How young can you diagnose adhd

ADHD is the same as ADD.

They used to be considered different disorders. If a child showed inattentive symptoms, they were diagnosed with ADD. If they showed hyperactive or impulsive symptoms, it was ADHD.

Now, they are considered the same disorder — just different variations of it. Depending on which set of symptoms a child has, they fall into one of three categories:

• Predominantly inattentive – This is what used to be known as ADD. A kid displays most signs of inattention but isn’t hyper or impulsive.
• Predominantly hyperactive-impulsive – A child can focus and pay attention, but shows many signs of hyperactivity and impulsivity.
• Combined – Most children with ADHD are a mixed bag. They have symptoms from both sides of the disorder.

ADHD behaviors are so interconnected that they can change over time. Your child could be diagnosed with the combined form of ADHD and, years later, be predominantly inattentive. When their symptoms change, their treatment may change too.

There’s more to managing ADHD than medication.

By the last count, more than 11 percent of children in Iowa were diagnosed with ADHD, according to the 2011 National Survey of Children’s Health. Eighty percent of them are taking medication for it.

Ritalin and Adderall are well-known ADHD medications and are effective for the majority of children. They are fast-acting stimulants that reduce the number and severity of symptoms. But they don’t work for every child. Non-stimulants are used instead when stimulants are ineffective or present unwanted side effects like sleep issues, poor appetite and social withdrawal.

Medication is often used alongside behavior management, and that’s where parents come in. The American Academy of Pediatrics (AAP) just updated their guidelines for treating children with ADHD in September. The new guidelines emphasize parent training in behavior management and recommend it as the first-line of treatment — before medications — for children six and under.

Parenting Tips for Helping a Child with ADHD

Raising a child with ADHD can be challenging, especially in the early years when they are rapidly developing and aren’t old enough to try medication. But no matter their age or prescription, parents play a major role in managing problematic behaviors.

The AAP’s advice boils down to structure, organization and simplification. You can only really control the home environment. But if you do what you can to make things simple and structured, you can help improve your child manage their condition.

• Create a routine. Schedules are a must. They set expectations from breakfast to bedtime, helping to keep kids focused on tasks or activities while limiting their distractions.
• Organize everything. In addition to structuring your child’s days, structure their environment. An orderly environment where every toy and item has a home helps forgetful children keep track of their belongings.
• Limit their choices. The amount of options can be overwhelming for children with ADHD. Make your child’s life more manageable be letting them choose from a limited set of options, whether it’s what they want to eat or what they want to do during the day.
• Make lists. Break things down step-by-step for them. Lists help limit choices, build good habits and set clear paths for long-term and otherwise unmanageable tasks. For younger kids, illustrated lists are more effective. Use pictures that illustrate the steps they need to complete. You can make it interactive by allowing them to move a picture to a different area on the chart to help give them a sense of achievement.
• Stay positive. Rewarding good actions is a major component of behavior therapy. You must outline clear consequences and discipline for poor behavior. But positive reinforcement is critical. Offer up affection, praise, or prizes when they hit their goals, accomplish their tasks or even just pay attention.

Help establish healthy habits. An unhealthy lifestyle can make ADHD symptoms worse. Make sure your child is eating right and getting plenty of exercise and sleep. 

Additional Help for Parents and Children with ADHD

You control the home, but ADHD behaviors are present in at least one other setting. So you need additional support and coordination with teachers, family and the community to help your child manage their condition when you’re not there.

Your kid may require additional assistance in the classroom or other services at school where they have behavioral specialists trained to help. Keep an open line of communication with your child’s teachers and the staff at their school to better coordinate your efforts and keep tabs on progress.

Teachers are also important in diagnosing ADHD. They provide valuable insights into whether a child is having the same difficulties at school as they are elsewhere. If you or a teacher are concerned about your child’s behavior, set up an appointment with your pediatrician to get an accurate diagnosis of the type and receive proper treatment. It’s a team effort, but with the right tools, your child can succeed and thrive despite their condition.

How Young is Too Young for Diagnosis

Written by Hedy Marks

Medically Reviewed by Dan Brennan, MD on June 24, 2016

How early is too early to tell if your toddler or preschooler might have ADHD?

Most children aren’t checked for ADHD until they’re school age, but kids as young as 4 can be diagnosed, according to guidelines set by the American Academy of Pediatrics (AAP).

At that age, many kids are active and impulsive. So what’s different about kids with ADHD? And if your young child has ADHD, how is it treated?

Stand Out From Other Tots

Compared to other kids their age, children with ADHD often have a harder time sitting still, even for a few minutes. They are unable to wait their turn -- blurting out answers or cutting to the front of the line, for example -- and they may talk excessively.

"Young kids with ADHD are incredibly active all the time," says James Perrin, MD, a pediatrics professor at Harvard Medical School. "Most 4-year-olds are very active in general, but they settle down -- take naps, sit for meals. A child with ADHD is on the go all the time."

"What sets these kids apart is the degree and frequency with which they are hyper and impulsive," says George DuPaul, PhD, professor of school psychology at Lehigh University. "These kids are literally plowing through activities and people at a high pace."

The Diagnosis

ADHD is diagnosed based on symptoms of inattention, hyperactivity, and impulsivity. But inattention often isn’t as apparent in preschoolers.

Sometimes, well-meaning parents, caregivers, or teachers may suspect ADHD. That's not enough. A doctor's full evaluation is needed for diagnosis.

To diagnose a preschooler, a doctor will rely on a detailed descriptions of your child's behavior from parents, day care providers, preschool teachers, and other adults who regularly see your child, along with their own observation. It’s important to talk about all symptoms with your doctor.

Just because your child has some hyperactivity and impulsivity doesn't mean they have ADHD. For example, children who are frustrated because they have a problem with seeing, hearing, or talking may act out in the same way as children with ADHD. Your child may need testing to rule out other possibilities.

Behavioral Therapy Comes First

For preschoolers diagnosed with ADHD, behavioral therapy is the first treatment.

This type of treatment involves changes in behavior by parents and teachers. Techniques include praising and rewarding good behavior, ignoring bad behavior, and using time-outs. Structure and routine are important for young kids with ADHD.

The Medication Question

If your child is 4 or older and you’ve tried behavioral therapy for at least 6 months without much change, you can also try low-dose ADHD medication.

"But don't ever give up on behavioral therapy," Perrin says. "Behavioral therapy is important even when a child is on medication."

Not all ADHD medicines are FDA approved for children younger than 6. But many doctors prescribe these drugs for preschoolers with ADHD.

"ADHD medication doesn't work as well for this age group," Perrin says. "It definitely does work, but it works less powerfully and less predictably in younger children than in an older child."

Although there can be side effects, the AAP believes that the benefits outweigh the risks in young children who aren't getting better with behavioral therapy.

A study found that young children are more sensitive than older children to the side effects of methylphenidate, one of the more commonly used medications. Those side effects may include delayed growth, loss of appetite and weight loss, insomnia, and anxiety. The side effects, including delayed growth, reversed once the kids stopped taking the medication, DuPaul says.

There aren't any studies on the long-term effects in children who start ADHD drugs at such a young age. But studies of children in elementary school "have not indicated any long-term side effects of treatment," DuPaul says.

Deciding whether to make medication part of your child’s treatment isn’t easy. It's a decision that’s made after carefully weighing the pros and cons. What’s right for one child (and family) may not be right for yours. Talk to your child's doctor, and together you can decide what’s best for your child.

Attention Deficit Hyperactivity Disorder - LabyrinthMed Medical Center Krasnoyarsk

Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that manifests itself in preschool or early school age. It is difficult for such children to control their behavior and concentrate. It has been found that 3 to 5 percent of children suffer from ADHD. This means that in a class of 25-30 children, it is likely that at least one will have ADHD.

ADHD was first described by Dr. Heinrich Hoffmann in 1845. In 1902, Sir George F. Still published a series of lectures that described a group of impulsive children with significant problems due to genetic dysfunction rather than poor parenting - children who are today diagnosed with ADHD.

A child with ADHD faces difficult but not insurmountable challenges. For these children to reach their full potential, they need the help, guidance and understanding of parents, school teachers and the education system.

The medical center "LabyrinthMed" practices an integrated approach to the diagnosis and treatment of attention deficit hyperactivity disorder . Comprehensive examination includes:
- reception of a psychotherapist;
- appointment with a neurologist;
- session of a medical psychologist, correctional session of a defectologist.
According to the results of the examination, a correction program with specific recommendations is prescribed and treatment is prescribed.

You can make an appointment with a specialist or undergo a comprehensive examination on this problem by calling (391) 235-00-15, 217-80-30 or through the website in the Appointment with a doctor section.

In this article you can learn in detail about the features of attention deficit hyperactivity disorder.

Clinic
The main symptoms of ADHD are attention deficit, hyperactivity and impulsivity . These signs appear at a very early age. Since many healthy children also have these symptoms, but to a lesser extent, or caused by another disorder, it is important for the child to have a thorough examination and an appropriate diagnosis made by a highly qualified specialist.

Symptoms of ADHD appear over many months, usually symptoms of impulsivity and hyperactivity precede symptoms of inattention, which may not appear for a year or more. In different social conditions, different symptoms appear, depending on the requirements for self-control of the child in a particular situation. A child who "can't sit still" or who ruins everything is visible at school, but an inattentive dreamer may not be noticed. An impulsive child who acts first and thinks later may be thought to have "discipline problems", while a passive or slow child may simply be considered not very motivated. However, both can have different types of ADHD. All children are sometimes restless, sometimes they do something without thinking, sometimes they float away somewhere in their dreams. When hyperactivity, distractibility, poor concentration, or impulsivity begin to affect school performance, relationships with other children, or behavior at home, ADHD may be suspected in a child. Since symptoms vary greatly depending on social conditions, it is very difficult to diagnose ADHD. This is especially true in cases where attention deficit is the primary symptom.

There are three types of ADHD. There is a hyperactivity/impulsivity predominance type (where there are few signs of inattention), an attention-deficit predominance type (the signs of hyperactivity/impulsivity are mild; and a mixed type (with both attention deficit hyperactivity/impulsivity symptoms).

Hyperactive/impulsive

Hyperactive children seem to be constantly on the move and on their feet They destroy everything around them by grabbing and playing with everything in sight or talking incessantly They find it difficult to sit still at the table during lunch and school, or calmly communicate They squirm and fidget in chairs, or roam around the room Or twirl their feet, touch everything, tap loudly with a pencil Hyperactive teenagers or adults feel inner anxiety They often tell that they need to be busy and may try to do nes how many things at the same time.

Impulsive children cannot control their immediate reaction or think before doing something. They often blurt out inappropriate comments, show their emotions uncontrollably, and act without considering the consequences of their behavior. Their impulsiveness prevents them from waiting for something they want or their turn in the game. They may take a toy from another child or hit if they are upset. Even teenagers or adults impulsively choose activities that bring even a small but immediate return, instead of doing something that requires a lot of effort, but also provides a much larger reward - but later.

Some of the signs of hyperactivity-impulsivity are manifested in the fact that children:

• Feel restless, often wiggle their arms and legs or fidget in a chair
• Run, climb and leave their place in situations where they need to sit and be quiet
• Shout out answers before the whole question is heard
• Having difficulty standing in line or waiting their turn in a game

Carelessness

It is difficult for inattentive children to concentrate on one thing, the task can tire them just a few minutes after it starts. If they are doing something they really enjoy, they have no problem concentrating. But on purpose, consciously focusing on organizing and completing a task, on learning something new, is hard for them.

Homework is especially difficult for these children. They forget to write it down or leave it at school. They forget to bring a textbook or bring the wrong one. If, nevertheless, homework is done, it is full of mistakes and blots. Homework often causes despair in both the child and the parent.

Criteria for attention deficit disorder are:

• Children are easily distracted by irrelevant sights and sounds
• They do not pay attention to details and make mistakes due to their carelessness
• Rarely follow instructions carefully and completely, forget or lose things such as small toys, pencils, books and tools needed to complete the task
• Often rushing from one unfinished business to another

Children diagnosed with ADHD with attention deficits rarely have problems due to hyperactivity or impulsivity, but have significant difficulty concentrating. They appear dreamy, "absent," easily embarrassed, and move slowly and sluggishly. They find it difficult to process information as quickly and accurately as other children. When a teacher gives verbal or written instructions, it is difficult for such a child to understand what he or she should do, and they make many mistakes. In addition, such a child may sit still, be well-behaved, and even seem immersed in work, but he does not pay enough attention to it or does not fully understand the task or instructions.

These children do not have serious problems with impulsivity or hyperactivity in the classroom, at school or at home. They get along better with other children than those with the more impulsive and hyperactive type of ADHD. They may not experience the social problems of mixed ADHD at all. Too often, their attention problems are overlooked. And they need help just as much as kids with other forms of ADHD who have more obvious problems in the classroom.

Is it really ADHD?

Not everyone with excessive hyperactivity, inattention or impulsivity has ADHD. Since most people sometimes say things they didn't want to say, jump from one task to another, be disorganized and forgetful, the question arises: how experts determine whether a child has ADHD or not.

Since every child has these problems from time to time, this diagnosis requires that such behavior be unacceptable for a person of this age. The diagnostic standards also contain specific criteria for identifying symptoms that are indicative of ADHD. Behavioral problems should start in early childhood, before age 7, and last for at least 6 months. Most importantly, such behavior must actually create severe problems in at least two areas of a person's life: at school, on the playground, at home, in the group of people to which he belongs, or in the environment where he has to communicate. Therefore, if a person has these symptoms, but they do not disrupt their school life and relationships with friends, then they will not be diagnosed with ADHD. Nor would such a diagnosis be given to a child who is overly active on the playground but has no difficulty in other social settings.

To determine if a child has ADHD, psychiatrists consider several critical questions: is the behavior excessive, how long has it been occurring, is it creating difficulties in life? That is, does this behavior occur more often in a child than in peers? Is this a permanent problem or is it a response to a temporary situation? Do these behavioral problems occur in multiple social settings, or only in one particular place—on the playground or at school?

Diagnosis

Some parents notice signs of inattention, hyperactivity and impulsivity in their infant long before they start school. The child may lose interest in the game and the TV show, or run aimlessly back and forth, not listening to the parents at all. But since all children develop differently and vary greatly in personality traits, temperament and activity, it would be useful to hear the opinion of an expert on how acceptable such behavior is at a given age. Parents can see a pediatrician, child psychologist, or psychiatrist to determine if their child has attention deficit hyperactivity disorder or, more commonly at that age, it's just immaturity or unusually high energy.

ADHD may be suspected by a parent or caregiver, or may go unnoticed until the child has problems at school. Due to the fact that ADHD most strongly affects a child's activities in school, sometimes the teacher is the first to determine that the child is hyperactive or not attentive enough, and can point this out to parents and / or the school psychologist. Since educators work with many children, they begin to understand how "average" children usually behave in lessons that require attention and self-control. However, teachers sometimes fail to notice the needs of children who are inattentive and passive, and also quiet and cooperative, such as children with an inattentive form of ADHD.

Specialists who can diagnose

If ADHD is suspected, who should the family contact first? Which specialists should be contacted?

Diagnosis should ideally be made by a specialist in the field of ADHD. Psychiatrists, pediatricians, neurologists - these are the specialties most often involved in the differential diagnosis of ADHD.

Parents can start by contacting their pediatrician. Some pediatricians can make the diagnosis themselves, but more often they refer parents to a suitable psychiatrist they know and trust.

Psychiatrists are doctors who specialize in the diagnosis and treatment of childhood mental disorders. A psychiatrist can provide treatment and prescribe any necessary medications. Psychologists can also treat ADHD. They can help the family develop ways to deal with the disorder. Neurologists—doctors who treat disorders of the central and peripheral nervous systems—can also diagnose ADHD and prescribe medications. But unlike psychiatrists and psychologists, they cannot provide treatment and correction of the emotional aspects of the disorder.

The main task of the specialist is to collect information that excludes other possible reasons for the child's behavior. Here are the possible causes of behavior similar to ADHD:

• A sudden change in a child's life - the death of a parent or grandparent; divorce of parents; job loss by parents
• Undiagnosed epilepsy
• Otitis media causing hearing loss
• Somatic diseases affecting brain function
• Teaching below the level of one's ability due to learning disabilities
• Anxiety or depression

In most cases, the child's social adaptation and mental health are assessed. He is given tests to determine the level of intelligence and school knowledge to see if the child has learning difficulties and in what subjects these problems occur.

After that, the specialist creates a general picture of the child's behavior. What type of ADHD behavior is the child exhibiting? How often? In what situations? How long ago did he have it? How old was the child then? Are the behavior problems chronic and permanent, or are they temporary due to some cause? How seriously do behavioral problems interfere with the child's friendships, school activities, home life, or participation in social activities? Does the child have other related problems? The answers to these questions will help determine whether the child's hyperactivity, impulsivity, and inattention are indeed significant and have been around for a long time. If so, the child may be diagnosed with ADHD.

A correct diagnosis often clears up confusion by clarifying the causes of a child's problems, and this allows parents and children to move on with more accurate information about what is wrong and what can be done to help. Once the disorder is diagnosed, the child and family can begin to receive the combination of educational, medical, and emotional support they need. This may include providing guidance to school staff, selecting the most appropriate class, selecting the correct drug, and helping parents establish and maintain control over their child's behavior.

What causes ADHD

One of the very first questions parents ask is "Why? What went wrong?" "Am I to blame for what happened?" There is currently little direct evidence that ADHD can only arise from adverse social factors or poor parenting. The most well-founded causes seem to lie in the fields of neuroscience and genetics. This does not mean that environmental factors do not affect the severity of the disease, in particular, the degree of damage and suffering inflicted on the child may depend on them, but such factors do not cause ADHD by themselves.

Parents should focus on the future and look for the best possible ways to help their child. Scientists are studying the causes in an effort to find better treatments, and perhaps someday even ways to prevent ADHD. They are finding more and more evidence that ADHD does not depend on the situation in the family, but follows from biological causes. Knowing this, you can remove a heavy burden of guilt from parents who may blame themselves for the child's misbehavior.

Over the past decades, scientists have proposed several theories of ADHD. Some of these theories have stalled, while others lead to new lines of research.

Environmental factors

Studies have shown that there is a possible relationship between smoking and drinking during pregnancy and the likelihood of ADHD. To avoid this, it is better to refrain from using cigarettes and alcohol during pregnancy.

Another environmental factor that may be associated with an increased likelihood of ADHD is high lead levels in young children. Since the use of lead in paint was banned, it can only be found in older buildings, and exposure to toxic levels of lead is not as dominant a cause of ADHD as it once was. Children living in older homes where lead is found in plumbing and lead-based paint surfaces that have been repainted are at risk.

Brain injury

One of the first theories claimed that attention disorders were caused by brain injury. Some children who have had accidents that lead to brain injury may exhibit some of the behaviors that are characteristic of ADHD. But it was found that only a small percentage of children with ADHD had suffered a traumatic brain injury.

Heredity

ADHD is often present in several family members, therefore genetic causes are likely. Studies show that 25% of close relatives of children with ADHD also have this syndrome, while in the general population this figure is approximately 5%. Most studies of twins have now shown that heredity strongly influences the occurrence of this disorder.
Scientists continue to study the influence of genetics on ADHD and identify the genes responsible for a person's predisposition to ADHD

Treatment for ADHD

Every family wants to know what treatment will be most effective for their child. Each family should answer this question to their attending physician.
The results of the study showed that the combined treatment was the most effective. An additional benefit of combination treatment was that these children were successfully treated with lower doses of drugs compared to the drug-only group.

What treatment should my child receive?

No one type of treatment can be considered universal for every child with ADHD. Sometimes a child may have unwanted side effects, and this may make the use of drug therapy unacceptable. And if the child also suffers from anxiety or depression in addition to ADHD, then the combination of drug treatment and psychotherapy is the best option. The child's needs and personal medical history must be carefully considered.

Things to remember about ADHD medications

• ADHD medications help many children concentrate and be more successful at school, at home or on the playground. The ability to avoid negative experiences can really help children avoid alcohol or drug addiction in the future and cope with other emotional problems.

• About 80 percent of children who need medication for ADHD continue to take medication into their teens. More than 50 percent need the drug as adults.

Family and child with ADHD

Drug therapy can help the child in his daily life. It will be easier for him to control some of the behavior problems that lead to difficulties in relationships with parents and siblings. But in order to remove the despair accumulated over a long period of time, the habit of blaming and anger takes time. Both parents and children may need specialized help to learn how to manage their child's behavior. In such cases, psychiatrists and psychotherapists can counsel the family and the child, helping them develop new skills, attitudes, and ways of communicating with each other. During individual conversations, a psychotherapist helps children with ADHD learn to improve their self-esteem. In addition, a psychotherapist can help them find and build on strengths, deal with everyday problems, and control attention and aggression. Sometimes psychological counseling is necessary only for a child. But more often, because a child's disorder affects the family as a whole, all family members need help. The therapist helps the family find the most appropriate ways to deal with the child's destructive behavior and suggests new options. If the child is small, the therapist works mainly with the parents, teaching them how to cope with the child and improve his behavior.

There are different methods of influence. Having information about various methods of influence, it is easier for the family to choose the right psychotherapist.

Psychotherapy aims to help people with ADHD love and accept themselves for who they are, despite the disorder. It does not deal with the symptoms or causes of the disorder. During psychotherapy, patients talk to the therapist about sad thoughts and feelings, identify self-destructive behaviors, and look for alternative ways to manage their emotions. During the conversation, the therapist tries to help them understand how they can change, or how best to cope with their disorder.

Psychological Correction helps people develop more effective ways of dealing with immediate problems. It helps the child to change his way of thinking and psychologically adapt rather than to understand his feelings and actions - and thus can change the behavior of the child. Support can take the form of practical help, such as help with homework or schoolwork, or in dealing with emotionally stressful situations. Or support can be about self-control of behavior, self-reward, and self-rewarding for actions performed in a desired way - say, if a person coped with anger or thought before doing something.

Communication training can also help children learn new behaviors. By teaching communication skills, the therapist discusses and models appropriate behaviors that are important for developing and maintaining relationships with others in situations such as waiting in line, sharing toys, asking for help, or responding appropriately to teasing. Subsequently, the children are given an attempt to practice these skills. For example, a child may learn to read other people's facial expressions and tone of voice in order to answer them correctly. Communication skills training helps a child find better ways to play or interact with other children.

support groups help parents connect with others who have similar problems and who are concerned about their children with ADHD. Members of support groups meet regularly (eg, monthly) to hear lectures from ADHD specialists, share frustrations and successes, get referrals to qualified professionals, and learn about their work. Their strength lies in numbers, and by sharing their experiences with others who have similar problems, they learn things that they could never have known if they were alone.

Parenting Skills Training , provided by psychotherapists, provides parents with methods and techniques to manage their child's behavior. One such method is the use of badges or points systems to immediately assess good behavior or performance. Another method is to "time out" or isolate the child in a chair or in the bedroom when he becomes too rebellious or out of control. During "time-outs" the child is removed from the disturbing situation and sits quietly alone for a while to calm down. Parents are also sometimes advised to spend time with their child every day doing something enjoyable and relaxing. During this time spent with the child, the parent looks for opportunities to note and point out what the child is doing well and to praise him or her for success and ability.

Rewards and penalties can be an effective way to change a child's behavior. The parent (or teacher) identifies several good behaviors that they want to encourage in the child (for example, asking for a toy rather than grabbing it, or completing a simple task in its entirety). The child is directly told what he must do in order to receive a reward. The child is rewarded when he performs the desired behavior and moderately punished when he does not. The reward may be small - for example, a badge of honor is given to a child for special merits - but it must be something desired for the child to want to earn it. As a punishment, you can remove the badge of honor or give a short "time-out". The goal is to eventually teach the child to control his behavior and choose the most desirable way of behavior. This method works well with all children, although children with ADHD may need additional, more frequent encouragement.

In addition, parents can learn to create situations for their children in which they can succeed. This may be the case, for example, when parents allow only one or two partners to take part in the game so that their child cannot become overexcited. Or, when a child has trouble completing tasks, they must learn to help their child, break a large task into several smaller ones, and reward the child for completing each small part. Regardless of how parents specifically influence their child's behavior, some general principles will be helpful to most children with ADHD. These principles call for more frequent and even immediate responses to a child's actions (this applies to both rewards and punishments), to take the necessary measures in advance to prevent potentially problematic situations, to look after children more closely and to encourage them in situations when they are not interested or boring.

Parents can also learn how to use stress management techniques such as meditation, relaxation techniques and exercise to help them cope when things go wrong and respond more calmly to their children's behavior.

A few simple ways to influence behavior

Children with ADHD may need organizational help. So you need:

• Schedule. Organize the same routine for each day from the moment you wake up until you go to bed. The schedule should allocate time for homework and play (including outdoor walks and home activities like computer games). Hang this schedule on your refrigerator door or on a stand in your kitchen. If changes need to be made to the schedule, make them as early as possible.

• Get all the essentials in order. Everything should have its own place, and everything should be kept in its place. This applies to clothing, backpacks and school supplies.

• It is necessary to use diaries to control homework. Emphasize the importance of writing down assignments and having all the necessary books at home.
Children with ADHD need a consistent system of rules that are clear and strict. If children follow these rules, give them small rewards. Children with ADHD are often criticized, and they are already waiting for criticism. Try to find examples of your child's good behavior and praise for it.

Your child with ADHD and the school

You are the best advocate for your child. To be a good advocate for your child, learn as much as you can about ADHD and how it affects your child at home, at school, and in community life.

If your child has symptoms of ADHD at an early age, has been evaluated, diagnosed and treated with behavior modification, medication, or a combination of both, notify the child's teachers when the child enters school. Then they will be better prepared to assist the child in entering this new world away from home.

Never forget the fundamental rule: Your child's best protector is yourself.

Your teenager with ADHD

Your child with ADHD has successfully made it to the end of elementary school and is starting middle school and then high school. Although your child has been examined periodically during these years, now is the time to fully re-examine his health.

The teenage years are challenging for most children; for a child with ADHD, these years are doubly difficult. With all the problems of youth - pressure from classmates, fear of failure, both in school and in communication, low levels of self-esteem - a child with ADHD is more difficult to cope with. The desire to be independent, trying new and forbidden things - alcohol, drugs, sex - can lead to unforeseen consequences. The rules of conduct hitherto largely followed have now been abandoned. Parents may disagree with each other about how to deal with a teenager's behavior.

Now – more than ever – these rules should be clear and easy to understand. Communication between teens and parents can help the teen understand the reasons behind each rule. When a rule is set, it should be clear why it is set. Sometimes it is useful to have a table - usually hung in the kitchen - that lists both all the rules of behavior at home and all the rules of behavior outside the home (in society and at school). Another table might contain a list of chores with space left to mark the completion.