What to tell parents of hyperactive children

Attention-deficit/hyperactivity disorder is among the most common neurodevelopmental disorders diagnosed in children, and parents often have concerns about the best way to help their child.

Primary care physicians can help parents understand and remember that ADHD can be successfully managed through behavioral training, for both the child and parents, and medication. The American Academy of Pediatrics (AAP) recommends that health care professionals also be aware of psychological resources available in the community, and be prepared to refer children, particularly young children in preschool, for behavior therapy.

“Children with ADHD have behavior problems that are so frequent and severe they interfere with their ability to function adequately on a daily basis,” Mark Wolraich, MD, FAAP, of the AAP, said in a statement detailing advice for parents who have hyperactive children. “… But once a diagnosis is confirmed, ADHD treatments are available to help them control their behaviors.”

The AAP recommends physicians prescribe behavior therapy as the first line of treatment for children aged 4 to 5 years with ADHD. According to the CDC, behavior management training for parents, in which they learn the skills needed to help and guide their children, has the most evidence of being effective.

For children aged 6 years and older, the AAP recommends a combination of behavior therapy and medication, with close monitoring to determine if the treatment is helping the child.

Physicians can refer parents with children who have ADHD to several resources to assist them, including the CDC-funded National Resource Center on ADHD, which offers information and advice. The National Resource Center on ADHD is a program of Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD), which provides educational programs. In addition, physicians can alert parents of special services and accommodations at schools available to them under the Individuals with Disabilities in Education Act (IDEA), and the anti-discrimination law known as Section 504. According to the CDC, physicians can have a key role in working with schools to ensure their patients are getting the services they need.

The CDC and AAP have offered additional tips that physicians should consider telling parents of children with ADHD:

Try to follow the same schedule each day, creating a set routine;
Stay organized by encouraging children to place items back in the same place every day after using them, so they are not lost;
Limit distractions by turning off the television, reducing noise and providing a clean, uncluttered space in which to complete homework;
Limit choices, such as what to eat and wear, to avoid overwhelming or overstimulating the child;
Speak clearly and specifically, reassuring the child you are listening to what they are saying;
Help them break down complicated tasks into small, more manageable goals in order to limit stress;
Set goals for positive behaviors and reward them for meeting those goals;
When disciplining them, use timeouts rather than spanking or yelling;
Find out and encourage them to peruse what their child does well; and
Eat nutritious food and get plenty of exercise.

Additional information:

https://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Documents/AAP_ADHD_2011.pdf

http://www.cdc.gov/ncbddd/adhd/treatment.html

http://www.cdc.gov/ncbddd/adhd/facts.html