The Video Game Dilemma and the ADHD Child

Do you sometimes wonder if your child is addicted to video games?  Is getting off or ending video game sessions often the cause of fights or meltdowns for your child?

In an increasingly digital world, children are spending more time in front of screens and parents are left  to negotiate the muddy waters of figuring out how much screen time/video game time is healthy for their child.  This can be particularly difficult for a child with ADHD as video games lend themselves to being ‘time sucks’ and can often distort a child’s temporal awareness.  Here are some tips for setting and maintaining healthy boundaries for video games and screen time.

  1. Communicate clearly with your child about the amount of screen time that is allowed

During a calm period of the day, sit down with your child and discuss your concerns about screen time and present your concerns.  Make sure to listen to your child and reflect their concerns.

  1. Consider the time of day when you agree to schedule gaming/screen time.

Scheduling screen time right before homework or bedtime can be a recipe for disaster especially for children who have very difficult moments detaching.  Try to involve your child in problem solving and ask for ideas of when you can best schedule screen time so that it is not disruptive when it must come to an end.  Be flexible.

  1. Always monitor and preview content before your child views it.

Some games and videos can have violence or sexual content that may be inappropriate or overwhelming for your child.  Always check the suggested ages and consider watching the video game first before you purchase or rent it for your child.

  1. Consider what your child is getting out of screen time.

Playing a video game or watching a youtube video may provide much needed zone out time for the ADHD brain.  Make sure to expose your child to a range of other activities that may also provide relaxation and self-soothing feelings such as yoga, meditation, music lessons etc.

  1. Practice what you preach.

Modeling is one of the most powerful tools of influence that parents possess.  Practice your own healthy boundaries with your cell phone and screen time.  Schedule regular family media -free times or zones, such as meal times, bedtime or family outings.

  1. Use Screen time to build on your child’s strengths

Not all screen time is unhealthy. There are amazing tools available that can help support learning.   Research some great new learning sites or games that support your child’s reading or math and spend some time with your child exploring their interest in art or science by checking out online museums.  Speak to your child’s teacher or the school librarian for recommendations.

 

 

ADHD: Myths vs. Reality

 

Attention difficulties commonly occur in children and adults for various reasons. Sometimes they can be related to mood issues, motivational issues, environmental challenges or physical health issues. But, when there are significant and persistent difficulties, with a combination of inattention, overactivity, impulsivity, and distractibility that impairs functioning or development in multiple settings, this can be attributed to Attention Deficit Hyperactivity Disorder in children and/or adults.

Of children aged 4-17 years of age in the United States, 5.1 million or 8.8%, have a current diagnosis of ADHD, with boys (12.1%) more than twice as likely as girls (5.5%) to have ADHD. Approximately half of children with ADHD continue to have symptoms into adulthood, or 4.4% of adults overall.

The exact cause of the disorder is unknown but research shows that areas of the brain are affected and there is a family/genetic connection. The impact of the disorder includes lower academic performance, increased risk of injury, increased risk of traffic accidents, increased likelihood of smoking, poorer social function and lower self esteem. Treatment can reduce the symptoms of ADHD, but it does not completely eliminate the impact of these complications.

When it comes to ADHD, it’s important to separate the myths vs. the facts. Here are some important considerations to keep in mind when thinking about an evaluation, diagnosis and treatment.

Myth


Fact


“ADHD isn’t a real disorder”

  • It is a recognized medical condition
  • ADD = ADHD
  • Exact cause unknown
    • Multiple factors have been implicated in the development of ADHD – family history/genetics, certain environmental factors, problems with the central nervous system /an imbalance of chemical messengers, or neurotransmitters, within the brain.
  • Research has shown that certain brain regions don’t synchronize properly and overall brain architecture is different.

“ADHD is overdiagnosed”

  • Studies show that ADHD is underdiagnosed in minority populations
  • Awareness of the disorder has been growing since the 1990s when it became recognized under special education law as a condition that affects learning.

“ADHD only occurs in childhood”

  • The symptoms of ADHD can occur as early as the preschool years. The intensity of the behaviors and how they are affecting a preschooler’s life, development, self-esteem, and general functioning is considered.
  • Some children with ADHD continue to have symptoms during their teen years and about 50 out of 100 have symptoms into adulthood.
  • Symptoms in adults look different.
  • Hyperactivity tends to diminish
  • Inattentive symptoms become more troublesome
  • Sense of “inner restlessness”

“Children outgrow ADHD”

  • ADHD is a lifelong condition
  • Some children do outgrow their symptoms
  • Most children carry the disorder into adolescence and adulthood
  • Symptoms change as a child gets older and learns ways to manage them

“My child is just lazy or dumb or unmotivated”

  • ADHD has nothing to do with a person’s intellectual ability.
  • A child who finds it nearly impossible to stay focused in class, or to complete a lengthy task may try to “save face” by acting as though he/she does not want to do it or is too lazy to finish.
  • This behavior stems from real difficulty in functioning and possible frustration.
  • They simply work differently.

“My child is a handful or is a daydreamer – but that’s normal”

  • There are variations of “normal”
  • How much behaviors consistently impede a child and their ability to succeed at school, fit into family routines, follow household rules, maintain friendships, interact positively with family members, avoid injury or otherwise manage in his/her environment should be considered

“My child focuses on video games for hours. He/she cannot have ADHD”

  • ADHD poses problems with tasks that require focused attention over long periods of time, not so much for activities that are highly engaging or stimulating
  • Less or unstructured time can be difficult to manage
  • Social situations can also be problematic due to the constant, subtle exchange of social and emotional information

“ADHD is caused by poor parental discipline”

  • ADHD is not caused by bad parenting.
  • Parenting techniques can affect symptoms.
  • Try to stay positive
  • Establish structure and stick to it
  • Set clear expectations and rules
  • Encourage healthy lifestyles – eating, exercise, sleep
  • Teach how to make friends
  • Learn to anticipate potentially explosive situations
  • Be a good role model

“If after an evaluation, a child does not receive the ADHD diagnosis, he/she doesn’t need help”

  • ADHD is diagnosed on a continuum
  • A child may not always show symptoms of ADHD, especially in an unfamiliar setting
  • Monitoring symptoms and behaviors in multiple settings is critical
  • Counseling, home management tools, school behavior management recommendations, social skills interventions, and help with managing homework flow, organization and planning can be helpful

“All you need are medications to treat ADHD”

  • Medications often curb symptoms
    • They help children focus and be less hyperactive
  • Typically a combination of treatments are the most effective way to treat ADHD
    • Behavioral therapy
    • Notes/reminders to prevent self from forgetting tasks
    • Academic help

“Medicine for ADHD will make a person seem drugged”

  • Properly adjusted medicine for ADHD sharpens a person’s focus and increases his or her ability to control behavior
  • Sedation or personality changes are not side effects of the medication

“ADHD stimulant medication leads to addiction”

  • No evidence
  • Research has shown that people with ADHD who take medication tend to have lower rates of substance abuse than people with ADHD who don’t take the medication
  • A long-term study looked at childhood & early teen use of stimulants and early adulthood use of drugs/alcohol/nicotine in males with ADHD and showed no increase or decrease in substance use.

“Treatment for ADHD will cure it. The goal is to get off medication as soon as possible”

  • ADHD is a chronic condition that changes over time
  • Depending on the circumstances and demands as a person matures, the need for continuing medication or other treatments varies
  • TRUE GOAL = function well at stage of development in all environments

Children Who Can’t Pay Attention/ADHD

Parents are distressed when they receive a note from school saying that their child won’t listen to the teacher or causes trouble in class. One possible reason for this kind of behavior is Attention Deficit/Hyperactivity Disorder (ADHD).

Even though the child with ADHD often wants to be a good student, the impulsive behavior and difficulty paying attention in class frequently interferes and causes problems. Teachers, parents, and friends know that the child is misbehaving or different but they may not be able to tell exactly what is wrong.

Any child may show inattention, distractibility, impulsivity, or hyperactivity at times, but the child with ADHD shows these symptoms and behaviors more frequently and severely than other children of the same age or developmental level. ADHD occurs in 3-5% of school age children. ADHD must begin before the age of seven and it can continue into adulthood. ADHD runs in families with about 25% of biological parents also having this medical condition.

A child with ADHD often shows some of the following:

  • trouble paying attention
  • inattention to details and makes careless mistakes
  • easily distracted
  • loses school supplies, forgets to turn in homework
  • trouble finishing class work and homework
  • trouble listening
  • trouble following multiple adult commands
  • blurts out answers
  • impatience
  • fidgets or squirms
  • leaves seat and runs about or climbs excessively
  • seems “on the go”
  • talks too much and has difficulty playing quietly
  • interrupts or intrudes on others

A child presenting with ADHD symptoms should have a comprehensive evaluation. Parents should ask their pediatrician or family physician to refer them to a child and adolescent psychiatrist, who can diagnose and treat this medical condition. A child with ADHD may also have other psychiatric disorders such as conduct disorder, anxiety disorder, depressive disorder, or bipolar disorder. These children may also have learning disabilities.

Without proper treatment, the child may fall behind in schoolwork, and friendships may suffer. The child experiences more failure than success and is criticized by teachers and family who do not recognize a health problem.

Research clearly demonstrates that medication can help improve attention, focus, goal directed behavior, and organizational skills. Medications most likely to be helpful include the stimulants (various methylphenidate and amphetamine preparations) and the non-stimulant, atomoxetine. Other medications such as guanfacine, clonidine, and some antidepressants may also be helpful.

Other treatment approaches may include cognitive-behavioral therapy, social skills training, parent education, and modifications to the child’s education program. Behavioral therapy can help a child control aggression, modulate social behavior, and be more productive. Cognitive therapy can help a child build self-esteem, reduce negative thoughts, and improve problem-solving skills. Parents can learn management skills such as issuing instructions one-step at a time rather than issuing multiple requests at once. Education modifications can address ADHD symptoms along with any coexisting learning disabilities.

A child who is diagnosed with ADHD and treated appropriately can have a productive and successful life.

Re-printed with Permission from American Academy of Child & Adolesccent Psychiatry