What can make ADHD worse in children?

Night time. Sleep problems and ADHD can be a vicious circle. ADHD can lead to sleep problems, which in turn can make symptoms worse. Many children with ADHD will repeatedly get up after being put to bed and have interrupted sleep patterns.

nhs.uk - Living with attention deficit hyperactivity disorder (ADHD) - NHS

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It's important to get the support you need to understand and cope with your or your child's condition. Caring for a child with attention deficit hyperactivity disorder (ADHD) can be challenging. The impulsive, fearless and chaotic behaviours typical of ADHD can make everyday activities exhausting and stressful. Although it can be difficult at times, it's important to remember that a child with ADHD cannot help their behaviour. People with ADHD can find it difficult to suppress impulses, which means they may not stop to consider a situation, or the consequences, before they act.

Plan the day

Plan the day so your child knows what to expect. Set routines can make a difference to how a child with ADHD copes with everyday life. For example, if your child has to get ready for school, break it down into structured steps, so they know exactly what they need to do.

Set clear boundaries

Make sure everyone knows what behaviour is expected, and reinforce positive behaviour with immediate praise or rewards. Be clear, using enforceable consequences, such as taking away a privilege, if boundaries are overstepped and follow these through consistently.

Be positive

Give specific praise. Instead of saying a general: "Thanks for doing that," you could say: "You washed the dishes really well. Thank you." This will make it clear to your child that you're pleased and why.

Giving instructions

If you're asking your child to do something, give brief instructions and be specific. Instead of asking: "Can you tidy your bedroom?" say: "Please put your toys into the box and put the books back onto the shelf." This makes it clearer what your child needs to do and creates opportunities for praise when they get it right.

Incentive scheme

Set up your own incentive scheme using a points or star chart, so good behaviour can earn a privilege. For example, behaving well on a shopping trip will earn your child time on the computer or some sort of game. Involve your child in it and allow them to help decide what the privileges will be.

These charts need regular changes or they become boring. Targets should be:

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immediate – for example, daily

intermediate – for example, weekly

long-term – for example, 3-monthly

Try to focus on just 1 or 2 behaviours at a time.

Intervene early

Watch for warning signs. If your child looks like they're becoming frustrated, overstimulated and about to lose self-control, intervene. Distract your child, if possible, by taking them away from the situation. This may calm them down.

Social situations

Keep social situations short and sweet. Invite friends to play, but keep playtimes short so your child does not lose self-control. Do not aim to do this when your child is feeling tired or hungry, such as after a day at school.

Exercise

Make sure your child gets lots of physical activity during the day. Walking, skipping and playing sport can help your child wear themselves out and improve their quality of sleep. Make sure they're not doing anything too strenuous or exciting near to bedtime.

Eating

Keep an eye on what your child eats. If your child is hyperactive after eating certain foods, which may contain additives or caffeine, keep a diary of these and discuss them with a GP.

Bedtime

Stick to a routine. Make sure your child goes to bed at the same time each night and gets up at the same time in the morning. Avoid overstimulating activities in the hours before bedtime, such as computer games or watching TV.

Night time

Sleep problems and ADHD can be a vicious circle. ADHD can lead to sleep problems, which in turn can make symptoms worse. Many children with ADHD will repeatedly get up after being put to bed and have interrupted sleep patterns. Trying a sleep-friendly routine can help your child and make bedtime less of a battleground.

Help at school

Speak to your child's teachers or their school's special educational needs co-ordinator (SENCO) about any extra support your child may need.

nhs.uk - Living with attention deficit hyperactivity disorder (ADHD) - NHS

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