My child just received a diagnosis of ADHD. Now what?
It’s always a lot of information to absorb, so don’t worry if you don’t remember all of the points. If you did not get all of your questions answered when you initially received the diagnosis, reach out to the provider. Write your questions down to make sure you get the information that you need. Hopefully this post can also help you organize and digest all of the information. If you’re still needing more help understanding ADHD and how to support your child, consider working with a clinician who can provide parent education and training related to what ADHD is and how to support your child with ADHD at home.
Treatment recommendations for ADHD are likely to vary based on the child and their needs. That said, there are some common recommendations that we can review here.
It’s always a lot of information to absorb, so don’t worry if you don’t remember all of the points. If you did not get all of your questions answered when you initially received the diagnosis, reach out to the provider. Write your questions down to make sure you get the information that you need. Hopefully this post can also help you organize and digest all of the information. If you’re still needing more help understanding ADHD and how to support your child, consider working with a clinician who can provide parent education and training related to what ADHD is and how to support your child with ADHD at home.
Treatment recommendations for ADHD are likely to vary based on the child and their needs. That said, there are some common recommendations that we can review here.
Basics
Basic skills such as sleep, diet, and exercise support our overall health as well as our mood and concentration. For example, evidence for using physical exercise for children with ADHD as a way of supporting their focus and concentration is growing (see this short article for a good description of what is being looked at: https://childmind.org/article/adhd-and-exercise/). In this way, you can always go back to the basics and aim to optimize your child’s sleep, diet, and exercise (by the way, exercise can help increase focus in children without ADHD as well).
Organized physical activity can be one way to schedule exercise into your child’s day, but there are other ways as well. Consider 20-30 minutes of playing outside before doing homework, or as a break between different homework tasks. Make it fun, and don’t forget that you can participate as well (exercise is also helpful for adults’ mental health).
Environmental Supports
In general, kids tend to do well with structure, consistency, and predictability. Kids with ADHD especially tend to do well under these circumstances, because structure and predictability help to lessen the impact of difficulties with organization and getting started on tasks. If children always put their homework in the same folder, in the same place in their backpack, it’s harder to lose (but still not impossible to lose, unfortunately). Similarly, structured and consistent routines can also be helpful. If children do their homework at about the same time every day, homework time starts to become more like a habit and less like a monumental effort that depends on their motivation, fatigue level, and interest.
Some ideas for increasing structure, predictability, and consistency at home include:
Additionally, children with ADHD can have a hard time understanding how to break tasks down or sequence steps. The idea of cleaning their room can be overwhelming, or it can be hard for them to know what steps might need to happen to complete a larger project. So, they benefit from support figuring out what needs to happen first, second, and third and when this needs to happen. Younger kids may benefit from visuals that represent each step, whereas older kids may benefit from lists and deadlines.
Finally, we all like to hear when we are doing well! Children with ADHD can sometimes get disproportionately negative messages about their skills and capabilities, especially if they are being frequently redirected to listen, do something again, or “try harder.” All children need lots of positive reinforcement and praise, and this can be particularly powerful for children with ADHD. Highlight when your child gets started on a task without being asked, tries something before asking for help, and completes a request the first time you ask. Remind them of how wonderful their skills and interests are!
Educational Supports
Some children might benefit from formal educational accommodations in order to support their participation in the school environment. There are two primary ways of getting educational accommodations in a public school setting: a 504 Plan and an IEP. The differences between the two will be discussed in another post, but they are both avenues for children to receive supports and interventions in the school setting.
Basic accommodations that may be helpful for children with ADHD may include the following:
Social Skills
Symptoms of ADHD can also interfere with social relationships. As a result, some children with ADHD may benefit from social skills support, and learning ways to regulate themselves and interact more successfully with their peers. They may participate in a social skills group at school, or they may be referred to a social skills group outside of school.
Occupational Therapy
Occupational therapy may also be recommended. Children with ADHD can benefit from movement and from certain types of sensory input (e.g., swinging, jumping). Occupational therapy can help kids with ADHD and their families learn ways to implement this type of movement at home, which can help kids feel more regulated and in control of themselves.
Psychotherapy
Children with ADHD work hard at school, and school can be a tiring and stressful place for them. As a result, some children with ADHD may display concerns with self-esteem, depression, and anxiety. They may sense or feel like there is something wrong with them and that school is harder for them than for others. In these cases, therapy can help kids learn more about their diagnosis and shape a more helpful narrative around what it does and does not mean for them. Many children with ADHD can be incredibly creative, productive, and passionate about their interest areas, whereas sitting for long periods of time, focusing during lectures, and managing time can be more difficult for them. Therapy can also help address any symptoms of depression or anxiety that may be making it even harder for them to focus, complete their schoolwork, or interact with their peers.
Medication
Medication is an evidence-based treatment for ADHD, and you may have been encouraged to pursue a medication evaluation with your pediatrician or a child psychiatrist. While this blog post will not be an in depth look at the pros and cons of medication or how to know when to use medication, I encourage all of the families that I work with to gather more information. Read from reputable sources and even meet with your pediatrician or a child psychiatrist with a list of questions you might have about medication types, side effects, and long term effects. Being as informed as possible makes you a better advocate for your child. Straight Talk about Psychiatric Medications for Kids, 4th Edition by Timothy Wilens and Paul Hammerness also contains helpful information about psychiatric medications in general.
Other resources on ADHD and medication specifically:
https://www.additudemag.com/long-term-effects-of-adhd-medication-brain/
https://childmind.org/article/will-adhd-medication-change-my-childs-brain/
Parenting Support
There are many avenues for treatment for ADHD. One avenue is through modifying the child’s environment, for example, through educational accommodations or environmental structure and predictability. Another avenue is through intervening directly with the child, by teaching skills, talking through difficulties, learning ways to regulate their emotions and behavior, and medication. Yet another intervention is parenting support, or modifying the parent-child dynamic.
Managing expectations can be a big stumbling block for families of children with ADHD. Working with a therapist who understands child development and ADHD can help parents make sure that they are setting realistic expectations. It can be a very delicate balance to both challenge our children and build their skills while also holding realistic and attainable expectations, so additional input can be helpful. Parents can also receive support and feedback about ways to continue to modify the environment at home in an effective way. Finally, parents can benefit from support processing their own thoughts and feelings around their child’s diagnosis, parenting successes and challenges, and family dynamics. By being able to process some of our own stuff, it frees up resources. When we have resources, we can work to create more affirming and supportive environments for our children and show up as our best selves. Not to mention, when we model asking for and utilizing help, our kids are watching.
Basic skills such as sleep, diet, and exercise support our overall health as well as our mood and concentration. For example, evidence for using physical exercise for children with ADHD as a way of supporting their focus and concentration is growing (see this short article for a good description of what is being looked at: https://childmind.org/article/adhd-and-exercise/). In this way, you can always go back to the basics and aim to optimize your child’s sleep, diet, and exercise (by the way, exercise can help increase focus in children without ADHD as well).
Organized physical activity can be one way to schedule exercise into your child’s day, but there are other ways as well. Consider 20-30 minutes of playing outside before doing homework, or as a break between different homework tasks. Make it fun, and don’t forget that you can participate as well (exercise is also helpful for adults’ mental health).
Environmental Supports
In general, kids tend to do well with structure, consistency, and predictability. Kids with ADHD especially tend to do well under these circumstances, because structure and predictability help to lessen the impact of difficulties with organization and getting started on tasks. If children always put their homework in the same folder, in the same place in their backpack, it’s harder to lose (but still not impossible to lose, unfortunately). Similarly, structured and consistent routines can also be helpful. If children do their homework at about the same time every day, homework time starts to become more like a habit and less like a monumental effort that depends on their motivation, fatigue level, and interest.
Some ideas for increasing structure, predictability, and consistency at home include:
- Going to bed and waking up at the same time everyday
- Having a consistent time for doing homework and doing chores
- Having and writing out a morning routine, where you do the same actions in the same sequence (e.g., brush teeth, get dressed, eat breakfast, put shoes on)
- Having specific places in the home for things like backpacks and lunch boxes, and doing your best to place items in these locations exclusively and consistently
- Having a homework routine, where you can support your child in getting into the habit of reviewing what they have to do for homework and developing a plan for completing their homework before they begin
- Setting up a reward system where children can receive tangible rewards for task initiation and completion
Additionally, children with ADHD can have a hard time understanding how to break tasks down or sequence steps. The idea of cleaning their room can be overwhelming, or it can be hard for them to know what steps might need to happen to complete a larger project. So, they benefit from support figuring out what needs to happen first, second, and third and when this needs to happen. Younger kids may benefit from visuals that represent each step, whereas older kids may benefit from lists and deadlines.
Finally, we all like to hear when we are doing well! Children with ADHD can sometimes get disproportionately negative messages about their skills and capabilities, especially if they are being frequently redirected to listen, do something again, or “try harder.” All children need lots of positive reinforcement and praise, and this can be particularly powerful for children with ADHD. Highlight when your child gets started on a task without being asked, tries something before asking for help, and completes a request the first time you ask. Remind them of how wonderful their skills and interests are!
Educational Supports
Some children might benefit from formal educational accommodations in order to support their participation in the school environment. There are two primary ways of getting educational accommodations in a public school setting: a 504 Plan and an IEP. The differences between the two will be discussed in another post, but they are both avenues for children to receive supports and interventions in the school setting.
Basic accommodations that may be helpful for children with ADHD may include the following:
- Some children and adolescents with ADHD struggle with balancing speed and accuracy (i.e., they work quickly and inaccurately), and some children and adolescents with ADHD have slower processing speeds, meaning it may take them more time to understand and use information. As a result, these children can benefit from extended time on tests and assignments
- Preferential seating (e.g., next to the teacher or somewhere quiet) to help limit distractions and promote focus
- Frequent breaks to refocus their energy and help them re-engage with material if they have lost focus
- Movement breaks throughout the day
- Access to alternative seating such as standing desks, wiggle seats, bands that wrap around the bottom of the chair, or fidgets
- Access to directions and instructions verbally and in written format
- Frequent check-ins in order to ensure that they have understood task instructions and know what to do next
Social Skills
Symptoms of ADHD can also interfere with social relationships. As a result, some children with ADHD may benefit from social skills support, and learning ways to regulate themselves and interact more successfully with their peers. They may participate in a social skills group at school, or they may be referred to a social skills group outside of school.
Occupational Therapy
Occupational therapy may also be recommended. Children with ADHD can benefit from movement and from certain types of sensory input (e.g., swinging, jumping). Occupational therapy can help kids with ADHD and their families learn ways to implement this type of movement at home, which can help kids feel more regulated and in control of themselves.
Psychotherapy
Children with ADHD work hard at school, and school can be a tiring and stressful place for them. As a result, some children with ADHD may display concerns with self-esteem, depression, and anxiety. They may sense or feel like there is something wrong with them and that school is harder for them than for others. In these cases, therapy can help kids learn more about their diagnosis and shape a more helpful narrative around what it does and does not mean for them. Many children with ADHD can be incredibly creative, productive, and passionate about their interest areas, whereas sitting for long periods of time, focusing during lectures, and managing time can be more difficult for them. Therapy can also help address any symptoms of depression or anxiety that may be making it even harder for them to focus, complete their schoolwork, or interact with their peers.
Medication
Medication is an evidence-based treatment for ADHD, and you may have been encouraged to pursue a medication evaluation with your pediatrician or a child psychiatrist. While this blog post will not be an in depth look at the pros and cons of medication or how to know when to use medication, I encourage all of the families that I work with to gather more information. Read from reputable sources and even meet with your pediatrician or a child psychiatrist with a list of questions you might have about medication types, side effects, and long term effects. Being as informed as possible makes you a better advocate for your child. Straight Talk about Psychiatric Medications for Kids, 4th Edition by Timothy Wilens and Paul Hammerness also contains helpful information about psychiatric medications in general.
Other resources on ADHD and medication specifically:
https://www.additudemag.com/long-term-effects-of-adhd-medication-brain/
https://childmind.org/article/will-adhd-medication-change-my-childs-brain/
Parenting Support
There are many avenues for treatment for ADHD. One avenue is through modifying the child’s environment, for example, through educational accommodations or environmental structure and predictability. Another avenue is through intervening directly with the child, by teaching skills, talking through difficulties, learning ways to regulate their emotions and behavior, and medication. Yet another intervention is parenting support, or modifying the parent-child dynamic.
Managing expectations can be a big stumbling block for families of children with ADHD. Working with a therapist who understands child development and ADHD can help parents make sure that they are setting realistic expectations. It can be a very delicate balance to both challenge our children and build their skills while also holding realistic and attainable expectations, so additional input can be helpful. Parents can also receive support and feedback about ways to continue to modify the environment at home in an effective way. Finally, parents can benefit from support processing their own thoughts and feelings around their child’s diagnosis, parenting successes and challenges, and family dynamics. By being able to process some of our own stuff, it frees up resources. When we have resources, we can work to create more affirming and supportive environments for our children and show up as our best selves. Not to mention, when we model asking for and utilizing help, our kids are watching.
Author
Dr. Danielle Mohr is a licensed psychologist at Wolff Child Psychology. She specializes in comprehensive evaluations for children, teens, and young adults, and she conducts regular individual and family sessions.
ADHD Interventions