A Formula That ADDs Up To Success
Here you are…parents waiting for the doctor to meet with you about your child’s testing results. Suddenly you feel like the little kid getting ready to go into the principal’s office. Then you bring yourself back to your adult zone and reflect. You begin thinking of all of the questions you answered about Johnny. :Yes, he was difficult to get to nap as a baby. He did seem to always be full of energy…always running never walking. He did fidget a lot, but he was just an excitable little kid…full of fun, life, and energy…all the way till midnight!!”
The doctor comes to the door and welcomes you into the office. Suddenly the moment you’ve been waiting for. A diagnosis. Then he begins, “Yes, it does seem that Johnny has an unusually high activity level, coupled with marked levels of inattention for his age. I feel that we are looking at Attention Deficient/Hyperactivity Disorder. You may have heard about this problem. It is often referred to as ADD or ADHD.”
ADD is a diagnosis that some parents dread, while others are relieved that it is indeed a manageable condition. ADD is a diagnosis that some parents refuse to acknowledge, however. It is also a diagnosis that some parents do not want to treat with pharmacological interventions. ADD is a diagnosis that may leave some parents wondering, “where did I go wrong or what did I do?” The most important thing to acknowledge with an ADD diagnosis is that children with ADD can lead successful lives. ADD can add up to success!!!
The first thing that parents need in order to help their child with ADD be successful is a good working knowledge of what ADD is and how it manifests in daily activities. A solid understanding of the disorder can help parents anticipate difficult areas by making necessary, yet simple modifications.
We know that ADD often runs in families and can, in many cases, be traced to other family members. Children are born with ADD, although they may not manifest the typical symptoms for several years.
Parents of ADD students also need to understand some of the manifestations of ADD, both in the classroom and in other settings such as home and on the playground. By understanding manifestations of ADD, the parents can help the child to anticipate pitfalls and to make modifications that can lead to success.
Three primary factors are characteristic of ADD children. These factors include 1) increased activity, 2) short attention span, and 3) impulsivity. A child may exhibit one, two or three of these factors. Most commonly, children with ADD have a markedly short attention span for their age. The key here is “for their age.” Fidgeting and squirming is characteristic of children with ADD. They may fidget with their hands or feet, bite their nails or drum their fingers incessantly on anything near to them. Children with ADD also have difficulty in remaining seated for an extended activity. This includes working at a desk as well as sitting on the floor during group activities in the earlier grades. Some children with ADD may not exhibit hyperactivity at all, but hypoactivity. These children appear to be day dreamers and non-focused. Unfortunately, many of these children go undiagnosed until middle school or even high school. In addition, children with ADD may have little patience in taking turns at tasks or games. This may often result in social behavior that is unacceptable in the eyes of their peers. In the classroom, this inability to take turns may manifest itself in blurting out answers, even before the question has been completely asked. ADD students may also have difficulty in finishing tasks in an allotted time period.
Likewise, they may have trouble in shifting from one activity or from one academic subject to another. Many times, the ADD student will shift to a second activity, without completing the first activity.
Attention to details is another problem that some ADD students have that may lead to careless errors in the classroom setting. Losing things like pens, pencils, assignments and the homework that the child worked so hard on the day before is not uncommon for the ADD student. The child with ADD may have trouble screening out extraneous stimuli. Noises like the hum of the air conditioner, the bubbling of the fish tank, and the chirping of a bird in the tree become the dominant noise to the ADD child and not the background noise. Understanding some of these common symptoms can help the parent see the world through the eyes of the child with ADD. By understanding the ADD child’s world, the parent can help the child to develop strategies to cope effectively and achieve success.
Parents also need to bear in mind that ADD is a trait and not a dread disease or illness. Just as some children are stronger in math than others, other children are more attentive and focused than others. Likewise, just as some children are sufficiently weak in math to be considered learning disabled, others have such limited focusing abilities that they are considered “attention disabled” or ADD.
Parents will also need to separate fact from myth about ADD. Let’s examine a few myths and facts:
*ADD is a result of something the parents have done or have not done in regard to the child. (MYTH) Many parents immediately begin to wonder what they may have done to cause ADD. Some parents come into the office mentioning medications taken during pregnancy. Likewise, parents begin to question any unexplained illness that the child had as an infant Falls and accidents are also brought into question by parents, wondering which exact event can explain the ADD. The prevailing thought, however, is that ADD is not necessarily the result of prenatal influences nor postnatal accidents. While there is a higher incidence of ADD in children who were premature or were exposed to drugs in utero, the vast majority of children with ADD do not fall into either of these categories.
*ADD will fade away as adolescence sets in and will cease to be a problem. (MYTH) For many children the symptoms of ADD continue throughout adolescence and into adulthood. Many adults have learned strategies that help them to focus more effectively. Likewise, some of their extreme motor hyperactivity may diminish with maturity. Consequently, they do not seem to have as many of the overt symptoms of ADD. As children with ADD grow into adulthood, they may also find careers in fields that are highly compatible with the energy level that is present in ADD like telecommunications, sales, the theater, and the arts.
*ADD only affects boys. (MYTH) The ratio of boys to girls that are identified as ADD is about 3/1. Boys are usually classified as being more hyperactive thus causing a disruption in the classroom. Consequently, they are more quickly referred for an ADD evaluation. Girls are also affected by ADD, but may be classified more often as being inattentive without the hyperactivity. Girls can be hyperactive too, however.
*ADD can be controlled solely with medication. (mostly MYTH) Ritalin and other drugs such as Dexedrine and Cylert, have produced some remarkable results in children with ADD. Drugs are not a panacea, however, that can be used alone for maximum results. The most effective results happen when the drugs are monitored and consistent medication is a part of a three prong approach to working with children who have ADD including: 1) the medical component, 2) school component, and 3) home component.
*ADD can be controlled by good parenting techniques alone and outside intervention is not needed. (Partly MYTH) Consistent parenting techniques are crucial in the success of children with ADD. Consistency, patience, and the willingness to advocate for the child is critical in helping them to cope with the symptoms of ADD. Advocacy on the part of the parent with the school system and community is also a key factor in helping others better understand ADD. But, the parents alone cannot produce the maximum benefit. The parents are a vital component in the wheel of success, but not the entire wheel.
*ADD is the problem of the school. The parents need to let the professionals handle the school situation. (MYTH) The school situation may indeed present the most challenges with ADD. But, the ADD issue is not the sole responsibility of the school. Because the school day comprises over 50% of a child’s waking time, success in the school environment is critical to a child’s long term self esteem. No parent should want the school to “handle the school thing” and not be an active and involved participant in their child’s education, whether the student has ADD or not!
The parents of children with ADD must be even more involved in the school setting to make certain that there is a partnership between family, teachers, and physician. The effective use of these three components: home, school, and medical community, do ADD up to success for the ADD/ADHD student.
*ADD students can be successful in the classroom and in the working world. (ABSOLUTE FACT) Let’s look at how the parents, school and medical component can work in the best interest of the child.
Understanding the Medical Component: The use of medication to help children with ADD has been common practice since the 1960’s. Drugs such as Ritalin and Dexedrine have been used most frequently, but are many others. In laymen terms these drugs affect the chemicals in the brain called neurotransmitters. These drugs stimulate parts of the brain where inadequate amounts of neurotransmitters are present. The stimulation can produce a decrease in hyperactivity, impulsive behavior, and aggression. Drugs have also helped to increase concentration and academic productivity. Side effects such as appetite loss, headaches, and sleep disturbances have been reported. It is critical that the parents and teacher note special changes in a child in regard to his medicine.
Periodic records are the key to monitoring and adjusting the medical component of ADD. It is very important to understand the basic effect of the medicine that is being used and to see how the particular medication and dosage interact to provide the best results. Parents need to understand that each child is different and the reaction to the medication may vary. In addition, the timing and dosage that worked during the past school year may not be right for this school year. The child’s schedule may change dramatically and you need to work with the physician to determine when maximum concentration is needed for core academic subjects. Puberty, weight gain, and an increase in physical activity may alter the effectiveness of the medication. Just because one medication did not work does not mean another medication will fail to provide benefit. Likewise, the medication that has worked for a period of time may not be as effective as the child grows older. The doctor needs input from the parent and teacher to determine how to best prescribe for the child. In looking at the medical component, best success comes from cooperation and communication between home, school, and the medical community.
Planning The Educational Component: The success of the ADD child in the educational arena is perhaps the biggest challenge and the most important concern for future self esteem and success as an adult. Students with ADD may be eligible for services under two different federal laws, Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973. A note of clarification is important in order that parents understand the difference in IDEA and Section 504.
IDEA details a special education plan that may include resource classes and special education classes for the child who has a disability. Under IDEA a child will receive an Individualized Education Program (IEP) that is specifically designed to the child’s unique needs. The most common example is the child who attends special classes for a learning disability. In regard to IDEA, ADD students may be classified as “other health impaired” where ADD presents a significant adverse effect of the child’s educational performance.
If a child does not qualify for special education under IDEA, the child may still qualify for reasonable modifications under the Section 504 legislation. Section 504 modifications address ways that the teacher can alter delivery styles and curriculum in the regular classroom for the ADD student. Parents should request an evaluation from the school in order to determine if their child will be eligible under IDEA legislation or for Section 504 modifications in the traditional classroom.
Section 504 is a civil rights law prohibiting discrimination against persons with disabilities. All schools that receive federal funds must comply with addressing the unique needs of children with disabilities. ADD is considered a hidden disability that can limit a child’s right to learn in the least restrictive environment. Common modifications can include but are not limited to tailoring home work assignments, increased communication between home and school, providing a more structured learning environment, reducing distractions for the student, simplifying instructions, modifying test delivery, adjustment of medication for maximum results, the use of tape recorders, computer aided instruction, reduction of copying tasks, and allowing more time for completion of tasks.
Both federal laws require a multi-disciplinary team to evaluate the child to determine which services may be appropriate for the ADD child. PARENTS ARE A CRITICAL PLAYER ON THIS TEAM. The parents must sign the plan outlined for their child and the plan should be reviewed by the evaluation team at least once a year for changes. These educational plans are working documents that should meet the needs of the individual child. Again, cooperation and communication between the medical community, school community, and parents are central to success.
Structuring The Home Component: Children with ADD can greatly benefit by strategies that are incorporated into their daily life at home. Parents can be a key in establishing routines, discipline, and positive coping skills. Consistent discipline for children with ADD is critical. Discipline should consist of a set of rules, but ones that bear immediate consequences. Rules should be phrased positively in terms of what the children should do. Children with ADD should be praised for small steps in the direction of good behavior and impulse control.
Children with ADD respond better to a structured environment that outlines a system of rewards for good behavior. The parents may want to try a behavior modification program where the child earns points for desired behaviors, rather than punishment for unacceptable behaviors. The parents should be careful to select only a few behaviors at one time. As the child’s behavior is shaped into acceptable responses, then additional behaviors and higher expectations can be added. Focusing on the positive rather than the negative can help the child develop a positive self esteem. Punishing a child is not as effective as using praise and rewards. It is critical for parents with a child who has ADD to help the child develop personal strengths.
The parents can also structure a home environment that will lead to success at the school level. A study area set away from distractions is needed. The parent should establish firm routines for homework and bed time, as well as medication times. Students with ADD need more external cues in developing routines. External cues such as checklists, planners, and a long-range calendar posted in a prominent place are helpful. These external cues will provide a sense of structure and organization.
Children with ADD are considered “high maintenance.” It is true that ADD children will need more help in traversing the road to successful adulthood. With the combined efforts of the school, medical community, and home front students can be successful in learning how to structure their time and prioritize what they have to do. As they grow older, they can accept more responsibility and learn from their experiences. The hard work of the child, coupled with the support of the home, school, and medical community will help the child to develop abilities and prepare for success as an adult. ADD can ADD up to SUCCESS!!!
WHERE TO SEEK HELP IF YOU SUSPECT YOUR CHILD HAS ADD
Many medical, behavioral, emotional, and academic problems can produce symptoms that look like the characteristics of ADD. A few examples are allergies, side effects of certain medication, depression, anxiety, and learning disabilities. A good place to start looking for help is your child’s physician and or school staff such as the school psychologist. He or she will know who is a specialist that deals with ADD in your community and can make a referral for you. Because of the number of other problems that can mimic ADD, it is critical that the team that evaluates your child has a good understanding of these “look a likes.” The team must be willing to work with you and your child. This team approach is best in helping the child and the families to seek the services and programs that lead to success. Bear in mind that even the best specialist may not be able to help every individual. If nothing seems to work or if problems arise during treatment, a good suggestion is to have the child reevaluated.