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