ADHD in Elementary School
As children enter into third grade, demands increase. During the coming years, schoolwork becomes more complex, with projects that may require planning and need to be completed in steps. Teachers expect students to take on more responsibility and to be able to complete more work on their own or with minimal assistance.
Children at this age need to have organizational skills and this is one area where many children with ADHD struggle. Parents and teachers need to work with students and help with planning for projects. Monitoring large assignments and creating checkpoints can help a child with ADHD stay on task.
Homework is frequently a daily struggle. While classmates may complete homework in a timely manner, parents of elementary age children may spend one to two hours each night working with their child to help him or her stay focused and complete the work. Even so, forgetting to hand the work in is still a major problem. Losing items, including pens, pencils, books and homework assignments may also happen on a regular basis.
Inconsistency is also a major part of ADHD. Some days children with ADHD may perform well and complete their work, while on other days, distractions and overwhelm may prevent a child from getting anything done. This inconsistency often confuses parents and teachers and can result in a child being labeled lazy or uncaring. However, inconsistency is a common characteristic of ADHD and is not a behavioral problem.
By the time children have entered 3rd grade, they have learned to sit still during class, no longer getting up and walking around at inappropriate times, but may still feel restless and squirmy and have a difficult time sitting still for extended periods of time.
Outdoor activities that allow a child to release excess energy can help, but parents face a dilemma. Some children may focus better to complete homework if he or she is allowed time to run around and use up some energy after school. Other parents may find once a child becomes disassociated from schoolwork, he or she may have a more difficult time focusing again later. Parents must determine what will work best for their child, consistency and structure are important for children with ADHD at this age.
Although children without ADHD can be unsupervised for short periods of time (not left home alone, but allowed to play without an adult in the immediate area), children with ADHD are often not ready to be unsupervised at this age. Emotional maturity for a child with ADHD may be several years less than their non-ADHD counterparts. This also can cause problems with social skills as many children with ADHD are emotionally much less mature than their classmates.
Some children with hyperactivity can get into trouble. At home he or she may still jump on furniture or annoy siblings just to stay amused. Outside of the home children with impulsivity may shoplift, set fires, or experience physical injuries more often than children without ADHD.
In the family, the child with ADHD often requires much more attention than his or her siblings, creating tension and frustration in the household. Too often, parents are confused and are not sure where to turn for help. Both parents may have different ideas on how to handle an extremely impulsive child and arguments can create even more tension.
Children with hyperactivity or impulsiveness are the ones that receive more medical care and attention. Children without hyperactivity may been seen as lazy or uncaring and may not be treated for ADHD until later in middle or high school, if at all.
Treatment for children at this age often includes a combination of medication and behavioral modifications. Medications for ADHD have been approved by the FDA for children over the age of six. A multimodal treatment study showed that long-term combination treatment, including both medication and behavioral management strategies was the most effective in treating elementary age children. The study also showed that children receiving a combination treatment needed lower doses of medication than those children treated with medication only.
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