What Parents Should Know - Diagnostic Checklist

Identifying ADD

If you believe your child shows signs of Attention Deficit Disorder -- short attention span, impulsive behavior, and hyperactivity -- there are several steps you can take. Since most children occasionally show some of these signs, ask yourself if the behavior you are concerned about is persistent and if your child consistently exhibits such behavior in most settings.

If so, you should first consult with others who know the child well, such as relatives and family friends. Talk to them about the ADD behaviors and have them indicate the ones they see your child regularly exhibit. You also may want to keep notes on your child's behavior.

Next, speak to your child's teachers, as many behaviors characteristic of ADD are most visible in the classroom. Your child's teachers may want to complete a checklist on ADD signs, or use their own experience with other children with ADD to help you reach conclusions of your own. In many cases, teachers may be the first to suspect a child has ADD and notify the parent(s). Keep in mind that some children show behaviors similar to children with ADD when they have learning problems stemming from other causes.

In addition, you should consult with a physician or other healthcare provider. A doctor will know the medical signs of ADD and can recommend local sources of information or a psychologist for your child to see. The physician should give your child a general medical exam and perhaps recommend a neurological evaluation, if he believes it necessary.

Your Child with ADD in School

There are two primary Federal laws applying to the education of children with ADD, the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973.These laws are discussed in "Attention Deficit Disorder: Adding Up The Facts," which is also in this information kit.

If you believe that your child has a disability whether resulting from ADD or any other impairment, and the school district believes that your child may need special education or related services, the school district must evaluate your child. If the school district does not evaluate a child, it must notify the parents of their due process rights. According to federal law, a school is responsible for providing an educational diagnosis of a child. To determine a child's level of disability and best treatment, a multi-disciplinary team is formed that includes teachers, parents, and someone with training in child psychopathology (usually the school psychologist or school social worker).

At the meeting with these professionals, you should have your notes on your child's behaviors with you; and you also should bring report cards and any comments about your child made by teachers. Later, you may have the opportunity to fill out a standardized rating scale that compares your child's behaviors to those of children already diagnosed with ADD. Ideally, the team should follow a two-tiered approach to first determine the presence of ADD symptoms and then to determine its adverse effect on academic performance.

Once your child is evaluated and determined to have ADD, the school and the teacher may design modifications in your child's classroom and schoolwork based on his or her needs and abilities. The school may provide assistance and training in study skills,class room management, and organization. A student should have access to a continuum of services, from pull-out programs that give the student individualized attention in a resource room to related aids and services provided in the classroom. Teachers have found that in order to help children with ADD they frequently need to make modifications in the lesson, its presentation, and its organization as well as specialized behavioral management.

Parents and teachers should work together and communicate frequently with one another to form a complete picture of a child and to note changes in his or her behavior. If your child is taking medication, you should request notes on his or her progress and notify the school of any changes in medication. Since children with ADD have difficulty obeying two different sets of rules, parents and teachers should agree on the same rules and the same management system. If your child's teachers do not have much knowledge about ADD, you should meet with them, explain your child's problems, and give them copies of this information sheet and other sources of information on ADD.

Medication: Pros and Cons

Medication of children with ADD remains controversial. Medication is not a cure and should not be used as the only treatment strategy for ADD. While doctors, psychiatrists, and other health care professionals should be consulted for advice, ultimately you must make the final decision about whether or not to medicate your child.

The short-term benefits of medication include a decrease in impulsive behavior, in hyperactivity, in aggressive behavior, and in inappropriate social interaction; and an increase in concentration, in academic productivity, and in effort directed toward a goal.

However, studies show that the long-term benefits of medication on social adjustment, thinking skills, and academic achievement are very limited. If you do choose to use medication, you should observe your child for possible side effects. Some children lose weight, lose their appetite, or have problems falling asleep. Less common side effects include slowed growth, a tic disorder,and problems with thinking or with social interaction. These effects usually can be eliminated by reducing the dosage or changing to a different medication.

Strategies for the Home

Children with ADD can learn to control some aspects of their behavior and to succeed in school and at home. When parents establish and enforce a few rules and maintain a system of rewards, children incorporate such rules into their daily routine. Remember that every child, with or without ADD, has individual strengths and weaknesses. Once you identify your child's strengths, you can use them to build your child's self-esteem and help to provide the confidence your child needs to tackle whatever he or she finds difficult.

• Discipline can best be maintained by establishing a few consistent rules with immediate consequences whenever each rule is broken. Rules should be phrased positively in terms of what your child should do. Praise your child and reward him or her for good behavior.
• Children with ADD respond well to a structured system of rewards for good behavior. This system encourages the child to work in order to earn privileges or rewards he or she wants by accumulating points for desired behaviors and removing points for undesirable behaviors. You can make charts or use tokens or stickers to show your child the consequences of good behavior. You should only work on a few behaviors at one time and add additional behaviors as others are learned.
• Make a written agreement (a contract) with your child in which the child agrees to do his or her homework every night or to demonstrate other desired behavior in return for a privilege he or she selects, such as the right to watch a certain television show. If your child does not fulfill the contract, remove the promised privilege.
• Another effective strategy is to provide a specified time-out location for your child to go when he or she is out of control. This should not be seen as a place of punishment, but as a place the child uses to calm down. Younger children may need to be told to go the time-out location, but older children should learn to sense when they need to calm down and go on their own.
• Set up a study area away from distractions and establish specific time each day for the child to do homework. Do not allow your child to do homework near the television set or the radio.
• Devise a calendar of long-term assignments and other tasks. Keep this on the refrigerator door, or other visible place, where it can remind your child of what he or she needs to do.
• Have the teacher make a checklist of homework to be completed and items to be brought to school the next day. Before your child goes to bed, check the list to make sure everything has been completed.
• In general, punishing the child is not as effective as using praise and rewards. Rather than focusing on weaknesses, you should assist your child in developing personal strengths.
• Avoid emotional reactions such as anger, sarcasm, and ridicule. Remember your child has problems with control, and it only makes him or her feel worse to be told a task is easy or anyone can do it. However, short, mild reprimands can remind children to focus their attention.

This document was developed by the Chesapeake Institute, Washington, D.C., with The Widmeyer Group, Washington, D.C., as part of contract #HS92017001 from the Office of Special Education Programs, Office of Special Education and Rehabilitative Services, United States Department of Education. The points of view expressed in this publication are those of the authors and do not necessarily reflect the position or policy of the U.S. Department of Education. We encourage the reproduction and distribution of this publication.

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