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Created September 2013; Revised September 2020
ADHD in Children
Presented by NAMI Main Line PA,
an affiliate of the National Alliance on Mental Illness
Please view the final slide for NAMI Main Line PA, contact information
and the link to the complete YouTube video of this PowerPoint with narration.
A six video series of this talk can be found at this YouTube
playlist: https://www.youtube.com/playlist?list=PLqHjin-
DJco7nc-Mnj96Mve-Q0wIHyKCm
History
Diagnosis
— Need 6 criteria in 2 different settings
Ex. School and home
— Onset before age 7
— Evidence of problems in daily living
— 2 basic varieties: inattentive and hyperactive
— Many ways to diagnose
Who How
Inattentive
sustained attention
listening
loosing things
boring tasks
Difficulties with
details
follow through
organization
distractions
remembering
Hyperactive
staying in your seat
quiet play
taking turns
blurting out answers
— Difficulties with
fidgeting
climbing
excessive talking
interrupting
“on the go” all the time
Over diagnosis
— Normal childhood behavior is diagnosed as illness
— Behavioral problems are diagnosed as illness
— Other conditions the can look like ADHD are
misdiagnosed as ADHD (anxiety, depression, mania)
— Provider inexperience
Under diagnosis
— “That’s just the way she is”
— Daydreaming doesn’t catch attention
— Chaos in the household due to parental or sibling
mental illness, divorce, or other difficulties can pull
attention away from a child with ADHD
— Shame
— Provider inexperience
Multiple diagnoses
Difficult aspects of ADHD
— Excessive talking
— Disturbs others (can’t sit still, hits)
— Inappropriate comments
— Doesn’t listen
— Lose things
— Homework difficulties
— 1-2 yrs delayed socially because don’t know how to
read social cues
— Engage in risky, impulsive behaviors
— Risk of MJ and alcohol use if ADHD is untreated
Parental stress
— Managing calls from the school about behavioral
problems
— Handling homework that takes a very long time to
complete
— Books, papers, hats, etc get lost
— Needing to repeat yourself
— Difficulties with social interactions
— What if the parent has ADD too?
Take-home message: Be patient
Positive aspects of ADHD
— Creativity
— Smart
— Spontaneous
— Works quickly
— Good at problem solving
— Emotional sensitivity
— Exuberance
Some famous people with ADHD
— Robin Williams
— Walt Disney
— John Lennon
— Russell White
— Greg Louganis
— Thomas Edison
— Dustin Hoffman
— Michael Phelps
— Leonardo da Vinci
— Albert Einstein
— Galileo
— Henry Winkler
— Henry Ford
— Jason Kidd
— Dwight D. Eisenhower
— Salvadore Dali
Myths vs facts
— Caused by poor parenting
¡ Biological and often genetic
— If 1 child has it, all of my children will
¡ Not all children in a family will have it
— ADHD is not a disability
¡ ADHD is recognized as a disability by ADA and IDEA
— Medication is the only treatment
¡ There are several treatment options
— Kids with ADHD want to behave badly
¡ Kids with ADHD cannot be consistent in their behaviors
The ADHD brain
ADHD treatment
— Get the ADHD brain “on line” with medications that
stimulate the brain
— Provide behavioral modifications via rewards that
stimulate the brain
— Teach family members and teachers how to work
with an ADHD brain to get the best results possible
Take-home message: The ADHD brain needs
to be stimulated
MTA study
— 14-month study with 500+ children ages 7-10
— 4 groups of children
- Medication
- Combo
- Behavioral therapy
-Usual community care
(2/3 received some meds)
— All 4 groups had a reduction of ADHD symptoms
— Significantly greater improvement in the medication
and combo groups with those in the medication
group doing a little bit better
Take-home message: Medication is the best
MTA follow-up
— 2 yrs after the end of the study
¡ Symptoms remained better than baseline in all groups
¡ There were no differences in symptoms between any of the
groups
Take-home message: It doesn’t matter what
you do, but do something
Risks of not treating
— Poor academic performance
— Low self-esteem
— Less emotional stability
— Less success in the future
— Physical injury
— Higher rates of substance abuse
Take-home message: Less chances of living to
their full potential
Medications
— Short acting and long acting
— 2 basic types
¡ Amphetamines (ex. Vyvance, Adderall)
¡ Methylphenidate (ex. Conterta, Methadate)
— Used less often
¡ Atomoxetine (Stratera)
¡ Alpha agonists (Clonidine, Guanfacine)
Behavior modifications
— Behavior breaks down when the demand placed on a
person exceeds their ability to complete the task
— Want your child to develop skills to master life
— Learned helplessness can be the result of not taking
the time to teach a child how to master life with an
ADHD brain
Take-home message: Pills don’t teach skills
What you as a parent can do
— Pick 2 or 3 key areas to address
— Discuss these with your child and set clear
boundaries with clear consequences
— Remain neutral when there are violations and simply
institute the agreed upon consequences
— Maintain a loving relationship with your child
Take-home message: Clear consequences
delivered with neutrality
Tips and ideas
— Use a timer
— 1 instruction at a time
— Frequent praise (ratio of 3:1 at least)
— Charts to check off items
— Rewards to stimulate the brain
— Provide choices
— Give reminders and support
Take-home message: Be creative, be patient
Other points to keep in mind
— All looks normal on the outside - inside there are
things going on/not going on that we can't see
— Keep your cool. When there's a problem - no raised
voices, no pointing
— ADHD kids are very needy. Recognize that & adjust
to it but don’t judge
— Get help for yourself when you need it
Take-home message: Be patient and stay calm,
remember your love for your child
Resources - Books
— Raising Boys With ADHD: Secrets for Parenting Healthy,
Happy Sons by Mary Anne Richey and James Forgan
— The ADHD Workbook for Teens: Activities to Help You
Gain Motivation and Confidence (Instant Help Book for
Teens) by Lara Honos-Webb
— The Survival Guide for Kids with ADD or ADHD by John
F. Taylor Ph.D.
— Taking Charge of ADHD: A Complete Authoritative
Guide for Parents by R. Barkley
— 1-2-3 Magic Effective Discipline for Children 2-12 by
Thomas W. Phelan, Ph.D.
Resources – Web sites
— Children and Adults with ADHD www.chadd.org/
— Jim Forgan Ph.D. http://jimforgan.com/
— A magazine with tips for parents
http://www.additudemag.com/
Presented by NAMI Main Line PA
an affiliate of the National Alliance on Mental Illness
www.NAMIMainLinePA.org
info@NAMIMainLinePA.org
All information is current as of publication date; please let us know if you encounter broken hyperlinks.
A six video series of this talk can be found at this YouTube
playlist: https://www.youtube.com/playlist?list=PLqHjin-
DJco7nc-Mnj96Mve-Q0wIHyKCm

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ADHD in Children

  • 1. Created September 2013; Revised September 2020 ADHD in Children Presented by NAMI Main Line PA, an affiliate of the National Alliance on Mental Illness Please view the final slide for NAMI Main Line PA, contact information and the link to the complete YouTube video of this PowerPoint with narration. A six video series of this talk can be found at this YouTube playlist: https://www.youtube.com/playlist?list=PLqHjin- DJco7nc-Mnj96Mve-Q0wIHyKCm
  • 3. Diagnosis — Need 6 criteria in 2 different settings Ex. School and home — Onset before age 7 — Evidence of problems in daily living — 2 basic varieties: inattentive and hyperactive — Many ways to diagnose Who How
  • 4. Inattentive sustained attention listening loosing things boring tasks Difficulties with details follow through organization distractions remembering
  • 5. Hyperactive staying in your seat quiet play taking turns blurting out answers — Difficulties with fidgeting climbing excessive talking interrupting “on the go” all the time
  • 6. Over diagnosis — Normal childhood behavior is diagnosed as illness — Behavioral problems are diagnosed as illness — Other conditions the can look like ADHD are misdiagnosed as ADHD (anxiety, depression, mania) — Provider inexperience
  • 7. Under diagnosis — “That’s just the way she is” — Daydreaming doesn’t catch attention — Chaos in the household due to parental or sibling mental illness, divorce, or other difficulties can pull attention away from a child with ADHD — Shame — Provider inexperience
  • 9. Difficult aspects of ADHD — Excessive talking — Disturbs others (can’t sit still, hits) — Inappropriate comments — Doesn’t listen — Lose things — Homework difficulties — 1-2 yrs delayed socially because don’t know how to read social cues — Engage in risky, impulsive behaviors — Risk of MJ and alcohol use if ADHD is untreated
  • 10.
  • 11. Parental stress — Managing calls from the school about behavioral problems — Handling homework that takes a very long time to complete — Books, papers, hats, etc get lost — Needing to repeat yourself — Difficulties with social interactions — What if the parent has ADD too? Take-home message: Be patient
  • 12. Positive aspects of ADHD — Creativity — Smart — Spontaneous — Works quickly — Good at problem solving — Emotional sensitivity — Exuberance
  • 13. Some famous people with ADHD — Robin Williams — Walt Disney — John Lennon — Russell White — Greg Louganis — Thomas Edison — Dustin Hoffman — Michael Phelps — Leonardo da Vinci — Albert Einstein — Galileo — Henry Winkler — Henry Ford — Jason Kidd — Dwight D. Eisenhower — Salvadore Dali
  • 14. Myths vs facts — Caused by poor parenting ¡ Biological and often genetic — If 1 child has it, all of my children will ¡ Not all children in a family will have it — ADHD is not a disability ¡ ADHD is recognized as a disability by ADA and IDEA — Medication is the only treatment ¡ There are several treatment options — Kids with ADHD want to behave badly ¡ Kids with ADHD cannot be consistent in their behaviors
  • 16. ADHD treatment — Get the ADHD brain “on line” with medications that stimulate the brain — Provide behavioral modifications via rewards that stimulate the brain — Teach family members and teachers how to work with an ADHD brain to get the best results possible Take-home message: The ADHD brain needs to be stimulated
  • 17. MTA study — 14-month study with 500+ children ages 7-10 — 4 groups of children - Medication - Combo - Behavioral therapy -Usual community care (2/3 received some meds) — All 4 groups had a reduction of ADHD symptoms — Significantly greater improvement in the medication and combo groups with those in the medication group doing a little bit better Take-home message: Medication is the best
  • 18. MTA follow-up — 2 yrs after the end of the study ¡ Symptoms remained better than baseline in all groups ¡ There were no differences in symptoms between any of the groups Take-home message: It doesn’t matter what you do, but do something
  • 19. Risks of not treating — Poor academic performance — Low self-esteem — Less emotional stability — Less success in the future — Physical injury — Higher rates of substance abuse Take-home message: Less chances of living to their full potential
  • 20. Medications — Short acting and long acting — 2 basic types ¡ Amphetamines (ex. Vyvance, Adderall) ¡ Methylphenidate (ex. Conterta, Methadate) — Used less often ¡ Atomoxetine (Stratera) ¡ Alpha agonists (Clonidine, Guanfacine)
  • 21. Behavior modifications — Behavior breaks down when the demand placed on a person exceeds their ability to complete the task — Want your child to develop skills to master life — Learned helplessness can be the result of not taking the time to teach a child how to master life with an ADHD brain Take-home message: Pills don’t teach skills
  • 22. What you as a parent can do — Pick 2 or 3 key areas to address — Discuss these with your child and set clear boundaries with clear consequences — Remain neutral when there are violations and simply institute the agreed upon consequences — Maintain a loving relationship with your child Take-home message: Clear consequences delivered with neutrality
  • 23. Tips and ideas — Use a timer — 1 instruction at a time — Frequent praise (ratio of 3:1 at least) — Charts to check off items — Rewards to stimulate the brain — Provide choices — Give reminders and support Take-home message: Be creative, be patient
  • 24. Other points to keep in mind — All looks normal on the outside - inside there are things going on/not going on that we can't see — Keep your cool. When there's a problem - no raised voices, no pointing — ADHD kids are very needy. Recognize that & adjust to it but don’t judge — Get help for yourself when you need it Take-home message: Be patient and stay calm, remember your love for your child
  • 25. Resources - Books — Raising Boys With ADHD: Secrets for Parenting Healthy, Happy Sons by Mary Anne Richey and James Forgan — The ADHD Workbook for Teens: Activities to Help You Gain Motivation and Confidence (Instant Help Book for Teens) by Lara Honos-Webb — The Survival Guide for Kids with ADD or ADHD by John F. Taylor Ph.D. — Taking Charge of ADHD: A Complete Authoritative Guide for Parents by R. Barkley — 1-2-3 Magic Effective Discipline for Children 2-12 by Thomas W. Phelan, Ph.D.
  • 26. Resources – Web sites — Children and Adults with ADHD www.chadd.org/ — Jim Forgan Ph.D. http://jimforgan.com/ — A magazine with tips for parents http://www.additudemag.com/
  • 27. Presented by NAMI Main Line PA an affiliate of the National Alliance on Mental Illness www.NAMIMainLinePA.org info@NAMIMainLinePA.org All information is current as of publication date; please let us know if you encounter broken hyperlinks. A six video series of this talk can be found at this YouTube playlist: https://www.youtube.com/playlist?list=PLqHjin- DJco7nc-Mnj96Mve-Q0wIHyKCm