From Parenting New Mexico June-July 1999
ARTICLE FOUR OF FOUR ARTICLES ON
ATTENTION DEFICIT/HYPERACTIVITY DISORDER
& Coping with ADHD
by Gayle L. Zieman, Ph.D.
In the articles of the last few months we have examined the diagnosis
of Attention Deficit/Hyperactivity Disorder, conditions which
often coexist or look like it, and the treatments for the disorder.
In this final article of the series we explore living with ADHD
on a daily basis. Given that no treatment cures or totally removes
ADHD, it is very important to understand the lifelong course
of the disorder and how to cope with it. Many ADHD sufferers
successfully learn to live effectively with their problem, often
using it to their advantage. Some tips on how they do so is this
To understand life with ADHD it is first
important to know its developmental course. For many, ADHD is
a lifelong problem, but one which changes from childhood to life
as an adult.
ADHD always begins in early childhood,
almost always by first grade. In the preschool and early elementary
school years it is characterized by the classic symptoms of being
highly distracted by environmental stimuli, poor impulse control
(difficulties with patience and waiting), and hyperactivity.
While there are individuals, usually girls, who show only the
distractibility symptoms, most children with ADHD have the full
Many have a major reduction in their
ADHD symptoms as they develop through late childhood and early
adolescence. Only about two-thirds of high school students who
distinctly had the disorder as a young children continue with
significant symptoms. And for those with continuing major symptoms,
the most common pattern is that their hyperactivity is less (often
changing from outright can't stay in a chair to restlessness
such as playing with things at hand). Also, many experience notable
improvements in patience and waiting. The symptom which is the
least affected by maturation is distractibility and associated
By young adulthood, the early to middle
twenties, only about half of those with significant problems
as young children continue to manifest major daily impairments.
For adults the typical continuing problems are distractibility,
disorganization, and a general on-the-go lifestyle characterized
by restlessness and frequent changes of activity. Fortunately,
many occupational settings value ADHD adults. Got ADHD? Don't
want a desk job? Like running in and out of buildings all day?
Might want to be a FedEx or UPS delivery person. And then there
are fast-paced sales jobs and high-energy computer careers (distractible,
hyper individuals frequently love computers) which encourage
ADHD. In fact, there are thousands of well-adjusted ADHD adults
who absolutely enjoy their ADHD and would be insulted to think
that someone might consider them to have a "disorder."
Coping Every Day with ADHD
There are strategies for managing and
learning to live with ADHD, especially in childhood. ADHD sufferers
and their parents have discovered literally hundreds of helpful
yet simple methods and accommodations. Here are a few of the
At Home and Around the Community
- Encourage Acceptable Outlets for
Hyperactivity. Expecting highly
restless ADHD sufferers to remain still is unreasonable. Allow
them to carry along items which are socially acceptable to play
and fiddle with. For years I've kept worry stones and those hand
manipulation, squeezable, stress-relief "thingies"
in my office to hand out to ADHD individuals. Don't play with
what's sitting around, carry your own!
- Provide a Distraction Reduced Place
for Work. I know - at my house
I go to another room and close the door to read even simple things
like magazines. My wife says "he's gone to roost,"
but, hey, it's either "roosting" or limit my "reading'
to looking at the pictures. Reading or doing homework at the
kitchen table is often too distracting for the ADHD child. A
special desk in another room may be needed, along with adult
checking every few minutes to assist with remaining on task.
- Use Background Stimulation. Many ADHD individuals concentrate better if
they have "white noise" in the background. Background
music, especially instrumental but probably not the radio with
its advertisements, can be a great help to ADHD sufferers. I've
had so many kids explain to me how they do their homework better
with a CD in the stereo, even though their parents think this
- Supply Organizational Aids. One of the classic ADHD behaviors is starting
things, becoming distracted, and then never finishing. For this
reason ADHD individuals need reminders, and not just other people
to keep them on task, but self managed reminders like lists and
pocket organizers. For a couple of decades I've carried an index
card in my shirt pocket every day with a list of things to get
done - I even write down things to do in the next half hour!
Many ADHD kids do so much better if they're the kid in class
with an organizer in their backpack, and use it faithfully.
- Avoid Boring or Overstimulating
Situations. ADHD suffers aren't
good at handling low or high stimulation environments. We get
bored fast and then create our own stimulation - moving around
or playing with things until other people scream "cut it
out." As adults, many ADHD sufferers also quickly fall sleep
when bored, like in movies and concerts etc. And when highly
stimulated, they become more hyper than others and take longer
to calm down. Don't give an ADHD kid an exciting evening birthday
party and then expect them to fall asleep as usual; it's not
going to happen. Many ADHD adults have learned to avoid high
excitement in the evening for this very reason.
- Skip the Dark, Quiet Room for Sleep. Going to bed can be an under stimulating situation
for many with ADHD. You may recall from my first article the
mother who said of her ADHD son at bedtime, "He flops in
there like a fish." Many with ADHD don't wind down easily
into sleep, and create their own stimulation by being hyperactive
in bed, thus preventing themselves from going to sleep. For many
this can be significantly reduced by following the above suggestion
of providing background stimulation. A little background music
and a night light or quiet activity in bed at bedtime can do
wonders for some.
- Give Conversational Timing Cues. So many ADHD sufferers falter in social situations
because they talk too much (and often too fast) and interrupt
others rather than listen. Most who do this aren't really aware
that they do it, so subtle and agreed on reminders can be a useful.
Cue them with simple facial gestures or hand signals that they're
talking when they shouldn't be or interrupting. My wife kicks
me in the ankle!
- Seek out the Traditional Classroom.
As already noted, ADHD kids
don't do well in high stimulation situations. This is especially
true in what has been called the "open" classroom where
desks are arranged in circles, kids move about a great deal,
and every square inch of wall space has something bright on it.
Youngsters with ADHD do a whole lot better in the simple classroom
with individual desks spaced apart and a teacher who runs a very
orderly class tending toward the quiet and structured. Ask, often
school principals are willing to work with parents in trying
to place ADHD children with teachers who run an "old school"
- The Quiet Place. Many an ADHD child has been helped by the teacher
who has taken a four-foot high bookcase and used it to screen
off a desk in the corner, labeling it the "Quiet Place"
where a child in need of reduced stimulation can go work (or
"roost" as my wife would say). If such a space is presented
in a non-stigmatizing way it can be a useful outlet for the ADHD
child in need.
- Write It Down. How many ADHD kids have heard me say this one.
As described above under organizational aids, most children with
ADHD aren't going to be the ones to just hear a multiple step
set of directions from the teacher and then go do it. They're
the ones who need to take notes. I believe, or at least hope,
I've convinced many third graders that they can be "cool"
by looking like high school and college students who have a notebook
filled with copious notes.
A few strategies and small coping methods
can make raising an ADHD child go smoother and can make having
ADHD less burdensome. While teachers and parents often don't
think so, life with ADHD can be fulfilling and rather exciting.
ADHD isn't always a problem, it can be just a different approach.
I think of my physician friend who I affectionately call "Dr.
Hyperactivity." One day in a meeting I told him to slow
down and listen. He just looked indignantly back at me and remarked,
"Hey, I'm just busier than the rest of you." And he
is-he never sits still.
Children and Adults with Attention Deficit
8181 Professional Place, Suite 201
Landover, MD 20785
ADD Action Group
P.O. Box 1440
New York, New York 10023
P.O. Box 7804
Tacoma, WA 98407
The ADD/ADHD Checklist: An Easy
Reference for Parents and Teachers,
by Sandra Rief, Prentice Hall, Paramus, NJ, 1998
Driven to Distraction: Recognizing
and Coping with Attention Deficit Disorder from Childhood through
Adulthood, by Edward Hallowell
and John Ratey, Simon and Schuster, New York, NY, 1994
A Parent's Guide to Attention
Deficit Disorders, by Lisa
Bain, Bantam/Doubleday/Dell, New York, NY, 1991
Dr. Zieman is an Albuquerque psychologist
who specializes in the evaluation of child and adolescent disorders.
He also works with families and teachers regarding childhood
behavior problems and learning disabilities.
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