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Featured Doc Blog: How to Help a Child with ADHD Adjust to a New School Year

Dr. Joanna Ghegan in our Mount Pleasant, SC office recently contributed to an article in Lowcountry Parent Magazine.  This article describes 5 ways you can make sure your child has a great start to a better school year. Parents of children with ADHD understand the difficulties that come along with new routines (or getting back in a routine!), new teachers, and more advanced coursework.  You can find the original article here, or read below.

“For parents of children with attention deficit hyperactivity disorder (ADHD), facing those first few months of a new school year can be a challenge. Routines have changed, teachers are different and academic struggles may be more pronounced as coursework becomes more advanced.

But helping your children get comfortable in a new school year doesn’t have to feel like an uphill battle. Here are 5 ways to help your child with ADHD have better school year.

1. Confirm the ADHD diagnosis.

Usually a pediatrician or family doctor makes a diagnosis based on subjective questionnaires from parents and teachers, and that information may be conflicting.

“While those questionnaires are very important and part of the diagnostic process, it’s not enough information,” says Dr. Joanna Ghegan, a physician with Focus-MD in Mount Pleasant . In fact, that’s part of the reason she switched from a general pediatric practice to Focus-MD, which uses a FDA-cleared objective test to improve accuracy in ADHD diagnosis.

This computerized test objectively measures activity, attention and impulse control and compares each patient’s results with other kids of the same age and gender. “Including an objective measure of the patients symptoms helps prevent over-diagnosis of ADHD, which is a real comfort to parents,” according to Dr. Ghegan.

2. Adjust medications as needed.

Like all medications, ADHD medications can have side effects, but these can be avoided almost entirely by working closely with your child’s doctor to find the optimal medication and dose.

Teacher and parent input is critical and it’s important to listen to children and teens about their experiences with medication, both positive and negative, to get to the right balance.

“Having our objective testing to assess the effect of medication helps prevent over-medication and allows us to find the optimal dose more quickly that waiting for grades or subjective assessments”, says Ghegan. At Focus-MD physicians follow patients closely to monitor improvement in symptoms, academic and social progress and minimize side effects.

3. Go to bed early.

Many parents don’t always realize just how much sleep children need. While adults need 8 hours of sleep, children – especially ages 4 to 7 – require 11 or 12 hours of sleep.

With earlier school start times, after-school activities and both parents working, many children are sleep deprived. A child with ADHD will benefit greatly from getting enough rest since sleep is proven to help with attention, focus and hyperactivity.

4. Cut down on screen time.

We could all probably benefit from less time spent in front of the TV or computer, but this is especially true for children with ADHD. Remove televisions and computers from your child’s bedroom to eliminate distractions during both sleep time and study time.

5. Stay organized.

For children struggling to stay focused, getting organized will help greatly. Have the child keep an assignment book for school, makes lists and use a calendar. This not only helps the child stay on track but will cut down on stress at home.

Gheghan also stresses the importance a good diet and exercise, which releases endorphins that aid in concentration and focus.

“It’s not just about handing out medicine,” she says. “We take a holistic approach to the patient and talk about lifestyle as well.”

Focus-MD is a medical practice in Mount Pleasant for children with ADHD and related problems. At Focus-MD, ADHD is treated like a medical problem, not a psychological one. Their team of qualified and experienced medical doctors is committed to providing the high-quality, individualized care.

Call (843) 593-9332 for additional information or to schedule an appointment.”

6 Tips for a Stress-Free Holiday for Kids with ADHD

6 Tips for a Stress-Free Holiday for Kids with ADHD | Focus-MD

The most joyful time of the year can also be the most stressful time of the year for children with ADHD and behavioral issues. Engaging in unfamiliar social settings, such as at holiday parties with friends and distant relatives, can be a triggering time for children. Be aware of this potential struggle and follow these six tips to help your child have as much fun as possible during this busy season:


1. Practice hellos and goodbyes – Rehearsing this behavior and eye contact will help your child smoothly handle arriving and leaving a holiday party. Tell your child that he doesn’t have to say a lot. A simple, “Hi, it’s nice to meet you!” will work for an introduction and a “Thank you!” will work on his way out of the door.

2. Role-play receiving gifts – Practice with your child what to do if he gets a gift he doesn’t like, a gift he already has, and a gift he loves. Act out these scenarios and give your child tips on how to be appreciative of any gift he gets.

3. Script conversation starters – Before going off to mingle with the other parents, make sure your child is settled in with a group of children. Remind him of ways to start conversations with them. Questions such as, “Do you play sports?” and “What’s your favorite movie?” are fool-proof ways for your child to jump right into the group.

4. Plan a schedule with your child – Your child knowing exactly what events are coming up is a useful way to manage anxiety. Use a calendar to countdown days until the next big party and to help him get excited for it. Also, make sure you don’t overschedule events for your child so that he has enough rest time amidst all of the festivities.

5. Practice breathing exercises – To calm your child down in a stressful situation, give him tips to take deep breaths and clear his mind and frustration. Rehearse the “stop, relax, think” technique with im, and encourage him to use this trick when he’s frustrated in a social setting.

6. Applaud successful behavior – Encourage your child by pointing out what he did well at a party! This will only lead to more successful behavior.


By practicing these tips, you can help your child have a relaxing and enjoyable holiday season. And, give Santa Claus a reason to bring them more gifts for their good behavior! Contact Focus-MD if you’d like to talk to your child’s doctor about his behavior during the holidays. From all of us at Focus-MD, we wish you happy holidays and a joyful new year!


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5 Things Teachers Should Know About ADHD in the Classroom

Focus-Md | 5 Things Teachers Should Know About ADHD in the Classroom

By James Wiley, MD, FAAP

It’s back-to-school time, and as the father and brother of teachers, I get to hear firsthand the joys and struggles educators face in the classroom. One challenge is managing hyperactive and impulsive behavior in the 10% of students that have ADHD. Here are 5 tips that will help you keep your sanity and make your students with ADHD (and their parents) eternally grateful.

1. Let them move
Research is in! Kids with ADHD perform better and learn more if they can wiggle while they work. Help them find less disruptive ways to do just that! A fidget pal — like an eraser or a small stress ball — can be helpful, but some kids will need more. Allowing students to sit on exercise balls has been helpful for some. Consider allowing students to stand at desks in the back of the room or have a walking and listening track if you find you have a kid that has to move. Incorporate stand up and stretch breaks into instruction.

2. Encourage PE and recess
Kids who get recess do better on standardized tests than those who don’t. If you restrict these high-movement times, then be prepared to face the repercussions. The need for the ADHD brain to move is cumulative — that is, it builds over the day. PE and recess allow a pop-off valve for that energy. Restriction from these activities due to behavioral issues or unfinished work is counter-productive.

3. Preferential seating
Some kids with ADHD get distracted visually and need to be in the front. For the ones more distracted by sound, consider letting them sit in the back of the class — these are the kids that are always looking behind them when you place them in the front closer to you so that they can listen better! Separating a child from his/her peers in a chair away from the action can lead to stigmatization and give a subconscious green light for bullying that child. Any changes in seating should be done privately and never in front of the other students or out of frustration. One thought is to move everyone around — that way no one is singled out, and the wiggle worm just happens to land in the seat you want him/her in! Don’t hesitate to rearrange if it doesn’t help.

4. Catch them being good and be specific on the negative behaviors
Kids with ADHD hear a lot of negative messages. When they have success controlling their behavior or completing their work, make sure to notice, and be easy on the frowny faces! Equal is not always fair. Most of God’s children, including the grown-up kind, will work more for encouragement and praise than for correction and discipline. When there are behavioral problems that need to be addressed, BE SPECIFIC. “He was blurting out answers and out of his seat a great deal today” is much more helpful than “Terrible day!” Consider identifying three problem behaviors and giving a daily grade of 1-5, with 1-2 being problematic, 3 being average and 4-5 being great! Parents can then see how their child is doing in the classroom and reinforce or discipline as indicated.

5. Never mention medication in the classroom
Asking a child about medication in the classroom or in front of a peer is a serious violation of privacy. Most teachers reading this will certainly agree! But from what kids say, it happens all too frequently, and it is devastating for them and often leads to problems with medication non-compliance. It’s much better to say, “You seem distracted today” or “You’re active today” than to ask about medication. If there needs to be a conversation about medication, remember to do it in private. Finally, please share concerns about medication side effects or lack of effectiveness of medication with the parent (or physician with parental approval). You are with the child eight hours a day, five days a week for nine months (as you no doubt know!), and your professional opinion counts!

Watch the late Rita Pearson’s Ted Talks video Every Kid Needs a Champion. She says it best.


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Follow James Wiley, MD – “Every day I learn something new about ADHD from the wisdom of my patients.”