Parenting

Family - Parenting
By: - at May 27, 2013

Tips on How to Manage Your Hyperactive Child

Hyper Active KidJohn is eight years old. He is an inattentive, impulsive and hyperactive child who is facing serious academic, social and disciplinary problems. He often fails to finish things he starts, doesn't seem to listen and is easily distracted. Because of poor concentration, he often makes mistakes, loses books, pens and pencils. He finds it difficult to sit in one place for long and is fidgety. He keeps switching activities or running around and needs constant supervision.

John is suffering from Attention Deficit/Hyperactivity Disorder (ADHD), which accounts for the largest category of psychological referrals among children. This disorder affects about 5% of primary schoolchildren, with 75% or more being boys. The exact cause of ADHD is not known, but it seems to be a genetic disorder. There is presumptive evidence of minimal brain damage, which in most cases is genetically inherited, but ADHD could also be due to complications during pregnancy and birth. A history of learning or conduct problems is commonly found in a parent or close relative of children with ADHD. Early identification and prompt intervention is crucial for these children, as it can prevent maladjustment at home and with the peer group. Although principles of management are useful, individualized care for each child achieves greater success. Effective treatment depends on close co-operation and constant communication between the psychotherapist, parents and school. This helps to reduce frustration and feelings of helplessness in the child, as well as the care providers.

Below you'll find some tips on how to manage your hyperactive child.

Encourage Good Behavior Immediately

Parent explaining to child

When a hyperactive child acts or behaves impulsively or in a socially unacceptable manner, don't just point out his/her mistake, but try to explain the inappropriateness of his/her behavior. Encourage good behavior immediately by praise or gift because waiting too long to reward the child may not have the desired effect.

Try To Identify Strengths of Child
Parents and teachers should try to identify those strengths of their child which can be praised in public. This not only boosts the child's morale, but also changes the negative mindset of other children.

Alarm ClockUse Alarm Clock
At home, an alarm clock can be used to deal with the problem. Make a deal with the child – he/she can get up only after the alarm goes off. Set the alarm for 30 minutes in the beginning and subsequently increase it to 45 minutes and then an hour. The anticipation of being allowed to leave the seat motivates the child to remain seated. This conditioning exercise has been successful with most children and should help your child too.
 

Establish Close Cooperation with Teachers

Parent Teacher Conference

Hyperactive children are generally disorganized and frequently forget to write down homework assignments. They also have problems in listening and taking notes. Parents must establish close cooperation with teachers and request them to spare a few minutes to verify whether the child has completed his/her class-work and taken down the home assignment or not. Occasionally, the teacher may allow the child some extra time to complete his/her work. Parents can also seek the help of a friend and ask his/her to assist their child with his/her work.

Designate the Study Area
Do not allow the child to study just anywhere in the house. To prevent distraction and improve concentration, switch off the lights in the room and use a table lamp. Treating the study area as sacred (by removing one's slippers, lighting incense, etc.) may help in motivating the child.

Avoid Giving Multiple Tasks
Avoid giving multiple instructions or assignments simultaneously. Allow the child to carry out one direction or finish one assignment, before going on to the next one. Some children get flustered if there's too much to do. The way out is to allow the child to tackle one problem at a time and keep the rest covered by a piece of paper.

Permit the Child to Use Graph Paper
Graph PaperPermitting the child to use graph paper while doing arithmetic work provides a structured format to place numbers. Large graph paper should be used so that the child can easily place one number in each box. This helps the child to approach the task in a systematic manner. There is no harm in allowing these children to use a calculator. They should also be provided with basic maths tables and formulas while doing their assignments. The aim here is to successfully accomplish the task at hand by avoiding frustration arising from the inability to remember and recall the facts.

Tape-Record a Chapter
Some children grasp concepts better if they are provided with auditory and visual inputs concomitantly. Parents can record a chapter so that the child can read and listen at the same time.

Use a Computer to Organize Your Child's Work
The computer has become popular in most households, and the child should be familiarized with it at the earliest. A computer can be used to organize your child's work, to teach typing skills, and to improve his/her vocabulary by using various educational programs. This machine is fascinating, addicting, and can be motivating. The child will feel very good about himself/herself, especially when they see positive grades generated by his/her own efforts.

Organize Your Child's Things at Night
Organize your child's things at night to avoid stress and confusion before going to school in the morning. Ask the child to keep a checklist, so that the school dress, books, copies and home assignment are ready for the next morning. This will help the child feel secure as he/she will get to school better prepared.

Be Realistic About Your Expectations from the Child
Parents must be realistic about their expectations from the child and should ignore minor incidents and focus on the major areas of concern. They should familiarize themselves with the situations which frustrate the child. Avoiding confrontation and providing emotional support is the right approach during such moments.

Psychotherapy
Psychotherapy helps the child to:

  • Gain self-esteem
     
  • Release pent up frustration
     
  • Acquire control over impulsiveness

Psychotherapists use “behavior modification” to control hyperactivity and improve the child's power to concentrate. This mode of treatment involves a system of incentives and deterrents, daily report cards, and feedback sessions. Some people also recommend family therapy.

Medication


 

There has been a lot of research on the use of medication for the treatment of ADHD. Methylphenidate, Atomoxetine and Imipramine are used in the treatment of ADHD. These drugs are highly effective and very safe.

Methylphenidate: This is a first-line drug used in the treatment of ADHD. It is a psycho stimulant and produces significant improvement in attention span, impulse control, hyperactivity and aggressive behavior. This results in better organization of behavior, task completion and self-regulation. The child's social skills and academic performance improve considerably.

Methylphenidate is available as 10 mg scored (can be broken into two equal parts) tablets. The dose range is 10-60 mg/day. The usual starting dose is 5 mg; the dose is then gradually increased by 5 mg intervals to a maximum of 60 mg/day. Most children will need to take it three times a day (8 am, 12 pm and 4 pm). This schedule gives cover during school hours and during homework time. It provides an opportunity for children to interact with teachers, peers and parents while experiencing the beneficial effects of the medication.

The most common side effects of methylphenidate are abdominal pain, decreased appetite, headache and insomnia (during the first few days). The heart rate and blood pressure may show a slight increase. Some children experience irritability and sudden mood changes. Earlier it was thought that methylphenidate inhibits the production of growth hormone and “holidays” from the drug were recommended so that the body could catch-up with this deficiency. The current medical view is that methylphenidate does not decrease the production of growth hormone and has no adverse effect on a child's growth. Therefore, drug “holidays” are not necessary and the medication can be used whenever it is needed.

Atomoxetine: This is also a first-line drug which is very effective in the management of ADHD. It has been studied extensively in children with this disorder, and has been shown to reduce both inattentive and hyperactive/impulsive symptoms. Atomoxetine can be administered on either a twice-daily or once-daily schedule. The usual starting dose is 40 mg/day. It can be increased to 100 mg/day.

Adverse effects of Atomoxetine are generally mild, with sedation, nausea, abdominal pain and vomiting being most common. Because its effects are highly selective, it is believed to have no abuse potential. This is one major advantage it has over Methylphenidate. Another advantage over Methylphenidate is that Atomoxetine is widely and freely available because there are no restrictions on its stocking, prescription and dispensing.

Imipramine: This is a second-line drug used in the treatment of ADHD. The usual dose is 10-20 mg/day. It is available as 10 and 20 mg tablets and is also known as Depsonil, Antidep and Depsol. Imipramine is also used in the treatment of depression and enuresis (bed-wetting).


 

 

 

 

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