HYPERACTIVITY
ADHD and Learning
Disabilities
Many people believe
that children with ADHD also have learning disabilities and
vice versa. A learning disability is generally defined as a
two-year delay in grade level in either spelling, reading, or
math. Forty percent of children diagnosed with ADHD have learning
disabilities, and 15 to 20 percent of learning-disabled children
have ADHD. The disorders overlap somewhat, but keep in mind
that not all children with ADHD have difficulties in school.
In fact, some are in gifted and talented programs.
There are several
approaches to treating ADHD. These include stimulant medication
and behavior modification. Stimulant medications such as Ritalin,
Dexedrine, and Cylert help normalize a child's behavior. These
drugs have a calming effect when used to treat ADHD. These medications
have been around for a long time and were used in World War
II to help keep radar operators awake. Behavior modification
techniques often make use of positive stimuli to change undesirable.
For example, parents of young children are taught that it is
better to impose a "time-out" or to send a child to his or her
room than to yell and scream at the youngster. Rewarding ADHD
children with "smiley" faces or stars also goes over well with
younger children. As children grow older, the behavior modification
techniques must become more sophisticated. Parents of teen might
say, "I'm pleased with your behavior," and grant the child permission
to use the car for a few hours on the weekend.
At the National Institutes
of Health (NIH), we are currently using a multimodal treatment
approach. We combine medication and behavior modification, we
use every single tool that we have to help these children and
their families.
Parents and educators
must understand the disorder and its symptoms. Since school-age
children spend so much time is school, we encourage parents
to talk to the school counselor and teacher(s) about the disorder,
its symptoms, and current approaches to treatment.
NIH has devoted up
to six beds of its day hospital program to the evaluation and
study of ADHD children. Children arrive on the NIH school bus
and attend, class from 9 a.m. to 3 p.m. It's a highly structured,
positive, reinforcing day.
In the past, we've
used things like activity monitors, which are solid-state mini-computers
that can be worn on the wrist, to measure a child's activity
level.
Because hyperactive
children do best in highly structured settings, where things
are clearly mapped out, we encourage parents to prepare schedules
for school and home. Structure combined with positive reinforcement
helps most of these children.
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