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Neurology Now:
doi: 10.1097/01.NNN.0000453349.40272.99
Departments: The Waiting Room

Quick Tips: Back-to-School Advice for Parents of Children With ADHD

Stephens, Stephanie, MA

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To listen to Dr. Barkley discuss his advice for parents of children with ADHD, go to bit.ly/NN_ADHD_Barkley.

Has your child has been diagnosed with attention-deficit/hyperactivity disorder (ADHD)? These expert tips will help you better manage persistent patterns of inattention, hyperactivity, or impulsivity that can get in the way of your child's success.

BE OPTIMISTIC: “Worrying comes with the territory of being a parent,” says Lawrence Brown, MD, Fellow of the American Academy of Neurology, associate professor of neurology and pediatrics, and director of the pediatric neuropsychiatry program at The Children's Hospital of Philadelphia. “But children—even those with challenges such as ADHD—can develop their own ways of learning, solving life's problems, organizing, and prioritizing what needs to be done.”

KNOW FOR SURE: Confirming ADHD requires a comprehensive evaluation, including a complete history, behavioral checklists, and a neurologic examination, according to Dr. Brown. “If your child is diagnosed with ADHD, a multidisciplinary approach—psychological support, academic and behavioral intervention, and, where indicated, medication—can help improve symptoms and improve academic performance,” he says.

TRUST MEDICATION: Stimulant medications such as methylphenidate (brand names Concerta, Daytrana, Focalin, Metadate, Methylin, Quillivant, and Ritalin) and amphetamines (Adderall, Dexedrine, and Vyvanse) are approved by the U.S. Food and Drug Administration for use in patients age 6 years and older—Adderall for as young as 3 years.

“Stimulants are tolerated in 80 to 90 percent of all children,” says Dr. Brown. “When used properly and in conjunction with psychological support and academic intervention, these medications don't change children but allow them to be themselves and fulfill their potential.” Non-stimulant medications including guanfacine (Intuniv), atomoxetine (Strattera), and clonidine (Kapvay) may be prescribed when stimulants are ineffective or cause problems.

UNDERSTAND EXECUTIVE FUNCTIONS: ADHD is also known as executive function deficit disorder, according to Russell A. Barkley, PhD, clinical professor of psychiatry and pediatrics at the Medical University of South Carolina and author of the book Taking Charge of ADHD: The Complete Authoritative Guide for Parents.


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“The seven executive functions are self-awareness, self-restraint or inhibition, nonverbal working memory of mainly visual imagery (the mind's eye), verbal working memory of mainly self-speech (the mind's voice), self-regulation of emotions, self-motivation, and planning and problem-solving (mental play),” he says. “Remember to externalize, creating ‘scaffolding’ around children—external structures such as the following to compensate for inherent deficits in executive function.”

WATCH THE CLOCK: Children with ADHD often have difficulty keeping track of time, according to Dr. Barkley. To compensate, provide them with an external time reference such as a clock, Dr. Barkley suggests. “A cooking timer works as well, so they can see how much time has elapsed as they are working on homework or chores,” he says.

PAY NOW: “Create a reward system that provides prompt feedback,” says Dr. Barkley. “Make consequences external and immediate, as children with ADHD may have a difficult time grasping long-term goals with delayed consequences. Devise a point system, or use privileges like extra time before bed, for completing tasks.”

© 2014 American Academy of Neurology

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