Q: My child was diagnosed with ADHD over the summer. How can I help him succeed in school this year?
A: A significant number of children and adolescents will return to their classrooms this fall with a diagnosis of Attention-Deficit Hyperactivity Disorder (ADHD). A chronic disorder characterized by developmentally inappropriate and impairing levels of inattention, impulsivity, and hyperactivity, ADHD is one of the most common chronic conditions of childhood.
As the school year proceeds, many parents will need to face the challenges and common misconceptions associated with this disorder. To better support and advocate for their children, parents should understand the nature of ADHD, its potential effects, and recommendations for effective treatment.
Media reports often inaccurately portray ADHD as a myth or downplay its significance. Students and parents are likely to encounter individuals at school or in their communities who will question the legitimacy and impact of the diagnosis. ADHD is a real disorder with the potential for very serious negative outcomes. The American Medical Association, American Academy of Pediatrics, American Psychiatric Association, American Psychological Association, and the U.S. Surgeon General all recognize ADHD as a valid disorder.
In addition, recent research indicates that attention deficits and impulsivity can create a variety of problems for students. For example, children and adolescents with ADHD are at higher risk for academic underachievement, repeating grades, and being suspended and/or dropping out. These children may also struggle with poor social relationships, substance dependence and abuse, and other psychiatric and health problems, including accidental injuries.
Effective treatment is critical to help students either avoid or deal with these problems.
Experts in the field are reporting increasing scientific support for the use of medication, behavioral strategies, or a combination of the two treatments. Stimulants (e.g., Ritalin, Concerta, Adderall) are the most commonly prescribed medications and, for most children, appear to be effective in reducing core ADHD symptoms. Behavioral strategies such as positive reinforcement, star charts, daily report cards, and time-out periods have also been found to be effective treatments.
A combination of medication management and behavioral strategies, however, has produced some of the best improvement for children, especially in regard to academic outcomes. Even so, behavioral treatments are often overlooked. This is unfortunate because many children may not respond well to medication or may experience unwanted side effects.
Determining the effectiveness of medication and/or behavioral strategies should involve more than the subjective impression of one person. Several adults should objectively determine whether or not treatment is effective. Parents should establish a collaborative partnership with school staff, such as a teacher and school psychologist, to more effectively monitor academic and/or behavioral changes as well as potential adverse medication effects.
This parent/professional team might choose to measure a single behavior (e.g., out-of-seat behavior) that is recorded each time it is observed during class. Alternatively, they may rate the severity of multiple symptoms each week using behavior-rating scales when assessing stimulant side effects.
Parents will need to work with school staff to decide what and how behaviors will be measured. Effective treatment is dependent upon accurate, repeated measurements.
Information collected by teachers and parents can be shared with a child’s doctor to help in medication management. In addition, open communication with the child’s teacher is also likely to ensure the success of behavioral treatments at home and school. If goals are not being met, the child’s doctor may reevaluate the original diagnosis, consider alternative treatments, and/or examine the potential for other coexisting conditions.
With adequate adherence to and management of effective treatments, children and adolescents with ADHD can succeed in school and at home.
Dr. Heick is a behavior analyst with May Institute. He can be contacted at 413-734-0300 x247, or at email@example.com
May Institute is a national nonprofit organization that provides educational, rehabilitative, and behavioral healthcare services to individuals with autism and other developmental disabilities, brain injury, mental illness, and other behavioral healthcare needs. May Institute operates six schools for children and adolescents with autism and other developmental disabilities. For more information, call 800-778-7601, or visit www.mayinstitute.org.