The Government Health Publications give a list of behaviours that may be recognised in children and young people with ADHD. The difficulty is that at first glance this list is of behaviours that may be seen in many different children and at different stages of their development and particularly in children between eighteen months and three years old. However, that said, we know that children respond well to routines and boundaries and that these will give a feeling of security to them and to young people. Children understand the different routines and boundaries at home or school and develop into these environments. They begin to settle and cope with change in their environment, nevertheless, children with ADHD may become particularly anxious and find such change extremely difficult to manage.
It is suggested in the Government Health Publication that children and young people may display some of these symptoms, they may be distracted and forgetful, have short attention span, trouble with directions and daydream more than expected. They may have trouble finishing tasks like homework or chores and frequently lose toys, books, and school resources. They may be constantly fidgeting and wriggling and talk non-stop and interrupt others, and also run around a lot. They may want to touch and play with everything they see and be impatient. They may also make inappropriate comments and have trouble controlling their emotions.
These symptoms may develop and become more evident during the first twelve years and diagnosis may well be made at school between the ages of six to twelve years. We should remember that despite the inclusion in the umbrella of ‘Hyperactivity’ that some children may present as being very quiet and well behaved yet find it very difficult to remain focussed and given to being distracted very easily. Children may also have problems with sleeping and anxiety.
As a parent it is very easy to become so used to your child’s behaviour that it is not always obvious that there may be a reason for certain behaviours. We may simply feel that the child is boisterous, energetic, and wanting to be involved in everything around them. Children may appear to be bored, disengaged or distracted and for most children these behaviours will be evident at some stage in their early years as part and parcel of their normal development.
As foster carers you would naturally make assumptions about why children behave in a certain way when they join our family. There will likely be anxieties, perhaps introversion and equally perhaps extrovert behaviour. You may have information from previous carers, from the family, or from the social worker that will enable you to create a picture of the child. Over time the child will, as children do, become used to the boundaries and routines, and generally, though not always immediately, appreciate the safe environment that these create. As we know children and young people will also push the boundaries and test how far they can go, and again this is quite normal; not always easy, but definitely normal!
If however the symptoms referred to earlier persist after a three month period it may be appropriate to consult a Doctor and it may be that he or she may in turn refer the child or young person on to a mental health specialist for an assessment. Information will be collected for an assessment from the school, the social worker, the family, if appropriate and of course from you as the carer. The reason that I say after ‘approximately three months’ is because we know that potentially it can take three months to change behaviours, in that children require consistency, routines and boundaries to give a secure environment, and some children may not have had this prior to becoming part of your family.
There is no cure for ADHD, there are however three ways to improve the condition and circumstances for the child, young person and the parent/carer. Frequently documentation has medication at the top of the list, my preference however would be to try therapy first, then therapy and medication if necessary and as a last resort medication alone.
We know that behaviours can change when support and boundaries are consistent. And so with help and advice from professionals in a therapeutic capacity changes can happen, coping skills can be learned. My suggestion is to always go for this option first. If it is necessary to move up to the next stage of medication I would urge you to continue with the therapy as well, especially if medication is advised within three months. It is, I believe, likely that the therapeutic intervention will effect positive change long term in behaviours and that if required the medication may support concentration and focus, enabling the child or young person to cope with their education and learning opportunities. The down-side of the medication is that as with all medication there are possible side effects, such as sleep problems and chronic stomach-ache; children can become lethargic and uninterested in their surroundings.
Whilst of course the professionals with this specialism are the experts, I do think that it is very important that carers are listened to, observe carefully, make notes, look at antecedents and have as much information as possible to give the doctor, therapist or consultant. Your notes will help to create a full picture of how the child copes on a day-to-day basis. We tend to think that we can remember dates, scenarios and circumstances and antecedents which may result in unusual behaviours; the reality is that a specific note book and a ‘real-time’ record of events will give a clear picture of the child.
As a foster carer it is important to be aware of the ‘norms’ of development when considering both behaviour and capability as well as other areas of development. All children and young people will develop at slightly different rates and of course environment, circumstance and previous experience will influence both holistic development and behaviour.
ADHD can occur in individuals of all abilities although it seems to be more prevalent in individuals with some degree of learning disability. Caring for children and young people with ADHD can be exhausting, challenging and rewarding, so be sure to ask for the support that you need as well.
There may be no cure, but there is support, advice, and help for children and young people who suffer with ADHD.
Cathy Mayes MEd.
Associate of Simply Fostering Consultancy.