Parenting the ADD Child: Can't Do? Won't Do? Practical Strategies for Managing Behaviour Problems in Children with ADD and ADHD (3 page)

ADHD = inattention + impulsiveness + hyperactivity

Hyperactivi y

What first struck Harry's mother, comparing him to her other children, was
that as soon as he could walk he was always `on the go' - impossible to keep
up with. Now, at six, if he is not literally climbing the walls, he is never still,
whether fidgeting, tapping his fingers or feet, swinging his legs or just
wriggling. He is constantly up and down, usually doing several things at
once, and he can never settle at mealtimes.

Harry has ADHD - Attention Deficit Hyperactivity Disorder. The term
ADHD is sometimes used interchangeably with ADD, but strictly speaking
they are different, although related, disorders. In addition to the impulsiveness and short attention spans which characterise ADD, ADHD children are
hyperactive. However, the overall behavioural problems associated with the
two conditions are very similar. Parents of ADHD children will find my
parenting techniques extremely effective, even though throughout this book
I will refer to ADD.

Every ADD child is different

ADD children share some symptoms but not all. For instance, Molly lacks
concentration but isn't noisy; Jamie can play well with a jigsaw puzzle for
short periods but shouts the whole time; Harry is a fidget but can concentrate
on a game for hours; Simon can be still but seems in a dream world.

However, an ADD child is likely to show most if not all of the following
traits:

often fails to give close attention to details and makes careless
mistakes

• often has difficulty sustaining attention in what he or she is doing

• often seems not to listen when spoken to directly

• often seems not to follow through on instructions and fails to finish
tasks

often has difficulty in organising tasks and activities

• often avoids or tries to get out of doing tasks that require sustained
mental effort

often loses things

• is often distracted

is often forgetful in daily activities

• often fidgets with her hands or feet or squirms in his seat

• often leaves his seat in the classroom or in other situations where
staying seated is expected

• often runs about or climbs over things when this is inappropriate

• often has difficulty playing quietly

is often on the go or acts as if driven by a motor

• often talks non-stop

• often blurts out answers before questions have been completed

• often has difficulty waiting for her turn

• often interrupts or intrudes on others; butts into conversations or
games.

ADD is more common than many people might think. Researchers have
identified it in every nation and culture they have studied. In Britain, where
the diagnosis is still expanding, conservative estimates suggest that as many
as 5 in 100 children have it. Many studies estimate that between 2 and 9 per
cent of all school-age children worldwide have ADD. Boys with ADD
outnumber girls by 3 to 1.

What you need to know

• The behaviour patterns that typify ADD usually emerge between
the ages of three and five, although some children don't develop
them until late childhood or even early adolescence.

The condition can last into and through adulthood.

ADD children frequently experience problems making friends and
sustaining relationships. They often suffer from low self-esteem as a
consequence (see Step 4).

• Children with ADD need special parenting techniques with far
greater attention paid to consistency than other children (see
Chapter 7).

• There is no cure for ADD - although Ritalin and related drugs can
reduce some of the symptoms (dramatically in many cases).

No one knows for sure what causes ADD. There are a number of
different theories. The most likely causes lie in the brain,
specifically the actions of chemicals like Dopamine which have a
role in inhibiting impulsive behaviour and influencing the ability
to concentrate (see the article by R.A. Barkley listed on p.161 of
this book).

ADD is taken very seriously in the scientific and medical
communities. Every month research throws more light on our
understanding of it.

• Diagnosis of ADD is difficult. As yet there is no blood test or brain
scan to confirm the condition. All our lives would be simpler if
there were.

Help! This thing is crushing me!

Like all behavioural disorders, ADD is very complex. There will be
some similarities among ADD children but there may also be big
differences. The mix and the severity of symptoms vary widely.

A broken arm is a broken arm, but ADD can be more elusive. Your
child may behave really badly most of the time, then be a perfect
angel for that brief time when you are with the doctor or specialist.
This also hampers the process of diagnosis.

• The growing number of diagnoses of ADD does not mean the
condition is widely understood in society at large or even among
all professionals. Too many people still believe that ADD is a myth,
that it does not really exist as a condition. ADD children still risk
getting stuck with the labels 'bad' or 'naughty'. Their parents risk
getting labelled 'inadequate' or 'neglectful'. This labelling is
grossly unfair and can have terrible consequences (see Chapter 4).

Medication is regarded by many as the treatment of choice for
ADD. But medication often has only moderate success with the
associated behavioural problems. Alongside drug therapy,
behavioural training (such as the programme set out in this book) is increasingly seen as an essential companion to drug therapy (see
Chapters 2 and 3).

• Support groups for parents with a child with ADD and ADHD are
growing around the country. Many parents find them an essential
lifeline (see Step 12 and Appendix 3).

This book will not tell you all there is to know about ADD and its related
conditions like ADHD. It gives you as much background information as you
need to follow the programme, but no more than is strictly necessary. There
are many excellent books around which go further into the theories about
what is happening in ADD. Some you have probably read. My suggestions
for further reading are found on page 161.

Together we will get to grips with it

Let me congratulate you for setting out on what should be an exciting, if
arduous, journey. We are now emerging from the time when the professional
always knew best into an age when professionals and their clients can be
collaborators - sharing knowledge and insights along the way. I believe the
potential for this type of collaboration and mutual respect is especially
strong in areas like ADD. So welcome to the informal society of those
committed to finding better ways of helping children with this condition.

Read on to discover what this book offers you.

I have worked in the field of child and adolescent psychiatry for over ten
years. A large part of this time has been spent helping parents who have a
child with ADD. I am all too well aware of the frustrations and agonies they
experience. They come to see me worn to a frazzle by the behaviour of their
child, and they usually feel they are to blame. The children feel bad too. They
arrive feeling labelled as uncontrollable and naughty. They lack self-confidence and self-esteem.

Often the family as a whole is at crisis point, each member blaming the
others for creating the problem although each may secretly fear that it may
all be his or her fault.

Parents with ADD children are people searching for solutions. They are
desperately in need of support and understanding. The reason I have spent
the last ten years helping them and have written this book is that I know
things can change for them, and change rapidly.

Why you might need this book

Getting the right help for parenting an ADD child can be difficult. This is
certainly true of England, which I know best, but I suspect it applies in other
countries too. Medication is available but some doctors will not prescribe it.
Professional help aimed at giving you extra parenting techniques is scarce.
Getting the right help can be a lottery that depends on where you live.

Lottery of help with ADD

Hence this book. It will give you the know-how to make lasting changes in
your child's behaviour. In the pages that follow you will find solutions to the
behaviour problems common with ADD. The programme I offer you I have
christened ADDapt - ADD Alternative Parenting Techniques. You
could call it training, education or behaviour modification, but it all comes
down to special parenting techniques that will gradually and gently get your
child to behave in the way you want. You, as parents, are the best people to
help your ADD children change.

Why ADDapt will work for you

ADD children need different kinds of parenting - different, that is, from the
ways that come, so to speak, `naturally'. Parents need to know what works
best with very difficult children. This is where ADDapt comes in. For
example, ADDapt begins by making changes in the quality of the
relationship between you and your ADD child - which may have taken a
battering. As the programme progresses you will learn how to build his or
her self-esteem; how to praise and reward effectively; how to reduce
conflicts; how to tackle discipline issues, and so on.