Anak adalah anugerah dan amanah Allah SWT kepada ibu bapa.
Namun, tidak semua anak yang dilahirkan normal dan tidak memberi masalah
kepada ibu bapa mereka. Ini semua adalah qadha dan qadar yang telah
ditentukan, yang mana secara langsung dan tidak langsung menjadi suatu
ujian kepada kedua ibu bapa. Kata orang, tidak ada penyakit yang tidak
ada ubatnya kecuali tua dan mati, cuma ibu bapa perlulah mengetahui
apakah masalah dan penyakit yang dihidapi oleh anak-anak mereka supaya
mudah dicari ubatnya.
Disebabkan keadaan persekitaran dan juga pemakanan sekarang ini, banyak
kanak-kanak yang menjadi hiperaktif dan agresif. Perilaku hiperaktif ini
bukannya perilaku normal kanak-kanak tetapi ia merupakan suatu penyakit
yang perlu ditangani dan diubati. Perilaku hiperaktif ini dikenali
sebagai Attention Deficit Hyperactivity Disorder (ADHD) di mana
kanak-kanak ini tersangat aktif dan lasak, ia boleh memahami dan
berfikir tetapi sukar memberi tumpuan atau perhatian. Ini menyebabkan
kanak-kanak hiperaktif ini sukar bergaul dalam masyarakat dan lemah dari
segi akademiknya.
Perilaku hiperaktif dan agresif ini terjadi disebabkan oleh perubahan
kimia (neurotransmitter) pada otak dan selalunya otaknya bersaiz lebih
kecil (5-10%) daripada normal. Di antara punca penyebab anak hiperaktif
ialah ibu yang merokok semasa hamil, faktor genetik, kelahiran pramatang
(premature), mengalami kecederaan otak semasa dalam kandungan, dsb.
Di antara perilaku hiperaktif yang mudah dikenalpasti ialah kanak-kanak
bersikap degil, lasak dan tidak tahu duduk diam, suka membantah, suka
melanggar peraturan, leka dan sukar memberi tumpuan (terutama dalam
pelajaran), sering tidak berpuas hati, mudah rasa tertekan, bermasalah
dalam pelajaran dan hubungan sosial dengan kawan-kawan, sering berpeluh
dan mengalami sakit perut atau cirit birit.
Masalah perilaku hiperaktif di peringkat kanak-kanak ini jika tidak
diubati atau ditangani dengan sewajarnya, mungkin penyakit ini akan
berterusan hingga dewasa. Kanak-kanak hiperaktif ini selalunya melakukan
sesuatu tanpa memikirkan orang lain di sekelilingnya, cuma ikut hatinya
sahaja dan suka bermain bersendirian.
Perilaku hiperaktif ini boleh dirawati atau ditangani dengan pengurusan
emosi yang berkesan, seperti tidak meninggalkannya bersendirian bergaul
dengan kanak-kanak yang lebih muda kerana ditakuti dia akan menyakiti
atau mencederakan mereka, jauhkan benda-benda yang tajam dan merbahaya
supaya dia tidak mencederakan dirinya sendiri, perlu ditegur dan dididik
serta didisplinkannya, jangan bercakap dan berlaku kasar di hadapannya
kerana selalunya dia akan mengikut apa yang ibu bapa lakukan, perlukan
perhatian dan tunjukkan kasih sayang yang lebih, dan jangan
merendah-rendahkan dirinya di depan orang sehingga dia terasa tidak
disayangi kerana ini kan memburukkan lagi keadaannya.
Petua menjaga dan merawat kanak-kanak hiperaktif diperincikan
dalam artikel di bawah ini untuk dijadikan perhatian panduan kepada ibu
bapa yang mempunyai anak hiperaktif…..
Tips for Parenting a Child With ADHD
Reviewed by Melissa Conrad Stoppler, MD
What Is ADHD?
ADHD, or attention deficit hyperactivity
disorder, is a behavioral condition characterized by inattention,
impulsiveness, and/or hyperactivity. It has been estimated that
approximately 5% of U.S. children have ADHD, according to established
diagnostic criteria.
What Are the Symptoms of ADHD?
The three key symptoms of ADHD are
hyperactivity, impulsivity, and inattention. These symptoms typically
interfere with the child’s functioning in social and academic settings,
such as paying attention to tasks at home or school, making careless
errors, being easily distracted, not following through with tasks or
completing instructions, being easily bored, losing things, being
forgetful, having difficulty organizing tasks, being fidgety, having
difficulty remaining seated, and talking excessively, to name a few.
Many children with ADHD will have symptoms
that persist into adulthood. Effective treatments for ADHD include both
medications and behavioral therapies. Not surprisingly, parenting a
child with ADHD can pose special challenges.
How Do I Know if My Child Has ADHD?
Many of the symptoms of ADHD are also
symptoms seen during normal childhood and development, and exhibiting
one or more of the symptoms does not mean that a child has ADHD. It is
also important to note that for a health-care professional to make a
diagnosis of ADHD, the symptoms must have been present for at least six
months in more than one setting (for example, home, school, and in the
community), usually beginning before 7 years of age, and the symptoms
must be inconsistent with the developmental level of the child and
severe enough to interfere with the child’s social or academic
functioning.
What Should I Do if I Am Concerned That My Child Might Have ADHD?
If you are concerned about your child’s
behavior, it is appropriate to communicate this to your child’s primary
health-care provider. He or she can help you determine whether further
evaluation may be necessary and whether your child’s behavioral symptoms
are suggestive of ADHD. If a formal evaluation is indicated, this
evaluation will involve professionals from various disciplines to
provide a comprehensive medical, developmental, educational, and
psychosocial evaluation.
Think Positively
While ADHD can certainly present unique and
sometimes what can seem to be daunting challenges, being able to
sincerely know and have confidence in your child’s strengths can go a
long way toward helping him or her be the very best person he or she can
be. Many famous, accomplished, and indeed brilliant people of the past
and present have ADHD. An outstanding example of learning to have a
positive outlook about ADHD is demonstrated in the children’s book and
movie called, Percy Jackson and the Olympians: The Lightning Thief.
Another benefit to thinking positively about
your child with ADHD is its infectious nature. It is much easier for the
child’s teacher, coaches, peers, and in fact, the child him- or herself
to accept and harness strengths when the parent communicates and
emphasizes those strengths. The challenge for parenting a child with
ADHD is to be able to use the child’s unique gifts and address his or
her challenges to work toward achieving the child’s fullest potential.
Define Schedules and Routines
Clearly defined schedules and routines are
essential for children (as well as for teens and adults) with ADHD.
Having an established, while not inflexible, pattern for getting ready
in the mornings, preparing for bedtime, and managing after-school
homework and activities provides a sense of consistency and allows the
child to know what to expect. It can be helpful for older children to
have plenty of conspicuous clocks to use as cues for time management.
Some parents find that the use of timers (for homework time, time to
finish up play, etc.) helps for younger children.
To make the process more enjoyable or easier
to remember, charts and checklists can be used that list the steps or
tasks required for each time of day. For example, the “morning
checklist” can include items like making the bed, brushing their teeth,
and helping to prepare school lunch. Hang the checklists in a
conspicuous place and allow your child to check off completed items as
they are done, if he/she wishes.
Set Clear Rules and Expectations
As with clearly defined schedules,
attainable, clearly defined rules and expectations are also essential
for kids with ADHD. In both school and at home, children with ADHD need a
consistent and clearly defined set of rules. It can be helpful to
create a list of rules for the home and post them in a place where the
child can easily see them. It’s very important to stick to the rules and
provide fair and consistent rewards and consequences when the household
rules are not followed.
Give Clear Instructions
Avoid vague or open-ended instructions such
as “clean up your mess” or “play nicely” that do not accurately convey
the specific tasks that you want to be done. Instead, use clear language
and specific instructions such as “please put all the dirty clothes in
the hamper,” “please put all the toys back on the shelves,” or “let’s
allow your friend to have a turn playing with the toy.” Speak in a calm
and clear voice, and be sure to establish kind eye contact with your
child when you give instructions so it is more likely he or she is
focused on what you are saying. It can be helpful to have your child
repeat the instructions back to you. Breaking down instructions for
larger tasks into simple steps can also be helpful.
Discipline, Rewards, and Consequences
Children with ADHD respond very well to a
defined and predictable system of rewards and consequences to manage
behavior and discipline. Reward positive behaviors with praise or with
small rewards that cost little or no money, such as special time with a
parent or participating in an outing or favorite activity. Focus on
praise or privileges as rewards rather than offering foods or toys as
prizes.
It’s always best to give more rewards and
positive praise than negative comments or consequences. For example,
smile and say, “I like the way you’re working on your homework” or
“you’re doing a great job clearing the table.” Ask your child to say
what he or she did well during an activity and help him or her to come
up with something if he or she cannot.
Likewise, consequences for negative behaviors
should be fair, appropriate, consistent, predictable, and swiftly
implemented and completed. Major events like holidays or the child’s
birthday should never be completely withdrawn or uncelebrated because of
something the child did. Consequences ideally should be explained in
advance and should occur immediately following the negative behavior.
Delayed consequences (such as not participating in an event or outing in
the following week) are not as effective as immediate consequences.
Consequences can include time-outs, removal from the situation or
setting, or restriction of privileges. It is very important that the
consequence occur after every instance of negative behavior.
Use Time-Out Effectively
Particularly for younger children, time-outs
can be an effective consequence for negative behaviors that serve the
additional purpose of removing the child from an overstimulating or
stressful environment. A time-out is also an immediate consequence that
is likely to be more effective than a delayed consequence. Many experts
recommend that time-outs not last longer in minutes than the child’s age
in years (for example, a five-minute time out for a 5-year-old). Longer
than that may be too difficult for the child to complete, leading him
or her to be more likely to defy doing the time-out at all.
Ignore Within Reason
In some situations, ignoring an undesired
behavior may be an effective behavior-modification technique for
children with ADHD. Obviously, behavior that is risky or injurious to
the child or to others cannot be ignored, but behaviors such as whining,
nagging, and arguing sometimes can be ignored until the behaviors stop.
Many children with ADHD crave attention from others, even if it is
negative attention in the form of yelling, shouting, or scolding.
Refusing to provide any attention to the child who is behaving
inappropriately can be effective if done consistently. For the child who
gets increasingly loud or disruptive (escalates) when ignored, another
way to respond may involve calmly and quietly telling the child that
when they are calm and quiet the conversation can resume.
Develop Organizational Aids
Children with ADHD have poor executive
functioning skills, which means, among other difficulties, that they
have trouble organizing their belongings and tasks. Some parents (in
cooperation with teachers) have found it helpful to provide color-coded
binders and notebooks for each school subject, as well as a homework
sheet in the front of the binder that lists homework for each school
day. Others may find that purchasing a second set of textbooks for the
home is useful for the child who frequently forgets to bring the proper
materials home. Help your child develop an organizational system for
his/her room and belongings and stick to it.
Eliminate Distractions
While this sounds obvious, many home
environments are simply chaotic and full of distractions for the child
with ADHD. Be sure that your child has plenty of quiet time and space to
complete homework and other tasks. A homework space that is free of
external distractions like television and video games, and is not
located in rooms in the home where most people congregate is key to
successful completion of assignments.
Set Small, Attainable Goals
Think of changing your child’s less positive
behaviors like training for a marathon. Just like no one would expect
you or anyone else to go from never running at all to completing 26-plus
miles, it is unfair and unrealistic to expect your child to change 15,
or 10, or even five behaviors immediately. Don’t expect dramatic changes
overnight. If your goal is to have your child sit still politely
through a restaurant meal or family outing, break the process down into
small and attainable goals like not interrupting a conversation for five
minutes, remaining seated for 10 minutes, etc. Be sure to offer plenty
of praise and rewards when these small goals are met.
Focus on One or Two Challenging Behaviors at a Time
Changing all of a child’s negative behaviors
at once is never possible, and attempting to do so can create unbearable
stress for both parent and child, setting up both for failure. Instead,
pick one or two challenging behaviors that you’d like to improve and
focus on those. Examples might be interrupting, not remaining seated,
forgetting to put toys away, or arguing about bedtime. Whichever
behaviors you choose to modify, understand the behavior changes must be
gradual to be successful over time.
Find Areas in Which the Child Excels or Succeeds
No one enjoys being subjected to constant
criticism or complaints about their behavior. As every individual needs
to feel good at something, constant criticizing can result in the child
unwittingly working more at perfecting negative behaviors they get
attention for rather than the positive behaviors if he or she is not
praised. Help your child find an area or interest in which he or she is
successful. This can be a sport, musical instrument, academic subject,
art form, or other hobby. Being successful or having a strong interest
in a hobby can greatly improve your child’s self-esteem and well-being.
There is no single “best” activity for children with ADHD. Let their
interests and enthusiasm be your guide.
Promote a Healthy Lifestyle – Nutrition
A healthy lifestyle will help not only your
child but the entire family to preserve both physical and emotional
health. Stick to a nutrition plan and avoid giving your child junk foods
and “empty” calories on more than an occasional basis. While sugary
foods are not a cause of ADHD, some parents find that lots of sugary
foods may worsen their child’s symptoms. Sometimes older children with
ADHD are so distracted and disorganized that they may skip meals or eat
irregularly. Decreased appetite can be a side effect of some medications
that treat ADHD. Try to ensure that your child is eating regularly, and
small meals every few hours may be most effective for some children
with ADHD. While allowing your child to enjoy childhood by allowing for
an occasional treat, it is important to teach your child to make good
food choices by modeling these choices yourself.
Promote a Healthy Lifestyle – Exercise
Exercise can help excitable children “burn
off” excess energy, and regular exercise promotes physical well-being
and healthy sleep habits. Encouraging your child to participate in
organized sports after school can provide both regular exercise and the
benefits of a regular and predictable schedule. Many children with ADHD
do well in martial arts or yoga classes that emphasize mental as well as
physical control over their bodies. In general, it’s important to pick a
sport that suits your child and his or her abilities, but sports that
involve constant activity or motion may be better choices for some kids
than sports that have significant “down-time” like baseball or softball.
Promote a Healthy Lifestyle – Sleep
Sleep is the final factor in ensuring a
healthy lifestyle for your child and family on a daily basis. If your
child is not well-rested, he/she will have even more difficulty staying
focused and on-task. Falling asleep can be difficult for children with
ADHD who may be overstimulated and have an increased activity level. As
part of your regular and predictable schedule, it’s important to have a
set bedtime and bedtime routine. You can use a checklist or timer if you
like to help your child make the transition to bedtime. Eliminating
caffeine in your child’s diet as well as providing a calming nighttime
ritual (such as cuddling or sharing a book or story) can help your child
wind down at the end of an active day. For older children and teens,
turning off the computer and storing cell phones and other electronic
devices outside the child’s room for the night serve to prevent their
interfering with sleep.
Show Your Unconditional Love
Be sure your child is aware of your
unconditional love and support, no matter how he or she behaves.
Withdrawal of love or affection is never an appropriate consequence for
undesired behavior. It’s OK to let your child know that you are angry or
frustrated with his/her behavior at times, but remember to say “I love
you” every day and be sure your child knows that he or she is an
accepted and valued member of the family.
Take Care of Yourself
Finally, don’t forget to take care of the
caregiver. In addition to the joy of accomplishment, parenting a child
with ADHD can bring on a variety of upsetting emotions, including
embarrassment, anger, anxiety, worry, and frustration. In fact, you may
feel any or all of these on a given day. Try to keep a sense of
perspective and understand that your child’s behaviors are due to a
disorder and may not always be under his or her full control.
If you need a break, you shouldn’t feel
guilty. Parenting is a stressful job, and it’s OK to accept help from
family and friends in caring for your child. Take time off from
parenting to spend time on activities you enjoy or even spend time alone
in order to recharge yourself. You won’t be an effective parent or role
model if you have no energy to devote to the process.
