HYPERACTIVITY ::: ADHD

HYPERACTIVITY ::: ADHD

Mention that your child won't sit still or pay attention and most folks would say you've got a typical, red-blooded, all-American kid. Say that Junior can't seem to and he might be diagnosed with the most common psychiatric condition of childhood.

Attention deficit hyperactivity disorder (ADHD)--better known as hyperactivity, with or without the classic busy-bee behavior--affects about two million children in the United States, most of them boys. Yet even though ADHD is so widespread, scientists are only beginning to learn more about it. For years, the popular opinion was that these fidgety, incredibly impulsive kids were just brats--and that upbringing (or the lack of it) was the likely cause.

"Now we know that ADHD is not the fault of the parents but rather the result of an insufficient amount of one or more of the chemicals in the nervous system responsible for concentration and attention," says Ellen Gellerstedt, M.D., assistant professor of pediatrics at the University of Rochester School of Medicine and Dentistry in Rochester, New York, who specializes in developmental and behavioral pediatrics. "It's not that these kids are stupid or brats. They know the rules. They just are so impulsive that they act before they think."

Raising a hyperactive child is no easy task, but that doesn't mean it's a lost cause. "The symptoms always appear before age seven, so raising a hyperactive child is a real challenge," says Dr. Gellerstedt. "What may seem to be a disability in school often becomes a gift in adulthood. The kids often grow up to become adults who have incredible amounts of energy, are usually very creative and can often see things in ways that others can't."

Some prescription medications such as Ritalin can help reduce overactivity and focus attention. But here are some other ways to help children who have been diagnosed with hyperactivity.

Make everything step-by-step. "Hyperactive kids need an extreme amount of structure and orgaization, and if they get it, they usually calm down and do a lot better," says Ben J. Williams, Ph.D., a child psychologist who is the former director of the Hyperactivity Assessment Program at Baylor College of Medicine and Texas Children's Hospital in Houston.

"To do that, I encourage parents to break every activity into a six- or seven-step process, whether it's getting up, eating meals, watching TV, doing homework-virtually every aspect of the child's life. It's not enough to say 'Get ready for school.' It has to be 'First get out of bed. Then go to the bathroom to brush your teeth. Then wash your face.' And so on." Such regimentation may seem like belaboring the obvious, but Dr. Williams says it's necessary for hyperactive children, whose attention often lapses after just a minute or two.

Chart their progress. Another good way to give hyperactive kids the structure they need is with a daily calendar or chart outlining what's expected of them. "It's good to operate on a point system. By fulfilling their obligations, kids earn points, which are used for special privileges such as going out for ice cream or going to the movies," says Dr. Williams. "You should back up this structure with logical punishment-taking away privileges, for instance, rather than giving them spankings when they fail to meet their obligations. It's best to spell out everything on the chart, so there are no arguments later."

Be a "parrot" parent. "Since these kids act on impulse, you have to be prepared to remind them 5,000 times about what they're supposed to be doing," says Dr. Gellerstedt. "And not just for a day or two. For always. It's very important for parents to discipline themselves to remind kids again and again and again they have to brush their teeth or shut off the TV, even when it seems perfectly obvious."

Get them involved in the right activities. "Hyperactive kids tend to be above average in activities involving large-muscle movements but slower than average in sports that require hand-eye coordination. So they will do very well in activities such as swimming and soccer but will probably become very frustrated playing Little League baseball," says Dr. Williams.

"Outside of sports, it's good to get hyperactive kids involved in activities that have a good parent/child ratio, such as Cub Scouts or the YMCA Indian Guide Program. And try to arrange for the hyperactive child to sit either next to or directly across from the leader for maximum eye contact and involvement."

What about Diet? Although studies have not proven that certain foods and ingredients (such as sugar) cause hyperactivity, the diet connection has been explored often and debated even more. While most doctors say there is no solid medical evidence that shows that diet plays any role in hyperactivity, many parents of hyperactive children believe otherwise. One such parent is Jane Hersey, mother of a hyperactive child and national director of the Feingold Association of the United States, a group in Alexandria, Virginia, that believes food additives and even common fruits and vegetables trigger certain reactions in chemically sensitive people--including those with hyperactivity. "Many parents tell me they see a drastic change almost immediately when they change diet," says Hersey. "My daughter showed improvement in her behavior very quickly and dramatically once she started the Feingold diet." The Feingold diet--started by a noted allergist and pediatrician, the late Ben Feingold, M.D.--helps parents find out whether a child is sensitive to food additives. The Feingold Association has a shopping list of foods that do not contain artificial colorings, flavorings or the preservatives BHA, BHT and TBHQ. If a child shows a lot of improvement while consuming the acceptable brand-name foods, he or she is probably chemically sensitive and should stay on the diet, according to Hersey. "Besides the food additives, a large number of common fruits and some vegetables appear to have compounds in them that can also trigger reactions," says Hersey. Among them are berries, cherries, apricots, apples, grapes, peaches and tomatoes.

Have family rap sessions. Sibling rivalry is often a problem in families with hyperactive children--particularly when the hyperactive child torments a younger sibling. "One of the best ways of dealing with that, outside of professional counseling, is to have regular family meetings where everyone discusses his feelings--not just about that but everything, says Dr. Williams. "This allows the younger child to express his feelings, and the family will usually come up with solutions." It's better to "talk out" than to "act out" or be hyperactive.

It's also helpful because many hyperactive children often have trouble identifying with role models. Hearing his father talk about how he deals with life's everyday stresses, for instance, may teach a hyperactive boy important lessons. "In fact, one of the best things you can do for a hyperactive child is give a lot of quality time with the same-sex parent," adds Dr. Williams.

Give kids responsibilities. To channel these children's attention, many experts suggest providing them with household chores to foster responsibilty. "You can incorporate the chores into the point system from about second grade on," says Dr. Williams. "I recommend a procedure where the child has four chores a day that are tied in to his allowance and special privileges. He gets a base allowance regardless but has an opportunity to make more money based on what he does with regard to his grades, behavior, chores, and other responsibilities. Generally, these kids make excellent workers, because they have so much energy.