Caring for Kids…at Billings Clinic

ADHD Part 1

Attention Deficit Hyperactivity Disorder is a behavioral disorder that has been recognized for decades but often there is a lot of confusion and misinformation about this surprisingly common disorder.  Lots of kids are high energy, hyper and disorganized at times.  How do you tell if your child has symptoms more concerning for ADHD?

There are 3 types of ADHD:

1 Primarily inattention

2. Primarily hyperactive

3. A combination of both (the most common type)

For kids with inattention they struggle to focus on everyday activities.  This behavior can lead to careless mistakes and forgetfulness in daily activities.  These children often can’t follow complicated commands (put your clothes in the laundry, find your shoes, and put on your coat – they come back with 3 hot wheel cars and nothing else done).   Parents and teachers find themselves giving only simple commands one task at a time.  Tasks are started but often not completed.  Homework or school assignments start out looking great but by the end of the page it’s either not done or nearly unreadable.  Or homework is finished but then never turned in to the teacher.  These children often miss recess or other fun things to stay and complete assignments everyone else completed during class.  Or they bring home massive amounts of homework, but most of it should have been completed in class.  And now the parents struggle at home to keep their attention long enough to complete the homework.  Sometimes these kids are incorrectly labeled as “daydreamers.”  Yet when participating in activities they are passionate about they can concentrate for hours.  These same children will play 3 hours of uninterrupted video games but can’t sit 10 minutes to do a math assignment.

The children who struggle with hyperactivity are high energy but to the extreme.  Always seem to be driven by an internal motor.  In class they fidget, get out of their seats, interrupt, can’t wait their turn and are very disruptive to a classroom.  They have to sit near the teacher and can’t participate in group activities.  Other students soon get tired of the behavior and affected children can become socially isolated.  They can also be very impulsive, acting without thinking of consequences.

Most children have a combination of both types of ADHD.  In addition, children cannot be diagnosed with ADHD unless the symptoms have been present for more than 6 months starting before the age of 7, the symptoms are present in multiple situations, and the symptoms are causing problems with academic success.

So if the above sounds familiar what can you do? First, be in close contact with teachers. They are a great resource for ideas and strategies to help children succeed.  Parents and teachers need to work as a team to make sure children receive a consistent message.  These kids thrive with routine and always knowing what is expected of them.  Make chore charts, have a communication notebook that can be sent back and forth to school, place completed homework in the same place every time and let the teacher know where it can be found.  In school these children are often separated from other children, or allowed to work in separate areas where there is less distraction.  Using stress balls helps direct the excess energy and can keep kids sitting longer.  And of course getting plenty of sleep and proper nutrition is always important.

Worried that this is sounding too familiar? Stay tuned for next week where I will discuss the next steps you can take including medical treatment.

Kathryn Lysinger, MD

I am a part-time pediatrician and full-time mom of 5 year old Jacob and 3 year old Lauren. After several years away in the “big city” my husband Jeri and I are excited to be back home in Montana. When not working I love to travel, cook and can’t wait to get the entire family back on the slopes in my hometown Red Lodge, MT.

2 comments on “ADHD Part 1
  1. April Sanchez says:

    Hello, My 9 year old daughter suffers from severe ADHD we have tried everything including medication. Her biological father has fought me tooth and nail about medicating her. He even threatened to take me to court. I finally agreed I would stop medication if he wanted to let her stay with him and see if he could do better. Broke my heart as I was a single mom up until March this year when he decided he was ready to be a dad. Unfortunatly I don’t think she is doing better and she stays with me thursday through sunday. I have such a hard time. I have three other children 7, 2, and 11 months. The house is turned upside down as soon as she walks in the door. Everything depends on how she is acting. I pray that she comes home in a good mood for the sake of the entire household. Please help. Is there other ways besides medication. We have cut out sugar, gave her a stress ball, and I try to accommodate her in every way I can but it seems nothing I do matters. I will be following your posts.
    Sincerely, A concerned mom! Thank you

    • Kathryn Lysinger, MD says:

      April, I am so sorry you are going through such a difficult time. You are not alone; I see lots of families going through very similar problems. You might considered therapy for your daughter and possibly family counseling. It sounds like there are a lot of stressful things in your daughter’s life: struggling with school and dad newly involved in her life. As the oldest she might have the most trouble making a transition to a new living situation and not be able to express how she is feeling. A therapist, as a person outside the family, can act as a sounding board for fears and frustrations. And they can help create a plan so there are less of those times she disrupts the whole household. Secondly I would suggest helping dad become an active participant in your daughter’s treatment. Encourage him to go with you to doctor appointments. If you have concerns that she is having issues beyond just ADHD, testing by a psychologist may be helpful as well. They can screen for learning disorders, anxiety disorders, as well as confirming the diagnosis of ADHD. Have dad participate in this too. I think it would be helpful for him to see her in this classroom type setting and hearing about ADHD from someone other than you may also help you come together and decide what treatment is best for your daughter. Good Luck.

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