Worried your child has ADHD: first steps
If you think your child might have attention deficit hyperactivity disorder (ADHD), the first step is to visit your child’s GP or paediatrician.
If your child isn’t already seeing a paediatrician, the GP might refer your child to one or to a child psychologist or psychiatrist for further assessment and diagnosis.
If your child is diagnosed with ADHD, you and your health professional can work together to develop a management plan.
Managing attention deficit hyperactivity disorder (ADHD) in children is about first accepting that your child will behave in challenging ways. But you can work with health professionals to develop a behaviour management plan. A plan can make the behaviour easier to handle.
Developing a behaviour management plan for your child involves getting a balance between what you expect your child to do and what your child actually can do. It’s also about setting up a daily routine, rules and consequences for your child’s behaviour.
To get the balance right, a behaviour management plan might include:
- behaviour strategies, including strategies for the classroom, for good sleep and for healthy eating and physical activity
- support for any other learning, language, movement and emotional problems your child might have
The best plans are usually based on sound professional advice that takes into account what suits your child and family. Plans should also consider all aspects of your child’s life, including your child’s needs and responsibilities at home, at school and in other social settings.
Discussing your plan with your child’s family, carers, therapists and teachers will help everyone have realistic expectations of your child’s behaviour.
You can also let people know about useful ways to handle your child’s behaviour, as well as the things your child finds difficult. And if your child’s carers have to give your child medication, they’ll need to know how much to give and when.
When you work with health professionals, school teachers, other adults in your child’s life, and your family and friends, it can be easier for you and your child to keep to the plan.
Behaviour strategies for ADHD
Behaviour strategies focus on teaching your child the skills she needs to increase her cooperative behaviour and reduce her challenging behaviour.
You can start learning about and using these strategies even if you’re still waiting for an official diagnosis for your child.
Clear verbal instructions
Your child will find it easier to behave well if he has a good understanding of what you want him to do. Clear, easy-to-follow verbal instructions with demonstrations will help. You can help your child to follow verbal instructions by:
- keeping instructions clear and brief, with the shortest number of steps
- showing your child what to do – for example, ‘Please pick up the clothes from the floor and hang them up in the cupboard’
- keeping eye contact with your child
- asking your child to repeat instructions back to you to make sure he has understood.
All children find it easier to behave well if they’re not tired. You can stop your child from getting too tired by:
- providing healthy food options for longer-lasting energy and concentration
- building rest breaks into activities
- doing learning tasks like reading or homework, and then doing some physical exercise for a little while
- being ready with a few fun but low-key activities like picture or sticker books – your child can do these if she starts to get overexcited
- getting your child into good sleep habits, like getting to sleep and waking up at much the same time each day
- keeping screen time to a minimum during the day and making sure all electronic devices are switched off at least an hour before bed.
Regular, predictable routines
Routines help children feel safe and secure, which can encourage good behaviour. You can set up routines and handle changes by:
- talking to your child about his daily schedule. You can also ask teachers if they can keep a copy of the school schedule where your child can see it
- using lists, pictures of your child’s routines and/or timetables
- letting your child know in advance about changes – for example, ‘In five minutes, you’ll need to brush your teeth and get ready for bed’
- limiting the number of choices your child has to make – for example, instead of saying, ‘It’s time to get dressed. What do you want to wear?’, you could say, ‘It’s time to get dressed. Do you want the green t-shirt or the red one?’
Children with attention deficit hyperactivity disorder (ADHD) might need a bit of extra help learning to get along with other children. You can help your child develop social skills by:
- rewarding her for helpful behaviour like sharing and being gentle with others
- teaching her strategies to use if there’s a problem with another child – for example, walking away or talking to a teacher
- teaching her how to keep an eye on her own behaviour, using a short prompt like ‘Stop, think, do’.
Praise for positive behaviour
Praise, encouragement and rewards for positive behaviour will make this behaviour more likely to happen again. You could try:
- getting your child involved in activities where he’s likely to go well
- making a big deal when he does go well, even if it’s just a small success to start with – for example, ‘You finished that entire page of homework. You must feel so proud!’
- going over the highlights for your child at the end of each day. You can also talk through things he might have had trouble with.
In the classroom
You could talk with your child’s teacher about:
- dividing tasks into smaller chunks
- offering one-on-one help whenever possible
- giving your child a ‘buddy’ who can help her understand what to do
- planning the classroom so that children with special needs are seated near the front of the room and away from distractions
- making a visual checklist of tasks that need to be finished
- doing more difficult learning tasks in the mornings or after breaks
- allowing some extra time to finish tasks.
To get the support your child needs for any learning, language and physical problems at school, you might need to ‘speak up’ for your child. This could involve talking to your child’s classroom teacher, the principal, the special needs support officer or teacher and others about special programs, funding and other help for your child.
Schools can help by setting out these support plans in your child’s individual learning plan. The school should also work with you to set and review your child’s goals in regular support group meetings.
Doctors will sometimes prescribe stimulant medications for children diagnosed with ADHD. These medications improve the way the parts of the brain ‘talk’ to each other. This can help children with attention, self-regulation and sometimes language and motor skills.
Methylphenidate is the most commonly used medication of this type. It’s sold under the brand name medications Ritalin, Ritalin LA and Concerta. These different medications release the methylphenidate at different rates and different times of the day.
Other stimulant medications are dexamphetamine or lisdexamfetamine. Dexamphetamine is sold under the brand name Dexedrine. Lisdexamfetamine is sold under the brand name Vyvanse.
Your child’s paediatrician or psychiatrist will be able to work out which drug and dose will be right for your child.
Here are a few questions you might want to ask your doctor:
- What are the side effects of the medication?
- How long do side effects last?
- How can these be monitored?
There’s also a non-stimulant medication available for treating ADHD, called Strattera (atomoxetine). This medication might reduce anxiety too.
These medications can cause some side effects – for example, loss of appetite. This can affect your child’s weight gain or your child’s growth. Other side effects might include difficulty getting to sleep, tummy upsets or headaches.
Because of these possible side effects, a child who has been prescribed medication should always be closely monitored by a health professional.
Most side effects are mild and don’t last long. If there are side effects that don’t go away, your health professional might change the dose or timing of medication.
Treatments that are backed up by science are most likely to work, be worth your time, money and energy, and be safe for your child. If you’re interested in other ADHD treatments, it’s always a good idea to speak with a health professional.
When your child has ADHD: looking after yourself
Looking after yourself by asking for help and support is a big part of managing your child’s attention deficit hyperactivity disorder (ADHD). Here are some options for you to think about:
- Ask for help from family members and friends. If your child relates well to a particular family member, like an aunt or grandparent, that person might be able to go shopping with you, or spend some time with your child while you get some chores done.
- Speak to your child’s teacher about classroom behaviour strategies that you can try out at home.
- Go to a support group for parents of children with ADHD.
- Talk to your child’s health professional about any difficulties you’re having.
- Learn about stress and how you can handle it.