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· 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

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2. What causes Attention Deficit Hyperactivity Disorder?

3. Is ADHD just a lack of discipline or respect for parents?

· 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

4. Is it mom's fault?

No, ADHD is not Mom’s fault. It's that simple.

5. If it's not my fault, then why does my hyperactive son with ADHD respond differently to me than my husband?

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.

6. How is Attention Deficit Hyperactivity Disorder diagnosed?

· 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!

7. Will kids grow out of Attention Deficit Hyperactivity Disorder?

· 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

8. What to do and when to do it?

· 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.

9. Do medications work for ADHD?

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?

10. What is the big deal about side effects?

· 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.

11. Is Attention Deficit Hyperactivity Disorder a disability?

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.

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?

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!

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?

“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 434, Carmel, IN 46032

Charles S. Shinaver III, Ph.D. ALL RIGHTS RESERVED. Copyright 2008

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