Attention deficit hyperactivity disorder (ADHD) pervades all aspects of a child's life. ADHD behaviors make it difficult to build and maintain friendships, create obstacles to learning and cause dissension in the family. Different treatments are available to remediate ADHD but the key to success lies with dedicated parents and caregivers.
Definition
Combined ADHD means that the diagnostic symptoms are met for both hyperactive and inattentive subtypes. Combined ADHD is distinguished from typical misbehavior or a difficult developmental stage by several criteria. Symptoms must be present before the age of seven and be noticeable for at least six months. The behaviors must be more severe and occur more frequently than what would be expected in typical peers. The hyperactivity and inattentiveness must significantly impact the child's ability to function in more than one environment. If the behaviors are seen at school but not at home, then they might be caused by a learning disability. If they only appear at home then there might be other issues causing stress at home that aren't related to ADHD. Sorting through all the potential issues requires a professional psychological evaluation.
Medical Treatment
Medications are often the first line of treatment because many children need help getting their symptoms under control. Stimulant medications such as Ritalin and Adderall are used to improve concentration. Despite being "stimulants," the National Institutes of Mental Health states that they often have a calming effect. The most common side effects---difficulty getting to sleep, anxiety and reduced appetite---usually disappear as the body adjusts to the medication. Stimulants carry a slight risk of serious psychiatric side effects such as personality changes or hallucinations. These need immediate medical attention.
Therapeutic Treatment
Therapy is used to educate people about ADHD, provide strategies for managing behaviors and remediate interpersonal problems that may have developed. Parent training is often necessary because standard discipline methods usually don't work well. Sometimes a negative cycle of repeated bad behavior and punishment has become deeply ingrained and a new technique is needed to break it.
Behavior modification targets a specific behavior then uses rewards (and punishments) to replace the undesired behavior with the desired one. Parents need to be committed to the goals and objectives for behavior modification to be successful.
Cognitive behavioral therapy is a structured program that uses workbooks and assignments to guide the child through the process of recognizing negative thoughts, inaccurate perceptions and their related behaviors. The goal is to help them gain a better understanding so that they can learn effective ways to manage the behavior. This therapy is successful but it requires a child who is capable of introspection.
Neurofeedback
Preliminary studies indicate promising possibilities for neurofeedback. Researchers have found that the brain waves of children with ADHD operate in a different range than those of typical children when they're engaged in a task that requires concentration. Neurofeedback uses computer games to train brainwaves to operate in a normal range. As the brain waves are normalized, ADHD symptoms improve.
Attention Training
Attention training uses computer programs that demand sustained attention and thoughtful response. Tasks start out easy; for example, the space bar may need to be tapped every time a bird appears on the screen. But over time the tasks become more difficult and employ problem-solving skills and working memory.
Lifestyle
A balanced diet, enough exercise, structure and help with organization will provide much-needed support. Talk to teachers about accommodations to enable a positive educational experience. Above all, keep your focus on the positive rather than the negative.
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