Use the tips for management of children with fetal alcohol syndrome: Many children who have fas also have ad(h)d and so most of the techniques work with both groups of children.
Consider medication: There are differing opinions on the value of medicating the child. However, before ruling it out, parents should at least consider whether it can allow the child to have a more successful home and school experience. Make sure that the pediatrician assessing the child’s need for medication is well trained in attention deficit and can consider the viability of not medicating.
Use dietary management: Do some experimenting Find out which foods cause an increase in the child’s energy. Not all children increase activity with sugar and dyes.
Try a variety of behavior management techniques: Some techniques will work for a while, and then stop being effective. That is a sign that it is time to switch to something else. But just because something stopped working a year ago, does not mean it cannot be tried again.
Use appropriate therapy: Many of the therapies commonly used with children, such as play therapy and non-directed talk therapy, are not effective with this condition. Behavior modification, cognitive behavioral therapy, bio-feedback, and relaxation training can be effective for some children and youth with ad(h)d. The parents may also benefit from stress management counseling.
Drop an issue and return to it later: When the child cannot focus on a task or will not cooperate, leave it and return to it later. Over time, the child may develop her own strategies for lengthening her attention span, but while she is young, it is likely that when she appears finished, she is really finished and needs to move on. Respect this, and guide the child back to the task later. Chores such as cleaning the bedroom can be broken into small tasks that are undertaken throughout the day. For example, have the child pick up clothes from the floor every day after school and before playing time; have the child pick up her books and crayons from her floor or around the house every day just before supper; have the child pick up toys right before bed. While this method will never result in a completely clean room, it will at least mean that parts of the cleaning are done each day so the neither the child nor the parent is overwhelmed by a mess. It also allows the child to see that she is able to contribute to the organizing of her own life.
Do not engage in long explanations: Children and youth who have attention problems often also have co-existing memory problems (or, they easily forget what they have been told because they could not stay focused to listen to it). When something needs to be explained, do it in as few words as possible. Keep the explanation basic and short. If the issue is complicated, try explaining it over a period of time. Give the first part of the explanation in the morning, some more at lunch, and the rest after school. And, remember to re-explain frequently.
Target the most difficult points of the day: Make note of which parts of the day, or week, are the most difficult for the child and plan around them. If the child is always a problem right after school, make sure that this is never the time to take the child grocery shopping or to doctors appointments. If the child is always a problem on Fridays, that is a good day for the family to go to the local swimming pool or to undertake some other activity that involves extensive use of the large muscles. If the child is always scattered and a serious problem at school for the last two months of school (nine or ten months of school is too long for most children and youth with adhd) , try to work out an agreement with the school where he only attends four days a week. He will likely be suspended a great deal in those last two months of school anyway, and a proactive approach to this can give him a better school record.
Assign chores that are short and obvious: The child with ad(h)d can manage her share of the chores as well as the other children in the family. However, the she will most likely complete chores that can be done quickly and which have a clear finish. For example, emptying the dishwasher will only take a few minutes and she can see the progress as she takes the dishes out. Sweeping a floor is not has likely to succeed because it is too easy to miss spots and ignore major parts of the floor.
Negotiate a reduced homework load: Try to negotiate with the teacher for a reduced homework load. The child or teen will have trouble focusing by the end of the day and too much homework requiring parental supervision can set the stage for intense daily parent/child conflict. If the homework load cannot be reduced, try to break it up into smaller time chunks. The child can do one part of right after school and another right after supper.
Enroll the child in sports that use the large muscles: Swimming is excellent because it uses the large muscles and leads to recreational activities, such as Friday night swimming. Sports that require intense concentration or complicated team work may not be successful for the child with this condition as they will become frustrated with the rules and they may interfere in the game for their teammates.
Source: Handout for NYSCCC 2003 conference workshop presented by Brenda McCreight, PhD, May 9, 2003, Albany, NY. Reprinted with permission of the author.