ADHD Part 5: Living & Coping

From Parenting New Mexico June-July 1999

ARTICLE FOUR OF FOUR ARTICLES ON
ATTENTION DEFICIT/HYPERACTIVITY DISORDER

Living & 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 month's topic.

Developmental Course

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.

Childhood

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 pattern.

Adolescence

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 disorganization.

Adulthood

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 most common.

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 is craziness.
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!

In School

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" classroom.
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.

ADHD RESOURCES

NATIONAL ORGANIZATIONS

Children and Adults with Attention Deficit Disorder (Ch.A.D.D.)
8181 Professional Place, Suite 201
Landover, MD 20785
(800) 233-4050
www.chadd.org

ADD Action Group
P.O. Box 1440
Ansonia Station,
New York, New York 10023
(212) 769-2457
www.addgroup.org

ADDult Support
P.O. Box 7804
Tacoma, WA 98407
(253) 759-5085
www.addult.org

BOOKS

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
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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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ADHD Articles
Part 1 | Part 2 | Part 3