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Hilber Psychological Services

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Posts in ADD/ADHD
How Adults can help Teens with ADHD

In the article, “The Pivotal Role of Adults in Teen ADHD Care,” author Mark Bertin acknowledges the effects of ADHD on teens and how parents can have an important role in their child's development. Attention-deficit/hyperactivity disorder (ADHD) is defined as a medical disorder that affects one's impulses, concentration, organization and planning skills, and delays academic independence.

Many teens struggle with ADHD and have a hard time keeping up with their peers. Because of this, it is important for parents to understand the impact of ADHD on academic planning. Students who have ADHD usually require a helping hand from an adult until they demonstrate that they are capable of being independent on their own. For teenagers, difficulty in administrative functions such as memory, productivity, time management, and writing skills is seen to hold some back at times. This is when teenagers need their parents. They need someone to support and motivate them to keep going even though it is challenging.

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Some ways to help support students is by creating habits and routines that can get them on a schedule. Those with ADHD like to have activities planned out for them at certain times. This helps them plan out their day and have a visual of what they are going to do. If tasks and activities are repeated each day, then teens with ADHD will excel at those tasks even quicker because they are practicing it so often. Once your teenager completes a set of activities that are up to par, then it is time to introduce new ones. Slowly but surely, your teenager will be able to remember their schedule on their own and take responsibility for doing their tasks on time. By practicing, teenagers are able to build up muscle memory on their own and enhance their cognitive skills without help from a parent. Through repetition and consistent reminders, parents can step back and let their student thrive on their own once their routine is solidified. Even though it may be frustrating at times, it is part of the process of building up a child’s muscle memory so they know how to do tasks on their own. It is important to confirm that students know how to:

  • Keep track of assignments by making a to-do list

  • Break projects up into parts

  • Manage their time

  • Organize themselves

  • Study and write well  

If they need extra help, it is important for parents and teachers to know how to support teenagers with ADHD using the following approach:

  • Promote independence. Only assist students if they need help refocusing on what their routines are supposed to entail by frequently checking in. Otherwise, let them learn from their mistakes and grow as an individual.

  • Intervene early. Instead of sitting back and watching, prompt students to fix their mistakes at the moment.

  • Provide guidance. Try to collaborate more with students and give more direct instruction when problem-solving. This reinforcement will help students understand what is needed to be done when it is first asked.

  • Take the lead. If students are struggling to maintain their habits, this is the time to step in and help them.

  • Gradually withdraw supports. Slowly step away from consistently helping students when they show that they are capable of being on their own. It may take time to fully withdraw support, so be patient. Based on one’s academic skills, it may take them all the way through college to be independent.

  • Return to step one at any time new ADHD-related challenges continue.    

For more information on how ADHD affects teenagers, please contact us. For more information on therapy, visit FAQ at Hilber Psychological Services.

-Written by Lily Schmitt and Tanya L. Hilber, PsyD

#ADHD affects, parent roles, teen health

Referances

Bertin, Mark. “The Pivotal Role of Adults in Teen ADHD Care.” Psychology Today. Child Development Central. Web. 24 Sep. 2018. https://www.psychologytoday.com/us/blog/child-development-central/201809/the-pivotal-role-adults-in-teen-adhd-care

Fortnite and Kids with ADHD & Social Issues

In the article “Fortnite and Kids With ADHD or Social Skills Issues: 7 Things I Tell Parents,” Mark Griffin provides 7 pieces of advice to parents whose child plays Fortnite everyday for long hours on end. An estimated 50 million people (teenagers 13 years and up) play Fortnite. 50 million teenagers spend their evenings playing a video game. 50 million teenagers are glued to their digital devices. 50 million teenagers are focusing their time on video games rather than doing their homework or trying to get at least six hours of sleep. In specific, children with ADHD may have a harder time focusing on other important activities surrounding them because they are hyper focused on the game at hand.

Fortnite can be played on any device whether it is on one’s phone, tv, or computer. Because our mobile devices are portable, teenagers can play the game at school rather than learning. However, most parents are unaware of the impact that fortnite has on kids with learning and attention issues or even those that do not have ADHD. Griffin noted that some teenagers can handle the action of the violent video game but others with ADHD may have a hard time with social interaction. However, interaction between players is required if the player decides to play on a team, providing an opportunity for your child to practice their social skills without having to speak to a person face to face. This may be good for some children because they can practice teamwork while collaborating with others without having the stress or anxiety of being judged for what they say. If teenagers have ADHD or social skills issues, Fortnite may help to develop their social skills in a sense that it is a good conversation starter that most kids have in common and can talk about.

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In addition, the same skills needed to survive (escape potential danger, think quickly on your feet, and be alert of one’s surroundings) in the game can be transferred to real life when they are not playing and turn out to be helpful skills to have. In comparison, “these are the same skills that can trip up many kids with ADHD in their daily lives” (Griffin). In this case, it is good to keep a close eye on your child’s screen time if your child has ADHD or social skills issues and is playing excessively or negative behaviors have increased.

In general, Griffin advises that “if you allow video game screen time (with Fortnite or any other game), it’s important to have clear rules and set limits about when and where.” If your child is going to spend time on their digital device for hours, be sure your child takes breaks for their eye and brain development. It is okay to have social interaction, although helping your child understand their limits of how much they can handle without increasing negative behaviors is also important. It is okay to say no and follow through if your child asks to play because you are keeping their best interest in mind.

If your child does not understand your rules and limits then increase the communication and conversations help them understand how screen time can affect their brain and behaviors. Make a plan together of when they can play the game and associated boundaries with gaming. This will increase the communication and help you and your child to be on the same page, as well as allowing your child to get a good night's rest.

Contact us for more information on how Fortnite and other video games can affect teenagers with ADHD or social skill issues.

If you have questions about tween and teen development and the effects of screen time, please contact us. For more information on therapy, visit FAQ at Hilber Psychological Services.

-Written by Lily Schmitt and Tanya L. Hilber, PsyD

Reference

Griffin, Mark. “Fortnite and Kids With ADHD or Social Skills Issues: 7 Things I Tell Parents.” Understood for Learning and Attention Issues. Expert Corner. Web. 17 July 2018. https://www.understood.org/en/community-events/blogs/expert-corner/2018/07/17/7-things-i-tell-parents-of-kids-with-adhd-or-social-skills-issues-about-fortnite

Consistent Use of ADHD Medication May Stunt Growth by 2 Inches

According to the article, "Consistent Use of ADHD Medication May Stunt Growth by 2 Inches, Large Study Finds", written by Dr. David Rabiner, "although the benefits of medication treatment on ADHD symptoms dissipate, the impact on adult stature persists". The Multimodal Treatment Study of ADHD (MTA Study) tested 600 7–9-year-old children with ADHD. These children were randomly assigned into one of these four groups: 
1. Carefully monitored medication treatment
2. Intensive behavior therapy
3. Medication treatment combined with behavior therapy
4. Community care (parents obtained whatever treatment they want)

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After 14 months, the study showed that those children who received carefully monitored medication treatment or medication treatment combined with behavior therapy had lower levels of overall ADHD symptoms and better overall adjustment compared to those children who received intensive behavior therapy or community care. The results stayed the same after an evaluation 10 months later. However, evaluation after 1 year and again after several groups showed no group differences based on the initial group treatment assignments. Therefore, the initial benefits of the medication had disappeared. The study continued annually through age 18 and then reduced visits to age 25. Within this group, individuals were categorized based on their medication usage:
a. Consistent, i.e,. those who had met the minimum threshold during each year;
b. Inconsistent, i.e., those meeting the minimum threshold in some but not all years; and
c. Negligible, i.e., below the minimum threshold in all years. 

At the last evaluation, age 25, participants self- and parent-reported, and doctors measured the patient's height compared to other individuals around the area that had not been diagnosed with ADHD in their childhood. Based off of the medication categorized above, only 14.3% of participants consistently used medication through age 18. After comparing the other participants, participants with ADHD maintained substantially higher ADHD symptoms over time regardless of their initial treatment. It was clear that ADHD symptoms in young adulthood are not related to patterns of medication use through adolescence. 

There was thus no indication that consistent medication treatment over a number of years had any persistent impact. However, there was a relationship found between persistent medication use and adult height. According to Dr. Rabiner, "Students in the Consistent and Inconsistent medication treatment groups had average heights — combined across these groups — that were about an inch shorter than those in the Negligible treatment group. And, participants in the Consistent Group were nearly an inch shorter on average than those in the Inconsistent group, i.e., nearly 2 inches shorter than those in the Negligible group". 

Overall, the study concluded there was substantial persistence of ADHD symptoms into adulthood and although the benefits of medication treatment on ADHD symptoms dissipate, the impact on adult stature persists. However, it is possible that some other factor that contributed to some participants taking medication more consistently, e.g., more severe symptoms, also explains the reduced height attainment in this group.

There are many take home messages:
1. Relatively few youth with ADHD use medication consistently over their development.
2. Many individuals with ADHD will continue to struggle with ADHD symptoms into adulthood. 
3. Although medication helps control symptoms in the short-term, it is not a cure.
4. It is unknown whether optimal medication treatment maintained over many years would have a greater impact.
5. Parents and clinicians need to balance the need for persistent treatment in some children with the likely consequences of reduced adult height. 

Due to the symptoms that may occur from using persistent medication, an optimal solution would be to find the lowest effective dose of medication, or combine medication treatment with other behavior therapy and/or other approaches.

If you have questions about ADHD and how it can affect you or your child or would like to schedule an appointment, please contact us. For more information on therapy, visit FAQ at Hilber Psychological Services

~Written by Allison Parker and Tanya L. Hilber, PsyD

Reference: Rabiner, David. “Consistent Use of ADHD Medication May Stunt Growth by 2 Inches, Large Study Finds.” SharpBrains, SharpBrains, 28 Mar. 2018.

America’s Real Digital Divide

The biggest question being asked: How bad are electronics for children? The answer: bad. The problem is people are not aware of the consequences screen time can have on their children.

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One of the problems is that people believe that middle-class children are being harmed by too much screen time. However, minority and disadvantaged kids spend much more time in front of screens."According to a 2011 study by researchers at Northwestern University, minority children watch 50 percent more TV than their white peers, and they use computers for up to one and a half hours longer each day. White children spend eight hours and 36 minutes looking at a screen every day, according to a survey by the Kaiser Family Foundation, while black and Hispanic children spend 13 hours." This large amount of time spent staring at a screen has a negative effect on children’s ability to understand nonverbal emotional cues, and is linked to higher rates of mental illness, including depression. 

Unfortunately, low-income and less-educated parents receive the message that screen time is going to help their children. Parents are being told be teachers and other staff, that a faster computer can help raise their child's grades. However, in states, such as Maine, that supply tablets for each student, there has been no noticeable improvement on standardized testing 

No one is telling poorer parents about the dangers of screen time. This is the factor that is stopping these parents from limiting their child's screen time. The real digital divide is not between children who have access to internet or don't, it's about the parents who have been brain washed into thinking more screen time is good because they don't know any better. It's time to make a difference in the lives of all children. 

If you have questions about the effects of too much screen time and how it is linked to a higher rate of mental illness or would like to schedule an appointment, please contact us. For more information on therapy, visit FAQ at Hilber Psychological Services

~Written by Allison Parker and Tanya L. Hilber, PsyD

Reference: Schaefer Riley, Naomi. “America’s Real Digital Divide.” The New York Times , The New York Times, 11 Feb. 2018.