Mom Questions ADD Medication

A combination of medical, behavioral, and educational therapies usually results in the best long-term outcome for children with ADD.
Q
I am a single parent and my child has been very disruptive in school and at home. The doctor has diagnosed him with having ADD and put him on medication. Can you please give other advice before I start with the medicine?
A
Attention Deficit Disorder (ADD) is an older term for a common problem. The newer term--Attention Deficit/Hyperactivity Disorder (ADHD)--describes problems with attention, hyperactivity, and impulsiveness. Children can have difficulty in one or more of these areas. The cause of attention disorders is still unknown; diagnosis and treatment remain controversial.

Initial concerns about behavior are usually raised by parents or teachers. Other medical, neurodevelopmental, psychiatric, or psychosocial conditions may be present with the same behavioral complaints. A pediatrician may use standard behavior checklists to help make the diagnosis. Often a complete evaluation by a team of professionals is performed. Several medications may be beneficial, but these won't work alone. Research has shown better long-term outcomes when treatment includes a combination of medical, behavioral, and educational therapies.

Disruptive behaviors are associated with ADHD and may respond to specific behavior modification therapy. Children may be frustrated by not being able to do things other children do, and act out to get attention. They may stubbornly refuse to do chores or school work because they are afraid of not being able to keep up with their classmates. Remember to praise your child for his efforts, especially when completing tasks or trying new activities.

Children with ADHD may also have low self-esteem. Parents and teachers can encourage participation in structured extra curricular activities (e.g. music, drama, sports, art) which may give the child an opportunity to demonstrate non-academic strengths or talents. This will build social skills and improve self-esteem.

Kids tend to do better with more structured environments both at school and at home. Your child's teacher should be involved in the diagnosis and treatment. Try to keep daily routines consistent. Minimize distractions in the classroom and in the study space at home. Before giving any instructions, focus your child's attention and then divide tasks into small, more manageable pieces.

Keep in close contact with your child's doctor and school to achieve the maximum benefit from this approach in treatment.

Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.

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