There does not appear to be a cure. The goal of care is tomitigate the consequences ADHD in children or adults, that is to say their academic or professional difficulties, their suffering related to the rejection that they often suffer, their low self-esteem, etc.

Create a context that will allow the person with ADHD to live positive experiences is therefore part of the approach recommended by doctors, psychoeducators and remedial teachers. Parents also play a crucial role. Indeed, although many professionals accompany the child and the family, “parents remain the most important ‘therapists’ for these children,” says Dr.^r François Raymond, pediatrician⁷.

Medication

Here are the types of pharmaceuticals used. They are not always necessary and they must always be associated with one or more psychosocial approaches (to see further). Only one medical assessment complete assessment will determine whether drug therapy is required.

Le methylphenidate (Ritalin®, Rilatine®, Biphentin®, Concerta®, PMS-Methylphenidate®) is by far the most widely used drug in ADHD. It does not cure the disorder or prevent it from continuing into adulthood, but it does reduce the symptoms as long as the person is on treatment.

This is a stimulant which increases the activity of Dopamine in the brain. Paradoxically, this calms the person, improves their concentration and allows them to have more positive experiences. In children, we often observe an improvement in academic performance. Relationships are also more harmonious with relatives and friends. The effects can be dramatic. With some exceptions, methylphenidate is not prescribed before school age.

The dose varies from person to person. The doctor adjusts it according to the improvements observed and the adverse effects (sleep problems, loss of appetite, stomach aches or headaches, tics, etc.). The side effects tend to subside over time. If the dose is too high, the person will be too calm or even slow down. A readjustment of the dose is then necessary.

In the majority of cases, the drug is taken 2 or 3 times a day: one dose in the morning, another at noon, and if necessary, a last one in the afternoon. Methylphenidate is also available as long-acting tablets, taken once a day in the morning. You should know that methylphenidate does not create any physiological or psychological addiction.

Other drugs can be used as needed, such asamphetamine (Adderall®, Dexedrine®). Their effects (both beneficial and undesirable) resemble those of methylphenidate. Some people respond better to one class of medicine than another.

A non-stimulant drug,atomoxetine (Strattera®), would also reduce the main symptoms of hyperactivity and inattention caused by ADHD. One of its interests is that it would not influence the quality of sleep. It would allow children to fall asleep faster and be less irritable, compared to children who take methylphenidate. It would also reduce anxiety in children who suffer from it. Finally, atomoxetine may be an alternative for children in whom methyphenidate causes tics.

The child should be seen 2 to 4 weeks after the start of treatment, then at regular intervals of a few months.

Psychosocial approach

There are a variety of interventions that can help children, adolescents or adults control their symptoms. There are many forms of support that help, for example, improve attention and reduce anxiety related to ADHD.

These interventions include:

• consultations with a psychoeducator, a remedial teacher or a psychologist;
• family therapy;
• a support group;
• training to help parents care for their hyperactive child.

The best results are obtained when parents, teachers, doctors and psychotherapists work together.

Live better with a hyperactive child

Since the hyperactive child has attention problems, he needs clear structures to promote learning. For example, it is better to give it only one task at a time. If the task – or the game – is complex, it’s best to break it down into steps that are easy to understand and perform.

The hyperactive child is particularly sensitive to external stimuli. Being in a group or in a distracting environment (TV, radio, outside agitation, etc.) can act as a trigger or aggravating factor. For the execution of school work or other tasks requiring concentration, it is therefore recommended to settle in a quiet place where there will be no stimuli that could distract your attention.

For children who have difficulty falling asleep, some tips can help. Children can be encouraged to exercise during the day, but indulge in calming activities, such as reading, before bed. You can also create a relaxing atmosphere (subdued light, soft music, essential oils with soothing properties, etc.). It is advisable to avoid television and video games within an hour or two of bedtime. It is also desirable to adopt a sleep routine that is as consistent as possible.

Taking Ritalin® often changes your eating habits of the child. In general, this one has less appetite at the midday meal and more at the evening meal. If so, give the child the main meal when the child is hungry. For midday lunch, focus on small portions of a variety of foods. If needed, nutritious snacks can be offered. If the child is taking a long-acting medicine (a single dose in the morning), hunger may not develop until the evening.

Living with a hyperactive child takes a lot of energy and patience from parents and educators. It is therefore important that they recognize their limits and that they ask for help if necessary. In particular, it is advisable to set aside time for “respite”, including for brothers and sisters.

The hyperactive child does not have the concept of danger. This is why it usually requires more supervision than a normal child. When looking after such a child, it is important to choose a reliable and experienced person in order to avoid accidents.

Force, yelling and corporal punishment are usually of no help. When the child “goes beyond the limits” or the behavioral problems increase, it is better to ask him to isolate himself for a few minutes (in his room, for example). This solution allows everyone to regain a little calm and regain control.

As a result of being reprimanded for their behavioral problems and blunders, hyperactive children are at risk of suffering from a lack of self-confidence. It is important to highlight their progress rather than their mistakes and to value them. The motivation and encouragements give better results than punishments.

Finally, we often talk about the “unmanageable” sides of children with ADHD, but we must not forget to underline their qualities. They are generally very affectionate, creative and athletic children. It is crucial that these children feel loved by the family, especially since they are very sensitive to signs of affection.

For more information and resources, visit the Douglas Mental Health University Institute website (see Sites of interest).