Q: Dear Shira,

My six-year-old's teacher is frustrated that my son has a hard time sitting still for too long in class. My son is very bright and says that the teacher is boring. I told him that he has to get used to sitting still and paying attention whether the teacher is boring or not. The principal wants to have him tested for hyperactivity, but I don't know what this can accomplish. It's funny, because he can play Nintendo for hours. He's able to concentrate on what he wants to! I'd appreciate any advice that you have.

A: The origin of ADHD (Attention Deficit and Hyperactive Disorder) is not yet clear, but it is a problem that can definitely be helped by modifying certain behavioral conditions in a child's environment. Some parents find that decreasing a child's intake of sugar is helpful, but this has not always been proven statistically. Testing helps to clarify if your son does have this condition or any other possible learning disability that may be an impediment to your son's learning. By testing and seeing the severity of the disorder, a parent can help judge what seems best for his/her child. If a child's behavior is severely disrupting his classmate's or his own learning, the possibility of using medication may need to be explored.

However, in general, a parent needs to initially work with a child's environment in order to address the child's natural inclination for distraction. Children such as these need much positive reinforcement and structure. As they become so easily distracted and find it difficult to be "down to earth," defined beginnings and ends of activities add a sense of security to the world around them. Enhancing time limits and using timers are other examples of giving structure to children.

Immediate rewards for positive actions are necessary in relation to positive reinforcement. The goals for such children should be small goals, as large goals may seem insurmountable for children who seem to view life as quick, fleeting moments on a screen. These children (as all children) need consequences for their negative behavior. Yet these children generally respond less to punishment than to reward. These children often see punishment as a criticism of their very personality, especially if punishments are inconsistent and unstructured.

If a parent or teacher only punishes a child for disruptive behavior, this punishment is unlikely to have a long-lasting effect on the child. They would accomplish more by complimenting the child's understanding of a topic in front of family members and changing the child's view of him/herself as always being "the problem." This is perhaps the greatest challenge in dealing with such children, the ability of a parent to keep his/her patience after seeing continual disruptive behavior, and constantly redirecting the child to short-term goals with rewards.

ADHD children are often not attuned to social cues, which is obviously no fault of their own. Being easily distracted makes it difficult to know which human interactions are most important to respond to. Thus, teachers do not necessarily find a great emotional connection with these children as they may feel slighted that the "child never listens to me."

Helpful ideas for teachers is the often used "placing the child in front of the teacher" allowing for less distraction. Other often helpful ideas are that of giving ADHD children more active jobs in the classroom, such as being board monitor or going to the school office on errands. In general, the reward system that one uses at home can be similarly implemented at school. A child can be rewarded for behaving properly for one class and see school as segments of times to work with. If, however, a child misbehaves, a teacher needs to withhold remark or write a zero on a star-chart, and not write a berating report on the child's lack of attention. Counseling can be very helpful in helping the child to acclimate to his world.

In relation to your child's ability to concentrate on electronic games for long periods of times – this is not necessarily a sign that your son does not have ADHD. An intensive relaxing activity can be a great release for a sidetracked child – almost a restful island in a fast moving world.

If one were to examine the childhood history of many great "doers" in our world, a sizable portion of this group might easily have been diagnosed as having Attention Deficit Disorder. What caused them to be successful in their endeavors was a rechanneling of their great energies to admirable pursuits and actions. May this be the direction that your son follows, as well as all the individuals whose potentials need to be uniquely realized.