ADHD Awareness Month: Tips and Support for Parents

Parenting children with Attention-Deficit/Hyperactivity Disorder, or ADHD, can be overwhelming and stressful for families and caregivers. To mark ADHD Awareness Month, we talked to an expert with tips and strategies for these families.

“Kiddos with ADHD respond best to predictable, consistent parenting and positive intervention strategies,” says Rosmary Ros-Demarize, PhD, a licensed clinical psychologist in the Division of Developmental-Behavioral Pediatrics at MUSC Children’s Health, who specializes in treating young children. Ros-Demarize’s research work focuses on examining the intersection between ADHD and autism, and she says the behavioral treatments are similar.

“Parent training and education are key for children who struggle with challenging behaviors such as difficulty listening, being overactive, and having extreme temper tantrums,” she says.

Here, she shares her expertise in diagnosing ADHD and supporting and disciplining children with this neurodivergent condition.

Q: What's involved in finding out if my child has ADHD?
Ros-Demarize: ADHD is prevalent and one of the more frequent referrals for mental health care. There is not a single test – not a blood test, brain imaging, or genetic test – that can determine if a person has ADHD. Instead, it requires a diagnostic evaluation by a mental health care professional or physician who gathers information using several tools, including symptom checklists and behavior rating scales.

The gold standard is to gather information from “reporters,” including parents and teachers, who rate how often behaviors related to ADHD are happening.

Q: Are there early signs of ADHD?
Ros-Demarize: We often see risk factors early on. Signs of ADHD as early as preschool include trouble paying attention or controlling impulsive behaviors, being overactive, and having difficulty sharing or staying seated during circle time.

Kids with ADHD are often highly distractible and shift from one activity to the next very quickly. Many of these behaviors can be typical for young children, so it’s important for parents and caregivers to notice:

• Frequency — how often during the day is the behavior occurring? Is it more than we would expect for their age?
• Duration – how long has this been going on, how long does the behavior last?
• Intensity – how severe is the behavior? Is it hindering your kiddo’s ability to get through the day, transition, or get along with others?

It’s also important to determine if there are safety concerns – such as running out of the home into the streets or jumping from tall furniture – which might prompt an early diagnosis.

Q: What types of therapy may help children with ADHD and their parents?
Ros-Demarize:
Medicine combined with behavioral therapy is the most effective form of treatment for ADHD. While ADHD medicine can minimize the impact of ADHD symptoms on your child’s life, behavioral therapies are extremely beneficial and a frontline approach for younger children. These can enhance the effectiveness of ADHD medicine and give kids tools to help them better control their behavior.

For parents and caregivers, behavioral parenting interventions are the number one approach to support kids struggling with disruptive behaviors. There are many behavioral parenting interventions and training programs.

Parent-Child Interactive Therapy, or PCIT, is a successful parent therapy we use at MUSC. During PCIT, the therapist works with parents and kids together. The parent plays and interacts with their child in one room while, in another room, the PCIT therapist coaches the parent on how to respond to challenging behaviors via a Bluetooth earpiece. The parent gets in-the-moment feedback – statements and tools – on how to respond to real-life behaviors. These types of therapies are also highly effective when delivered via telehealth.

Parents learn the best way to provide instruction and to set developmentally appropriate expectations. In real time, they learn how to apply positive behavior strategies.

These effective discipline methods help set a child up for success during daily life activities.

Q: Do you have advice for parents for helping their children within social settings?
Ros-Demarize:

● Model appropriate social behavior and provide opportunities for children to improve skills in social settings.
● Help facilitate social interactions without being overly directive and set appropriate goals.
● Give praise and positive attention for meeting goals.

Some kids might need an extra push, something more tangible than praise. Rewards work best if they’re immediate. Be concrete about what it takes to earn a reward during a social interaction. For instance, you could offer your child a reward if they keep their hands to themselves for a certain number of minutes, based on what is feasible for them.

Younger kids do best with daily and immediate rewards. Older children (ages 12 to teen) may be able to work for a weekly goal.

Q: What are some tips for parents struggling with their child’s behavior?
Ros-Demarize: Increase positive parenting strategies. Focus on praise, and provide lots of attention for behaviors you want to see. Ignore or take attention away from behaviors you don’t want to see.

Be predictable and consistent with boundaries so kids know exactly what to expect if they don’t honor a limit.

Q: How do I reward a child with ADHD for appropriate school behavior?
Ros-Demarize: I get asked this a lot. Set up a home-school communication system with the school, such as a daily report card or a visual that gives your child the chance to earn immediate rewards for meeting their goals – for instance, check marks or stickers.

When reinforcing goals, step away from anything vague, such as “behaving well” or “being good.” Try specifics such as “remaining in your seat, “keeping hands to yourself” and “completing assignments.”

Once your child is a teen, parents still play a big role, but their support shifts to support the teen’s own organizational skills. We coach parents on how to set their child up for success, including teaching teen students how to keep an agenda or organize a book bag.

Q: Do children outgrow ADHD?
Ros-Demarize: Parents often ask about me about the future and if ADHD is something their child will outgrow.

ADHD is a neurodevelopmental disorder thought to be a lifelong diagnosis. Difficulties and challenges caused by ADHD change with social and behavioral expectations over time. During the teen and early adult years, your child may have more difficulty with organizational skills or time management.

Source

CDC Information page: Attention-Deficit / Hyperactivity Disorder (ADHD)