Analysis of a study on the tremendous negative impact that children with ADHD can have on their siblings.

What is it like for a child when one of his or her siblings has ADHD? What are the kinds of issues that children in this situation tend to struggle with? This is an extremely important area for parents and professionals to attend to and almost no research on this topic exists.

That is why I was so pleased to recently locate a study in which this issue is examined (Kendall, J., Sibling accounts of ADHD. Family Process, 38, Spring, 1999, 117-136). I found this to be a wonderful study, even though the information presented is somewhat upsetting. As you read the information below, please keep in mind that what the author of this study reported does not necessarily apply to all children who have a sibling with ADHD. I have personally seen families where the relationship between sibs when one had ADHD was quite positive, and this may certainly be true of your own family. Nonetheless, I believe what was uncovered in this study is potentially quite instructive and useful to know about.

Because so little work has been done in this area, the author elected to conduct a qualitative rather than a quantitative investigation. Rather than collecting rating scale data, or other kinds of data that could be translated into numbers and then analyzed statistically, the approach was to gather as much in-depth information as possible about the experience of children who live with a sibling who has ADHD.

This was done by conducting a series of in-depth interviews with children and parents in 11 families. These families were participants in a larger study on the family experience of living with a child with ADHD. Thirteen non-ADHD siblings, 11 biological mothers, 5 biological fathers, 2 stepfathers, and 12 boys with ADHD each participated in 2 individual interviews and 2 family interviews. Eight of the 13 non-ADHD siblings were younger than their ADHD brother and 5 were older. Seven were boys and 6 were girls. The average age of the boys with ADHD in these families was 10. None of the children with ADHD were girls. Five of the boys diagnosed with ADHD had also been diagnosed with Oppositional Defiant Disorder. Three of the families were of low income and receiving federal assistance. The other 8 families were of either middle or upper-middle socioeconomic status.

In addition to collecting data by interview, written diaries were also kept by the non-ADHD siblings. These children were asked to write in there diaries once a week for 8 weeks regarding their account of a critical incident - either particularly good or particularly bad - that related to ADHD. These diaries, along with the interviews that were were audiotaped and transcribed, formed the data base that was used to examine common themes in the lives of siblings. The goal was to identify the major themes that emerged across the accounts of the 13 different siblings who participated.

The author emphasizes that the findings to emerge represent only one possible account of the sibling experience, and should be considered as tentative. Because these accounts were provided spontaneously by siblings themselves, however, it is reasonable to believe that they capture important aspects of the experience for many children.

From the massive amount of data collected - over 3000 pages were transcribed - 3 major categories of the sibling experience were identified. These categories were disruption, effects of disruption, and strategies for managing disruption. An overview of the experiences represented by these different categories is presented below. An extremely rich set of descriptive data was presented, and I will do my best to capture this for you.

DISRUPTION

Disruption caused by the symptoms and behavior of their brother with ADHD was the most central and significant problem identified by the siblings. Children described their family life as chaotic, conflictual, and exhausting. Living with a sibling with ADHD meant never knowing what to expect next, and children did not expect this to end.

Seven types of disruptive behavior were identified. These included: physical and verbal aggression, out-of-control hyperactivity, emotional and social immaturity, academic underachievement and learning problems, family conflicts, poor peer relationships, and difficult relationships with extended family. These are the different problem areas that the siblings of ADHD brothers indicated as being most disruptive to their lives and to their family.

Although these types of disruption were reported consistently across the 13 siblings, there were, of course, important differences in the extent to which children reported themselves to be adversely affected. Children who were most affected lived in families where the sibling with ADHD was an adolescent, with more than one sibling or a parent who had ADHD, and where the sibling with ADHD was more aggressive which went along with having ODD in addition to ADHD. Among all siblings, however, it was clear that that the vast majority of family disruptions were attributed to their brother with ADHD.

There were several different types of disruptive patterns that were identified. These included the child with ADHD doing something that needed immediate attention, younger siblings mimicking disruptive behavior, seeking revenge on the sib with ADHD, or parents allowing the child with ADHD to "run wild". Children described family life as focusing on their sibling with ADHD and of constantly having to adjust to the disruption and the negative effects it had on themselves and family life.

EFFECTS OF DISRUPTION ON SIBLINGS

The disruptive effects of their ADHD siblings were experienced by children in 3 primary ways: victimization, caretaking, and feelings of sorrow and loss. These are described below.

VICTIMIZATION

Siblings reported feeling victimized by aggressive acts from their brothers with ADHD through overt acts of violence, verbal aggression, and manipulation/control. Although the most severe acts of aggression were reported by boys whose ADHD sibling also met diagnostic criteria for Oppositional Defiant Disorder, every sibling interviewed reported feeling victimized to some degree by their ADHD brother.

Although not all acts of aggression reported would be considered severe, all were perceived by siblings to be destructive to their sense of safety and well-being. They also reported that parents often minimized and did not believe the seriousness of the aggression. Thus, while parents tended to attribute such behavior to normal sibling rivalry, none of the children interviewed experienced their brother's aggression in this way.

Many children reported that they were easy targets for their brother's aggression because their parents were either too exhausted or too overwhelmed to intervene. Interestingly, this impression was confirmed by many of the ADHD children themselves, who noted that they could get away with hitting their sibling while they would get in trouble for such behavior at school.

Overall, siblings of boys with ADHD tended to report feeling unprotected by parents and were resentful of the degree to which family life was controlled by their brother. They often worried about the ADHD child "ruining" potentially fun activities that were planned and no longer looked forward to certain events because so much depended on how their brother with ADHD would behave.

Feelings of powerlessness was a commonly expressed sentiment. As children became increasingly resigned to their situation, many seemed to develop an image of themselves as unworthy of attention, love, and care, and experienced feelings of rejection from their parents.

CARETAKING

Many siblings reported that they were expected to act as their brother's caretaker. Both younger and older siblings talked about how parents expected them to befriend, play with, and supervise the ADHD child. Among the caretaking activities that children reported being expected to perform were: giving medication, helping with homework, intervening with other children and teachers on behalf of their brother, keeping their brother out of trouble, and getting their brother involved in activities when parents were exhausted.

Although 2 of the 11 siblings reported positive feelings and pride about taking on such a role, the others said this was quite difficult because they were expected to care for their brother even though they were frequent targets of his aggression. They also reported feeling that although they were supposed to provide relief for parents, they never received any relief themselves.

Children expressed resentment that they often felt responsible for their brother's care even though they had no input into the decision-making. Many felt caught in the middle - having to care for and supervise their brother while being attacked and victimized by him.

It is important to note that parents tended to regard such caregiving as what siblings do for one another, and did not regard it as anything particularly difficult or extraordinary. The children themselves, however, felt very differently about this.

FEELINGS OF SORROW AND LOSS

Many siblings of boys with ADHD reported feeling anxious, worried, and sad. They yearned for peace and quiet and mourned not being able to have a "normal" family life. They also worried about their sibling with ADHD - about his getting hurt by other people and getting into trouble.

Children reported feeling that parents expected them to be invisible - to not require too much of their attention and help since they were consumed caring for their child with ADHD. Many felt ignored and overlooked much of the time. They reported trying not to burden their parents any more then they were already burdened. They felt their needs were minimized by parents because they seem so much less significant than the needs of the ADHD child.

Some of these sentiments, of course, could be considered to be part of the competition for parental attention that is part of many sibling relationships. The author suggests, however, that these feelings are much more pronounced in siblings of a child with ADHD. It would have been quite instructive to collect similar data from children with non-ADHD siblings to see how such feelings compare.

STRATEGIES TO MANAGE DISRUPTION

Three of the 10 siblings reported that they dealt with their brother's behavior by fighting back. All 3 of these children had been diagnosed with Oppositional Defiant Disorder. Whether their aggressive behavior arose purely in response to the attacks of their ADHD sibling, or reflected other important causes as well, could not be determined.

The majority of siblings, however, responded to the situation with their ADHD brothers by learning to avoid and accommodate themselves to their brother. The process they described was a transformation of intense anger about how they were being treated, to sadness and resignation. In some children, this process appeared to result in clinical depression.

Some of the statements that children made about dealing with their sibling are really quite telling.

"I've learned to check and see how he's feeling before I even say hi when I come home from school. If he looks upset I don't say anything because I know he will yell at me. I dread coming home sometimes."

"I've learned not to talk to him about what's important to me because he won't listen or he'll say its stupid. So, I only talk to him about what he wants to talk about and that way he won't get mad at me."
"I just try to stay out of his way most of the time and go with the flow." Overall, 10 of the 13 siblings interviewed in the study thought they were severely and negatively affected by their brother with ADHD.

IMPLICATIONS

It is important to put the results of this study into the proper perspective. As the author points out, these findings are based on a small sample of ADHD children and their siblings, and the experiences of the siblings in this study may not necessarily be representative of what many children experience. Certainly, one would expect that some children with ADHD siblings have very positive relations with their sib and within their family. One can and should not assume, therefore, that children in one's own family are necessarily having a similar set of experiences.

As noted previously, it would be helpful to consider these children's reports in comparison to what children who live with non-ADHD siblings describe. This would help differentiate what may be more typical feelings that children with siblings have from what may be unique to children who have a sibling with ADHD.

The children in this study all had brothers with ADHD. One can certainly not assume that the experience of children with a sister who has ADHD would be similar. This would be a very interesting and important issue to examine in future research.

It is also possible that children's reports of their experience may not necessarily reflect the actual reality of their situation. They may feel frequently victimized by their ADHD brother and overlooked by their parents when this is not truly the case. Certainly, it is not uncommon for children to feel they are being treated unfairly by sibs and parents, and this could certainly have contributed to what these children had to say about their situation.

These caveat aside, these data have important implications and I think need to be taken quite seriously. The description provided by the children in this study is certainly consistent with what I have observed in many of the families I have worked with.

There are several things that parents can do to minimize the likelihood of their child without ADHD having the type of experience described here. An important place to start would be to think carefully about how the experiences shared by the siblings in this study fit with what may be going on for your own children. It is difficult for any parent to recognize that one of their children is being victimized - even when it is by their other child. The parents in this study, as you recall, tended to minimize the reports of siblings and to attribute what was going on to normal sibling rivalry. The children themselves, however, had a very different perspective.

The same applies to taking a careful look at how much one is expecting a child to care for his/her sibling. These children tended to feel burdened by caretaking responsibilities when parents believed it was what siblings do for each other. Asking oneself what your own family's expectations are and whether or not they are reasonable could be quite useful. I have to say reading this provided an important wake up call to me.

Sibling reports of aggression/violence need to be taken seriously. There can be an almost reflexive reaction to deny or minimize such accounts, which can leave a child feeling very much alone and unprotected.

As difficult as it can be in busy families, making the effort to spend special time alone with the non-affected sibling can be enormously helpful. These children were reluctant to make demands of their parents because they saw them as so overburdened trying to manage their sibling. They, of course, need parental attention as well, and making sure that it is provided can go a long way to helping a child feel better about his or her situation in the family.

For health care professionals, I think these results highlight the importance of paying close attention to the siblings of a child with ADHD in an overall evaluation and treatment plan. A focus on how to maintain a reasonable family life in spite of the disruption caused by behaviors related to ADHD may be important for many families. Looking back on my own practice, I now recognize how often I failed to consider the needs and experiences of siblings as fully as may be necessary.

The impact on family members of children with ADHD, particularly on siblings, is an important but under-researched area. This qualitative study is an important initial step to learn more about this. I am concerned that the findings of this study may be disconcerting to some readers and sincerely hope that if this is the case, you are able to take positive steps to address issues that you feel are important.

About the author: David Rabiner, Ph.D. is a clinical psychologist, Senior Research Scientist at Duke University and expert on ADHD in children.

Like the phases of grief, parents and family members go from denial to acceptance when a child or loved one is diagnosed with a mental illness.

Too often families coping with a brain disorder in a close relative neglect their own health. They are so emotionally involved that they fail to realize that they are under tremendous strain. This pamphlet is based on ideas from families around the world.

When anyone gets sick with any serious disorder they go through the various stages outlined in this pamphlet. Disbelief and denial are the first to appear, followed shortly after by blame and anger. When someone becomes ill with a brain disorder like schizophrenia, feelings and emotions are not very much different. What may be different is the long time people take to recognize mental illness and the need to seek treatment.

We hope that the pointers presented here will help families understand that feelings of loss, blame and sorrow are quite normal and that there are ways of overcoming them in time.

Emotional Phases on Your Way to Accepting Your Loved One Has a Mental Illness

Denial

Most people, when faced with the diagnosis of schizophrenia in a loved one, go through a phase of denial. This makes it very difficult for other members of the family to cope. Any efforts they make on the "patient's" behalf may be stymied when another family member won't accept the diagnosis. Removing the defenses of a family member who is protecting himself by denying that a real disorder is at work is difficult and distressing. Arguments may occur to disrupt the household even further.

There is no particular solution to this problem except to provide information about schizophrenia so that the person can see that many of the events happening in his family could be related to the disorder. Time may be the ingredient necessary for acceptance even when knowledge and support are available.

Blame

Sometimes families look around for a scapegoat for their situation. A common one is the doctor/psychiatrist. Sometimes the victim himself comes in for some blame. The sooner everyone realizes that the real enemy is the brain disorder itself, the sooner they can begin to cooperate with each other and work towards the person's recovery.

Shame

To come to terms with feelings of shame, it is necessary to assess how you felt about mental illness before it happened to you. If your attitude was of compassion before, then you may have no problem with shame. If you viewed mental illness with fear, extreme embarrassment or even horror, your feelings of shame will be difficult to overcome. Remember that 30 years ago people were ashamed if a relative developed cancer. It was spoken of in whispers because it frightened and horrified people. Today no one would dream of being ashamed about cancer. Through education, understanding and better medical knowledge, society has come to terms with a devastating disease. In time, this will be true about schizophrenia.

You may feel that you cannot tell anyone about the schizophrenia in your family, but making up false excuses or white lies for your relative's behavior will only compound the problem which is difficult enough. Confide in close friends who will lend positive support.

Finding the words is sometimes difficult. Calling schizophrenia "a mental breakdown" or a "thought disorder" is an introduction to further explanation if you cannot bring yourself to say the word. Explain some of the symptoms. Your friends will want to know, as you did, what schizophrenia means. You may want to join a self-help group where your problems will be treated in confidence, where you can speak freely about your experiences and fears.

In many countries, schizophrenia family organizations provide a helpline where you can talk about your situation. You should also request information from this source. There are also chat sites on the world-wide-web.

Guilt

Whenever anyone gets any illness, members of the family wonder how the illness developed. The difference with mental illness is that society has, for a long time, erroneously believed that it had to do with family life or events in one's past. Thus people spend endless hours wondering if in some mysterious way they could be responsible for the illness. It is doubtful whether families can avoid this soul searching but it is important that this initial reaction is overcome.

By listening to informed speakers through a self-help group (WFSAD can provide literature and put you in touch with a local group), by watching documentary films and listening to radio programs about schizophrenia and by speaking to other families experiencing similar problems, you will realize that you are not to blame. More and more research indicates that schizophrenia is a biological brain disease with an as yet unknown cause.

Guilt over being well while one's loved one is ill is a common occurrence, particularly among siblings. It is difficult to enjoy your successes-a first job, attending college, relationships with friends, while your brother or sister has none of these. It is paradoxical that dwelling on these things may reduce your own self-worth. Parents may not appear to value your achievements because they do not want to upset the person who is ill. Support from close friends should enable you to rebuild your sense of self-esteem and your ability to be proud of your own achievements. Parents should not neglect their children who are well.

Anger

Strong emotions are natural when your suspicions are confirmed by a diagnosis of a brain disorder. Realize that anger can be destructive to other members of the family as well as to yourself. Your relative will also sense a more stressful environment.

When anger or grief is overwhelming, release these emotions in as harmless a way as possible, away from your family. This release may take the form of vigorous physical activity. One relative bought an old punching bag from a boxing gymnasium and hung it in his garage. Another would drive to a quiet spot and scream as loud as she could for several minutes to release the built-up tension. A third relative enjoyed squash and would force himself to go to the squash court and play at times of anxiety. Some relatives simply go out for a long walk or run. Everyone should experience the release of tears, the body's own way of reducing tension.

None of us is perfect, so from time to time anger will spill over when you are caring for a sick relative and you will raise your voice in frustration. Many things that are said in anger are bitterly regretted afterward. Try to maintain some control.

Acceptance

Accepting illness is often looked on as proof that you are not going to fight against it. It suggests resignation. Those who have been diagnosed quite naturally often feel that they are unable to accept the diagnosis.

Coming to terms with a brain disorder means knowing the stigma and fear with which society has surrounded it. If you accept what people say about the possible long-term nature of the illness, then hopes and dreams for the future are in jeopardy. Families sometimes continue to seek the same goals for their relatives, despite the limitations that the illness may impose on them. Not only the person but also his family has to come to terms with the degree of disability imposed by the symptoms of schizophrenia, while still maintaining hope for the future.

When this is done, small measures of recovery can give rise to optimism and pleasure. This takes time. You may understand that you must accept what has happened, but actually feeling acceptance will be a long process. Knowledge can help the family understand and begin to accept. Accepting does not mean giving up hope. It means that you reduce the frustrations which stem from unrealistic objectives.

Things to Remember on the Road to Healing

Happiness

Even happy moments are difficult to enjoy. Sometimes it seems as if there are no happy moments. We are so busy seeing to the needs of our relative that we are worn out. Families have found that by putting parts of their lives into what one could call "compartments," they are able to feel some happiness. Thus, they force themselves not to worry about what might happen tomorrow so that they may enjoy a happy event today.

A sense of humour has helped many a family through difficult times. Laughter is therapeutic as long as you are all laughing together. Periodic breaks away from your relative will "recharge you batteries." Parents may have always shared holidays before. If this is not possible now, each family member must have recreational time free from worry.

Caring

Sometimes a caregiver tries to compensate for what she/he has lost in his relative by becoming overprotective. Personal pain is assuaged by the total management of the relative's life. The person, often the mother, becomes dependent on the caring role, in some cases treating an adult son or daughter as a child. This is not only destructive to the caregiver, but it is also stressful for the person with schizophrenia. The motto should be "Moderation in Caring."

Knowledge

The more you learn about schizophrenia the more you will realize that you are far from being alone. The major mental illnesses are thought to have a prevalence of 5% (United States National Institute of Mental Health statistics). Schizophrenia itself has a lifetime prevalence of 1 in 100. Your knowledge will arm you against any ignorance you meet. You will feel satisfaction in being able to impart the knowledge you have learned.

Making Adjustments

When serious illness hits a family all the usual, well-known behaviors of all the members are upset. Everyone has to adjust to the new reality. Because schizophrenia is a disease so closely associated with feelings and perceptions it is all the more important that the family react without too much display of emotion. It is also important that the person with the disorder does not feel abandoned because everyone is so perplexed. Quiet reassurances of love and respect are needed between all members of the family.

Source: World Fellowship for Schizophrenia and Allied Disorders

Co-parenting classes can be highly valuable when divorced or separated parents are raising their children separately. When a marriage or partnership dissolves, kids must navigate the worlds of two single parents and their different styles, rules, and expectations. Divorce takes a toll on parents and, especially, kids. The most crucial factor in raising secure, healthy children is having parents who have created a healthy parental partnership (Bass, n.d.). Co-parenting classes can help divorced parents do just that.

Co-Parenting Classes and the Negative Consequence of Divorce on Kids

Adjusting to the myriad of changes that occur when parents divorce is a struggle for many children. Separation anxiety and adjustment disorder are common. Kids often experience changes in their relationship with one or both parents, and they face big and unwanted changes such as a move to a different home, a change in schools, and increased stress at home.

These life changes can lead to difficulties for kids and their parents, such as:

• Anxiety (worries that their parents will stop loving them, self-blame, general worries and fears)
• Depression
• Anger
• Behavior problems (delinquency, conflicts with peers, truancy, impulsiveness)
• A decline in academic performance
• Increased chance of risky behaviors like substance use and sexual activity in adolescence

Divorce can be detrimental for children and teens, and the negative effects can follow them into adulthood. The good news is that divorce doesn’t guarantee poor outcomes for kids or parents. When parents cooperate with each other to nurture their children, their kids adjust well and can thrive. This is no easy task, which is why taking co-parenting classes can benefit you and your children.

What Topics Do Parents Learn in Co-Parenting Classes?

Co-parenting classes are structured to meet the specific needs of divorced parents wanting to be good parents for their kids. The classes are designed for both parents to take because the point is for parents to learn to work together to provide consistency and stability for their children. Also, parents learn how to focus on the needs of their kids rather than their own needs; while parents have needs, including divorce-related stress and emotions, they should be addressed separately. To help their kids do well, co-parenting classes teach topics like these:

• What healthy co-parenting looks like and how to achieve it
• How divorce impacts kids and how to be sensitive to their experiences
• Embracing your child as part of your lives and love
• Parenting kids at the different developmental stages
• Communicating positively and productively together
• Working together to create a parenting plan
• How to deal with a long-distance co-parenting situation
• Caring for your child’s mental health and wellbeing
• Conflict resolution and anger management
• Respectful relationship and parenting skills

While each course, whether it’s in-person in your community or is a co-parenting class online, differs in its specific curriculum, there is an overarching theme to what they teach: cooperative co-parenting. What do you and your kids gain when their divorced parents take co-parenting classes? You all have the potential to reap numerous benefits for your lives.

Benefits of Taking Co-Parenting Classes

Everyone is likely overwhelmed and under stress during a divorce. Co-parenting classes can help you know what to do about that stress and about the realities of daily life as a single- yet co-parent.

These classes can help you establish consistency and stability for your kids. Everyone will feel more peaceful and accepting of the new changes.

Parents learn how to maintain a positive relationship with each other to make communicating and decision-making less conflicted. When this happens, kids will feel less caught in the middle and more part of a cohesive unit.

With tools and skills learned in a class, you can develop and implement a discipline plan that’s fair to everyone and isn’t a hateful experience to create with your co-parent. In discipline as well as every facet of your lives, you’ll be operating out of a sense of shared parenting goals for your children’s growth.

Co-parenting classes allow you to come together for your child. Your communication will be more positive, you’ll be equipped to handle inevitable conflicts, you’ll be able to compromise and experience a give-and-take relationship, and you’ll be able to see the big picture of your children’s needs and wellbeing.

With the focus on what is best for your children, co-parenting classes help them thrive. These classes can help you address problems in a balanced way. Both parents can nurture their children and help them succeed. Co-parenting classes can help you help them.

See Also:

• Do We Need Co-Parenting Counseling, Therapy, or Mediation?
• Tips for Co-Parenting with a Toxic Ex
• Parent Coach or Counseling: Which is Best for You?

article references

Learning disability tests online offer a quick and easy way to investigate your child’s learning problems. Online tests can be the first step in a rather lengthy assessment process to determine if your child has a learning disability. Online learning disability tests aren’t official assessments and don’t lead to a learning disorder diagnosis regardless of how strongly they indicate a learning disability.

Although an online test can’t tell you if your child has a learning disability, it can provide you with useful information. Online assessments are screenings that allow you and your child to evaluate symptoms they’re experiencing. They often consist of checklists, rating scales, and other simple methods to clarify learning problems your child might be facing.

When the screening is complete, you receive a profile of your child’s areas of strengths and weaknesses. These results are meant to be a learning disability assessment tool to increase your understanding of your child’s difficulties as well as communicate your concerns to the school. Your child’s teacher or the principal with meet with you to discuss your child before meeting with other school professionals. If everyone agrees that learning disorder tests are necessary, the formal testing process will begin.

Learning Disability Assessment

The learning disability assessment process is one of gathering information about a child to determine if they have a learning disability. Information learned throughout the process will also shape learning disorder interventions for the individualized education program (IEP) that will be created to help your child succeed if they have a learning disability.

Learning disability assessment activities come in many forms. Common methods of assessment that might be used to evaluate your child include:

• Written observations of your child’s performance and behavior, completed by your child’s teachers and, often, parents to compare school and home behavior
• Interviews with the child, family members, and other relevant people such as coaches
• Checklists
• Rating Scales
• Informal tests
• Formal, standardized tests

Formal testing, also known as psychoeducational evaluation, involves a full battery of tests and provides objective, measurable results. Federal law mandates that testing be paid for by the school district. Parents can choose to have their child tested privately, but they must pay for the services themselves.

Among the qualified professionals who are authorized to administer learning disability tests for your child are:

• Clinical psychologist
• Child psychiatrist
• Educational psychologist
• Neuropsychologist
• Psychometrist

Another testing option for your child is to use learning disability testing centers. The professionals who administer tests at centers are as qualified as those listed above, but the fee is more reasonable. Local university testing centers are good choices, as are teaching hospitals when they are doing relevant research projects. A quick call will let you know if they’re currently administering learning disorders tests.

As this procedure progresses, there are different types of tests that your child might take.

Types of Learning Disability Tests

Some tests target the disability your child is suspected of having in order to verify or refute the disorder. Other tests look at your child’s global functioning to create a general profile. This adds to everyone’s understanding of your child and whether there’s a learning disability present. Many tests measure how your child’s ability compares to achievement. Some types of tests:

• Educational achievement
• Intellectual, or cognitive, testing (a type of test in this category is an intelligence quotient (IQ) test)
• Questionnaires
• Surveys
• Neuropsychological

What Info Is Gained from a Learning Disability Assessment?

The testing process to determine the presence of a learning disability is tedious but effective and valuable. As the testers and evaluators compile the results, they come to understand your child and their learning problems very well. Some of the information they learn includes:

• How this learning disability impacts your child at school and home
• Your child’s strengths and weaknesses
• The areas of functioning negatively impacted
• The degree (mild, moderate, or severe) of your child’s disability
• Whether an IEP and special education is needed
• The educational, emotional, and behavioral issues needing the most attention

Learning disability assessment isn’t a simple question with a yes-or-no answer. It’s complex, and it’s reliable. What sometimes starts as a concerned parent and child taking a learning disability test online to understand symptoms can end in results that move your child forward. You’ll get answers, and your child will get help so they can learn the same material as their classmates in a way that accommodates their learning disability.  

See Also:

• How Do You Define a Special Needs Child?
• What Are the Characteristics of a Learning Disability?
• What Are the Different Types of Learning Disabilities?
• Tips for Parenting Children with Special Needs

article references

Focus on the important role of parents in helping ADHD children have a positive educational experience.

Introduction
Accepting the diagnosis
How medication fits in
Community support
Confidentiality and disclosure in the school setting
Advocating for your child's educational needs
Homework
Assistive technology
Social skills-an educational issue
Adolescent issues
Conclusion

Introduction

Ever since our country established a system of universal compulsory education, educators and clinicians have begun to notice students with ADHD-like symptoms. It has gone by many names and has been addressed in many different ways.

Accepting the ADHD Diagnosis

Many families go through a period of uncertainty during the time leading up to the eventual diagnosis. Sometimes, but not always, school problems trigger the ADHD diagnostic workup. The experience of "getting diagnosed" is powerful and can either be a blessed relief or a crushing blow. Many parents experience this as a loss and need to go through a process of mourning so that they can eventually accept their child as he or she is.

The classic stages of mourning, denial, anger, grief, and acceptance all apply here. Parents and teachers may have different perspectives on this phase of the process of acceptance. The professionals need to be patient with parents as they come to terms with their child's condition. They should not be too quick to pathologize parents who become emotional or angry in meetings. Some of the nicest, most conscientious parents may become angry and tearful in meetings. Parents and children may go through repeated episodes of mourning as they experience the effects of ADHD in different settings and at different ages.

Parents need to listen carefully to teachers' observations. However, they must remember that teachers and schools do not make medical diagnoses. The classic symptoms of ADHD, inattention, impulsivity, and sometimes hyperactivity, can be due to a variety of causes. A parent might request that a specialist observe the child in class or go to observe the class himself. Conferences with teachers and guidance counselors are useful ways of gathering and sharing information. Finally, a thorough diagnostic workup is crucial. It is not a good idea to diagnose and medicate a child based on a few checklists and a brief office visit.

The psychiatrist or other clinicians should take a complete individual and family history, interview the child, and review data from the school. The clinician should assess the child for the presence of depression, anxiety disorders, and learning disabilities. These disorders are over-represented in ADHD children. The clinician should discuss a comprehensive program for addressing the child's difficulties. Although there are a few children who seem "cured" when they are on the right medication regimen, most need other interventions too.

ADHD Medication

Medication is often an important part of the comprehensive treatment of an individual with ADHD. Ritalin is the most commonly prescribed medication for ADHD. It is important to remember that it is a short-acting drug and only lasts 2.5 to 4 hours. Often children are given a morning dose at 7 AM before leaving home and do not get their second dose until Noon. If this is how your child's medication is scheduled, check to make sure that he is doing well in the two hours before lunch. Some children may experience a rebound effect as the medication wears off.

If there is a problem during this period, talk to your child's doctor about adjusting the timing of the medication doses or switching to a different medication. Sometimes a small change in the timing of Ritalin dosing can make a big difference. Since teachers and some clinicians may not understand the short-acting nature of this medication, they may interpret the rebound irritability as deliberate acting out. When teachers note difficult behavior in a child on Ritalin, be sure to find out whether it is occurring at a specific time of day. There are now several good longer-acting forms of Ritalin and other stimulants. There are also other medications that can be helpful for ADHD if the stimulants are not sufficient. If the current regimen is not adequate, a comprehensive psychiatric evaluation may clarify the roles of both medication and other interventions.

Part of dealing with medication is dealing with the issue of stigma. Some children may think that only the "bad" kids go to the nurse to get stimulants. Other children enjoy their daily visits to the nurse. When students line up to see the nurse, the students sometimes figure out who is getting the Ritalin. For some sensitive children, this may be a reason to consider other medications. In other cases, some general classroom education about ADHD and medications may suffice.

Community and Extended Family Support

Community support is important during and after the time of the initial diagnosis. It is easy for a family to become overworked or overwhelmed. At such a point, the family might be tempted to withdraw into itself just when support is most needed. Extended family can be an important source of support, but can sometimes also be a source of tension. Parents often feel that extended family members do not understand the situation. Educating grandparents and extended family can take time.

Confidentiality and Disclosure

Whom do you tell about the diagnosis and condition? This is a judgment call. Often it is best to consult the child about this. Many times, it is better to allow friends and their parents to get to know your child before telling them. That way, they know your child as a person before they can stereotype him.

How much do you tell your child's school? (before and after admission) This, too is a judgment call. Generally, it is a good idea to let the school know if your child has any special needs. However, this can be a particularly thorny issue if your child is applying to a competitive private school. Some schools are more understanding about ADHD than others. If 100 children are applying for ten slots, a few schools might not spend the time to understand your child's unique situation. Talk to other parents and get a feel for how the school personnel deal with these issues. If you know the parent of an ADHD child who attends the school, they might be able to give you advice. If your child is currently attending a particular school, one should be sure to tell the school nurse about any medications, even if they are given at home. Children do have accidents at school and the information should be available for emergencies

Advocating for Your ADHD Child's Educational Needs

Often simple interventions can make a big difference for a child with a short attention span. The teacher can place him near the front of the class and work out secret cues to remind him to stay on task. The parent should suggest more frequent telephone or face-to-face contact to monitor and coordinate school and home progress. The parent and teacher should work out a system of helping keep the child accountable for work.

Sometimes, the parent feels that further educational intervention is needed. Educational funding is not plentiful, so then the parent may need to become a more active advocate. When advocating for your child, try to start off with a positive attitude. Be aware of your child's educational and legal rights, but do not start off by quoting the law to staff. For children in the public schools, there is specific, legally mandated system to help determine the child's educational needs. If you feel that your child needs educational testing or special education resources, ask for an official meeting to review your child's educational plan.

Often parents can assist the school in gathering information to determine whether the child needs testing or special help. If your child has a special educational plan (IEP), always review it carefully before the formal meeting. If possible, both parents should come to the meeting. If one parent is feeling angry or frustrated, try to have the calmer parent do the talking. If the special education process is confusing, you may seek out an educational advocate to come to the meeting with you. If the school does the testing, you do not have to pay for it. Try to meet with the school psychologist to go over the test results before the official school meeting. You may obtain outside evaluations, at your own expense, to bring to the school meeting.

If you have the time and energy, try to volunteer time for your child's school. Volunteers can free up some of the teacher's time. This may, indirectly, give her more time to focus on your child's needs. This also gives the parent an opportunity to get to know the school environment and some of the child's classmates. Having a good knowledge of the functioning of your child's school can help clear up potential misunderstandings.

Some parents choose to arrange for private evaluations or tutoring. Speech therapy, occupational therapy, and some other services may be covered by some insurance plans. Some companies have dependent medical care plans which allow the parent to put pre-tax money aside for medical and childcare expenses. This can be used to cover certain kinds of assessments and treatments not covered by insurance or paid by the school. Check with your employer or tax specialist. Many private schools have arrangements with tutors and speech therapists. In these cases, the parents usually pay for the services. In some situations, a child in a private school may qualify for free services funded by the public schools. In this case, the parent usually has to drive the child to a public school to get the services there.

ADHD and Homework

A child with a short attention span may have more difficulty sitting down, turning off the TV and doing homework on his own. It helps to have a specific time and place for the child to do homework. In some cases, supportive parental supervision can be valuable. This can be a positive opportunity for the parent to see what the child is doing academically. The parent can also go over concepts that the child may have missed when not paying attention. As the student enters middle and high school, the direct supervision of homework shifts more to a coaching model which I will discuss later.

Some students may need medication adjustment so that they can focus enough to do their homework. For some students, particularly those with learning disabilities, the standard amount of homework is just too much. They and their parents spend the entire evening struggling and arguing about getting it done. There is no enjoyable family time left before bedtime. If this is truly the case, the parent should talk to teachers about allowing shortened assignments or setting a time limit on homework. Conversely, some parents ask for extra assignments so that the student can work at home on assignments not finished during the day.

Assistive Technology

Among the first self-help groups to make extensive use of computers was the disability community. Physically challenged individuals could use computers and later the Internet as eyes, ears hands and legs. Individuals who learn to compensate for a deficit may, through their efforts, gain special skills Children, parents and adults affected by ADHD can benefit from computer technology. At this point, there are computer applications devoted to most types of interests and activities.

Computer-based educational software can help children learn academic subjects. The best programs provide immediate feedback and appealing, changing visual and auditory input. Many feature cartoon characters who function like an encouraging tutor. There are also entertaining programs such as "Geometry Blaster" that cover high school topics. Parents and teachers can sometimes use easily available commercial software for academic remediation and for enrichment. The newer educational software allows a parent to customize the program by changing the difficulty deleting voices, and changing the reward frequency. In other cases, educational specialists may use software designed to remediate a specific problem.

Many parents feel intimidated by computers and the Internet and allow their children free reign with software and Internet surfing. It is better to supervise and have ground rules. Some software programs and Internet sites contain over-stimulating graphic violent or sexual themes. Children with ADHD may be more vulnerable to the adverse effects of over-stimulation.

The use of a word processor or a voice recognition program can help individuals who have difficulty with getting their thoughts out on paper. There are a number of excellent typing and word processing programs for children and adolescents. The voice recognition programs are mostly aimed at adult professionals. A child might be able to use some of them but would need excellent reading skills and close adult supervision.

Social Skills at School

One of the most important skills taught both at home and school, is how to get along with others. This may be the most important skill the ADHD child has to learn. Some ADHD individuals are naturally gregarious and popular. However, there are also a large number of individuals who have significant social deficits. Parents of younger students can help by encouraging constructive play dates. They can sometimes talk to the teacher about facilitating opportunities for socializing. If the student is not good at academics or athletics, he may have an interesting hobby such as fossil collecting. The student and parent might do a class presentation about the hobby or help the science class arrange a field trip connected with the hobby. The right martial arts class can instill a sense of confidence, help coordination and teach appropriate assertiveness.

Adolescents with ADHD are more likely to be impulsive. Thus parents might want to monitor peer relationships a bit more closely. Since individuals with ADHD are more likely to develop drug problems and sexual acting out, parents should begin education on drugs and sexuality early, and reinforce it often. If impulsivity is a problem after hours, consider a long-acting stimulant. Teachers and guidance counselors may be the first to notice if an adolescent has changed peer groups or is hanging out with the "burnouts."

Adolescent Issues

It is always tricky to tell a parent when and how to gradually move from direct supervision of homework to more of a coaching role. For some adolescents, the parent must continue to supervise homework for more years than would the parent of a non-ADHD teen. Parents may accomplish this gradual pullback by the use of calendars, checklists, and Day Planners. Some adolescents are more motivated to use these than others. Regular contact with teachers can give the parent feedback on whether they need to be as directly involved in homework supervision.

Older elementary school children and adolescents should be educated about ADHD and, if applicable learning disabilities. For the adolescent, knowledge, and acceptance of his strengths and weaknesses can help him make good choices. Denial of one's difficulties is common at this age.

Conclusion

Ultimately the most important thing is to instill in your child positive self-esteem and an attitude of responsibility and mastery. The child should be encouraged to learn all he can about ADHD. At the same time, the child should take responsibility for his actions.

About the author: Dr. Watkins is a board-certified child and adolescent psychiatrist and an expert in ADHD.

For some children, autism and learning disabilities share overlapping symptoms. Despite this, autism is not a learning disability. Traditionally, the fact that the two disorders—both neurodevelopmental—have similarities has confused even doctors and educators.  As we study, research, and observe, our understanding of both autism and learning disabilities increases. Is autism a learning disability? It isn’t. The two conditions are separate disorders. A child can have both, though, or they can have just one. Let’s explore autism and learning disabilities to learn how they affect kids.

Autism Is Not a Learning Disability, but What Is It?

Also called autism spectrum disorder (ASD) because of the wide range of symptoms, severity, and experiences kids can have, this disorder affects how kids process information their brain takes in. The hallmark symptoms and characteristics of autism include:

• Social difficulties
• Communication problems
• Sensory processing troubles
• Repetitive behaviors and movements
• Narrow, obsessive interests in a topic, toy, or other items and ideas

These are the defining features of autism; however, the experience of autism is different for every child. In the communication category, for example, some kids with autism don’t have significant speech deficits, but others experience speech delays and difficulties. Some have average or above-average intelligence, while others have intellectual delays. Overall, kids with autism can be very high functioning or experience severe disability.

Autism is not a learning disability, but it does affect learning. It’s not uncommon for a child with autism to have difficulties with language skills like listening and speaking. This might sound like a learning disorder, but learning disorders have unique symptoms and characteristics of their own.

How Is a Learning Disability Different from Autism?

Learning disorders can interfere in learning skills such as reading and math. A difference is how they impact a child’s life. The academic and developmental effects of autism are much broader than the effects of learning disorders. Autism tends to affect the whole child. Learning disabilities can, too, but typically their impact is narrower, impacting the area of specific disability.

Many different types of learning disorders exist, as opposed to autism’s single disorder on a spectrum of severity and effects. Some types of learning disorders are dyslexia, dysgraphia, and dyscalculia, disrupting abilities in reading, writing, and math, respectively. Other learning disorders are auditory and visual processing disorders, language processing disorder, and nonverbal learning disability. Children have problems learning and completing work in the specific area of their disability.

Nonverbal learning disorder has many characteristics similar to autism. Perhaps the question about autism should be, “Is autism a nonverbal learning disorder?” Kids with nonverbal learning disability experience, among other symptoms:

• Awkwardness
• Difficulty with change and transitions
• Concrete, literal thinking
• Problems with understanding nonverbal communication (such as facial expressions, body language, and tone of voice)

These characteristics fit both nonverbal learning disability and autism. Not only is autism not a learning disorder, nonverbal learning disability isn’t on the autism spectrum.

Other similarities between autism and learning disabilities do cause people to continue to wonder if there is a connection.

Despite Overlap, Autism Is not a Learning Disability

Children with autism and those with a learning disability share some common features. These symptoms are common to both:

• Sensory processing issues (needing to avoid or seek sensory input)
• Trouble with social skills
• Prone to meltdowns
• Communication issues, including difficulty with words
• Difficulty recognizing others’ feelings
• Problems with executive functions (organizing, problem-solving, self-regulating emotions and behaviors, etc.)
• Lack of coordination

Not all symptoms are shared between learning disabilities and autism. Perhaps one of the best reasons why autism is not a learning disability is not the “what”—not a list of similar and different symptoms—but the “how.” For kids with learning disabilities, their symptoms mostly (but not completely) affect their specific area of disability. Children who have autism feel the effects of the disorder more globally and evenly rather than attached to an area of learning.

Autism isn’t a learning disorder. Yet both disorders can significantly affect a child’s life, and kids with either (or both) disorder can be supported and helped. Arm yourself with knowledge about the disorders, and spend time with your child to observe their characteristics.

article references

Caring for someone with a mental health problem like bipolar disorder or ADHD can be overwhelming. Learn how to deal with caregiver burnout.

As the parent of a child (or children) with high needs, the lives of all involved are complicated. It's very easy to become hyper-focused, over-involved, and unable to separate "self" from "situation." This is very common, normal, and at the same time, dangerous.

The very things required to function within the daily life of caring for a child or other family member with exceptional needs can lead to feeling overwhelmed and frustrated. If unchecked, these feelings build; leaving one vulnerable to getting stressed over things that were once not stressful. This can be further complicated if the caregiver has a diagnosis of, or tendencies towards depression, anxiety, bipolar disorder or other similar mood disorders.

Compassion fatigue

Have you heard of compassion fatigue; sometimes called secondary victimization or traumatic stress, vicarious traumatization? It's a form of burnout, a deep physical, emotional and spiritual exhaustion accompanied by acute emotional pain. Compassion-fatigued caregivers continue to give themselves fully to the person they are caring for, finding it difficult to maintain a healthy balance of empathy and objectivity. The cost of this can be quite high in terms of functionality, family, work, community and most of all, self.

You probably already realize that living with an unstable child (with behavior problems) subjects all family members to daily trauma at times. Numerous symptoms indicate that a caregiver is experiencing reactions to traumatic stress. In fact, the very qualities that make one an excellent caregiver - empathy, identification, safety, trust, intimacy and power - are the very qualities that can cause one to face burnout.

Learning to recognize the symptoms within oneself that indicate heightened stress is imperative to addressing, relieving and avoiding it. Stress unchecked will lead to caregiver burnout.

Those who have experienced compassion fatigue describe it as being sucked into a vortex that pulls them slowly downward. They have no idea how to stop the downward spiral, so they do what they've always done: They work harder and continue to give to others until they're completely tapped out.

Symptoms of burnout

• Abusing drugs, alcohol or food
• Anger
• Blaming
• Chronic lateness
• Depression
• Diminished sense of personal accomplishment
• Exhaustion (physical or emotional)
• Frequent headaches
• Gastrointestinal complaints
• High self-expectations
• Hopelessness
• Hypertension
• Inability to maintain balance of empathy and objectivity
• Increased irritability
• Less ability to feel joy
• Low self-esteem
• Sleep disturbances
• Workaholism

To those who are in the throes of compassion fatigue, time, or more precisely the lack of it, is the enemy. To compensate, many caregivers try to do several things at once (e.g., eat lunch while returning telephone calls). And to make more time, they tend to eliminate the very things that would help revitalize them: regular exercise, interests outside of caregiving, relaxed meals, time with family and friends, prayer and meditation.

Treating caregiver stress and burnout

To recharge your batteries you must first learn to recognize when you're wearing down and then get into the habit of doing something every day that will replenish you. That's not as easy as it sounds. Old habits are oddly comfortable even when they're bad for us, and real lifestyle changes take time (some experts say six months), energy and desire.

The first line of action is to prioritize situations so you have some measure of control.

Ask yourself:

• What do I have control over?
• Who is in charge here?
• What do I really need to change?
• What do I see as necessary that really is not?
• Will the world stop spinning if I do not do ____?

Have your own self-care plan

The lifestyle changes you choose to make will depend on your unique circumstances, but three things can speed your recovery.

1. Spend plenty of quiet time alone. Learning mindfulness meditation is an excellent way to ground yourself in the moment and keep your thoughts from pulling you in different directions. The ability to reconnect with a spiritual source will also help you achieve inner balance and can produce an almost miraculous turnaround, even when your world seems its blackest.
2. Recharge your batteries daily. Something as simple as committing to eat better and stopping all other activities while eating can have an exponential benefit on both your psyche and your physical body. A regular exercise regimen can reduce stress, help you achieve outer balance and re-energize you for time with family and friends.
3. Hold one focused, connected and meaningful conversation each day. This will jump start even the most depleted batteries. Time with family and close friends feeds the soul like nothing else and sadly seems to be the first thing to go when time is scarce.

Here are some other ideas for relieving stress, compassion fatigue and caregiver burnout

• Plan time to be alone. (even 5 minutes can be a life saver)
• Develop a personal relaxation method.
• Claim a place that belongs to you alone for personal time.
• Dress comfortably in clothes you like.
• Take a bubble bath.
• Hire a sitter for an hour/evening.
• Make and keep a regular date with significant other or friend.
• Go for a drive, roll down the windows and crank up the radio.
• Reduce all sensory input. (dim lights, turn off TV's, radios and phones, put on comfy clothes)
• Read a book.
• Light some candles.
• Order dinner delivered.
• Get a massage.
• Take time to be sexual.
• Plan and get enough sleep.
• Eliminate unnecessary activities in life.
• Eat regular and healthful meals.
• Dance, walk, run, swim, play sports, sing or some other physical activity that is enjoyable.
• Try something fun and new.
• Write or call a friend.
• Give yourself affirmations/praise...you are worth it!
• Find things that make you laugh and enjoy them.
• Prayer or meditation.
• Let something go for a day. The world does not stop spinning if the beds are left unmade.
• When energy is flagging, a B Complex supplement is very helpful.

The idea is to take care of your "self" to avoid negative outcomes. What works for one person in avoiding or relieving stress differs from the next. It could take some experimentation or willingness to try something new to discover what really helps. Once found, practice often. If, after trying several things on a regular basis and not finding significant relief, consider that you may be suffering from depression and/or anxiety and consult with a mental health professional.

Sources:

• Can you care too much? Hippocrates. April 1994:32-33.
• American Academy of Family Physicians, April 2000.

An LGBT parent support group can be an invaluable resource for parents when their child comes out as lesbian, gay, bisexual, or transgender. Coming out can be difficult and stressful for people of any age, and it’s especially so for teenagers. They need acceptance and love from their parents, who aren’t always sure how to provide it. Attending an LGBT parent support group can be one of the best actions you can do to support your LGBT child.

LGBT Parent Support Groups Help Parents Be There for Their Child

If your child has just come out as LGBT, you might have a flood of emotions. Common parental reactions include:

• Curiosity
• Shock
• Bewilderment
• Panic
• Fear for their child’s safety if they’re bullied, harmed, or rejected
• Anxiety about whether their child will find love and have a family
• Sadness over their child’s quality of life
• Anger
• Guilt and self-blame, wondering what they did wrong

These feelings are normal for even the most supportive parents. They can be intense and interfere in family relationships. Teens need love, unconditional acceptance, and support from their parents as well as open-mindedness and the ability to listen fully during conversations.

Many parents want to be supportive of their child but are overwhelmed and don’t know how to sort out their own thoughts and emotions let alone provide what their child needs most. This is precisely why LGBT parent support groups exist. These groups help parents with their own emotions as well as provide insights into how they can support their teen.

How LGBT Parent Support Groups Help Parents Help Their Child

In support groups, parents of LGBT youth have an opportunity to talk freely with other parents with LGBT children. Parents need a place to talk frankly about their reactions and feelings and to listen to the stories of others. Shared experiences in these LGBT peer-to-peer support groups help people know that they aren’t alone, that all of the unknowns they’re facing are also faced by other families.

Support groups are safe places for parents of LGBT kids to process their negative feelings, express their positive thoughts, and develop complete acceptance of their child’s sexual orientation. Even more, participants learn to let go of the past and continue loving and supporting their child. Group participants often brainstorm together to generate ways of supporting their child.

Parents of an LGBT child attend support groups and find reassurance for thoughts, feelings, and parenting actions. Then, armed with inspiration and practical ideas, they are equipped to return home and reassure their child who is likely feeling tumultuous emotions. With strategies garnered in support groups, it’s easier for parents to be driven by love when interacting with their teen.

These support groups exist in cities and towns all over the US. The resources below can help you locate groups near you.

Finding Support for Parents of LGBT Youth

When you’re overwhelmed and focused on your child, it’s hard to take the time to find a support group. The below groups are prominent organizations with quality support groups or forums. You might also find small, grassroots groups in your community—look for information at a community center, local schools or counseling offices.

PFLAG began in the 1970s when a mother of a teenage son who came out as gay wanted to support him and thus created a parent support group. In exchanging stories and information, they grew as parents and were able to fully support their children. Today, PFLAG has support groups across the country and does tremendous advocacy work.

National Network of LGBTQ Family Groups by the Family Equality Council is a network of LGBTQ family groups. As part of a larger network, small community groups gain strength, access to resources, and more. Use their website to find connected groups across the US.

Strong Family Alliance is an online forum that allows parents to share frustrations and triumphs, ideas and resources just as they would in a community-based group. Strong Family Alliance also offers a wealth of articles, stories, information, and resources.

LGBT family support makes a positive difference as teens grow increasingly comfortable with their sexual or gender identity. In this, LGBT parent support groups do a great service. They help you support your child in the way they need it best in any given moment; this, in turn, strengthens your relationship right now and into the future.

article references

Suggestions for parenting a child with ADHD (attention-deficit hyperactivity disorder), creating stability and providing support.

Children with ADHD need consistent rules that they can understand and follow. ADHD kids should be rewarded for following these rules. Parents often criticize children with ADHD for their nonadaptive behavior -- but it's more helpful to seek out and praise good behavior. Parents should:

• Provide clear, consistent expectations, directions and limits. Children with ADHD need to know exactly what others expect from them.
• Set up an effective discipline system. Parents should learn discipline methods that reward appropriate behavior and respond to misbehavior with alternatives such as time out or loss of privileges.
• Create a behavior modification plan to change the most problematic behaviors. Behavior charts that track a child's chores or responsibilities and that offer potential rewards for positive behaviors can be helpful tools. These charts, as well as other behavior modification techniques, will help parents address problems in systematic, effective ways.

Children with ADHD may need help in organizing. Therefore, parents should encourage the child with ADHD to:

• Schedule. The child should have the same routine every day, from wake-up time to bedtime. The schedule should include homework time and playtime.
• Organize needed everyday items. The child should have a place for everything and keep everything in its place. This includes clothing, backpacks and school supplies.
• Use homework and notebook organizers. Stress the importance of having the child write down assignments and bring home needed books.

Homework Tips for Kids with ADHD

Parents can help a child with ADHD achieve academic success by taking steps to improve the quality of the child's homework. They should make sure their child is:

• Seated in a quiet area without clutter or distractions.
• Given clear, concise instructions.
• Encouraged to write each assignment in a notebook as it is given by the teacher.
• Responsible for his/her own assignments. Parents should not do for the child what he/she can do for himself/herself.

ADHD and Driving

Driving poses special risks, particularly for teens with ADHD. Driving hazards associated with ADHD include:

• Deficiencies in attention
• Impulsivity
• Risk-taking tendencies
• Immature judgment
• Thrill-seeking tendencies

Teen driving privileges should be discussed in light of the overall ADHD treatment plan. It is a parent's responsibility to establish rules and expectations for safe driving behaviors.

Children with ADHD and Relationships

Not all children with ADHD have trouble getting along with others. For those who do, however, steps can be taken to improve a childs relationships. The earlier a child's difficulties with peers are noticed, the more successful such steps may be. It is helpful for parents to:

• Recognize the importance of healthy peer relationships for children.
• Involve a child in activities with his or her peers.
• Set up social behavior goals with the child and implement a reward program.
• Encourage social interactions if the child is withdrawn or excessively shy.
• Encourage a child to play with only one other child at a time.

Sources:

• Cleveland Clinic

Are you taking your stress out on others and causing others to be stressed? It's time to take responsibility for dealing with your stress.

Stress is usually experienced as a state of threat arising from two questions. "Can I cope with this situation?" "And if I can't cope with this situation, what will happen to me then?" Stress both registers this sense of threat and mobilizes energy to respond to the emergency demand life has created. Thus, although stress tends to be experienced negatively, it also has positive survival value.

The demand with which stress is usually identified is some kind of pressure -- for example, from being injured, pushed, blocked, let down, cut off, overloaded, or from otherwise being overwhelmed.

Stress is not a problem in life, it is simply a part of life because so much of what happens to people is unexpected and outside of their control. When stress is occasional, a person feels depleted after coping with the threat, but then recovers and goes on.

When stress is ongoing, however, then a person can register stress on four increasingly damaging levels as he or she gets more depleted and worn down.

1. FATIGUE: "I feel tired all the time."
2. PAIN: "Physically or emotionally I hurt all the time."
3. BURN-OUT: "I have lost caring for what I normally care about."
4. BREAKDOWN: "I can't seem to physically function anymore."

Unfortunately, these levels are additive, so by the time someone reaches breakdown, he or she is also burdened by some degree of fatigue, pain, and burn-out.

It takes keeping oneself well physically, emotionally and spiritually, being able to limit excessive demands from oneself and others, and holding a positive mental outlook, to keep stress from inflicting more than normal wear and tear on a person's life.

Hardest of all can be keeping one's stress from becoming contagious to other family members.

Stress Can Be Contagious

How can stress become contagious? Recall the four levels of stress outlined above. Because FATIGUE from stress can cause a person's outlook to turn negative, it can be easy to become more CRITICAL of other family members. Because PAIN from stress can cause a person to become oversensitive, it is easy to become IRRITABLE with other family members. Because BURN-OUT from stress can cause a person to become unresponsive, it is easy to become INSENSITIVE to other family members. Because BREAKDOWN from stress can become disabling, it can be easy to simply become UNAVAILABLE to other family members.

To live around someone who is continually acting critical or irritable or insensitive or unavailable or in all of these ways can cause one person's stress to stress the entire family. Thus a hard day for one person becomes a hard night for everyone.

The solution? Take responsibility. Remember that how one handles stress is a matter of choice. Stress loved ones and one may lose their support. Rather than remaining close, to protect themselves they may elect to pull away.

Therefore, rather than act stress out in harmful ways, talk it out in helpful ways instead. Explain the stresses going on, how you feel, and think of relaxing and renewing ways to all be together.

About the author: Carl Pickhardt has a Ph.D. in counseling psychology and is author of several parenting books including Keys to Developing Your Child's Self-Esteem and The Future of Your Only Child: How to Guide Your Child to a Happy and Successful Life.