Coping strategies for ADHD

If you or someone you love is affected by attention-deficit hyperactivity disorder (ADHD), learn as much as you can about the condition to identify helpful treatments or approaches. Many doctors believe a combination of counseling and medication brings the most significant, long-lasting improvement in ADHD symptoms. Be aware that no single strategy or intervention will solve the problem, however, and effective strategies must be tailored to individual needs. Each situation must be analyzed in terms of personal strengths and weaknesses. Consistent case management and modification over time is also important.


Strategies for parents and other caregivers
For children who have ADHD, positive outcomes are often associated with one-on-one attention. Outline clear, overt rules and repeat brief, age-appropriate instructions. Prepare the child in advance for transitions from one activity to the next.
Focusing on positive rewards, make sure the child experiences immediate, frequent and consistent consequences for his or her behavior. It may be helpful to change or rotate rewards for good behavior. As much as possible, anticipate problematic situations and plan solutions ahead of time. Other examples of effective behavioral strategies include:

Positive reinforcement: Provide rewards or privileges for good behavior. For example, your child gets to play a favorite computer game after completing a homework assignment or household chore.

Time-outs: Remove the child from a situation as a consequence for unwanted or problem behavior. For example, your child is required to sit alone for five minutes in a quiet place free of distractions after hitting a sibling impulsively.

Response cost: Withhold rewards or privileges for unwanted or problem behavior. For example, your child loses free-time privileges for the evening when homework assignments are not completed.

Token economy: This is a combination of positive reinforcement and response cost. The child earns rewards and privileges based on good behavior, and loses them based on undesirable behavior. For example, your child earns stars for completing assignments, but loses stars for getting out of his or her seat. At the end of the week, your child cashes in the stars for a reward or privilege.

For a teen who has ADHD, keep in mind that developmental issues may complicate attempted interventions. For example, teens may need external coaches or ongoing support for effective treatment, but they may resist this support as they attempt to assert their independence.

As a parent or other caregiver, seek your own support through school or community resources or other parents or caregivers. Such support can help you successfully face the additional challenges ADHD causes for both you and your child.


Strategies for school
To start, it's helpful for teachers to become familiar with the child or adult's learning style, strengths and weaknesses, and motivating factors. If you're a parent or other caregiver, you may need to develop strong advocacy and case management skills to ensure the child's needs are met in the educational setting. Document all conversations and correspondence with teachers and administrators as soon as the problem is noted.
Be as proactive as possible by staying involved in the child's education from the beginning. To maintain regular, consistent communication about the child's performance and progress, request meetings with the child's teachers, principal, school social worker, school psychologist or others as often as needed. You may look to school personnel for answers, but many parents end up discovering the most effective interventions based on the child's individual needs and working with the teachers and other school personnel to implement them.

Seek outside support if needed, such as a psychologist or representative from a parent advocacy group. Parents must agree with the school and each other on a plan for managing the child's behavior. If there is a disagreement, the plan must be renegotiated.

Be aware that the law is on your side. The Individuals with Disabilities Education Act (Public Law 94-142) and the National Rehabilitation Act, Section 504 are intended to help children who have ADHD receive appropriate services in the public school system. These are federal laws, but how they're handled and the services available may vary widely from state to state.

Generally, these laws mandate that:

All children, regardless of disability, receive a free, appropriate public education.
The federal government will provide funds to help states educate students with disabilities.
Children who have special needs will receive an individualized education plan.
Special education students will be taught in the least restrictive environment possible.
Guidelines for determining what related services are necessary will be provided.
Procedures to ensure that children's needs are adequately met will be established.

Self-care strategies for adults who have ADHD
If you're an adult facing the challenges of ADHD, remember to take good care of yourself -- eat healthfully, exercise regularly and get adequate rest. To effectively cope with ADHD, consider the following suggestions:
Educate yourself. Learn as much as you can about ADHD. Share what you've learned with others, such as loved ones and friends.

Create a routine. Every day, get ready for school or work at the same time in the same way.

Make a daily "to do" list. Order the items in a logical manner and make a schedule for completing each item. You may want to use a calendar or daily planner to keep track of your activities. Some people find it helpful to use sticky notes as a reminder of things to do. Post them wherever the reminder is likely to be needed.

Break large tasks into smaller, more manageable steps. Do one thing at a time, work in a quiet area and give yourself breaks. When necessary, ask your teacher or boss to repeat instructions rather than guess. Reward yourself immediately after meeting a goal or accomplishing an important task.

Get organized. Store similar things together, such as bills or canceled checks. Use organizers for desks, drawers and closets. It's also helpful to write things you need to remember in a notebook that you carry with you at all times. Put assignments, appointments and phone numbers in different sections of the notebook.


Strategies for the workplace
If you're employed, choose jobs that provide an outlet for hyperactivity or allow you to expend physical energy. As much as possible, incorporate movement into your work plan. For example, you may be able to physically move to different areas for different tasks. Structure scheduled breaks into long jobs so your attention span fits each phase or period of work. As permitted by your employer, create a work space that blocks out noise and visual distractions. You may want to experiment with "white noise," such as background music or fans, to mask distracting noises. For routine tasks, it may help to establish set patterns or sequences (perhaps even using checklists). Finally, explore available resources and adaptations to make sure your needs are being met.