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ADHD Parenting Guide
This booklet has been written to provide you with some practical coping strategies for day-to-day situations. We hope it will
answer some of the questions you may have about ADHD and give you the confidence to support your child, and help them
overcome any difficulties they may face. If you have any further questions or concerns about your childs ADHD, please contact
your doctor or healthcare professional for advice.
ADHD Parenting Guide 02/03
3 CORE SYMPTOMS5
cure it is a complex
neurobiological ADHD is a
neurobiological
disorder 2 disorder. Research
shows strong evidence Hyperactivity
that the malfunction
Combine
of Dopamine and
Norepinephrine
ADD Impulsive
2
Treatment (neurotransmitters)
play a large role in
ADHD-type behaviours.5
5
commonly co occur with ADHD
Pattern of negative, hostile, and defiant behaviour including frequent loss
ODD (Oppositional
of temper, arguing, refusal to obey rules, intentionally annoying others,
Defiant Disorder)
blaming others.
Close to
Children with ADHD frequently have problems with reading fluency and
Affects Learning
mathematical calculations. Problems are associated with attention,
disability
References: 1) The genetics of ADHD: A literature review of 2005 Khan SA, Faraone SV. Curr Psychiatry Rep 8(5):3937. 2006. 2) ADHD A Complete and Authoritative Guide Michael I. Reiff,
Commonly low mood for days, over/under eating or sleeping, low energy
MD, FAAP with Sherill Tippins, Pg 4, published by The American Academy of Pediatrics 2004. 3) American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Depression
edition: DSM-5. Washington: American Psychiatric Association, 2013. 4) NCHS Data Brief No. 70 August 2011 Attention Deficit Hyperactivity Disorder Among Children Aged 517 Years in the and self-esteem, poor concentration, feeling hopeless.
United States, 19982009. Lara J. Akinbami, M.D.; Xiang Liu, M.Sc.; Patricia N. Pastor, Ph.D.; and Cynthia A. Reuben, M.A. 5) Attention-Deficit/Hyperactivity Disorder by Mary Fowler, National
Dissemination Center for Children with Disabilitties (NICHY), Page 15, 18-19, FS14, 3rd Edition, April 2002, Resouces updated 2004.
ADHD Parenting Guide 04/05
the procedure 1
5
2
AAP (2000) recommends that clinicians
collect the following information: Level of functions
ADHD cannot be detected from any laboratory tests. 1. A thorough medical and family history. By considering the childs current level
No urinalysis, blood test, CAT scan, MRI, EEG, PET 2. A medical examination for general of functioning and the extent in which
or SPECT scan can help to diagnose the disorder. health and neurologic status. a childs behaviour interfere with his/her
The diagnosis is made on the basis of observable 3. A comprehensive interview with the ability to function in social settings,
behavioural symptoms, in more than one setting. parents, teachers and child. the doctor or other health professionals
can begin to arrive at a better idea of
4. Standardized behaviour rating scales,
whether ADHD is the best explanation
including ADHD specific ones
for the problems.
completed by parents, teachers,
and the child when appropriate.
5. Observation of the child behaviour.
6. A variety of psychological tests to
measure IQ and social and emotional
Early 1 adjustment. These tests also help
6
to determine the presence of specific
warning 2
learning disabilities, which can co-
occur with ADHD.
signs 2
adhd or coexisting 2
3x 2 to 4x 10 %
more hospital
4x
more car
more parental more and ER visits2
accidents1
divorce/separation7 sibling fights8
employer
absenteeism
school and occupation and low
Key stage
productivity 9
46 %
35 %
Age (years)
2 ADHD only
Low self esteem
7 society
suspended 3
drop out 3
Substance Use Disorders
50 %
Key stage Disruptive behaviour earlier
Age (years) onset6
3 Learning delay
Poor social skills
11
more less likely
to quit in
risk
5
adulthood6
Oppositional Challenging
low
3x
defiant disorder behaviour
Key stage Criminal behaviour School exclusion Age (years)
occupational speeding
Lack of Complex References: 1) U.S. Department Of Health and Human Services, National Institutes of Health. NIH Publication No. 12-3572. Revised 2012 2) Use and Costs of Medical Care for Children and
1
m e n tal p r e paration 1
COMMON SENSE
3
take care of 1
yourself
Keep things in perspective and
refrain from being a perfectionist. Eat right, keep fit, beat stress,
remember to seek support when you
need help, take a break when you are
2 feeling a little exhausted.
ORGANISE
1,4
Organise your life in ways that
will allow you to manage your
KNOWLEDGE
familys challenges.
medications
Stimulants Non-Stimulants
Academic
achievement4,5,6,7,
Extracurricular
activity engagement9
Time management,
planning5
11 12 Noise/disruption3,7,8
Social relationships 10 1
and cooperation5,7,8, Attention span5,6,7 and
impulse control5,6,7
Self-esteem7
9 2
01 05 06
Educate protect PRIVACY
Your child needs to understand Your child is NOT doomed to Monitoring your childs
and take ownership of his a life of failure if you dont behaviour is a basic
challenges and thus, education protect him from every danger parenting responsibility but
GUIDE is a critical element of and solve every problem do not overdo it. Dont
101
treatment at every stage of for him. 5 snoop on your child. 5
development.1
02 07 08
DEMYSTIFY CHOICES Rules
Children often see their Use Structured Choices. Make rules and enforce
diagnosis as a stigma and their For example, Do you want them. Expect rule-breaking,
treatment plan as something to do your math or your respond like a police officer,
imposed on them instead of science assignment next?6 be respectful, consistent, and
seeing themselves as matter-of-fact. 6
active participants.2
03 04 09
ADVOCACY FOCUS on CAN BE REALISTIC 10 talents
Be your childs best advocate. Do not let him use ADHD as an Even with the ideal intervention
Strengths
As you discover new ways to excuse. Focus on what he can in place, most children will
facilitate positive behaviours, do rather than what he cannot. likely still struggle at times. Discover and nurture their
learning and self-esteem, pass This helps him build optimism Dont expect too much from strengths and talents.
it on to others in his life.3 and confidence.4 your child or yourself.5 Celebrate their success, praise
them as they overcome trials.4
References: 1) ADHD A Complete and Authoritative Guide Michael I. Reiff, MD, FAAP with Sherill Tippins, published by The American Academy of Pediatrics 2004, Pg104. 2) Pg107 3) Pg115 4) Pg97 5) Mothering Without Smothering: How to Avoid Being An Overprotective Parent Peter Jaksa, Ph.D. 6) Parenting Kids with ADHD: 16 Tips to tackle Common Challenges Published by Psych
Central, Reviewed by John M. Grohol, Psy.D. 2013
ADHD Parenting Guide 16/17
using 2
time-out or removal of privileges. In addition, spanking can lead to agitated
or aggressive behaviour, physical injury, or resentment toward parents.
Time-out involves sending the child to a specified room for a preset time-
Repeat command Praise child Time out
timeout usually 1 minute per year of the childs age. (Pg 142-143)
References: 1) ADHD A Complete and Authoritative Guide Michael I. Reiff, MD, FAAP with Sherill Tippins, published by The American Academy of Pediatrics 2004. Pg 140 2) Pg 142-144 it will reduce the effectiveness of this
3) Pg 131-133
method in future
ADHD Parenting Guide 18/19
60 to 80% of students with ADHD underachieve academically because of problems with work
production and consistency. Only 20% have specific learning disabilities such as reading
disorder, mathematics disorder, or expressive language disorder that are separate from their
1
ADHD symptoms.2 Educational Performance Problems
Routines and Starting Staying Completing
Systems3 task on task task
At the start of each academic
Producing Following
year, meet with your childs Setup after-school work at through
teachers to inform them of routines that include consistently on
your childs condition. Keep sports, and homework normal Directions
the communication lines levels
and stick to it. Use charts Making Organizing
open all year. and checklists to help transitions Multi-step task
your child track his
progress with chores
and homework. Keep
instructions brief3
4
References: 1) Attention-Deficit/Hyperactivity Disorder by Mary Fowler, National Dissemination Center for Children with Disabilitties (NICHY), Page 15, 18-19, FS14, 3rd Edition, April 2002,
Resouces updated 2004. 2) ADHD A Complete and Authoritative Guide Michael I. Reiff, MD, FAAP with Sherill Tippins, published by The American Academy of Pediatrics 2004. Pg 158
3) Pg 99, 100, 190 4) Pg 161 5) Teaching Children with Attention Deficit Hyperactivity Disorder: InstructionalStrategies and Practices By: Office of Special Education Programs
(ED/OSERS). US Department of Education. 2008 40 pp. (ED502960)
ADHD Parenting Guide 20/21
Provide Structure
Picture your growing child as The Child Guidance Clinic NUH Neuroscience Clinic Child and
a building in progress, the Adolescents Psychiatry Service
limits, lists, routines and other Health Promotion Board Building
measures you put in place 3 Second Hospital Avenue National University Hospital
are like scaffolding that will #03-01 Singapore 168937 Kent Ridge Wing, Level 4
provide necessary support as Tel: 6435 3878 5 Lower Kent Ridge Road
he grows.1 Singapore 119074
Tel: 6772 8686 / 6772 2002
DEPARTMENT OF
DEVELOPMENTAL PAEDIATRICS Children s Clinic
Tips for structuring your KK Womens and Childrens Hospital NUH Child Development Unit
Specialist Clinic M
childs home environment2 National University Hospital
Podium I, Childrens Tower
100 Bukit Timah Road Kent Ridge Wing, Level 4
Singapore 229899 5 Lower Kent Ridge Road
Tel: 6394 2211 Singapore 119074
1 2 3
Tel: 6772 6157/ 6772 2470
Keep your child on a daily Cut down on distractions - Organize Your Home - have Email: chi2@nuhs.edu.sg
schedule - try to keep the distractions for each child specific logical places for
time for various activites is different, as you identify your child to keep his toys, NUH Child Development Unit CDU
about the same each day. them, eliminate them schoolwork and clothes and Websites
Jurong Medical Center
one by one. he is less likely to
60 Jurong West Central 3, Level 2
lose them. www.spark.org.sg
Singapore 648346
Tel: 66652530/ 66652531
4 5 6 Email: cdu@nuhs.edu.sg
Use charts and checklists - Limit Choices - Help your Set small, reachable
Keep instructions brief, offer child learn to make good goals - This is to help the
frequent, friendly reminders decisions by giving 2 or child understand that he
and make sure each task has 3 options at a time. can succeed by taking small
been completed. steps and building on
those successes.
References: 1) ADHD A Complete and Authoritative Guide Michael I. Reiff, MD, FAAP with Sherill Tippins, published by The American Academy of Pediatrics 2004. Pg 99 2) Pg 100