Attention Deficit Hyperactivity Disorder Questions, ADHD Answers: ADHD FAQs
Dr. Charles Shinaver III, Ph.D.
"Close the gap between where you are and where you want to be."
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ADHD Frequently Asked Questions
1. What is Attention Deficit Hyperactivity Disorder (ADHD)?
2. What causes Attention Deficit Hyperactivity Disorder?
3. Is ADHD just a lack of discipline or respect for parents?
4. Is it mom's fault?
5. If it's not my fault, then why does my ADHD son respond differently to me than to my husband?
6. How is Attention Deficit Hyperactivity Disorder diagnosed?
7. Will kids grow out of ADHD?
8. What to do about Attention Deficit Hyperactivity Disorder and when to do it?
9. Do medications work for ADHD?
10. What is the big deal about side effects?
11. Is Attention Deficit Hyperactivity Disorder a disability?
12. How should I think about ADHD conceptually?
13. Why can my son, who has ADHD, tell me the rules, but not follow the rules?
14. What should I do about the fact that I get so angry at him?
15. At different times I blame him and then myself, what should I do?
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Characterized by excessive hyperactivity, impulsiveness and inattention.
Problems start by age 7
Based upon several factors, but rating scales are statistically significantly elevated compared to other children the same age.
Inattentive type includes 6 or more of the following:
Difficulty following instructions
Difficulty maintaining attention at school or at home
Loses things necessary for daily activities
Doesn't seem to listen
Doesn't attend to details
Is disorganized
Does not plan ahead
Forgets things
Easily distracted
Hyperactive/Impulsive type includes 6 or more of the following:
Fidgets
Runs or climbs inappropriately
Leaves seat in classroom or in other situations in which it is inappropriate .
Can't play quietly
Often 'on the go' or often acts as if 'driven by a motor'
Often talks excessively
Blurts out answers
Has difficulty waiting his turn
Interrupts others
Parents make these same distinctions, albeit in a casual way, when they say that their child is hyperactive or hyper, but say he has no trouble focusing. Other parents will say that their child has a problem focusing or is inattentive, but can sit still and isn’t a behavior problem in class. Then there are kids who have a hard time with focus and are hyperactive
GOING IN THE RING? Get massive pads & have some serious fun!
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Genetics are the Primary Cause of ADHD
Ongoing Research is Considering Other Possible Causes.
Kids don't do this on purpose.
He's not able to attend to you.
Don't misperceive this as defiance or a lack of respect
Shift your perspective by using humor
Don't take your child's struggles personally
If you avoid the Cycle of Anger and Frustration Defiance fades
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No, ADHD is not Mom’s fault. It's that simple.
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Moms and Dads parent hyperactive and inattentive kids differently and so kids respond differently.
Kids with ADHD need more frequent and more powerful feedback
Powerful means that the consequence should matter to your child NOW.
Often fathers respond quickly with consequences whether positive or negative
Mothers often discuss matters with their children more.
If moms act more and talk less they will get the same results.
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Family Mental Health History
Child's Infant Temperament
Current Behavioral Rating Scales (2 Settings)
Supplemental: Computerized Attention Testing (e.g. IVA)
Diagnosis is a matter for professionals credentialed to do so.
Deciding whether to intervene is a judgment call, a parent's judgment call.
Schools, doctors and therapists should not make that decision, you should!
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15-20% Have Reduced Symptoms, most often they become less hyperactive, but still have problems with inattention or focus.
Concern re Core Symptoms of Inattention, Hyperactivity and Impulsivity Remain
Worries about other Comorbid Problems Continue
80-85% are Diagnosable in Adulthood.
Most common problem: academic underachievement
Most worrisome comorbid problem: substance abuse.
If you address aggression early most of the other comorbid problems tend to fade
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Stop Aggression Before age 7.
Refine your Effectiveness as a Parent During that Time.
Age 7 to 12: Observe your child's Academic and Social Progress.
Make a Judgment about How to Intervene at this Time (ages 7 - 12)
Adolescents: Directly Involve them in Choosing What to do and When OR Expect Sabotage.
Substantial longitudinal and international research has found that aggression can be identified in preschool.
If aggression is not addressed it will continue into adulthood.
"Other problems" associated with ADHD, are actually associated with aggressive kids who have ADHD.
Say goodbye to aggression and many of your fears for his future go away too!
The school age period is the best time to address problems with the core symptoms of ADHD.
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See this website: Oregon Evidence-based Practice Center at the Oregon Health & Science University for an exhaustively thorough answer to this question.
60-80% of the time stimulants work in the SHORT-TERM on core ADHD symptoms
Lack of good quality studies of long-term outcomes of effectiveness & serious adverse events.
Lack of differentiating evidence between ADHD drugs within this class in both efficacy & adverse events.
Lack quality evidence of impact on: global academic performance, risky behaviors, social achievements
Other problems in the research including small sample sizes limit one's ability to generalize from these studies.
We have more questions than answers.
Since we don't know how ADHD drugs affect overall academic performance or risky behavior why risk it?.
We really don't know what happens when we medicate a child from age 7 to 17.
There is an awful lot we do not know about medicating our children long term with stimulants.
Given the concerns about drugs, is there ADHD treatment without medication?
Is there ADHD treatment without side effects?
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SUICIDE
SUDDEN DEATH
Liver Toxicity and Liver Failure
Insomnia, Appetite suppression and Irritability.
STUNNING DEVELOPMENT: February 10, 2006: FDA advisory panel warns the FDA to include 'black box' warning labels on 4 of what would be considered to be the most known and probably most used ADHD medications: Strattera, Adderall, Concerta and Ritalin. To see the CNN article click here.
'Black box' warnings should cause professionals and parents to take notice!
The top three side effects of these ADHD drugs listed above are life-long TRAGEDIES FOR PARENTS AND CHILDREN.
WHY RISK LIFE-LONG TRAGEDIES taking meds with so many questions unanswered?
Parents who have outlived their ADHD children make dire warnings:
See: Death From Ritalin. "Death caused from Long Term Use of Methylphenidate, (Ritalin)."
Their son's heart "showed clear signs of small vessel damage caused from the use of Methylphenidate (Ritalin)." They elaborate: "Between 1990 and 2000 there were 186 deaths from methylphenidate reported to the FDA MedWatch program, a voluntary reporting scheme, the numbers of which represent no more than 10 to 20% of the actual incidence."
"Lesser side effects" include insomnia, appetite suppressant, and irritability - all of serious concern.
There is an affirmative answer to the questions posed in the previous section: There is ADHD treatment with no side effects and ADHD treatment with no medication. Neurotherapy or EEG biofeedback is that treatment. Read below about this approach and see Neurotherapy FAQs for more information.
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Yes, think of ADHD as a Disability.
Barkley book (Taking Charge of ADHD) uses the 2/3s rule.
Take 2/3s of your inattentive or hyperactive child’s age and that is where he will be developmentally.
Developmental tasks: getting dressed, daily hygiene, clean and organized room, tracking homework, etc.
Adjust your expectations to 2/3s of your child’s age on developmental tasks and strongly reinforce his successes.
To maintain this perspective is to maintain a disability perspective.
It is not an excuse, a child still has to do as he is told.
Now move toward the 4 to 1 ratio of positive comments to negative comments.
Ignore this concept and risk constant hovering or a negative feedback cycle.
ADHD is not related to intelligence.
ADHD is related to using your intelligence or using ability.
Aggression does NOT Fit the 2/3s rule
Aggression is completely unacceptable and should merit a swift and powerful consequence.
Teach non-aggression throughout life.
Respect can and should be taught and maintained at all developmental levels.
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Inhibition: They just don't stop and think.
OOPS!!!!!
ADHD children and adults do not inhibit their impulses.
No review of rules is taken before taking action.
They don't follow the rules because they don't stop and think before acting. They just go!
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“To err is human, to forgive, divine.”
Alexander Pope, Essay on Criticism
Forgiving your child and yourself is the most critical concept for you to embrace as a parent of a child with disabilities – especially ADHD.
Stanford Forgiveness Project. “Failing to reconcile unresolved anger and blame for past hurt or offense can cause immeasurable physical and emotional health problems in people's lives.”
There are harmful effects of unmanaged anger and hostility on cardiovascular health and interpersonal relationships.
Heart attack patients were often able to demonstrate less anger and hostility and thus reduce morbidity when they acted in a more forgiving way (Stanford Forgiveness Project).
Inattentive and hyperactive children give you many more opportunities to exercise your forgiveness than other children.
You are going to make more mistakes as a parent because you have more opportunities. Forgive yourself!
Your inattentive and/or hyperactive child simply requires more and better parenting than most other kids.
You need to forgive yourself so you can reset with a better attitude for tomorrow morning, you will need it!
With fury and rage building, you cannot be the parent you want to be!
Put your child back on his throne in your Heart!
It is time to "close the gap between where you are now and where you want to be."
Call Dr. Shinaver at 317-337-9227 or e-mail him at charles.shinaver@gmail.com.
His new office is at Majestic Plaza: 9640 North Augusta, Suite 410, Carmel, IN 46032
Charles S. Shinaver III, Ph.D. ALL RIGHTS RESERVED. Copyright 2007
