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in Child & Care

ADHD: How Much Is Too Much?

17

Tips for parent and teachers for early identification of ADHD and how to handle it.

In the era of 3G and 4G, every parent feels that their children must be fast. But, as doctors we must not forget the disorder ADHD, which is being frequently observed in children.

ADHD (Attention Deficit Hyperactivity Disorder) is a disorder that is now increasingly recognised in children. If not identified early, It has the potential, to prove  disastrous for the future of an otherwise intelligent child.

How to identify children with ADHD

As per the DSM IV Criteria (UK), the following are the features that have to be present in the patient, before diagnosing ADHD:

Inattention: Six or more of the following present for at least six months and the child is maladaptive.

  • Fails to give attention to details or makes careless mistakes in school work or other activities
  • Has difficulty in sustaining attention in tasks or play
  • Doesn’t seem to listen when spoken to directly
  • Has difficulty in organising tasks and activities
  • Avoids/dislikes engaging in tasks that require sustained mental effort
  • Loses things needed for day-to-day activities
  • Easily distracted by extraneous stimuli
  • Forgetful in daily activities

Hyperactivity-impulsivity: Six or more of the following present for at least six months and is maladaptive.

  • Fidgets with hands or feet or squirms in seat
  • Runs about or climbs excessively when it is inappropriate
  • Has difficulty in playing or engaging in leisure activities quietly
  • Is ‘on the go’ or acts as if ‘driven by a motor’
  • Talks excessively

Impulsivity:

  • Blurts out answer before question is completed
  • Has difficulty in waiting for turn
  • Often interrupts or intrudes on others

Identifying ADHD is one thing but learning to handle such children both at home and school is a difficult and often frustrating exercise. Here are a few tips to make this a bit easier for parents and teachers.

Handling children with ADHD in school

  • Small class size
  • Keeping instructions simple and structured
  • Preferential front seating in class
  • Repetition of information
  • Use of instructions that incorporate both auditory and visual modality (Like signalling the start of a lesson with an aural case, such as an egg timer, a cowbell or a horn. We can use subsequent cues to show how much time remains in a lesson.)
  • List the activities of the lesson on the board
  • Before starting the lesson, tell students what they are going to learn and what your expectations are. Tell students what materials they will need.
  • Establish eye contact with any student who has ADD/ADHD
  • Avoid frequent change of classes and teachers
  • Structural coursework and classroom setting (explicitly organised, broken into steps that can be reinforced positively)
  • Allow a student with ADD/ADHD for frequent breaks
  • Try not to ask a student with ADD/ADHD to perform a task or answer a question publicly that might be too difficult
  • A touch on the shoulder of the child with ADHD or some other physical cue will help in sustaining attention
  • If an assignment is given, have three different students repeat it, then have the class say it in unison, and write it on the blackboard
  • Unlimited extended time-test
  • Limiting length of homework
  • Extra set of textbooks
  • Assignment notebooks to link teachers and parents
  • Buddy system: where every ADHD child is assigned another child in the class as his/her partner to supervise the class work and inform the child’s parents about the homework

Handling children with ADHD at home

  • Educate yourself about how ADHD affects school performance
  • Discuss with teachers/school about your child’s ADHD issues
  • Be available for regular discussion with teachers on your child’s progress
  • Check your child’s notebooks/diary every day for homework assignments and other communications from the school that
  • Make sure your child has a quiet, uncluttered place to do homework
  • There should be no distractions in the room. You cannot be doing something else while teaching your child
  • Breakdown assignments into smaller tasks
  • Have a regular time for homework and allow for frequent breaks
  • Reinforce study skills such as highlighting, making notes, and reading out loud
  • Praise your child for work done well and remember, ‘good’ is not necessarily the same as ‘perfect’
  • Check that completed homework and other materials are where they are supposed to be when your child leaves for school
  • Have a reward for good days or weeks at school
  • Focus on strengths of your child
  • Regularly praise your child for appropriate behaviour at school (positive reinforcement). This is better than negative reinforcement (where there is a reprimand for unacceptable behaviour).
  • Involve your paediatrician, the school counsellor and psychologist wherever necessary

Patience and perseverance is the key in handling children with ADHD. Do not blame them for something that isn’t in their control.

 

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