How to Help a Child with ADHD

Stop fidgeting.” “Listen to me when I’m talking to you.” “Think before you act.” As a parent of a child with ADHD, you’ve probably said those words a million times – without much effect. But don’t worry; experts have developed strategies that can help your child pay attention, focus and get things done. Read on for their top 9 tips…

Staying focused is one of the most difficult challenges for a child coping with attention-deficit hyperactivity disorder (ADHD).

“ADHD used to be called ‘minimal brain dysfunction.’ A more accurate name would be ‘attention shifting disorder,’” says Donald Haupt, M.D., a psychiatrist in private practice in Bryn Mawr, Penn., who has ADHD himself. “Asking a child with ADHD to shift attention every 45 minutes [in school] is like asking kids with polio to run between classes.”

The problem begins in the brain’s prefrontal cortex, home of the “executive function,” which helps you organize cognitive processes. It’s the part that tells you, “First I do this, then I do this, then I do that,” Haupt says.

A child with ADHD has a shortage of dopamine, the brain chemical that keeps the executive function running smoothly and enables people to put tasks in sequence, Haupt says. Without enough, distractions take hold and attention flounders.

The good news: There are proven strategies to help your child with ADHD stay focused at home and school, and improve common – and frustrating – ADHD behaviors like fidgeting, impulsiveness and inattention.

We asked top ADHD specialists what parents can do to improve their child's attention and quiet symptoms of ADHD. Here are their top tips:

1. Make sure your child gets enough sleep.
All kids need more sleep than adults – about 9-12 hours a night. But a child with ADHD often doesn’t get enough.

“Eighty percent of children with ADHD have sleep problems [such as trouble falling asleep, nightmares or restless leg syndrome],” says Patrick Kelly, M.D., a pediatric psychiatrist at Johns Hopkins Hospital in Baltimore, Md. “The kids we see with serious behavioral problems are only getting 5-6 hours a night.”

Several studies have shown that poor sleep can greatly increase symptoms and improved sleep calms them. One 2006 study, published in the Journal of Sleep Research, found that treating sleep problems can improve attention and hyperactivity issues in some children.

Adjusting ADHD medications can sometimes help. Ask your pediatrician, or consult a sleep specialist. You can find one through the American Academy of Sleep Medicine.

2. Create a daily routine.
Structure in family life is very important for helping your child stay focused, says Heidi Feldman, M.D., a professor in developmental and behavioral pediatrics at Stanford University.

Because a child with ADHD has trouble following directions and putting tasks in order, you have to do it for him.

“Your child should know when he needs to wake up, eat breakfast and other meals, do homework and play,” Feldman says.

Try to follow the same schedule every day, so he learns to anticipate what’s expected of him. Post the family’s schedule on the refrigerator or bulletin board to keep everyone informed.

3. Reward the effort, not the person.
Give praise or rewards when your child follows the rules. But only reward behavior he can actually control.

“Don’t say, ‘You’re so smart,’ because the child can’t change that,” Feldman says. “Instead, say, ‘That’s great; you put in 20 full minutes reading that book.’ A child can do that again – and may do 25 minutes the next time.”

4. Plan family time.
Children often can’t differentiate between negative and positive attention. If throwing plates across the room gets your attention, they’ll do that, says Kelly.

Curb acting-out by getting your child addicted to positive attention, he says. If he gets enough, he’ll be less likely to engage in destructive behaviors.

Kelly encourages parents to schedule “special time” with their child every day.

For at least 15 minutes, turn off the phone and don’t allow any interruptions while you do a one-on-one activity together, whether it’s tossing a ball or playing a game.

“You’d be astonished by the positive reports we get back from parents after trying this,” he says.

5. Teach healthy eating habits.
Recent news headlines have stirred up the old debate over whether sugary foods and food dyes might be responsible for kids’ attention problems.

Since sugar enters the bloodstream quickly, it produces a spike in blood glucose levels. And some suspect a child may become energized by the adrenaline rush from this rise.

Some research has shown a correlation. In one study, published the February 2011 issue of the medical journal The Lancet, researchers put children between age 4 and 8 on a restrictive diet containing no processed foods for five weeks. Symptoms of ADHD diminished in 78% of them.

But study results haven’t been definitive. In March, the Food and Drug Administration (FDA), which regulates food colorings added to processed foods, announced an advisory committee will look at the science behind food additives and behavior problems in kids.

Until answers are found, experts and parents are evaluating how diet affects behavior on a case-by-case basis.

“There’s a lot of anecdotal evidence that a diet of less-processed food can help symptoms of ADHD,” Kelly says. “Many parents tell us that lowering their child’s sugar intake helps, so we have to be supportive of it.”

Eating healthy foods like fresh fruits and vegetables will give children more vitamins than processed foods, Feldman adds. But, she says, gathering the family around the table could be just as important.

“The combination of good, healthy foods and eating family meals together would probably reduce the incidence of ADHD by 1%-2%,” Feldman says.

That’s because stable routines and situations that encourage family conversation benefit most children’s behavior.

6. Try therapy.
Behavioral therapists can help your child change behavior and learn social skills such as how to share and be patient.

As a parent of a child with ADHD, you can also benefit from a monthly therapy session. During parent-training sessions, therapists can teach you effective ways to praise your child for appropriate behavior and suggest activities you can enjoy together.

“In our parent-training sessions, we spend a lot of time on strategies that best address a child’s behavior,” Kelly says.

7. Keep a clean, organized home.
Children’s environments can affect their ability to focus and pay attention, says Feldman.

A child with ADHD usually does better in an orderly space, so it’s important to keep your home organized and clutter-free.

The first step: Establish a place for everything. That includes common family areas as well as the child’s bedroom. Show children where to put clothing, backpacks and toys – and let them know he’s expected to help keep the home organized.

8. Keep instructions simple.
A child with ADHD can’t follow too much information at once, so break tasks down into smaller steps, Kelly says.

“If you say, ‘Get dressed, brush your teeth, and then pack your bag,’ you’re lucky if he gets through the first task,” Kelly says. “First, tell him to get dressed. When you see that’s done, give the next task.”

This same rule applies to general directions, says David Dunn, M.D., co-director of the Riley ADHD and Disruptive Behavior Disorders Clinic at Indiana University Health.

“If your child has to read a book for school, don’t say, ‘Read your book,’” he says. Make the instruction more manageable by saying, “Read the first chapter and tell me what it says.”

9. Eliminate distractions.
When you want to keep your child focused and improve attention, such as during homework hours, reduce noise and other activity in the home. To do this, create a “quiet corner” where unnecessary noise and conversation are off limits until a task is complete.

That means turning off the TV, radio and computer games to help your child concentrate effectively.

Are You A Good Mom?
Being a good mom means more than baking cookies and joining the PTA. She provides guidance, encouragement, discipline and structure. But sometimes a busy schedule and not enough "me" time gets in the way of being the best mom you can be.