Parenting the ADD Child: Can't Do? Won't Do? Practical Strategies for Managing Behaviour Problems in Children with ADD and ADHD (4 page)

The 12 steps of the ADDapt programme help the ADD child acquire new
and good habits and to unlearn old and bad ones.

ADDapt leads to big reductions in:

disruptive behaviour

your child wanting your instant attention all the time

spitefulness, fighting and aggression.

ADDapt leads to big improvements in:

completing routine tasks

waiting turns

self-confidence

relationships with peers and siblings.

Most important of all, parents report that ADDapt has helped to rebuild the
harmony that has all too often been shattered during the ADD years.

ADDapt - not just for ADD

Although primarily for parents with an ADD child, many of the techniques
in this book have proved equally helpful in parenting children with other
behaviour problems, especially ADHD.

How this book supports you

This book is designed to be easy to follow, jargon-free, empowering and
practical, so that you can produce the necessary change yourself. This way
you become the `expert'. At each step you are shown the techniques you
need - what they are, why they work, how to use them - and the benefits you
can expect to see both immediately and in the longer term. Because it
assumes you are following the programme without outside support, much of
the book deals with ways you can support yourself and give yourself
strength and encouragement through all the hard work and the temporary
setbacks.

How to use this book

A great deal of thought has been given to the tasks and exercises set out here.
The order in which you complete the steps is important.

I can appreciate that you may be itching to get straight to issues that
bother you most. There is always a temptation to skip the sections in
self-help books that seem less relevant. I've done it myself. However, every
part of ADDapt has a purpose. Do try not to skip. But if you do, you may find
it useful to go back to the skipped sections if your morale begins to flag or if
you feel you have lost your way. You may also find it useful to do this in any
case. Each section has been designed to be reread whenever you feel the
need.

There is no timescale for completing ADDapt. Every family is different.
You are the best judge of when to move on to the next step of the programme.
Go at your own pace. If you hit a block in one part of ADDapt, don't give up.
Just carry on and come back to it later.

This chapter explains what you can generally expect from medication and
why I believe medication is a part, but only apart, of a complete approach to
ADD. Although in the preceding chapter I made some big claims for
ADDapt, I am not suggesting you should use the programme without
medication. Some of the best results are achieved when ADDapt and
medication are used together.

What medication can do

The causes underlying the hard-to-live-with behaviour of ADD children are
now widely believed to stem from the way their brains function. Researchers
are finding more and more evidence that the brains of ADD children are
different in subtle ways from those of other children, containing either too
much or too little of certain chemicals. These subtle brain differences seem to
make ADD children more easily distracted, impatient, unsettled, restless and
overactive, and less likely to think through the consequences of their actions
than other children of their age.

Drugs like Ritalin and Dexedrine are prescribed to correct these chemical
differences in the brain. They often bring a rapid improvement in the ability
to listen, concentrate, pay attention, focus on tasks, play constructively. The
changes can be quite dramatic. The drugs can also sometimes have an effect
on aggressive outbursts and temper tantrums.

The limitations of medication

Drugs commonly improve some aspects of a child's behaviour, but rarely all.
The main limitation of medication is that it does not usually stop all
`naughty' behaviour.

Many parents experience enormous relief when drug treatment starts.
Hope returns. However, in my experience this initial optimism can turn to
despair when the behavioural problems that were driving them to distraction
do not disappear.

The example of the Grant family is typical - Harry's mother Helen said:

After being diagnosed as having ADD, Harry was given Ritalin. It had a big
impact on him - his ability to remember things, and sit still without getting
ants in his pants. He just seemed calmer. But in other ways there was no
change. We had the same old battles. The tablets had no effect on his
constantly demanding attention, his spitefulness to his brother, always
having to come first, and lashing out with his fists and kicking when he
wanted his own way.

The worst aspects of a child's behaviour may escape the impact of the
medication because they have become deeply ingrained habits. Harry, for
instance, has learned ways to `fight' the situations he doesn't like. Even with
the medication making him more able to concentrate and remember things,
he is likely to continue to fight until he learns other ways of behaving.

Medication can enable children to concentrate for longer and learn better.
But they have to be helped to learn new ways of behaving and to unlearn the
old, disruptive ones.

How ADD has affected your child

Many of the problems you experience with your ADD child arise from his or
her difficulty in learning life's rules. We have all had to learn how to behave
at mealtimes. We have all had to learn that we cannot have our own way all
the time and that other people are not always able to attend to our needs
instantly. And we have had to learn that other people too have needs that are
just as important to them as ours are to us, and so on.

ADD causes children to be more impulsive, more inattentive and more
hyperactive than other children, and these traits make it much harder for
them to learn the lessons they need to learn to get along with other people.
Pills cannot teach skills and rules - what they can do, though, is calm
children down so that they can learn more easily. But they do still have to learn.
And this is where ADDapt works, in combination with medication, to provide the
training that pills have now made possible.

In short, my approach is to combine the best of both worlds.

The ADD drug debate

There are some practitioners who would argue that medication alone is the
answer and who will continue to try different drugs and dosages in an
attempt to get all aspects of behaviour under control. However, in my
experience this can lead to overprescribing, with increased dangers of
side-effects. I believe it is a mistake to expect drugs to do everything.

On the other hand, when parents who are apprehensive about giving drugs
to their child ask me, `Is medication really the quickest and most effective
way of ensuring that my child's concentration and attention span will
improve?', my answer has to be `Yes'. Given everything that we currently know from research and clinical experience, it is clear that medication can
create the conditions for new parenting techniques to succeed.

Some parents are so pleased with the effects of medication that they feel
nothing else is needed. If medication alone works for your child, fine.
ADDapt is not for you. But if, despite the drugs, your relationship with your
child is still an uphill battle, then ADDapt has plenty to offer you.

In this chapter I will explain more about what you can expect from ADDapt
and what ADDapt will expect from you.

The programme is based on four principles:

1. You, as a parent, are best placed to have the most influence on the
behaviour of your ADD child (even if you are using medication to
make the job easier).

2. Changing your child's behaviour is possible - when you know how.

3. Rewards, encouragement and explanation are the keys to change.

4. You too will have to learn some new skills and habits

How does ADDapt work?

ADDapt starts from where you are now. It recognises that you and your child
have been through a lot and that probably you have all - you, your child,
your partner and anyone else involved - had your confidence dented.
Although I shall be asking you to take another look at some of the ways you
have been dealing with your ADD child, ADDapt never assumes that you are
a bad parent or that you are to blame for your child's condition or naughty
behaviour.