Children with ADD can be a BIG challenge at home for the rest of the family. Although the following things are true with all children, those with ADD can greatly benefit from these tips:

1. Be very specific about rules, consequences, and rewards. Written down, reviewed, consistent rules are much more likely to be followed. Consistency (making the rule stick every time, all the time) is not easy. But you will be happier yourself as well as allow much less room for arguments with your child if you are consistent. Do not let your child "win" an argument to do or not do something with whining, crying, hitting, or other bad behaviors. If you do let this happen, the child just learned that whatever they just did is the way to get you to change your mind. "Well, just this once" may sound okay, but your child does not understand it that way.
2. Make lists of chores or other expectations. The short attention span of a child with ADD will keep them from completing a list of things to do that they have heard but cannot read. Put a written list in an obvious place (the bathroom mirror, the bedroom door, the door that the child leaves the house from).
3. Keep a consistent schedule. Being able to predict what happens when for a child with ADD will help. Warn your child in advance if there will be a change of schedule.
4. Have a place for everything. If having all the things your child needs in the morning for school or in the afternoon for soccer practice never seem to be where they need to be, organize them. Make a special box, drawer, hanger, or shelf for them and (verbally) reward the child for keeping them there.
5. Use lots of timers or alarms. If your child seems to have no concept of what "we're leaving in 10 minutes" means, use a kitchen timer so they can watch the time approach zero.
6. Find something to say something good about. Children with ADD are so likely to hear criticism of their behavior that they often respond well to even small amounts of praise. Finding one thing that your child does well and supporting it with your time, energy, and praise will go a long way towards helping your child's self-esteem.
7. Homework is often a major challenge and frustration. Providing a quiet place with few distractions (no TV, no radio, etc.) will help. So will sticking to a schedule of when the homework is to be done on school days or weekends. Make it mandatory to finish homework before special privileges, like watching TV or using the computer, are earned. Assignment notebooks are helpful for keeping track of assignments. Breaking bigger homework assignments into smaller parts often helps (the child's attention span in more likely to last).

 Many times, a child is diagnosed with ADD, we have discussed treatments, and a specific medicine is prescribed all in one office visit. The next steps are filling the prescription, following the instructions above, helping your child take their medicine as prescribed, watching for changes at home, and periodically checking with the teacher and school to see how things are working there. After starting the medicine, we like to hear from you by phone in 2 weeks for an update on how things are going. Then we like to see children back once they have been on the medication for 4 weeks (realize that for the child that only takes the medicine at school that the time to come back for follow-up may be longer if a break or holiday is involved). Each follow-up visit we will:

1. Check weight, check blood pressures, and check height (if it has been more than a month between visits).
2. Review improvements seen while taking the medicine.
3. Review any side effects.
4. Make a plan for further treatment: continue the medicine, change dosing or medicine, etc.
5. Agree on a time for follow-up in future months.

Visits may need to be every month or so initially until a medicine and medicine dosage is found that is helpful while making any needed adjustments for side effects. Often, as a child is consistently found to have improvements without significant side effects on a certain medicine and a certain dosage, the follow-up visits will be scheduled every 3-6 months. If in between follow-up visits, an issue should come up about the medicine, its dose, or side effects, the ideal time to review this with us is at the time of prescription refills each month. A message can be left with the nurse and then discussed with the doctor, or the doctor can call you back directly to discuss any concern that needs to be addressed. 

Many children with ADHD benefit from the help of other professionals. If you would like help learning techniques for dealing with your child's behavior, we can help refer you to psychologists, behavioral pediatricians, or counselors. Family therapy can be helpful. If concerns about depression or anxiety arise, we will recommend a referral to a child psychiatrist or psychologist. As it is discussed in the medication handout, children who do not respond well to the stimulants or Strattera for ADD will benefit from visits with a psychiatrist to discuss other options. Please recognize that we know that getting help for these issues is very important to you and your child. Often an appointment with a counselor or psychologist can be made in just a few weeks, but an appointment with a child psychiatrist or a developmental and behavioral specialist can take months.

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Last Updated: 07/2019