Parenting Inattentive-Hyperactive Children and Youth - Presentation

8/14/2019 Parenting Inattentive-Hyperactive Children and Youth - Presentation

http://slidepdf.com/reader/full/parenting-inattentive-hyperactive-children-and-youth-presentation 1/18

Community Education Servicein collaboration with

Child & Adolescent Mental Health

Parenting Inattentive/HyperactiveChildren and Youth

Funding generously provided by EncanaCorporation and the Alberta Children’s

Hospital Foundation

Outline1. What is Attention Deficit/ Hyperactivity

Disorder (AD/ HD)?- Possible Causes- Characteristics- Diagnostic Criteria- Additional Criteria

2. Related Problems

3. Treatment Options

Outline4. Strategies

- Social Skills Strategies- Basic Strategies

- Specific Strategies

5. Good things about having AD/ HD

6. Commun ity Resources



What is Attention Deficit/Hyp eractivity Disorder(AD/HD)?

AD/ HD is:Complex neurobiological condition

AD/HD is the most common psychiatric disorder forchildren

Affects between 5 – 12% of school age children8 – 10% of males and 3 - 4% of females under 18years have AD/HDMales outnumber females (3:1 to 6:1)Not caused by poor parenting

Possible Causes of AD/ HD?Brain function (i.e. neurology)- altered brain messenger substances

(neurotransmitters)

- under activity and/or reduced blood flow in thefrontal area of the brainHeredity and geneticsBrain injuryThe role of environment



Characteristics

1) Predominantly Inattention

2) Predominantly Impulsivi ty/ Hyperactivi ty

3) Combined Type

Diagnostic Criteria

Careless mistakesPoor sustainedattentionPoor listeningLack of follow throughand task completionDisorganized

Poor sustained mentaleffortLoses thingsEasily distractedForgetful6 out of 9 symptomsneed to be present (for6 months)

1) Inattention

Diagnostic Criteria

Fidgets/ squirmsLeaves seat

Runs/climbs a lotCan’t play quietly

“On the go” Talks excessively

Blurts out answersDifficulty waiting

Interrupts/intrudes6 out of 9 symptomsneed to be present (for6 months)

2) Hyperactivi ty/Impulsivi ty



Diagnostic Criteria

Combines criteria of both 1 and 2

3) Combined Type

Additional Criteria

Symptoms present before age 7Symptoms present in 2 or more settings (at home,school, or work)Significant difficulties in social, academic, andoccupational functioningSymptoms do not occur exclusively during thecourse of PDD, Schizophrenia, or another psychoticdisorder and are not accounted for by otherdisorders (mood disorder, anxiety disorder,dissociative disorder, a personality disorder, or aphysical condition).

Related Problems



Related Problems

Learning Disabilities (Nonverbal Learning Disorder)

Oppositional Defiant DisorderConduct DisorderTic Disorder (e.g. Tourette’s Syndrome)Mood/Anxiety Disorder (Depression and Bi-Polar)Substance Use and AbuseOther (Asperger’s, Sensory Integration)

Treatment Options

Treatment OptionsChild, parent, and teacher education about thisdisorderBehavior modification

Parent trainingFamily Therapy Anger Management & Social Skills TrainingStimulant medication/Non-stimulant medications- Ritalin, Dexedrine, Strattera



Treatment Options

Medication

Two types of medications used are stimulants andnon-stimulants

A combination of therapy and medication is themost successful treatmentParents and families are encouraged to talk to theirphysician and other healthcare professionals togather information to make a decision aroundtreatment.

Treatment Options

Dexedrine SR ®Methylphenidate CR (Biphentin®)

Dexedrine IR®Methylphenidate ER (Concerta®)

Adderall XR®Methylphenidate SR (Ritalin®)

Strattera® Adderall ER®Methylphenidate IR (Ritalin®)

Atomoxetine(Non-Stimulant)

Amphetamines(Stimulant)

Methylphenidate(Stimulant)

Treatment Options

Adaptations to the student’s educationalprogram/environmentClose positive home/school communication and

cooperation is criticalSocial skills training (individual or group)



Treatment Options

Alternative Therapies

Vitamins/dietary supplements: including these in yourchild’s diet to reduce symptoms of AD/HDElimination diets: removing certain additives and foodfrom your child’s diet for a given period of time if youthink they may be affecting their behaviourBiofeedback: a stress reducing technique used tocontrol certain body responses (ie. heart rate, muscletension). It can help children/adolescents with ADHDto normalize brain wave patterns.

Treatment Options Alternative Therapies cont’d

Sensory integration training – using light, sound,tactile stimulation to “exercise the brain”.

Note: Evidence-based research is underway on many of these therapies and information is still being gathered about how effective they are.

Strategies



Social Skills Strategies

Listening/Attending

Turn-taking

Anger management

Problem-solving

Cooperation

Emotional regulation

Role-playing

Modeling

Relaxation training

Communication skills

training

Therapeutic games

Basic Strategies

Establish predictabledaily routines

Prepare child inadvance for any changeof routine

Simple concrete rulesand expectations thatare known to child

Simple and concreteconsequences that areknown to child

Consistency in rules andconsequences over time

Regular physical activity

Quiet wind down

Specific Strategies

1. Accept that your child will be active andenergetic, because of the makeup of th eirbrain.

It is helpful for these children if their caregivers canbe calm and tolerant

Label the behavior and not the child (e.g. the child isNOT bad)



Specific Strategies

2. Provide outlets for releasing extra

energy.

These children need daily physical activities,involvement in sports such as running, dance,martial arts or family playtime

Specific Strategies

3. Find activities at which your child cansucceed.

All children need to experience success to feelgood about themselves

Specific Strategies4. Problem Solving - A person who has AD/HD may

have difficulties solving problems. She or he might:

o See the problem as more difficult than it truly is

o Have trouble finding solutions for the problem, or getstuck in one way of dealing with the problem eventhough it isn’t working

o Find it hard to put a plan into action.



Specific StrategiesProblem Solving (cont’d)

o Identify the problem

o Identify possible actions to help solve the problem

o Compare the good and bad points of the differentsolutions

o Pick the best action

Specific StrategiesProblem Solving (cont’d)o Identify the problem and potential actions to take to

help solve the problem

Consider things that you can do with and withoutthe help of someone else.

Don’t try to decide which one i s best.It’s okay if you tried something and it didn’t’

work.

3 things I could do (action)

What would you like the end result to be?What I want to happen:

Friends, siblings, parents, other concernedadults?

People who can support me:

Identify the problem by paying attention to howyour mood changes through the week.

Focus on only one problem at a time.

The Problem:


o Compare the good and bad points of the differentsolutions

3.

2.

1.

Bad PointsGood Points Action




o Pick the best action

o Be assertive: strike a balance between what youwant and what others want, stating your ownview and listening to the views of others

Specific Strategies5. Set small, reachable goals.

a) Choose a goal – SMART

Specific, Measurable, A greeable, R ealistic, Timeline

b) Carry out the goal

c) Evaluate the goal

d) Celebrate

Specific StrategiesGoal Setting cont’d:

a) Choose a goal for the next week, and make the goal:o Specific: unclear goals are less likely to be carried out

and result in feelings of failureo Measurable: develop a goal that is easy for you to

track your progress and successo Agreeable: develop a goal that works for you and

those around you (e.g., your family)o Realistic: goals that are too big often result in feeling

discouraged. Should be easy enough to carry outo Scheduled: the more exact in stating your goal, the

more likely to carry it out



Specific StrategiesGoal Setting cont’d:

b) Carry out the goal

c) Evaluate your progress/success

d) Celebrateo Recognize what has been accomplished

(Parents can help acknowledge the child’ssuccess).

o Give credit for trying to accomplish thegoal and review or revise as needed.

Specific Strategies6. Keep home environment organized

It is helpful to have a regular routine and be asconsistent as possible in daily activities, such asmealtime, homework and bedtime

Provide logical spaces to keep your child’sschoolwork, toys, and clothes to reduce thepossibility of these items being lost

Specific Strategies7. Avoid fat igue in these children

When they are tired, their self-control often breaks

down and their hyperactivity becomes worse



Specific Strategies

8. Maintain stimu lation at an appropriate level

Some children need more quiet time

Some children need to be kept busy, but NOT overstimulated

Specific Strategies9. Prepare for formal gatherings

The hyperactivity can be difficult to manage informal settings, such as church or restaurant

Make sure you have something for your child todo and rehearse your child through appropriatebehavior

Discuss positive and negative consequences to

redirect actions

Specific Strategies

10. Maintain firm & consistent discipline

Set realistic goals - pick your battles

Don’t ignore unsafe behavior

Intervene early

Give appropriate consequences or suggestalternative acceptable activity



Specific Strategies11. Use timely, age-appropriate consequences

Time out

Natural consequences

Loss of privileges

Physical punishment is not appropriate

Specific Strategies

12. Reward positive behaviour

Praise and reward your child’s efforts to payattention

Offer kind words, hugs etc. as soon as positivebehaviour is noticed

Specific Strategies

13. Help your child stay “on task”

Keep instructions brief

Offer frequent, friendly reminders

Use charts and checklists for homework and chores



Specific Strategies14. Advocate for your child

“You know your child best, need to be their biggestfan”

Learn as much as possible about AD/HD and how itwill affect your child at home, in school, and insocial situations

Help others understand their behavior.

Specific Strategies

15. Self-Care: Daily!

Life can never be stress free. Part of the learningto cope with stress is coming to the realization thatone cannot solve every problem one encounters

Its important to take into account one’s physicaland emotional limitations, and to have reasonableexpectations about what one can handle on one’sown and when it is time to get some help.

Self-Care StrategiesExpress your feelings!

Periodically get away from it all

Child benefits most when adult happy andcomfortable

Take care of yourself

Nurture adult relationships

Join a parent support group



Good Things About HavingAD/HD

Good Things about Having AD/H D

Happy and enthusiastic

Never boring

Charming

Sees things differently

Great memory for things

that interest them

Very good with younger

children

Full of energy

Requires less sleep

Observant of details

Are the first to volunteer

Good Things About Having AD/HD

Doesn’t usually hold

grudges

Risk takers - try newthings

Can do several things at

one time

Fun to be with

Easy to talk with

Great sense of humor

InnovativeSpontaneous

Creative and imaginative



Good Things About Having AD/HD

Sensitive/ compassionate

Loving and caring

Curious

Interested in new things

Candid

Positive of life in spite of troubles

Communit y ResourcesC.H.A.D.D.

Learning Disabilities Association

Calgary Learning Centre

Access Mental Health

Health Link

403-225-8512

403-283-6606

403-686-9300

403-943-1500

403-943-LINK (5465)

Credible Websites American Academy of Paediatrics

www.aap.org

Canadian ADHD Resource Alliancewww.caddra.ca

Canadian Mental Health Boardwww.cmha.ca

C.H.A.D.D (Children and Adults with AD/HDhttp://www.chadd.org/

Medline Pluswww.nimh.nih.gov

National Institute of Mental Healthwww.nimh.nih.gov



ReferencesBarkley, Russel A. (2005). Taking Charge of ADHD: The Complete

Authoritative Guide for Parents. New York: The Guilford Press.

Mayo Foundation for Medical Education and Research (1998 – 2008).Retrieved July 7, 2008, from www.mayoclinic.com.

Moghadam, H. (2006). Attention Deficit – Hyperactivity Disorder .Calgary: Detselig Enterprises Ltd.

National Institute of Mental Health (NIMH) (2008). Retrieved July 7,2008, from www.nimh.nih.gov.

National Standard: The Authority on Integrative Medicine (n.d.).Retrieved July 7, 2008, fromwww.naturalstandard.com.hinc.lib.ucalgary.ca/.

AcknowledgementsWe would like to acknowledge the contributions of the many clinicians who participated in our Focus Groups and thus contributed to refreshing the content of this presentation. As well, we would like to thank the following clinicians who have gone the ‘extra mile’ and made significant editorial and/or content contributions to this presentation:

Susan Ponting, M.Ed., R. Psych., Mental Health EducationSpecialist, Community Education Service

Lindsay Hope-Ross, M.Sc., R. Psych., Clinical Supervisor,Healthy Minds/Healthy Children

Rekha Jabbal, B.SP, Pharmacy Clinical Practice LeaderChild and Adolescent Mental Health

Community Education Service

Funding generously provided by EncanaCorporation and the Alberta Children’s

Hospital Foundation

To register for notification or anupcoming education session

go to: www.fcrc.sacyhn.ca

For general CES enquiriesEmail: [email protected]

Call: 403-955-7420

Parenting Inattentive-Hyperactive Children and Youth - Presentation

Documents