Since almost everybody has attention struggles sometimes, how do you tell if something is actually ADHD? People with ADHD experience symptoms more frequently than others and symptoms are more severe than for those without ADHD. ADHD does affect a considerable number of people -- approximately 7-8% of school aged children (over 4 million children) and 4-5 % of adults (over 8 million adults). What is the difference between those who actually have the medical condition known as ADHD and everybody else, who also show symptoms of the disorder from time to time?
A definition alone won’t tell you what the condition is or whether or not you have it. Only experts can do that. But the formal definition gives you an idea of what the experts look at when they decide whether you have ADHD. The technical definition of ADHD is that it is a neurodevelopmental, biological condition characterized by three hallmark symptoms: Inattention, Hyperactivity, Impulsivity. Each of these symptoms has a special meaning to ADHD experts. According to a well-recognized authority (the Diagnostic and Statistical Manual of Mental Disorders, DSM-IV), there are three subtypes of ADHD: ADHD, predominately inattentive type (formerly known as ADD), ADHD, predominately hyperactive type, ADHD, combined inattentive and hyperactive type.
If you are the predominantly inattentive type, you have may difficulty concentrating and be distractible, but perhaps you are not unusually restless or impulsive. A predominantly inattentive child is not likely to disrupt classrooms; he or she does have a tendency to be easily distracted, make careless errors, fail to complete tasks, and avoid activities that ask them to put in sustained mental work. About 30% of those with ADHD are of the predominantly inattentive type. If you are the predominately hyperactive type, then impulsiveness is the main problem. You may not have trouble with attention. About 10-20% of those with ADHD are the hyperactive-impulsive type. The most common type of ADHD, though, is a combined inattentive and hyperactive type. It is not uncommon for the person with the combined type of ADHD to display all the indicators of ADHD – inattention, distractibility, hyperactivity, and impulsivity. Fifty to sixty percent of those with ADHD are the combined type.
There are several conditions that often coexist with ADHD:
Depression: Kids with ADHD may struggle to perform “to their potential”. In school, they may prepare well for a test, think that they have happily answered the questions properly, and find out later that they did not put the answers into the right places in a few instances. Regardless of how hard these students try, often other people suggest they are unmotivated or lazy. They may be bright but not be doing well in school or at work. That can be discouraging.
Anxiety: A few times of failing at tasks without knowing the reason why can lead to anxiety the next time she takes a test. This is especially true when a child has to face consequences from parents or teachers when they fail.
Learning Differences: Many learning disorders occur independently. However, learning difficulties such as reading or language difficulties, slower processing speed, and other learning disabilities often co-occur with ADHD. Learning disabilities can also result in many of the traits associated with ADHD, but aren’t ADHD. For example, if a child has an emotional disturbance, the person may be impulsive and may get into fights at school. The source of the behavior, though, is the emotional imbalance, not ADHD. If a person has reading difficulty, it may look like the student has difficulty focusing on reading assignments but it is due to the reading weakness and not an attentional problem.
Sleep Disorders: If you are not performing well, you become anxious. Maybe you stay up late doing homework trying to improve your performance. Perhaps you develop a sleep disorder, such as sleep apnea or restless leg syndrome.
How do you sort out from all these possibilities?
You could have all of the symptoms and yet not have ADHD. If you have none of the symptoms, you would think you surely do not have ADHD. The only way to tell if you have it is, first, to identify the symptoms, then rule out everything else that might be causing those symptoms. This cannot be done with any single test. It calls for a comprehensive assessment which should include:
A history of the person’s development, showing what conditions showed up when, what normal development took place
A medical history, indicating things that might have led to the problems such as perhaps even a brain injury or problems with sight or hearing
A psychological history showing whether the person has any emotionally based struggles
Review of performance in school beginning with kindergarten
Interviews with people who know the student, such as parents and teachers
Symptom checklists, like ADHD rating scales.
Testing by a neuropsychologist to see how brain systems are functioning (such as memory, language, learning, processing information, etc…), to assess general learning style and areas of strengths and weakness and to determine if any psychological problems exist. By comparing the child’s results with others his/her age (called a normative sample) you can determine if the student is one of the 8% with ADHD.
How can parents help children reach their full potential?
Always focus on your child’s strengths and be sure to start with the basics which can frequently be overlooked. In addition:
What we eat determines how effectively our brain operates. Poor diet alone can lead to distractibility impulsivity and restlessness and look like learning difficulties or ADHD when it is not. Consider adding the following to your child’s diet:
Start with good nutrition.
· Omega 3 Fatty Acids in the form of Fish Oil
· Vitamin C, ideally through food which is better than supplements. It helps modulate the synapse action of dopamine, a key neurotransmitter needed for treating ADHD.
· Always eat breakfast, ideally with protein
· Less carbohydrates – these create a heavy Glycemic load, which drives the release of insulin. Match carbohydrate intake with protein.
Be sure your child is exercising!
· This is particularly true if your child is hyperactivity
· Children should not miss recess to make up work. They need to be physical
· Daily regular exercise.
Make sure your child is sleeping enough.
· Most people with ADHD don’t get enough sleep.
· They prefer to stay up too late and sometimes have trouble quieting their mind.
· Various sleep disorders such as delayed sleep latency or sleep apnea may be associated with ADHD. You should consider a sleep study if your child does not feel refreshed in the morning.
Learn about meditation and mindfulness.
· Teach your child how to quiet the mind
· Consider doing yoga as a family
· Teach strategies to reduce the attention given to mental distractions
Teach your child social cues
- Children with learning difficulties also often have difficulty reading social cues.
- When children have great trouble noticing and interpreting cues, they may strike others as socially clumsy, may stand too close, or interrupt with seemingly rude observations or may appear uninterested in their peers. Their peers may reject them, and their parents may become frustrated or despairing at such behavior.
Help your child with homework
- Make sure homework is given to your child by his or her teacher in a form that both of you can understand and remember. What helps your child understand and remember information?
- Find out if your child’s school has a homework website, where you and your child can get useful information about current homework assignments.. Find out if the school has after-school homework help, or a “homework bunch.”
- Consider a homework log that goes between teachers and parents – make sure that all of you have the same information about what’s due, and how your child is doing.
- You and your child should agree upon a scheduled time for doing homework. Consider whether the child needs a break after getting home, and what’s an appropriate amount of time for the completion of homework. Is your child too busy? Make sure that after school activities aren’t intruding on your child’s ability to complete and learn from his or her academic work.
- Agree upon a place in the home that is specifically for homework. Make sure this place is free of distractions and conducive to concentration.
- Break homework into “bite size chunks.” Complete a small chunk, then earn a small reward (a short break, another installment of snack, another ten minutes of evening TV time, etc.).
Help your child with Time Management
- Some parents may have unrealistic expectations for their child.
- It may be useful to brainstorm a list of expectations, then “trim” the list to only what is absolutely essential (does the room always have to be picked up? Are music lessons really necessary? Is an “A” grade more important than getting enough sleep?).
- Explore how many of your priorities for your child can be transformed into specific routines, featuring a list of concrete goals and behaviors. Try to be as explicit as possible and keep your priorities lists as short and focused as possible. Examples include: Getting up, getting dressed, eating breakfast, getting out the door for the bus, Coming home, avoiding distractions, doing homework, Preparing for dinner, sitting down, eating, being excused from the table, and preparing for bed, going to bed, turning out the light
Planning Ahead, Allowing Time
Many children with learning differences need a great deal of “hands on” help staying on task, no matter how specific their routine is. In order to be available to your child, and help him or her to get things done, you may need to significantly revise your own plans and schedule. Here are some examples of plans for getting up and getting ready for the school day:
- Parent(s) and child post a list of essential “prep steps” that have to be accomplished before leaving for school: brush teeth, get dressed, brush hair, eat breakfast, etc. These can be as specific as necessary.
- Parent works with child the night before to make sure all homework is completed, and in back-pack which should be kept near the door.
- Parent helps child set out complete set of clothing for the next morning.
- Parent gets child up, and stays in room as child begins “prep steps.”
- Parent stays with child, or checks in with child as often as necessary (every five minutes?), to make sure child is progressing.
Strategies to help children with ADHD stay on task.
Give child preferential seating close to the center of instruction and near appropriate role models to reduce distractibility. Have child work with a partner, or sit at a “distraction free” desk.
Establishing agreed upon “pay attention!” cue with the student. Perhaps a private signal, such as a tap on the shoulder, or a “secret word” that could be used to redirect attention if students mind appears to be wandering.
Encourage frequent exercise breaks Assign tasks such as passing out papers, collecting material, or delivering papers to the office to provide him/her with an outlet for restlessness. Students should be allowed to stand up and stretch, walk to the back of the room, or even visit the rest room a certain number of times per day, or pace in the back of the classroom if necessary.
Alert the class when important instructions and information are about to be presented. Provide opportunities to repeat back important information to be sure that he/she has attended to and accurately taken in the information.
Emphasize positive feedback and reinforcement to help with compliance, task completion, and staying on task. Give feedback about errors or difficulties sparingly, and in a calm, neutral tone. Make sure instructions about how to correct or proceed differently are explicit.
Kids with ADHD learns by doing. Engage him/her in hands-on learning and activities. Multi-modality messages: show and talk about something, touch the materials, etc.
Make adjustments in child’s academic workload and reduce lengthy tasks into more manageable units. For example, a specified work time could be divided into shorter segments with specific expectations for appropriate behavior and work production. Rewards could be given for successful and accurate work completion during particular segment. Work segments could be interspersed with short breaks so that students can vent excess energy and renew focus.
Kids with ADHD tend to rush through work. Encourage him/her to slow down, examine task parameters before responding, and check work for accuracy. The accuracy of work – rather than the speed – should be strongly and positively reinforced.
Help with planning, organizing, time management, and study skills whenever possible. Encouraging parents to do the same. Encourage parents to want to consider a study skills tutor.
List the steps and procedures for assignments done regularly (such as book reports) so that he/she can use the list like a recipe card. Teach him/her how to apply previously learned procedures to new or similar problems/situations.
Teach basic outlining techniques which will help him/her organize and integrate information that he/she is learning and/or presenting.
If possible train and supervise students in the use of an assignment notebook. This notebook should be initialed daily at school (by the teacher) and at home (by the parent) to make sure that my child has accurately recorded all assignments, has the materials needed to complete them, has completed the work, and has handed it in on time. Initiate frequent communication between home and school, with at least weekly notification of any missing or late assignments.
Allow extra time on tests and assignments to allow time to check his/her work for accuracy, organize his/her approach, and take brief breaks to help sustain optimal attention.
Varying teaching methods by including computer instruction, paired or small group instruction, incorporating hands-on and motor activities whenever possible, and using spiraling techniques that intersperse previously learned material with new material.
New information should be presented visually and verbally in outline format, should
Attentionally disordered children become bored very easily and lack the proper motivation to complete uninteresting tasks. Thus, it is often necessary to provide them with more than the usual feedback for performance and praise for a job well done. Teachers should consider providing relatively more feedback than would be the case for other children. When faced with a boring task, attempt to add a personal challenge to it in order to increase her motivation and, thus, improve attention.
When worksheets have been handed out, student might be required to “highlight” or underline the directions with a highlighter pen. Calling attention to the directions in this way may increase self-monitoring skills within this aspect of performance.
Consistently post homework assignments on a particular portion of the board. Give time to copy the assignments and ask questions.
Maintain a master list of all in-class and homework assignments for the student to check periodically. This master list can be posted in the room or kept in a file folder available for students.
Information should be periodically reintroduced in different contexts to help reinforce and generalize skills. Allow time at the beginning of the period to review previous knowledge in relationship to the present lesson. Similarly, allow time at the end of the period to summarize the lesson and encourage questions.
Before a long-range assignment is completed it could be organized into stages with projected dates of completion of each stage, and appropriate, "intermediate products" to be produced (books to be read, outline, 1st draft, etc.). Teachers could encourage this kind of planning and organization by helping to develop a calendar for intermediate products to be completed and to include efforts toward work on these shorter-term parts in the final grade.