ADHD can be especially challenging for children at school.
How can you help your child be their most successful?
Today’s guest, Dr. Lisa Bishop, is here to speak with us about ADHD and successful strategies for school.
We’ll talk about therapy and medications that can help.
And we’ll answer the question about “outgrowing” ADHD symptoms.
Selected Podcast
ADHD: How Can I Help My Child Concentrate In School?
Featured Speaker:
Lisa Bishop, MD – Pediatrics
Dr. Lisa Bishop is board-certified in pediatrics and sees pediatric patients at Allina Health Maple Grove Clinic. She has professional interests in adolescent health, ADHD, NICU graduates, autism, heart diseases and metabolic disorders. Transcription:
Melanie Cole (Host): ADHD can be especially challenging for children at school. How can you help your child be their most successful? My guest today is Dr. Lisa Bishop. She’s board certified in Pediatrics and sees pediatric patients at Allina Health Maple Grove Clinic. Welcome to the show, Dr. Bishop. Tell us a little bit about ADHD. How would you summarize it, and how is it diagnosed?
Dr. Lisa Bishop (Guest): ADHD is Attention Deficit Hyperactivity Disorder, but it can also be attention deficit disorder without the hyperactivity. It is a disorder of attention and focus, but it’s also a disorder of other things like executive function, processing information, filtering out unwanted information. So it is attention, but it also extends into other areas which affect learning, affect interactions with other people at a social level. Its diagnosis, there’s no single-sstep process to say this is how we diagnose ADHD. However, it’s generally diagnosed based on defined symptoms—symptoms of poor impulse control, symptoms of poor attention, often poor organization. So it’s defined by the American Psychiatric Association Diagnostic and Statistical Manual. These criteria which were set out, you’re looking at a questionnaire, usually the Conners questionnaire, which is given to schools and the parents. The symptoms of ADHD must be present in more than one environment. So if it was just present at school, we will look for something related to maybe something specific with that school. So it must occur at home and in school or at home and at work, so in at least two environments.
Melanie: At what age might parents start to notice some symptoms? What should they look for? Because a lot of parents, Dr. Bishop, say, “Oh, he’s just a boy,” or, “He’s all boy,” or something like that. What might they notice at what age that would signal something is wrong or a red flag?
Dr. Bishop: Often, parents will pick up something is different even by age two, because a child may be a little bit more active, may have more impulse control, although most children at that age will have more impulse control and focus. But they may just be more distractable. They may need to be told more times than a child without attention deficit disorder, which can be very frustrating for parents. But usually, most of the data that we have is based on school-age children, so children who are six and up. But parents will often notice it first. Parents who send their children to things like preschool, they’ll often get reports saying your child wasn’t listening, we had to tell them it’s not time, or they forgot their shoes, they forgot their papers. Parents will often get information from other people and won't be aware themselves earlier than school age. But the biggest things that parents will notice or that they will hear from other people will be that the child loses things, they have to tell them several times, and evidence of poor impulse control, such as hitting another child or throwing things or having poor emotional modulation. So they may be more upset and maybe more excited. If a child is having those types of behavior and it’s affecting how they’re learning or it’s affecting interactions with others, those can be red flags.
Melanie: What help can a child with ADHD diagnosis get at school? Because if they’re disrupting the classroom or they can't follow in the mainstream line of thinking, what do they do? What can a parent do to work with the schools to get their child the best education to ensure that success?
Dr. Bishop: With ADHD, first thing that should be done is getting a diagnosis. Actually having a diagnosis is very helpful so that you can say, “Look, my child has a neuropsychiatric diagnosis,” so that it’s not just because they’re willfully not paying attention or they’re willfully letting their minds wander during class, which often is helpful because one of the first things as their parents to understand what this process is. Because if parents understand that this is not a willful disorder, that the child is not just wanting to not pay attention or that they’re just ignoring instructions on purpose but very often they’re missing a lot of that information. So if parents can understand that this is a neuropsychiatric disorder and that there are certain things that are going to be difficult for them, it’s like if a child is in a wheelchair, there’s certain accommodations which can help that child to have the same access to things as their peer. And it’s the same with ADHD. Or someone has described it as getting glasses. So if you have your child who doesn’t have glasses and they’re wandering around and bumping into things, there’s certain accommodations. One of them is getting glasses. But just helping them to have the same access as their peers. That’s the first thing is for parents to understand the disorder. The second thing is to help teachers understand the disorder as well and, again, that it’s not just willful, that the child is lazy or that they just don't want to pay attention. So helping them to understand is a really helpful thing as well. And then working as a partnership. So there are several things in legislation that can help children with attention deficit disorder have access to an environment with greater accommodation. And there’s two processes. One is the 504, which is based on the Rehabilitation Act and it’s actually an employment law. And that is designed to level the playing field, so to provide some accommodation for children with ADHD, things like maybe having a check-in at the end of the day at school or in the morning. But it doesn’t provide as much protection or as much accommodation. There’s not funding attached to 504 through the ideal legislation, which can offer further help from the Department of Special Education. And that actually has a very similar criteria. So the diagnosis is the first thing, and then having that diagnosis impair aspects of learning for the child so that because they have this diagnosis, they’re unable to learn as well or they’re disorganized, which prevents them from learning as well as their peers. And so, getting those things started out. And organizations like [Pacer] or looking at a website like CHAD. There’s place for attitude and ADD that can actually help parents navigate the system. But for parents who just want the initial “let’s try to help these symptoms without taking it further,” one of the things is the understanding, and then also for that particular child. Because not all children with ADHD are the same, just like not all children are the same. So if that child has a real problem of forgetting things, again, that check-in in the morning and check-in at the end of the day is a very helpful thing. Kids with ADHD are often visual learners, and so when you have them at home, you can have a very colorful chart for them to actually tick a box if they’ve done or completed a task. If between the homework to have a place, the same place, same timing every day and having it as clutter-free as possible so they can have that quiet in getting their homework done and then having it very structured. The other thing is having frequent breaks, because kids, they will have their focus, but after a period of time, kids with ADD are really going to struggle. And at that point you’re not going to get good information or good learning until they can have a break and just move around physically. The other thing is sometime stress balls, where that can help them to actually focus. Because kids with ADD, they use something called the basal ganglia, which is part of our brains associated with movement. And that helps them to encode information. So often when they’re wandering about and they’re walking about and they’re learning something, that can be helping them actually learn that subject matter. And that’s where the stress ballscan be helpful. Or sometimes they can have the balls to sit on to provide extra sensation or texture while they’re trying to learn a material.
Melanie: Dr. Bishop, in just the last minute—we’ve run out of time now, and I’m sorry because it’s such great information—please give the listeners your best advice on ADHD and their children to assure a successful outcome in their school-age years.
Dr. Bishop: First of all, understand what the disorder is, that your child is not a bad child. The second thing is to work as a partner with the school and plan early. So talk to your teachers before you start the year, to plan, to try to avoid possible issues that you know that may come for your child, like the organization or self-esteem issues. So, to plan and to partner early.
Melanie: Thank you so much. It’s great information. More resources for additional information about ADHD can be found from your child’s pediatrician at allinahealth.org, at the Centers for Disease Control and Prevention at cdc.gov, and the National Institute of Mental Health, nihm.com. You’re listening to the WELLcast with Allina Health. For more information, you can go to allinahealth.org. That’s allinahealth.org. This is Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): ADHD can be especially challenging for children at school. How can you help your child be their most successful? My guest today is Dr. Lisa Bishop. She’s board certified in Pediatrics and sees pediatric patients at Allina Health Maple Grove Clinic. Welcome to the show, Dr. Bishop. Tell us a little bit about ADHD. How would you summarize it, and how is it diagnosed?
Dr. Lisa Bishop (Guest): ADHD is Attention Deficit Hyperactivity Disorder, but it can also be attention deficit disorder without the hyperactivity. It is a disorder of attention and focus, but it’s also a disorder of other things like executive function, processing information, filtering out unwanted information. So it is attention, but it also extends into other areas which affect learning, affect interactions with other people at a social level. Its diagnosis, there’s no single-sstep process to say this is how we diagnose ADHD. However, it’s generally diagnosed based on defined symptoms—symptoms of poor impulse control, symptoms of poor attention, often poor organization. So it’s defined by the American Psychiatric Association Diagnostic and Statistical Manual. These criteria which were set out, you’re looking at a questionnaire, usually the Conners questionnaire, which is given to schools and the parents. The symptoms of ADHD must be present in more than one environment. So if it was just present at school, we will look for something related to maybe something specific with that school. So it must occur at home and in school or at home and at work, so in at least two environments.
Melanie: At what age might parents start to notice some symptoms? What should they look for? Because a lot of parents, Dr. Bishop, say, “Oh, he’s just a boy,” or, “He’s all boy,” or something like that. What might they notice at what age that would signal something is wrong or a red flag?
Dr. Bishop: Often, parents will pick up something is different even by age two, because a child may be a little bit more active, may have more impulse control, although most children at that age will have more impulse control and focus. But they may just be more distractable. They may need to be told more times than a child without attention deficit disorder, which can be very frustrating for parents. But usually, most of the data that we have is based on school-age children, so children who are six and up. But parents will often notice it first. Parents who send their children to things like preschool, they’ll often get reports saying your child wasn’t listening, we had to tell them it’s not time, or they forgot their shoes, they forgot their papers. Parents will often get information from other people and won't be aware themselves earlier than school age. But the biggest things that parents will notice or that they will hear from other people will be that the child loses things, they have to tell them several times, and evidence of poor impulse control, such as hitting another child or throwing things or having poor emotional modulation. So they may be more upset and maybe more excited. If a child is having those types of behavior and it’s affecting how they’re learning or it’s affecting interactions with others, those can be red flags.
Melanie: What help can a child with ADHD diagnosis get at school? Because if they’re disrupting the classroom or they can't follow in the mainstream line of thinking, what do they do? What can a parent do to work with the schools to get their child the best education to ensure that success?
Dr. Bishop: With ADHD, first thing that should be done is getting a diagnosis. Actually having a diagnosis is very helpful so that you can say, “Look, my child has a neuropsychiatric diagnosis,” so that it’s not just because they’re willfully not paying attention or they’re willfully letting their minds wander during class, which often is helpful because one of the first things as their parents to understand what this process is. Because if parents understand that this is not a willful disorder, that the child is not just wanting to not pay attention or that they’re just ignoring instructions on purpose but very often they’re missing a lot of that information. So if parents can understand that this is a neuropsychiatric disorder and that there are certain things that are going to be difficult for them, it’s like if a child is in a wheelchair, there’s certain accommodations which can help that child to have the same access to things as their peer. And it’s the same with ADHD. Or someone has described it as getting glasses. So if you have your child who doesn’t have glasses and they’re wandering around and bumping into things, there’s certain accommodations. One of them is getting glasses. But just helping them to have the same access as their peers. That’s the first thing is for parents to understand the disorder. The second thing is to help teachers understand the disorder as well and, again, that it’s not just willful, that the child is lazy or that they just don't want to pay attention. So helping them to understand is a really helpful thing as well. And then working as a partnership. So there are several things in legislation that can help children with attention deficit disorder have access to an environment with greater accommodation. And there’s two processes. One is the 504, which is based on the Rehabilitation Act and it’s actually an employment law. And that is designed to level the playing field, so to provide some accommodation for children with ADHD, things like maybe having a check-in at the end of the day at school or in the morning. But it doesn’t provide as much protection or as much accommodation. There’s not funding attached to 504 through the ideal legislation, which can offer further help from the Department of Special Education. And that actually has a very similar criteria. So the diagnosis is the first thing, and then having that diagnosis impair aspects of learning for the child so that because they have this diagnosis, they’re unable to learn as well or they’re disorganized, which prevents them from learning as well as their peers. And so, getting those things started out. And organizations like [Pacer] or looking at a website like CHAD. There’s place for attitude and ADD that can actually help parents navigate the system. But for parents who just want the initial “let’s try to help these symptoms without taking it further,” one of the things is the understanding, and then also for that particular child. Because not all children with ADHD are the same, just like not all children are the same. So if that child has a real problem of forgetting things, again, that check-in in the morning and check-in at the end of the day is a very helpful thing. Kids with ADHD are often visual learners, and so when you have them at home, you can have a very colorful chart for them to actually tick a box if they’ve done or completed a task. If between the homework to have a place, the same place, same timing every day and having it as clutter-free as possible so they can have that quiet in getting their homework done and then having it very structured. The other thing is having frequent breaks, because kids, they will have their focus, but after a period of time, kids with ADD are really going to struggle. And at that point you’re not going to get good information or good learning until they can have a break and just move around physically. The other thing is sometime stress balls, where that can help them to actually focus. Because kids with ADD, they use something called the basal ganglia, which is part of our brains associated with movement. And that helps them to encode information. So often when they’re wandering about and they’re walking about and they’re learning something, that can be helping them actually learn that subject matter. And that’s where the stress ballscan be helpful. Or sometimes they can have the balls to sit on to provide extra sensation or texture while they’re trying to learn a material.
Melanie: Dr. Bishop, in just the last minute—we’ve run out of time now, and I’m sorry because it’s such great information—please give the listeners your best advice on ADHD and their children to assure a successful outcome in their school-age years.
Dr. Bishop: First of all, understand what the disorder is, that your child is not a bad child. The second thing is to work as a partner with the school and plan early. So talk to your teachers before you start the year, to plan, to try to avoid possible issues that you know that may come for your child, like the organization or self-esteem issues. So, to plan and to partner early.
Melanie: Thank you so much. It’s great information. More resources for additional information about ADHD can be found from your child’s pediatrician at allinahealth.org, at the Centers for Disease Control and Prevention at cdc.gov, and the National Institute of Mental Health, nihm.com. You’re listening to the WELLcast with Allina Health. For more information, you can go to allinahealth.org. That’s allinahealth.org. This is Melanie Cole. Thanks so much for listening.