Expert Insights on Treating ADHD in Children
When your child receives a diagnosis of attention deficit hyperactivity disorder (ADHD), it’s likely they were experiencing symptoms for a long time. However, a diagnosis doesn’t mean things will change overnight. Finding the right treatment can be a process, and your child will need support beyond medication and therapy. Dr. Karen Gill, a pediatrician who treats ADHD in children, answers common questions she hears from parents of kids with ADHD.
A: I suggest that parents explain to a child that ADHD is a collection of symptoms, where the parts of the brain related to focus and attention work differently from most people. Make it clear to a kid with ADHD that there’s nothing wrong with them; there’s just something different about the way their brains work. A parent could compare ADHD to needing glasses. Some people have eyes that need help with seeing things, so they wear glasses. Some people have brains that need help with focus and attention, so they use tools and treatments for ADHD. Most kids have friends who wear glasses and they get it.
A: Most of the research shows that the best treatment plan for pediatric ADHD involves a combination of medication and other interventions, like behavioral training, which are directed towards caregivers and education providers. Some parents want to get their kids on medication right away, and some want to try alternatives first, like counseling alone. It’s definitely a challenge to find the right approach at the beginning, and it’s always different depending on the child and their needs.
When we start medication, we begin with super low doses and kids will first take it on a weekend so the parents can see the effects. We don’t start them on a new medication and send them off to school. Medications can take couple of weeks to show effects, so it’s important to know things won’t change overnight.
If parents really don’t want to go the medication route, there are other options, like behavioral coaching and working with teachers on different strategies. Often, we don’t settle on the right treatment path during the first appointment after diagnosis. Sometimes, I’ll spend the entire visit listening to a parent’s concerns, and then after gathering feedback from the family and school, we’ll talk about treatment based on that information.
Parents and kids should know this can be a long process, but ultimately, we will find what works best.
A: Parents play a huge role in managing ADHD in their children because they are the ones who set their child’s schedule, decide what to offer their child to eat, encourage their child to get physical activity, and more. A lot of ADHD management is about routine. Keeping a normal, predictable routine can help kids with ADHD understand what’s expected of them and when.
Also, sleep is huge. I tell parents to make sure they’re prioritizing their child’s sleep and sticking to a regular schedule.
It’s also helpful to break down instructions into explicit, doable chunks. Don’t just say, “Clean your room.” Your child will respond better if you explain that you’d like them to go to their room, pick the toys up off the floor, and put them in the toy box.
It’s also important to help your child build their confidence. ADHD can make kids feel different or not good enough, and that can take a toll on self-esteem. Parents can help their child find something they’re really good at and encourage them to focus on that activity. It’s also about reframing. Everyone has things that are easy for them and things that are hard for them. Tell your child that although some things are hard for them, their friends without ADHD also find certain things hard. Focus on the things your child enjoys and excels at, and try to foster that passion in your child. Support their hobbies and be gentle when they struggle or find certain areas challenging.
The biggest takeaway I want to emphasize to parents is that kids with ADHD aren’t “bad” on purpose. They’re not bad kids. They often know what they should be doing but face roadblocks when it comes to actually doing it. And they feel bad about that. The best thing a parent can do is support their child and be intentional about praising their successes and their strengths.