Managing ADHD published in Canadian Family Feb. 22

The following article was published in Canadian Family.  Managing ADHD

My 9-year-old son had been struggling with making friends, completing his school work, and getting angry at every small thing.  He was arguing with us constantly.  Shelley, my wife, and I kept thinking, “It’s fine, it is just a phase he is going through. He will grow out of it.”  But when he started throwing things and getting into fights at school, we knew we needed to find some solutions.

We started by getting a referral to a pediatrician who focuses on special needs and having regular conversations with his resource teacher at school.  Through that, we got a diagnosis of ADHD-Oppositional Defiance Disorder.  Shelley and I were so relieved.  We couldn’t understand why he was always angry.  We thought we were doing a good job raising him, but he was starting to become the boy all the neighbors talk about.  However, with this diagnosis, we could proceed with solutions.

We started with Mental Health Canada (1) and read that recent studies have been focusing on the link between ADHD and frontal lobe development.  I already knew based on Dr. Thomas E. Brown’s research (2) that ADHD impairs executive functioning skills which comes from the frontal lobe.  This means he is going to struggle with organizing himself, regulating his emotions and actions, sustaining focus and effort, recalling information, or dealing with change.  We also read further that the best type of treatment is the combined form of behavioural treatment and medication.  This made a lot of sense to me. I have certainly seen when students with ADHD have routines and strategies combined with the proper medication, sleep and a good diet, they do all right.

The first thing we did was focus on behaviour.  We asked his resource teacher at school to start documenting every time he lost his temper and record when, where and what happened leading up to it.  We also kept a journal at home documenting the same thing.  We quickly discovered after a couple weeks of doing this, there were really only three things that were causing the difficulties.  We found out it happened more as the day went along, when he was touched, and in louder, less controlled environments.  So the occupational therapist got involved and figured out what he needed.  We started with a Hokki stool and weighted blanket for home and a rubber cushion and squeeze toys for school from fdmt.ca.  He also lines up last to go outside or to come back to the class to avoid being touched or bumped.  He also has the option of a timed 5-minute break throughout the day when he needs quiet.  Finally, his school team and we talk once a month to see how things are going for him.

At the same time, we started putting in strategies at home.  As soon as he comes home from school, he isolates himself for an hour doing something active like biking or skateboarding in the lane, jumping on the trampoline or hanging out with his best friend from across the road.  We then have a set routine of supper, chores, homework, quiet time and bed time.  We are very conscious of his diet and hydration, but the biggest factor is sleep.  He gets 11 hours of sleep on weekdays and anything less than that creates struggles for him.  He also takes 3mg of melatonin every night 30 minutes before bedtime.

Finally, with his pediatrician, we started experimenting with medication.  We knew it is only by trial and error that you find the right type of medication and dosage.  Because our son is also diagnosed with FASD, his body chemistry is unique, and it has been an ongoing process to find the right medication.  He is currently taking 20mg of biphentin, but we know every child is different when it comes to ADHD medication.  The two big things we have learned is one, be consistent in administering it.  He needs it every single day.  Second, just like sleep and routines, medication helps him manage it, not cure it.

Since putting these supports in place, my son has experienced a huge change.  He loves school, has several good friends, laughing all the time, and just having fun with life.  His teachers have seen that same change and are talking now about how much they enjoy having him in class.  While we know he may be dealing with this his whole life, we also know where the solutions lie now.  And that gives all of us hope.

1 http://www.mentalhealthcanada.com/ConditionsandDisordersDetail.asp?lang%20=e&category=60 

2 http://www.drthomasebrown.com/add-adhd-model/

Rob More is the adoptive father of three wonderful children and has over 20 years experience as a special education teacher.  He also serves as a FASD advocate.