Managing ADHD in your child

If your child is diagnosed with ADHD, figuring out how to manage it can be overwhelming. Medications may be a part of the plan, but there are many other things you can try too.

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This article gives an overview of ADHD management, along with some practical tips and resources for parents who are navigating this journey with their children. If you’d like to read an overview of what ADHD is (and how we diagnose it, check out this article).

Take it seriously

Many parents express reluctance about getting testing/evaluation for ADHD because they fear the label, or they fear it means their child will end up on medication.

Remember: you are part of the treatment team, and you can impact messaging your child receives. And at the end of the day, your goal is always to set your child up for success and to help them enjoy learning.

Part of the fear of treatment stems from the fact that people think that medications are the only effective treatment for ADHD. This is not true! Although many of the medications can be tremendously effective, there are many evidence-based behavioral modifications and interventions that can be impactful as well, especially for younger children.

Children under 4y

We do not diagnose ADHD in this age group, because there is considerable overlap between the symptoms of ADHD and normal toddler behavior. 

Preschoolers (4-5y)

For children this young, our first line approach is behavioral intervention, often in the form of parent/teacher training and support. If this does not work and there continue to be significant disruptions to a child’s day-to-day life, then medications can be prescribed.

Elementary school (6-11y)

At this age behavioral therapy still remains a core focus. This can include education and parent training for home, but also social skills training and modifying the school environment to set your child up for success. For example, 504 plans or Individualized Education Plans (IEP) can ensure there is formal classroom support, additional time for assignments, and other modifications as needed. But it is true that many children in this age group need FDA approved medication as well, which we will go through in a separate post. 

Teens

Again, the preference is to use a combination approach, incorporating behavioral therapy and individualized educational support, along with FDA-approved medications. It is worth noting that substance use and abuse in adolescents can also often look like ADHD.

An overview of ADHD interventions

Lifestyle changes

Ensuring a child who has trouble with attention is set up for success requires making sure they are physically active, eating well, and sleeping restfully. All far easier said than done, but for a parent just starting their journey, spend some time thinking about how best to do this. If your child is older, you can ask for their input about ways to make sure they thrive on these fronts. 

Behavioral modification

This comes up most often in young children who struggle with attention (age 4-5y). I strongly believe that creating a plan that includes behavioral modification and parent training is essential for long-term success. For a child who has struggled for awhile at school, or a parent who has been in conflict with their child about these issues, beginning with a cognitive shift sometimes has to be intentional. Working to create better behavior and thought patterns, and develop some positive associations with school/learning is important.

Social skills groups
These can be especially helpful for children who struggle to pick up on social signals, or are prone to interrupting or talking nonstop. Learning how to interpret pauses in conversation and what is appropriate in different settings (say, the classroom setting compared to a playdate)  helps your child develop friendships. There are specialists with expertise in these skills who can work with your child.

Therapy

More traditional therapy (such as play, cognitive-behavioral or talk therapy) is sometimes helpful for children who also have some anxiety or mood symptoms. For children with ADHD, there is often a challenging chicken-or-egg problem. These disorders often look like ADHD in a classroom setting. But struggling at school can also lead to anxiety about learning or depression. Either way, helping to address these feelings is important. Mindfulness is a technique that I think makes a difference here as well. 

Medication 

Both stimulant and non-stimulant medication are used to treat ADHD, and they work in different ways. The tricky thing about these medications is that it can be hard to predict which medication (or dose) is best for any given child, and there is a sometimes frustrating trial-and-error methodology to treatment. An experienced clinician will be able to make recommendations about where to start based on things like the length of the school day, what after-school activities your child takes part in, and how sensitive your child might be to side effects. 

The Pediatrician Mom Tip: Interestingly, if a parent or other family member did well on a specific medication, their child may too. 

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If your child is diagnosed with ADHD, or is struggling with school, this is not your fault. We all have challenges, and your job as a parent is to set your child up with tools for success. ADHD is a lifelong diagnosis, and recognizing that you’re playing the long game can be supremely helpful when you think about how to approach it.

The very fact that you’re here reading about this tells me you are approaching this the right way, and your child is lucky to have you on their team. You got this, mama!