Little children fall and scrape their knees or bump their heads. Big kids drive too fast, and get into accidents—or experiment with drugs or alcohol. They... well, it doesn't pay to spend too much time pondering all the risks youngsters face.
Suffice it to say that childhood and adolescence can be risky—especially if your child has ADHD. The risk increases in summertime, when kids spend more time outdoors—beyond their parents' supervision.
Not long ago, a mother called me to say that her 10-year-old son, a patient of mine, had vanished. It was 7:00 p.m., getting dark, and Billy was nowhere to be found. She was frantic. I suggested that she call the police. At 8:00 p.m., she called back. Billy had been found, safe, at a nearby creek. He was surprised to see the police and could not understand why his mother was upset.
Billy explained that he had been unable to find a friend after dinner, and so had decided to go frog-catching. Asked why he did not tell his mother where he was going, he said simply, "I forgot." Of course, forgetfulness was not the problem. The problem was that Billy's ADHD medication had worn off around 6:00 p.m. He had headed for the creek on impulse.
I share this story not to scare you, but to remind you of the fact that ADHD makes kids vulnerable.
Remember, ADHD is a neurological disorder, resulting from a deficiency of specific neurotransmitters within the brain. By correcting this deficiency, medication goes a long way toward curbing impulsivity, distractibility, and hyperactivity. But, as Billy's case illustrates, parents must be especially vigilant at those times of day when a child's symptoms may not be fully controlled: early in the morning (before the first dose kicks in) and at the end of the day (when the last dose has worn off).
Be especially careful if your child takes a break from meds on weekends or vacations.
Of course, medication alone is not enough to protect your child. You must be alert to the dangers ADHD kids face, and provide an extra measure of structure and supervision. Here are the biggest causes of accidental injury—and strategies you can use to protect your child:
Cuts, scrapes, bruises, and broken bones
Hyperactivity might cause a young child to jump on the furniture, or run around the house without looking, maybe bumping into someone or running headlong into a sharp corner. He might climb on counters or bookshelves without thinking about how to get down. Inattention might cause your daughter to be heedless of danger.
Impulsivity is often the biggest threat. It makes your child fearless—climbing high into trees, jumping from the top of the jungle gym, and so on. It might cause your child to dash into the street or, like Billy, to wander off without telling you where he's going.
Do your best to anticipate potential problems in all settings: home, street, playground, friends' houses, and so on. Make sure that your child's free play is supervised at all times by a parent, teacher, or older sibling. Don't count on your child or teen with ADHD to remember what not to do. Someone has to remind him or her often that it is not okay to swim in the quarry or ride a bike too fast down a hill. If your child is visiting a friend's house, be sure that a responsible grownup is there to supervise.
Put an end to your son's jumping or running sooner than you might with another child. When walking outside, hold your child's hand, and walk on the side that's closer to the street. (Or simply put your child in a wagon.) Be ready to grab your daughter should she try to dart off in a mall. Yelling "stop" might not work.
If your child plays sports, make sure that standard safety rules and equipment are used. As for bike riding, set limits on where your child can ride, how fast he can go, and what tricks he can perform.
You must know at all times where your child is, what he or she is doing, and with whom. If he says, "Butt out!," don't back down. Hold the line on safety.
This article comes from the June/July 2006 issue of ADDitude.