Parenting a child with attention deficit hyperactivity disorder (ADHD) is demanding, and there are many misconceptions about the diagnosis. But there is help as we learn more about the different facets of ADHD. For clarity, advice, and a healthy dose of optimism, we turned to Martin Kutscher, M.D., a pediatric neurologist and the author of the book ADHD: Living Without Brakes. His best advice: Stay positive!
Parent & Child: What is the biggest misconception parents have about ADHD?
Dr. Martin Kutscher: That it's primarily about kids with a short attention span, or kids who are hyper. A better understanding of it is that it's about an inability to inhibit behavior, which leads to a whole host of issues. If a child can't inhibit himself from distractions, he may be inattentive. If he can't inhibit checking out the things he finds interesting, he tends to be hyperactive. It's easy to think that he's always overreacting, but what he's really doing is overfeeling. That's an important distinction. If you think your child is overreacting, you may become annoyed. But if you see him as overfeeling, you can guide him more calmly.
P&C: You've said that ADHD is "the tip of the iceberg." What do you mean by that?
Kutscher: It means that kids with ADHD often have other conditions that might be missed. For example, 50 to 80 percent might also have a learning disability. A quarter of ADHD kids also have anxiety issues. About seven percent have tics.
P&C: What's the best way to deal with a child with ADHD?
Kutscher: I suggest four basic rules. First: Keep it positive. It's a rare child who, in response to negative attention, improves his behavior or performance. That's even more true of an ADHD kid. You need to keep it positive, constantly find something to praise, and try to avoid useless shouting or punishments, which don't work.
P&C: What is the second rule?
Kutscher: Stay calm. No one can think clearly when they're overwhelmed, and kids with ADHD are already having trouble accessing their thought processes. So when you further inflame them by yelling and engaging them in a fight, nothing is accomplished. If you find yourselves in a meltdown situation, try to stay calm. Have everyone retreat and relax, and make an attempt to discuss it later, when everyone's calmer.
The third rule is to keep your child organized. I like to say that kids with ADHD need surrogate frontal lobes. That's your job, and the job of the school. The school can help your child organize his work while he's there, and make sure it's all in place for you, and then you can pick it up when he gets home. The key is that this isn't something you'll do once, but over and over again.
P&C: And the last rule?
Kutscher: Keep doing rules one through three. It's not something that gets fixed overnight; it's not like dropping off a car at the mechanic's. One problem some parents have is that they are more than happy to help, but then they may think, "How will he ever learn if I keep organizing for him? If we keep him from sinking, how will he ever learn to swim?" But the fact is, "sink or swim" only works if you know how to swim. If you can't, you just sink. You're his safety net. And falling without a net is just too big a punishment.