Children with AD/HD struggle with focus and control, but they—and the adults who love them—can master skills to create positive change.
“Creative,” “generous,” “fearless,” “a natural leader”—these are the words used to describe the positive traits of children with AD/HD in a recent skills training for parents at Texas Children’s. Everyone here is more used to hearing about the problems that come with AD/HD: impulsive actions, short attention spans and high energy—symptoms that may affect their child’s ability to learn or behave as expected socially or emotionally.
More than immaturity or a developmental delay, AD/HD is one of the most common disorders among children, occurring in approximately 8 percent to 10 percent of school-aged children and two to four times more often in boys than girls. It persists into adulthood in as many as 70 percent of cases.
Though the exact cause of AD/HD is not known, it is associated with the reduced executive functioning that occurs in the frontal lobe, the part of the brain that serves as the internal “manager” that organizes tasks and makes future plans.
First appearing in early childhood, AD/HD often is not discovered and diagnosed until children have been in school long enough for their behavior to stand out as different from their peers. The complaints that send a “red flag” about the condition may come from parents, teachers or other caregivers.
Sorting out the symptoms
“Children who are being evaluated for possible AD/HD should undergo comprehensive medical, developmental, educational and psychosocial evaluation,” says Dr. Kevin Krull, head of the Child Neuropsychology Program and associate director at Texas Children’s Learning Support Center for Child Psychology.
Depending on the symptoms, AD/HD is generally diagnosed as one of three types: inattentive, hyperactive-impulsive or a combination of inattentive and hyperactive-impulsive (the most common). Hyperactivity and impulsivity often appear by age 4 and peak at age 7 or 8. By the adolescent years, hyperactive symptoms are barely discernible, while impulsive symptoms usually remain a problem throughout life.
Children with the inattentive type of AD/HD usually are diagnosed at age 8 or 9, when the symptoms become noticeable. As with impulsivity, inattention often remains a life-long problem.
A plan for managing
The most common treatment for AD/HD is stimulant medications, which work by improving connections between brain synapses that may not be “communicating” effectively. According to Krull, “Approximately 70 percent, and perhaps as many as 90 percent, of children will respond to at least one stimulant without adverse effects if the dose is carefully tested and regulated.”
Another approach to managing AD/HD is behavior therapy, which appears most effective when parents are taught techniques for helping their child improve his or her behavior. Ideally, physicians, parents, family members and educators can work together to target improved behaviors in a child’s relationships, academic performance, rule-following and other areas. Studies suggest that the most effective treatments combine medication and behavior therapy.
Texas Children’s Learning Support Center’s intervention program for families of 7- to 12-year-olds with AD/HD is Family STARS (Skills Training for AD/HD Related Symptoms). It provides skills workshops for parents while simultaneously working with their children to improve reactions and routines.
