Recommendations for parents

Introduction

"Being a parent is not easy. One is not born knowing how to be a father or mother nor are there universities for learning how to be one." It's easier to be (or seem like) a good parent when the child does not create significant problems. Many parents of "perfect" children are continually giving advice to parents of "problem" children, probably forgetting that the circumstances surrounding each child are quite different, as are families, schools, and ultimately people. And in the spectrum of traits and qualities, virtues and flaws, each individual has his or her own identity, resulting in some very positive things and some negative ones for others. And in regard to attention, hyperactivity (or agitation) and impulsivity, for excess or defect, we have a variety of combinations, among which are those who have trouble paying attention, staying still in social situations that require it and thinking before acting. And these people are often the "difficult children" because right in the period in which their education is most important, more reveal themselves to have these traits. In stages of development that begin to require skills such as patience, reflection/thought, planning or social appropriateness, these children or adolescents that are “jittery”, “inattentive” and / or “impulsive”, have difficultly hiding their defects. In many cases their own parents, begin to wonder whether such conduct that is difficult for others to understand, isn’t voluntary, "to annoy." And it is not the parents’ fault for thinking that way because their patience is at the limit for their own family, personal, professional circumstances ... for friends who continually remind them how badly their child behaves, for teachers who remind them every day how difficult it is to have their child in class and how "bad" he or she is compared with others. Therefore, the first thing we would like to highlight in this guide is for parents to try, as a first step, to AVOID GUILT.

Avoid guilt

One can not feel guilty for that which has not been produced by their own volition. And no parent wants their child to be difficult to educate, or be one that does not relate well with others. No parent wants to pass their less efficient genes on, nor want their child to behave inadequately. No parent wants to devote time to take their child to therapy (of any type) nor want their child to take medication, as no parent wants their child ill, or for him or herself to be ill ... or even anyone to be ill. Therefore, if this is the way it is, Why feel guilty and anchored in negativity? Why not replace the feeling with a sense of responsibility to "look forward", to be better every day: a better person, better parent, better companion...?

Positive thinking

As in Eastern cultures, mothers and fathers could look inside themselves and try to feel better every day, waking up every morning thinking about doing something that allows them to feel better. And if a source of annoyance has usually been the behavior of your child, ask what you can do to help the "little person" that sometimes "annoys" others or does not do enough to please them. As you love them and feel responsible for them being able to adapt as well as possible to a world that surrounds them, we will try to give them something each day that makes them feel good, happy, capable ...will make them want to keep learning and interacting with the environment.

Encourage their development

Our children are beings whom we have brought into the world "without their permission" and although in the early stages of development we must keep a close eye on them, especially "the most unruly". It is true that as they progress in their development, we begin to realize that they are independent people with their tastes, their strengths, their weaknesses, their obsessions ... Encouraging their development is allowing them to grow on the path emerging before them, allowing them to move forward, be themselves and not a clone of their parents or a reflection of what their parents dreamed they would be or, worse, what they wanted and could not be. Our child may not need to be a famous professional or an exceptional student ... much as all parents can make us feel proud of recognition, on the part of others, for the achievements of our children. Life can be long and everyone can succeed at a given time or fail or have problems at other times. That a child was badly behaved as a small child does not mean he or she will be an unhappy adult. Nor does it ensures that an adult will be happy, having been a "model child" or a "brilliant teenager." Among mental health professionals there is a common saying "grown-up child, infantilized adult.” Therefore happiness or the ability to feel good probably will depend more on the internal equilibrium of the individual and their ability to adapt to the environment, to regulate their emotions and to interact with others. And that is shaped over time, so have patience; everyone follows their own particular course of personal development.

Understanding what happens

As stated in other forums related to ADHD, we are talking about a condition with a biological component, which inherits some susceptibility to suffer from it. Understanding this clearly can free parents of guilt that unfortunately appears all too often. And the same can be said in regard to understanding a boy, girl, adolescent or adult with ADHD who does not voluntarily behave inappropriately, but because of their condition (ADHD), they have attention skills that are more limited than in most people. It also is harder for them to wait their turn and not rush. It is hard to think or reason and it is very difficult not to be in continuous motion. However, despite the biological component, our body and specifically our nervous system in particular, are highly changeable, much more than we imagine, and if we add to that our flexible and inclusive personalities, there is much that can be done to help those with ADHD and to disguise these “little defects” that tend to be so obvious to others. They can show off other traits that are more virtuous (kindness, sensitivity, passion, creativity ...) and they can find their place in life. Exercising responsibility for the well-being of our child, if someone suggests that our child may be suffering from an ADHD, especially if those comments come from the school, from our close family or our instincts, we must ask for help.

Ask for help

In the first place, to be clear why this child can be functioning worse than rest of those in his/her setting, it is advisable to:

Talk to parents and even older siblings, partners or caretakers who spend a lot of time with the child / kid / adult.
Talk to the teacher or teaching aid of the school (if it is an older child or an adult with someone in their work environment). It is possible that, if they are available at the school or workplace, the psychiatrist or psychologist could provide a possible pre-evaluation. According to their recommendation, another pediatrician could be consulted for another medical evaluation.
See your pediatrician to get his/her opinion and assessment of the case. In appropriate cases, the pediatrician refers the case to a specialist in child and adolescent psychiatry for them to conduct a comprehensive assessment. In our country (Spain), as there has been no formal specialty in children and adolescent psychiatry, we have developed a traditional tendency to refer such patients to a neuro-pediatrician. Some have a lot of experience in such cases. In any case, today the majority of the large Spanish cities have teams of child and adolescent psychiatrists for references in the public health sector, and there are usually also several in the private sphere.
Access other resources on your own for specific social, educational, family and even health through aid associations. There are some that are more general but others, such as this website, are more specific to ADHD. There are more and more resources to support families with a family member affected, some of them are still not known to most people(specific camps, specially trained caregivers to help provide care, help with their free time ...)
Follow the directions of a specialist in regard to treatments and resources. If we do not feel well treated or think that what the specialist offers is not suited to the characteristics of our child or our family, do not hesitate to ask for a second opinion. We want to obtain as correct a diagnosis as possible, but we also seek personalized care that helps us deal with and understand the disorder. And we're talking about people that we care about and that in the case of children they have their whole life ahead of them. We should not be "super questioners" and if a number of trusted professionals have diagnosed our child with ADHD, even though we do not want to accept the problem, the best way to help is to accept it and follow the guidelines of the specialists.

While parents are the ones primarily responsible for the care of their children, the more difficult the situation and the more unstructured the family is, the more help will be needed and being informed of available resources will be helpful. Because, as much as the parents try, often their entire effort may be insufficient for providing the best care to the affected person.

Seek support from schoo

If we talk about school aged children or adolescents, a fundamental part in the treatment plan is to include those responsible for the child's education at school. A lot can be done there, for obvious reasons, given the enormous amount of time that children spend in school and the importance of how they operate in this environment will depend on their ability to form relationships, in self-esteem, in their ability to improve, their motivation ... If we do not feel understood or cared about at school, the center may not be optimal and we may have to find another one that fits more with what is most appropriate for our child. We’ll try to choose a suitable school for our child and his personality at an appropriate level for him. It is helpful to talk to the specialist handling the case. The same applies to the various activities that the child does (ballet lessons, painting, football, judo, etc.). It is often very helpful for the specialist to be in contact with the child's teacher.

Encourage communication among those involved in their care (specialist-parents-school)

Multidisciplinary work is essential, i.e. between the different people involved in their care. Pediatricians, family doctors, psychiatrists, psychologists, therapists, teachers, instructors, caregivers, assistants ... who have contact with the person in question should strive to communicate regularly with an open and inclusive mind, with respect for the role of others and always seeking cooperation and avoiding confrontation. And parents, as those most responsible, have a lot to say in order to encourage the flow of such multiple communications. Avoid prejudice, most people have one problem or another in their lives and the best way is to not stigmatize these kids is to start by speaking naturally about what happens. ADHD is not going o prevent them from going far, many famous people have been or are inattentive-hyperactive-impulsive, and with the right help and by enabling them to develop their skills, they have managed to excel in many areas.

Seek ways to help that best suit the individual and their environment

There are many things you can do and among all, we must choose those that best suit the individual in question and their environment. There are proven efficient treatments, which therefore would be most suitable, but there are other measures that are essential to encourage development of the boy or girl, and even to improve the other treatments they are receiving. There are different psychotherapies and medications that can treat ADHD and they have demonstrated their effectiveness. Each has its advantages and disadvantages and the choice of one or another should be done with the help of a specialist, with consensus between the individual and his/her family. A good professional will always recommend what he/she considers best for each patient ... and it does not always have to be the same for everyone. We must tell the specialist about our peculiarities, our way of thinking ... but also keep in mind is that he/she knows the topic and is the best one to give advice. Along with the efficacy of treatments (methylphenidate, dextroamphetamine, amphetamine salts, lisdexanfetamine, atomoxetine, psycho educational psychotherapy, parent training, psychotherapy of parent-child interaction, cognitive-behavioral psychotherapy and interpersonal psychotherapy), there are other forms of support that can complement these treatments and promote the personal development of the child, increasing their self-esteem and improving their overall health, and in many cases facilitating the involvement of parents or siblings, who are identified with some of these approaches. These include training to strengthen the neuro-cognitive abilities most damaged by the disorder and try to match those of the majority; neuro-feedback, a technique of electrically stimulating brain areas with less developed functionality, and diets to avoid foods with artificial colors and preservatives, stimulants such as caffeine, excess sugar; or to prevent nutritional deficiencies; doing physical activity that promotes the integration of a person or group which enhances their individual capacities; or relaxation therapy or focusing of attention, such as hypnosis or visualization techniques; art therapy or any other therapy that encourages the expression of emotions (psychodrama, play therapy) or that encourages self identity (dynamic psychotherapies, animal assisted therapy). All of them can help and even promote the main treatment, if carried out by appropriately trained and experienced professionals that know the potential benefits and risks of these approaches for the recipient. In these cases it is helpful to ask all the questions we might have and do not trust the treatments that promise quick results with little effort, especially if they are particularly expensive. It is often better to follow our intuition, advice of those that care about us and those that know the most, and definitely recognize our own tendencies. Let us not deceive ourselves or expect magical results. Although we identify with one approach over another, remember that we have to adapt to the real needs of our child and family ... and not so much to ours. If we can combine both, all the better.

Some general recommendations

Provide an orderly way of life, organizing your schedules and setting times for recreation and physical exercise
Set routines for what they like least
Tasks should be divided into short periods of time, with breaks and constant reinforcement of what has been achieved
Make a time limit after which all are released from their task
Give guidance to pay attention to the fundamentals of what they are doing
In times of crisis, don’t lose control of your temper. Calm the situation and later, when it has passed, reflect on it
Adapt learning to his/her skills: structure homework, promote activities that he/she is good at
Let us strive to find their strengths and avoid continually judging what he/she does
Continually praise what he/she does well, even if is seems something minimal or expected
Avoid continual criticism in the family environment
Spend some time (even a few minutes each day) to share an activity with the child that he/she likes. If he/she is older, discuss how they feel, what they are worried about. It is their time just for him or her
Make it very clear that you care about him/her, that you love them, that you believe in him or her
Strengthen eye contact during communication with the child, this improves the bond and improves the quality of communication
Best rules are clear ones. Sometimes children do not follow them because they do not understand them or simply because they do not know them.
Our instructions are better if they are straightforward, concise and clear. Avoid them from being charged with emotion (these children are usually very sensitive and get lost in the implicit emotion of the message). Make it better with a neutral tone of voice
Do not give the child attention when they interrupt and make evident the moment they are allowed to interrupt and encourage him or her when they do it at the right time
Try to ignore their negative behavior whenever possible.
Use a phrase routinely to remind them that what they are doing we don’t like and do not want them to continue: "If you continue doing WHATEVER ... there will be consequences"
Reinforce positive behaviors, including point systems and rewards. Reward when important goals are met in the medium term, always one for one
Specify the behavior for which you praise them: Give him or her specified, clearly named praise.
Avoid the use of the word NO to give instructions, be creative in offering positive praise
Avoid punishment except situations where the conduct is intolerable, and in that case, avoid confrontation, avoid emotion in what is being said. With children, use "time out", i.e. time sitting motionless in a chair or a corner of the house
To communicate something important, choose a time when the child is receptive, in a "good mood" with us ... and not when he/she is angry and frustrated. In these situations, it is better to wait for another time
Let us convey the importance of behavior in public places, from when they are "little guys"
Dedicate all the time we can to our child... always being reasonable ... being a parent is very important… spending time usually has positive consequences that please parents and children
Ask someone to help when we feel overwhelmed. These children can wear out parents and time from a relative, friend or professional can let us calm down enough to continue giving it our best shot.
We realized that, within our family, it might not be healthy and we try to change it, "investing in promoting a healthy lifestyle is a source of health"

Arriba

The Elisabeth d'Ornano Association for ADHD

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