routines the same, even on the weekend. Go to sleep around the same time, wake up around the same time. This will help to regulate a child’s system.
Permit movement whenever possible to help regulate the system—use “sit fit” cushions when sitting to help with a little bit of movement. Exercise ball chairs will work also if permitted. Getting a water bed at home for the child who seeks out movement may help with sleep.
Rhythmic movement-can be soothing. Consider having a rocking chair at home and rocking before bedtime to induce a calming state. Rock younger children in your arms before bedtime. Use a weighted blanket for those children who may like it. Some may feel claustrophobic so use judgement when considering this option.
Praise motivates better than punishment-having a child with ADHD can be very challenging however kind words, praise and working towards an attainable goal is much more motivating then punishment.
Keep expectations reasonable, healthy and appropriate. Remember that the brain and body are working in a certain way as is physically possible.
Consult with an Occupational Therapist-an O.T. can help you develop a sensory diet based on your child’s needs. This will require an initial assessment and may take some time and money so it may not be an option for everyone.
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Konofal et al.: Iron deficiency in children with ADHD, Arch Pediatr Adolesc Med 2004 Dec; 158(12):1113-5.
Willcutt EG (July 2012). “The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review”. Neurotherapeutics 9 (3): 490–499. doi:10.1007/s13311-012-0135-8. PMC 3441936. PMID 22976615.