The Link Between August Birthdays and A.D.H.D.

A new study raises questions about age, maturity and overdiagnosis.

By Anupam B. JenaMichael Barnett and Timothy J. Layton

The authors are health policy researchers.

CreditJackie Ferrentino

The rate of diagnosis of attention deficit hyperactivity disorder among children has nearly doubled in the past two decades. Rates of A.D.H.D. diagnoses also vary considerably across states, with nearly three times as many children getting the diagnosis in Kentucky (where one in five children are said to have the condition) as in Nevada. More than 5 percent of all children in the United States now take an A.D.H.D. medication. All this raises the question of whether the disease is being overdiagnosed.

Diagnosing A.D.H.D. is difficult. Unlike other childhood diseases — such as asthma, obesity and diabetes — the diagnosis of A.D.H.D. is inherently subjective and depends on the assessment of parents, school personnel and health care providers. For a child who is easily distracted, an assessment of normal, inattentive behavior by one could be a formal diagnosis of A.D.H.D. by another.

It turns out that although diagnosing A.D.H.D. requires a subjective interpretation of facts, the month in which a child is born can be a strong, objective predictor.

Most states have arbitrary cutoffs for kindergarten entry, with children who do not reach a given age by a certain date required to wait a year. In 18 states, children who will turn 5 before Sept. 1 can enter kindergarten in the year that they turn 5; children who will turn 5 after Sept. 1 must wait until the next year. So in states with Sept. 1 cutoffs, in any given class, August-born children will usually be the youngest and September-born children the oldest.

These arbitrary cutoffs have important implications for the diagnosis of A.D.H.D. In a study published in The New England Journal of Medicine, we found that among several hundred thousand children who were born between 2007 and 2009 and followed until 2016, rates of A.D.H.D. diagnosis and treatment were 34 percent higher among children born in August than among children born in September in states with a Sept. 1 school entry-age cutoff. No such difference was found among children in states with different cutoff dates. The effects were largest among boys.

We believe these findings reveal just how subjective the diagnosis of A.D.H.D. can be. In any given class, inattentive behavior among younger, August-born children may be perceived, in some instances, to reflect symptom of A.D.H.D., rather than the relative immaturity that is biologically determined and to be expected among children who are nearly one year younger than September-born classmates.

The stakes of additional, potentially inappropriate diagnoses are high, particularly when diagnoses are accompanied by medical treatment, which has side effects. In cases where A.D.H.D. is appropriately diagnosed, we know that behavioral and medical treatments can improve concentration and school performance and other outcomes. And in these instances, the harms of medical treatments are, on average, outweighed by the benefits. But when the disease is improperly diagnosed, the clinical harms and dollar costs of treatment may not be met with commensurate benefits.

Image
A second-grade classroom in Minneapolis.CreditTim Gruber for The New York Times

Unlike other diseases such as asthma and diabetes, whose diagnosis is more objective and is not based on peer-to-peer comparisons, the diagnosis of A.D.H.D. appears heavily influenced by how children behave in school relative to peers and how those differences in behavior are interpreted by school personnel, parents and ultimately, physicians. Indeed, some evidence suggests that teachers and other school personnel are more likely than physicians or parents to first suggest that a child may have A.D.H.D.

Our findings aren’t new, but they suggest a continuing problem. Several older studies, both within and outside the United States, analyze rates of A.D.H.D. diagnosis among children born just before versus just after school entry-age cutoffs, similar in design to our study. Nearly all of these studies suggest that younger children within a grade are more likely to be diagnosed with A.D.H.D. than older children in the same grade. One study found that the relative age of a child in a class strongly affects teachers’ assessments of whether a child demonstrates A.D.H.D. symptoms but does not affect parents’ assessments, which suggests that many diagnoses may stem from teachers’ perceptions of students that are based on a child’s age relative to peers.

Our study, which uses recent data, tells us that the problem still exists and that it’s not small. Despite growing awareness that A.D.H.D. may be overdiagnosed and the fact that the medications used to treat it have serious side effects, something as arbitrary as the month a child is born still has a meaningful impact on the likelihood that the child is determined to have the condition.

At a minimum, physicians who frequently diagnose A.D.H.D. in children should be aware of these findings. A simple mental “adjustment” for whether a child is born in August may be sufficient to help physicians reduce overdiagnosis.

School personnel and parents should also be aware of how simple cognitive biases can creep into how important clinical decisions are made. Both our and previous findings suggest that parents of children who are young for their grade could reasonably question whether the initiation of medical treatment for A.D.H.D. should be delayed.

In his 2008 book “Outliers,” Malcolm Gladwell describes the now well-known phenomenon that a disproportionate number of Canadian professional hockey players have birth dates in the beginning of the calendar year. This is explained by the Jan. 1 age eligibility cutoff for hockey programs in Canada, which leads to the oldest hockey players within an age-based division exceeding the age of the youngest players by nearly a year, conferring them a performance advantage. A similar phenomenon is true for A.D.H.D., where a child’s age relative to peers confers a markedly different rate of diagnosis and treatment, but the stakes are higher.

Anupam B. Jena is an associate professor at Harvard Medical School. Michael Barnett is an assistant professor at Harvard School of Public Health. Timothy J. Layton is an assistant professor at Harvard Medical School.

How Exercise Helps Reduce ADHD Symptoms

Health Central

iStock-541272034.jpg
Credit: iStock

According to a number of recent studies, exercise, especially if it’s aerobic, can reduce symptoms of attention deficit hyperactivity disorder (ADHD). Researchers are still working to identify the exact causes of ADHD, but it is generally thought to be caused by an imbalance of chemicals in the brain.

Scientists think that ADHD symptoms are caused by a deficiency in the chemicals norepinephrine and dopamine, which “play essential roles in thinking and attention,” according to the National Institute of Mental Health.

Stimulant medications are effective because they increase these chemicals, therefore reducing ADHD symptoms and increasing an individual’s ability to focus. Exercise increases dopamine, norepinephrine, and serotonin levels in the brain, which means exercise can have the same effect on the brain as stimulant medications.

In recent years, a number of studies have backed up the idea that exercise helps decrease ADHD symptoms.

study published in the Journal of Abnormal Child Psychology in 2015 looked specifically at the effects of aerobic exercise on children with ADHD. Children were enrolled in a before-school exercise program for 12 weeks. Parents and teachers provided ratings of ADHD symptoms, including inattentionhyperactivity, and impulsivity as well as ratings for oppositional behavior, moodiness, and social interactions. At the end of the trial, researchers noted reduced impairment at school and at home. Betsy Hoza, the lead researcher believes the study showed that before-school exercise could be a way of managing ADHD symptoms.

study published in Current Psychiatry Reports indicated that sustained exercise programs benefited children with ADHD, specifically by enhancing neural growth and development, and improving cognitive and behavioral functioning. Executive functioning skills, which are often difficult for people with ADHD, were found to improve after exercise.

Another study assigned some students to a nine-month after school physical activity program. Other students were placed on a waitlist as a control group. The researchers found that students who actively participated in the physical activity program had better results on cognitive performance and had better brain function on tasks requiring executive function skills.

Dr. John Ratey, M.D., the author of “Spark: The Revolutionary New Science of Exercise and the Brain,” has advocated for exercise as a supplemental treatment for ADHD. Dr. Ratey discussed the study with Medscape Medical News and reported there have also been research in Taiwan and China supporting exercise for children with ADHD.

The study from China also found that balance training might be of benefit. Dr. Ratey explains that exercise increases dopamine and norepinephrine levels, which in turn decrease ADHD symptoms. “It also raises serotonin and all these other factors in the brain that really make for a nice recipe for an exercise pill, if we had such a thing,” Dr. Ratey said.

Besides improving cognitive functioning and executive functioning skills, exercise helps by:

  • Decreasing restless energy
  • Lowering stress levels
  • Improving concentration

In the studies, researchers mostly used aerobic exercises, such as running, cycling, and using elliptical machines, because this type of activity is known to increase the neurotransmitters in the brain.

Yoga might also help. In a review of studies, yoga was found to be effective as a supplemental or alternative therapy, with similar results as biofeedback or relaxation training for those with ADHD.

One of the major differences between exercise and medication in treating and managing ADHD symptoms is that the benefits from exercise are short-lived. It is recommended that a person continues to exercise to maintain benefits, and unfortunately, it isn’t always possible to stop what you are doing every hour or two to engage in aerobic exercise. However, building exercise into your everyday routine at a time that works for you can help to keep you consistent.

Eileen Bailey is a freelance health writer. She is the author of What Went Right: Reframe Your Thinking for a Happier Now, Idiot’s Guide to Adult ADHD, Idiot’s Guide to Cognitive Behavioral TherapyEssential Guide to Overcoming Obsessive Love, and Essential Guide to Asperger’s Syndrome. She can be found on Twitter @eileenmbailey and on Facebook at eileenmbailey.

Published On: Sept 19, 2017

In Praise of ADHD

Photo

CreditSarah Mazzetti

Ten years ago, when my son Nicolai was 11, his doctor wanted to put him on medication for attention deficit hyperactivity disorder. “It would make him less wild,” I explained to my mother, who was then 85. “It would slow him down a bit.”

My mother grumbled. “Look around you,” she said in Yiddish. “Look how fast the world is changing. He doesn’t need to slow down. You need to speed up.”

It was a surprising recommendation from someone who had never learned to use a microwave. But recent research suggests she had a point: Some people with A.D.H.D. may be naturally suited to our turbocharged world.

Today the word “hyperactive” doesn’t just describe certain individuals; it also is a quality of our society. We are bombarded each day by four times the number of words we encountered daily when my mother was raising me. Even vacations are complicated — people today use, on average, 26 websites to plan one. Attitudes and habits are changing so fast that you can identify “generational” differences in people just a few years apart: Simply by analyzing daily cellphone communication patterns, researchers have been able to guess the age of someone under 60 to within about five years either way with 80 percent accuracy.

To thrive in this frenetic world, certain cognitive tendencies are useful: to embrace novelty, to absorb a wide variety of information, to generate new ideas. The possibility that such characteristics might be associated with A.D.H.D. was first examined in the 1990s. The educational psychologist Bonnie Cramond, for example, tested a group of children in Louisiana who had been determined to have A.D.H.D. and found that an astonishingly high number — 32 percent — did well enough to qualify for an elite creative scholars program in the Louisiana schools.

It is now possible to explain Professor Cramond’s results at the neural level. While there is no single brain structure or system responsible for A.D.H.D. (and some believe the term encompasses more than a single syndrome), one cause seems to be a disruption of the brain’s dopamine system. One consequence of that disruption is a lessening of what is called “cognitive inhibition.” The human brain has a system of filters to sort through all the possible associations, notions and urges that the brain generates, allowing only the most promising ones to pass into conscious awareness. That’s why if you are planning a trip to Europe, you think about flying there, but not swimming.

But odd and unlikely associations can be valuable. When such associations survive filtering, they can result in constructive ideas that wouldn’t otherwise have been thought of. For example, when researchers apply a technique known as transcranial stimulation to interfere with key structures in the filtering system, people become more imaginative and inventive, and more insightful as problem solvers.

Individuals with A.D.H.D. naturally have less stringent filters. This can make them more distractible but also more creative. Such individuals may also adapt well to frequent change and thus make for good explorers. Jews whose ancestors migrated north to Rome and Germany from what is now Israel and the Palestinian territories show a higher proportion of the A.D.H.D. gene variant than those Jews whose ancestors migrated a shorter distance south to Ethiopia and Yemen. In fact, scientists have found that the farther a group’s ancestors migrated, the higher the prevalence of the gene variant in that population.

Or consider the case of the Ariaal, a Kenyan tribe whose members through most of its history were wild-animal herders. A few decades ago, some of its members split off from the main group and became farmers.

Being a wild-animal herder is a good job if you are naturally restless; subsistence farming is a far tamer occupation. Recently, the anthropologist Dan Eisenberg and collaborators studied whether people with A.D.H.D. might thrive in the former lifestyle but suffer in the latter. They found that among the herders, those who possessed a gene that predisposed them to A.D.H.D. were, on average, better nourished. Among the farming Ariaal, the opposite was true: Those who lacked the genetic predisposition for A.D.H.D. were, on average, better nourished. Restlessness seemed to better suit a restless existence.

A.D.H.D. is termed a disorder, and in severe forms it can certainly disrupt a person’s life. But you might view a more moderate degree of A.D.H.D. as an asset in today’s turbulent and fast-changing world. My mother, now 95, long ago realized that speed is the essence of our era. Her intuition about Nicolai proved correct, and she has lived to watch her grandson thrive without taking the A.D.H.D. medication she was dead set against.

How Exercise Helps Reduce ADHD Symptoms

Healthcentral https://www.healthcentral.com/article/exercise-reduces-adhd-symptoms

iStock-541272034.jpg
Credit: iStock

According to a number of recent studies, exercise, especially if it’s aerobic, can reduce symptoms of attention deficit hyperactivity disorder (ADHD). Researchers are still working to identify the exact causes of ADHD, but it is generally thought to be caused by an imbalance of chemicals in the brain.

Scientists think that ADHD symptoms are caused by a deficiency in the chemicals norepinephrine and dopamine, which “play essential roles in thinking and attention,” according to the National Institute of Mental Health.

Stimulant medications are effective because they increase these chemicals, therefore reducing ADHD symptoms and increasing an individual’s ability to focus. Exercise increases dopamine, norepinephrine, and serotonin levels in the brain, which means exercise can have the same effect on the brain as stimulant medications.

In recent years, a number of studies have backed up the idea that exercise helps decrease ADHD symptoms.

study published in the Journal of Abnormal Child Psychology in 2015 looked specifically at the effects of aerobic exercise on children with ADHD. Children were enrolled in a before-school exercise program for 12 weeks. Parents and teachers provided ratings of ADHD symptoms, including inattentionhyperactivity, and impulsivity as well as ratings for oppositional behavior, moodiness, and social interactions. At the end of the trial, researchers noted reduced impairment at school and at home. Betsy Hoza, the lead researcher believes the study showed that before-school exercise could be a way of managing ADHD symptoms.

study published in Current Psychiatry Reports indicated that sustained exercise programs benefited children with ADHD, specifically by enhancing neural growth and development, and improving cognitive and behavioral functioning. Executive functioning skills, which are often difficult for people with ADHD, were found to improve after exercise.

Another study assigned some students to a nine-month after school physical activity program. Other students were placed on a waitlist as a control group. The researchers found that students who actively participated in the physical activity program had better results on cognitive performance and had better brain function on tasks requiring executive function skills.

Dr. John Ratey, M.D., the author of “Spark: The Revolutionary New Science of Exercise and the Brain,” has advocated for exercise as a supplemental treatment for ADHD. Dr. Ratey discussed the study with Medscape Medical News and reported there have also been research in Taiwan and China supporting exercise for children with ADHD.

The study from China also found that balance training might be of benefit. Dr. Ratey explains that exercise increases dopamine and norepinephrine levels, which in turn decrease ADHD symptoms. “It also raises serotonin and all these other factors in the brain that really make for a nice recipe for an exercise pill, if we had such a thing,” Dr. Ratey said.

Besides improving cognitive functioning and executive functioning skills, exercise helps by:

  • Decreasing restless energy
  • Lowering stress levels
  • Improving concentration

In the studies, researchers mostly used aerobic exercises, such as running, cycling, and using elliptical machines, because this type of activity is known to increase the neurotransmitters in the brain.

Yoga might also help. In a review of studies, yoga was found to be effective as a supplemental or alternative therapy, with similar results as biofeedback or relaxation training for those with ADHD.

One of the major differences between exercise and medication in treating and managing ADHD symptoms is that the benefits from exercise are short-lived. It is recommended that a person continues to exercise to maintain benefits, and unfortunately, it isn’t always possible to stop what you are doing every hour or two to engage in aerobic exercise. However, building exercise into your everyday routine at a time that works for you can help to keep you consistent.

Is Your Child with ADHD Misbehaving or Is it Sensory Overload?

HealthCentral

CJXviNAUMpbHGBW.jpg?1447253208
Credit: Thinkstock

The holiday season is approaching. That means, lights, music, parties, family gathering, shopping trips. All the excitement surrounding the holidays equates to sensory overload in many children. For children with ADHD, sensory overload can spell disaster.

Poor behavior vs. sensory overload

You might be aware that your child has a hard time focusing or becomes more hyperactive when in places where there is a lot of activity and stimulation. But overstimulation has been associated with a host of other behavioral issues. The North Shore Pediatric Therapy center explains that, due to sensory overload, children might show the following behaviors:

  • Irritability
  • Inability to focus on concentrate
  • Temper tantrums
  • Overly hyperactive
  • Overly impulsive
  • Moving from one activity to another
  • Shuts down and avoids interacting with others

Reactions to sensory overload are as varied as the children themselves. Some might act out, others might turn inward and shy away from any social interaction. When you start looking at your child’s challenging behaviors and seeing the frustration or pain behind them, you can look for solutions rather than becoming frustrated and upset yourself.

What causes sensory overload?

Children with ADHD are often hypersensitive – they have a difficult time processing some sensory experiences. Loud noises, bright lights and high levels of activity can commonly bring on sensory overload but there are many other stimuli that can cause problems. Your child might be alright if one or two high stimulus things are going on at one time but during the holidays these add up quickly, causing your child to become overwhelmed. The following are situations that might cause a child with hypersensitivities discomfort:

  • Loud noises, buzzing noises, banging noises, loud talking or environments with noise coming from multiple sources
  • Bright lights, flashing or blinking lights
  • High activity levels
  • Smells of certain foods, strong aromas or smells of multiple foods at once
  • Texture of certain foods
  • Being touched
  • People being too close or bumping into other people
  • The feel of certain clothing including rough textured clothing, clothing with tags or seams that irritate the skin

Thanksgiving, which traditionally kicks off our holiday season, can be the start of a month long “overstimulation” event.

Be proactive to help your child manage overstimulation

There are a number of ways you can help your child better manage overstimulation during the holiday season:

Talk about what to expect. Before heading to any holiday event, talk to your child about what to expect, including what time you will be arriving and what time you expect to leave. Let him or her know what will happen during the event.

Provide a safe, quiet area. Whether you are in your home or a relative’s home, look for an area your child can retreat to when things become overwhelming. (In your home it could be your child’s bedroom, in a relative’s house you could ask your host if there is an area you can set aside for your child.) You might want to pack a backpack with a few items from home your child can play with alone.

Bring along food you know your child will eat. If your child has food sensitivities, pack food you know he will like. Hunger can add to irritability and behavior issues.

Let friends and relatives know if your child doesn’t like being hugged. Some families are “huggers” and don’t understand when someone avoids their hug. They may see your child as being rude. Let them know in advance that his preference is to simply say hello.

Think about other triggers that might causes your child to feel overwhelmed. Coming up with ideas and solutions to make the holiday event more bearable for your child will help everyone have a better time.

For more information on sensory difficulties:

What is Sensory Processing?

Sensory Processing Disorder: Managing Sensory Issues in Children with ADHD During the Holidays

Eileen Bailey is a freelance health writer. She is the author of What Went Right: Reframe Your Thinking for a Happier Now, Idiot’s Guide to Adult ADHD, Idiot’s Guide to Cognitive Behavioral TherapyEssential Guide to Overcoming Obsessive Love, and Essential Guide to Asperger’s Syndrome. She can be found on Twitter @eileenmbailey and on Facebook at eileenmbailey.

Helping Children With ADHD Beat Boredom

HealthCentral

Child-feeling-bored-iStock-504429344
Credit: iStock

If you have children with ADHD you probably know that summer brings on a new set of problems. One is boredom. Children with ADHD tend to become bored quicker than those without ADHD. When boredom strikes, children with ADHD often act impulsively, make risky decisions or seek high-stimulus activities — and this can get them into trouble.

Why are children with ADHD more prone to boredom?

There have been a few studies looking at the correlation between ADHD traits and boredom. In the first study, researchers found that people who get bored easily are more likely to exhibit symptoms of ADHD, both in attention deficits and hyperactivity. The second study came up with similar results: those prone to boredom had increased symptoms of ADHD and depression as well as faring poorly on sustained-attention measures.

In the book Driven to Distraction by Edward M. Hallowell and John J. Ratey, the authors list 20 criteria for diagnosing ADHD. The seventh item is “an intolerance for boredom.” Dr. Daniel Amen, in his book Reclaim Your Brain, explains that some individuals with ADHD have low activity in their prefrontal cortex. These people might seek out high-stimulus, risky or engaging activities because these increase the activity in the brain and actually help them to calm down. They seek activities that will jolt their brain out of the lethargy it feels during times of boredom.  They physically have “intolerance to boredom.”

For many children with ADHD, the boredom of the long summer days can lead to misbehaviors, accidents or creative thinking. By preparing for and managing boredom you can help your child enjoy the summer months.

Tips for managing boredom in children with ADHD

Provide structure and routine. You might be tempted to forego the routine since they just ended a school year that was highly structured, but routine actually decreases chances of getting bored. Structure and planned activities give your child something to do.

Incorporate movement into every day. Children with ADHD need to get up and move around. Try to start each day with exercise, even if it is only for 10 or 15 minutes. This helps get your child’s brain ready for the day. If you notice your child getting bored, play some music and dance. If your child is spending most of the day at home, plan for active play at least once every two hours.

Use your child’s interests as the inspiration for activities. Try to plan for your child to spend time each day pursuing his passion. If your children are younger, think about the activities that grab and hold their interest. For older children, find camps, clubs or classes that further their knowledge about the topic or allow them to build skills.

Create a boredom-beating box. Fill a box with different types of items: art and craft supplies, musical instruments and fascinating books. Take out the box for limited times to help keep the items interesting. You might take it out at a certain time of day or save it for when your child appears to be bored.

Look for variety in activities. Summer is a great time to explore different things and some children haven’t any idea what they are interested in doing. Search out community activities or plan short trips that will give your children new and interesting experiences.

Go outside. It’s great to be active outdoors; however, even during quiet activities, such as reading or playing on a tablet or phone, being outdoors helps to reduce ADHD symptoms.

See more helpful articles:

20 Ideas to Keep Children With ADHD Busy During the Summer

Creating a Summer Schedule for Children With ADHD

Adults With ADHD: Following Through on Summer Projects

Is Your Child with ADHD Misbehaving or Is it Sensory Overload?

Healthcentral.com

CJXviNAUMpbHGBW.jpg?1447253208
Credit: Thinkstock

The holiday season is approaching. That means, lights, music, parties, family gathering, shopping trips. All the excitement surrounding the holidays equates to sensory overload in many children. For children with ADHD, sensory overload can spell disaster.

Poor behavior vs. sensory overload

You might be aware that your child has a hard time focusing or becomes more hyperactive when in places where there is a lot of activity and stimulation. But overstimulation has been associated with a host of other behavioral issues. The North Shore Pediatric Therapy center explains that, due to sensory overload, children might show the following behaviors:

  • Irritability
  • Inability to focus on concentrate
  • Temper tantrums
  • Overly hyperactive
  • Overly impulsive
  • Moving from one activity to another
  • Shuts down and avoids interacting with others

Reactions to sensory overload are as varied as the children themselves. Some might act out, others might turn inward and shy away from any social interaction. When you start looking at your child’s challenging behaviors and seeing the frustration or pain behind them, you can look for solutions rather than becoming frustrated and upset yourself.

What causes sensory overload?

Children with ADHD are often hypersensitive – they have a difficult time processing some sensory experiences. Loud noises, bright lights and high levels of activity can commonly bring on sensory overload but there are many other stimuli that can cause problems. Your child might be alright if one or two high stimulus things are going on at one time but during the holidays these add up quickly, causing your child to become overwhelmed. The following are situations that might cause a child with hypersensitivities discomfort:

  • Loud noises, buzzing noises, banging noises, loud talking or environments with noise coming from multiple sources
  • Bright lights, flashing or blinking lights
  • High activity levels
  • Smells of certain foods, strong aromas or smells of multiple foods at once
  • Texture of certain foods
  • Being touched
  • People being too close or bumping into other people
  • The feel of certain clothing including rough textured clothing, clothing with tags or seams that irritate the skin

Thanksgiving, which traditionally kicks off our holiday season, can be the start of a month long “overstimulation” event.

Be proactive to help your child manage overstimulation

There are a number of ways you can help your child better manage overstimulation during the holiday season:

Talk about what to expect. Before heading to any holiday event, talk to your child about what to expect, including what time you will be arriving and what time you expect to leave. Let him or her know what will happen during the event.

Provide a safe, quiet area. Whether you are in your home or a relative’s home, look for an area your child can retreat to when things become overwhelming. (In your home it could be your child’s bedroom, in a relative’s house you could ask your host if there is an area you can set aside for your child.) You might want to pack a backpack with a few items from home your child can play with alone.

Bring along food you know your child will eat. If your child has food sensitivities, pack food you know he will like. Hunger can add to irritability and behavior issues.

Let friends and relatives know if your child doesn’t like being hugged. Some families are “huggers” and don’t understand when someone avoids their hug. They may see your child as being rude. Let them know in advance that his preference is to simply say hello.

Think about other triggers that might causes your child to feel overwhelmed. Coming up with ideas and solutions to make the holiday event more bearable for your child will help everyone have a better time.

For more information on sensory difficulties:

What is Sensory Processing?

Sensory Processing Disorder: Managing Sensory Issues in Children with ADHD During the Holidays

Eileen Bailey is a freelance health writer. She is the author of What Went Right: Reframe Your Thinking for a Happier Now, Idiot’s Guide to Adult ADHD, Idiot’s Guide to Cognitive Behavioral TherapyEssential Guide to Overcoming Obsessive Love, and Essential Guide to Asperger’s Syndrome. She can be found on Twitter @eileenmbailey and on Facebook at eileenmbailey.

Things Parents Of Children With ADHD Wish Someone Had Told Them

HealthCentral

iStock-660743358.jpg
Credit: istock

Parenting a child with ADHD isn’t always easy. Because every child with ADHD is unique and comes with a different set of challenges, there isn’t a roadmap to tell you what to do. Every day, it seems, you are faced with a new set of trials to overcome. When you finally think you have control of one issue, a different one pops up.

The following are six things parents of children with ADHD wish that someone had told them when their child was diagnosed.

You are the expert and the advocate

When your child is diagnosed with a medical condition, you might expect doctors to understand how the condition impacts everyday life. But not every doctor understands ADHD.

Some doctors might diagnose based on a few questions, and some might suggest medication without a thorough evaluation. Some might not understand that ADHD is more than just the major symptoms. While doctors today are more knowledgeable about ADHD than 10 or 20 years ago, you as the parent still need to be the expert.

Read everything you can about ADHD and how symptoms manifest in children. Read the pros and cons of medication and other treatment methods. If your doctor can’t provide answers, ask for a referral to a specialist. As the parent of a child with ADHD, it isn’t enough to rely on others for answers — you need to seek them out.

Your child needs an advocate

Children with ADHD are often seen as lazy. They are frequently immature for their age, and they may need extra assistance or accommodations in school to help them succeed. Some children may need extra help navigating social situations.

When you have a child with ADHD, your job of parent extends to the role of advocate. You might need to regularly meet with teachers, attend IEP or Section 504 meetings, discuss treatments with doctors, explain your child’s behavior to classmates’ parents, and work to find social settings where your child feels comfortable. In each of these situations, you are the parent and the advocate. By acting as both, you can make sure your child has every chance of success.

You should be on the lookout for other conditions

ADHD rarely travels alone. Learning disabilitiesanxiety, and depression are common coexisting conditions.

Sometimes symptoms or challenges from these conditions overlap, and it is hard to know which condition is at the root of some behaviors. Your child has the best chance at success in life with an accurate diagnosis and treatment.

It’s worth your while to know the major symptoms of conditions that are associated with ADHD. That way, if you have a concern, you can immediately bring it to the attention of your child’s doctor or school and have it addressed.

Schools don’t always agree with your accommodation requests

To you, it might seem like common sense that your child needs extra time for tests, an aide to help him stay focused, that he not be denied recess to complete work, or any other accommodation you believe will help. But schools don’t always agree.

Meetings about ADHD accommodations can sometimes become contentious, and sometimes parents end up frustrated with the process. It helps to understand the laws regarding accommodations and commonly-used accommodations in other schools.

As a parent of a child with ADHD, you should become especially familiar with the laws governing IEPs and Section 504. It is going to be up to you to request evaluations and meetings, and to advocate for your child every step of the way.

Your child is going to be frustrating, but he is still just a child

There are going to be days when you are pretty sure your child is being purposely defiant. You might think, “she must have heard me and is clearly ignoring me,” or “he can’t possibly have forgotten to do that, he is being stubborn.” If your child has ADHD, he probably isn’t being defiant on purpose.

She probably isn’t “acting out to get your attention.” Your child isn’t trying to be ADHD. Your child has ADHD.

Children who are impulsiveforgetfuleasily distracted, and can’t sit still for very long have symptoms of ADHD.

As a parent, it’s your job to love your child anyway. It’s your job to remember that as frustrating as it can get, your child is still just a child. He or she still wants your acceptance. In one way, it isn’t any different than any other child; love is what your child needs most.

You should take time to celebrate your child

It’s easy to get caught up in the constant cycle of trying to improve your child’s behavior, improve grades, to get your child to listen when spoken to, and get along with siblings.

When you have a child with ADHD, there is always something that can be improved. But don’t forget to celebrate your child’s successes, no matter how small, and his or her unique way of looking at the world. Take the time to enjoy your child’s sense of humor, enthusiasm for life, endless curiosity, and boundless energy.

Emotional Regulation for Kids With ADHD

Edutopia

Six brain-based strategies to help kids with attention-deficit/hyperactivity disorder build confidence, engagement, and focus.

According to the Centers for Disease Control and Prevention, approximately 11 percent of children—that’s 6.4 million kids—in the United States ages 4–17 were reported by parents to have a diagnosis of attention-deficit/hyperactivity disorder as of 2011. Dr. Russell Barkley, clinical professor of psychiatry at the Medical University of South Carolina and an expert on ADHD, says that this disorder is primarily about emotional regulation and self-control and is not just about inattention, impulsivity, and hyperactivity. Emotional regulation, which is foundational to social, emotional, and academic success, is underdeveloped in these young people. Barkley emphasizes that ADHD arises from neurogenetic roots and is not a knowledge or intelligence disorder.

This year, I am working with the Indianapolis Public Schools and co-teaching in a fifth- and sixth-grade classroom. In class, I have students who are significantly challenged in terms of paying attention, focusing, and regulating their emotions. Each day I see how they struggle emotionally, socially, and academically, and observe how they can begin to wither away in deep feelings of self-doubt and uncertainty if they don’t have a sense of purpose and connection. Below are a few brain-aligned strategies that we’re implementing in the district. I have found that these strategies, which focus on the strengths and interests of these struggling students, can have a profoundly positive impact.

1. Whole Class Discussions: It’s very unsettling when students see another student struggle and do not understand why that student is struggling. At the beginning of the year or grading period—or simply when behaviors and learning as a class go awry—we have the opportunity to address the challenges and strengths of various learning and emotional disorders with the entire class. Invisible disabilities are often met with fear and anger from other students because of the unknown or a simple misunderstanding of their classmates’ emotional, social, or academic challenges. Just as some of us need glasses to see clearly or take insulin to regulate blood glucose levels, others need an oxygenated supply of movement, brain intervals, or space and time to regulate after a 10- to 20-minute instructional lesson. Holding class discussions about the neurodiversity of human brains helps all students to understand each other.

2. It Takes a Village: Bringing in adult community members who have experienced ADHD, anxiety, or other attentional challenges is a wonderful way for students to feel connected and hopeful about their future and plans for success. When I invited young adults who have been challenged with these disorders into our classroom, they shared their personal and professional journeys, which deepened the sense of community, understanding, and acceptance of all learning styles and challenges. A motto that needs to be embraced is: “Everyone gets what they need.”

3. I Noticed: Homemade “I Noticed” sheets are great tools for reinforcing all that is going well moment by moment even when you’ve had moments of adversity. Students who struggle with attention and focus need this constant feedback throughout the day to help them track how they are learning and to know that the teacher is present and aware. All students love homemade sheets—they show that the teacher has taken time and effort to help them feel and be successful.

4. Brain Stories: Children and adolescents who struggle to pay attention sometimes don’t feel accepted or successful in school. Yet, beneath many of the challenges of neurodiversity are facets of your students that are not always shared during content instruction—personal stories that highlight these students’ strengths, gifts, and feelings.

Psychiatrist Dan Seigel says, “What is shareable is bearable, and what you can name, you can tame.” A great way to recognize these students is to have them share “brain stories”—personal experiences, strengths, interests, and feelings. You can further engage them by giving them a choice as to whether they want to create their stories in narrative or picture form. Younger students may begin to showcase their lives through pictures and artwork; older students may want to add sections, revise current categories, and change the format as they see their life journeys unfolding. Brain stories can be created throughout the semester or academic year and posted on a weekly or monthly timeline.

Much like an Individualized Education Program, the brain story will accompany each student throughout his or her school years, though you can invite students to modify, rework, and share their stories over time.

5. Homework for the Teacher: One of the best brain-aligned strategies I have implemented with all ages is doing homework for them on the weekend. Each Friday, I select a couple of students who are in need of affirmation and who have struggled to meet a few of their goals. I usually know their interests and likes, and so I ask, “I have some time this weekend and would love to learn for you! What would you like for me to research this weekend? What would you like to know more about? I will bring my work to you on Monday!” The excitement, the feelings of connection are palpable, and each time, I see more effort from these students than I did the weeks prior to this invitation.

6. Chunking: Chunking or condensing assignments and instructional time with frequent feedback is an excellent way to build on small successes. Students diagnosed with attention challenges may require a smaller list of tasks to complete within a structured, shorter period of time. As an example, I’m working with a second-grade student diagnosed with ADHD and anxiety who was literally throwing tantrums and disrupting the class several times a day when he began feeling frustrated, overwhelmed, and unsuccessful. We have now chunked his assignments and written those on colored sticky notes. When he arrives in the morning, he has two assignments to complete that are clear and easy to accomplish. When he completes those two assignments, he is given a brain break for a few minutes and then moves on to the next task. We have seen amazing improvement with his ability to pay attention and to remain focused and inspired with these shortened assignments and tasks. We will continue to  build and lengthen these assignments over a period of time with the renewal of time spent on something he loves and enjoys.

Brain Intervals

Brain intervals have two purposes. They provide novelty and and increase interest when implemented after a student has worked on an assignment for a period of time. A young person’s attention span is limited, and following a period of direct instruction and independent work, students with ADHD need to step away with a brain interval that is interesting and engaging. Here are some ideas to support brain intervals:

  • Reading a favorite book/comic
  • Drawing or designing art for the classroom or main office
  • Computer time and/or watching motivational videos
  • Playing a brain-aligned video program such as Brain Pop

Relaxation Apps for Kids with ADHD

If your kid has ADHD or sensory processing issues, transitions, frustration, and situations with too much sensory input can be extra challenging. While doing things like practicing meditation can be really helpful, there’s no one-size-fits-all solution to finding relaxation: Little kids may need to build some skills to manage feelings, and older kids may need a more subtle path to serenity. Try some of these teaching tools, skill builders, movement apps, and tranquil games to ease anxieties and find stillness.

Browse Relaxation Apps for Kids with ADHD

Adorable monster de-stresses kids with Sesame Street style.
Devices: iPhone, iPod Touch, iPad, Android
(2013)
Simple yet beautiful emotional-regulation tool for kids.
Devices: iPhone, iPod Touch, iPad, Android
(2015)
Get kids moving and relaxing with warm video intro to yoga.
Devices: iPad
(2014)
Create and interact with mesmerizing natural landscape.
Devices: iPhone, iPod Touch, iPad, Android, Kindle Fire, Nook HD
(2014)
Release worries and embrace joys with anxiety-fighting tool.
Devices: iPhone, iPod Touch, iPad, Android
(2015)
Ingenious tool helps kids calm themselves down quickly.
Devices: iPhone, iPod Touch, iPad
(2012)
Fantastic app teaches emotions, coping strategies for kids.
Devices: iPhone, iPod Touch, iPad, Android
(2012)
Sim turns devices into potter’s wheel to teach craft.
Devices: iPad, Android, Kindle Fire
(2010)
Solid exercise guide with video, voice; adult must monitor.
Devices: iPhone, iPod Touch, iPad, Android
(2016)
Stop, breathe, reflect with easy intro to guided meditation.
Devices: iPhone, iPod Touch, iPad
(2016)
A meditative musical journey through a lush neon wonderland.
Devices: iPhone, iPod Touch, iPad, Android, Fire phone, Kindle Fire
(2016)
Appealing tool guides meditation and promotes compassion.
Devices: iPhone, iPod Touch, iPad, Android
(2014)
Great tool for managing varied daily sensory activities.