For a year, a kitchen timer went everywhere 3-year-old Eddie Fitzgerald did - home, playground, day care.

Counting down the time before he had to switch activities, fun ones or not so fun, helped the Pennsylvania youngster control outbursts spurred by attention deficit hyperactivity disorder, known as ADHD.

New research suggests simple techniques that give more structure to a preschooler’s day can offer a nondrug alternative to help the tiniest sufferers of ADHD.

The research highlights a poorly understood problem. Yes, frazzled parents know it’s normal for preschoolers to be hyperactive, impulsive and have problems paying attention. But some are too hyperactive, too impulsive, and too inattentive - they can develop hallmark ADHD symptoms that young.

“We looked at the preschool years as an important window of time in the development of these children,” says Lehigh University psychologist George DuPaul, who co-authored the work.

“We know ADHD carries long-term risks,” including difficulty in school and making friends, he said. “Wouldn’t it make sense to intervene as early as possible?” …

“Do not be too quick to jump on the bandwagon in making early diagnoses,” says Dr. Louis Kraus, child psychiatry chief at Chicago’s Rush University Hospital. He cautions that even when a preschooler’s unruliness really is abnormal, other causes must be ruled out.

This is not routine temper tantrums or a fidgety 4-year-old. To be diagnosed with ADHD, a preschooler must have extreme symptoms when compared with youngsters of the same age. These are kids so out of control they may be kicked out of preschool…

ADHD drugs are not formally approved for use in preschoolers, and while they may help some, side effects are more common in younger children, including a worrisome slowing of growth.

Thus Lehigh’s hunt for alternatives is sparking interest. The five-year study, paid for by the National Institutes of Health, provided a range of behavioral-only therapies to 135 preschoolers with severe ADHD…

What helped? Stressing consistent rules and routines, and more praise for good behavior than punishment for bad. Surprisingly, both groups fared equally well, raising questions about how to tell which children need more intense aid.

Preschoolers with ADHD learn more through repeated practice than through observing social cues like other youngsters, DuPaul says. So the study stressed role-playing things like how to ask to share a toy…

Parents were taught to reserve stronger punishments for worst cases, and to try reward systems where children gain or lose “points” for behavior instead. Even the time-out standby was to be used sparingly.

“If they end up in time-out a lot of time, they’re not learning social skills,” Kern says. “We want parents and teachers to implement strategies that prevent the behavior and teach children skills.” …

Tips to help kids with ADHD…

Source: Bradenton Herald, United States
http://www.bradenton.com/health/story/169136.html