Parenting a child with AD/HD is, as you know, no small task. If you have other kids without the condition, you're probably relieved that they're doing well and don't demand as much attention. Unfortunately, though, without realizing it, you could be neglecting the needs of your non-AD/HD child.

In a household with an AD/HD child, especially one with a severe case, the parental balancing act is critical and difficult to manage. Between enforcing routines, dealing with erratic or aggressive behavior, helping with homework, monitoring medication, or attending counseling sessions, even the best-intentioned Mom or Dad might not pay sufficient attention to the needs of the non-AD/HD sibling. As a result, that child often feels marginalized or, worse, invisible.

The AD/HD effect

While little research has been done on kids with an AD/HD brother or sister, a 2002 study in the Journal of Attention Disorders found a significant link between the severity of a child's AD/HD and the degree of conflict among the siblings, the mother and child with AD/HD, and the non-AD/HD kid and the mother. A parent who's stressed may take out her frustration on all of her children, even the ones who aren't acting out. In addition, sometimes a non-AD/HD child gets in trouble with Mom by imitating an older sibling's unacceptable behavior.

Despite the turmoil at home, though, the non-AD/HD kids in the study displayed more positive behavior and emotional adjustment in the classroom than peers without AD/HD siblings. While it may be tempting, given this finding, for a parent to adopt a "See, there's nothing to worry about!" attitude, the experts disagree.

"It's great that your other child is doing well academically, but that success doesn't make up for a lack of attention and affirmation at home," says Patrick Kilcarr, Ph.D., a clinical psychologist at Georgetown University, who has written extensively on siblings and how they are affected by disabilities within the family. "Kids want to feel prized in their home," he says. When you have one exceptionally needy child, it's tough to find time for your other kids. But Kilcarr believes parents should regularly evaluate the quantity and quality of time spent with the non-AD/HD child.

Here are some suggestions for making every moment count:

GIVE THE GIFT OF TIME. Set aside an hour or two after work or on the weekend to bond with your child, by taking a walk, going to an amusement park, or having dinner out. Attending her dance recital or soccer game, although important, doesn't qualify as bonding. Kilcarr, who's the father of two children with AD/HD, promises that spending time together is a powerful stress reliever for the parent and a benefit for the child.

Try this: If your time is at a minimum, some parents recommend pulling a non-AD/HD child out of school for a day or even an afternoon, to go biking, shopping, or to a movie. Whatever schooling the child misses is compensated for by relationship maintenance. An alternative is to enlist a grandparent, an adult sibling, or a good friend to take the AD/HD child for a sleepover or Sunday afternoon visit while you spend that time with the child's sibling. All the children will benefit from being individuals for a day.

HEAR OUT YOUR CHILD. While the first aim of bonding should be to have fun, improved communication is often a result of the increased closeness. Ask your child how she's feeling and if there's anything you can do to help. A sibling needs to be able to express pain and anger without adults rushing to the AD/HD child's defense. Just listen. Kilcarr does, however, caution against setting up an "us versus them" dynamic. It's fine for your child to express negative feelings about her brother or sister, but it shouldn't turn into a gripe session, with the AD/HD child as the target.

Try this: Just as there shouldn't be One Big Talk on the subject of sex, neither should there be one summit conference with siblings about another child's AD/HD. Be open to conversations as concerns come up.

CONSIDER COUNSELING. If you feel unable to handle the issues that your child raises, enroll him or her in a sibling support group. (Check with your local children's hospital to see if there is one in your area.) If there is none, start one through a school or church, and include siblings of children with disabilities other than AD/HD, since many of their issues are similar. To find a list of support groups across the country, to get advice on starting a group, or to locate online support groups for siblings, go to the Sibling Support Project Web site.

BE PROACTIVE. Take a stand on behalf of your non-AD/HD child. Although every family is different and the severity and symptoms of AD/HD can vary wildly, it's common for siblings to complain about their brother or sister disturbing them - whether by turning off the TV while they're trying to watch it or by hitting or kicking them. These behaviors, if persistent, can lead to anxiety disorders in your non-AD/HD child, so it's important to take action. "A child who's out of control shouldn't be tolerated," says Kilcarr. With the success of medications in treating AD/HD, as well as behavior therapy, there's no reason that a child with this condition can't be held accountable. "It's important that the sibling feel like he or she is in a safe, protected environment," adds Kilcarr.

Try this: In his own household, Kilcarr has instituted a "no hands, no feet" rule, which stipulates that you're not allowed to touch your siblings unless they request, say, a hug. Once in place, there must be consistent (the magic word for kids with AD/HD) consequences if the rule is broken, such as immediate time-outs.

TEACH YOUR CHILD TO BE ASSERTIVE. Training a child to stand up for herself doesn't replace the parent's duty to protect her, but it empowers the child in difficult situations. Kilcarr creates cues in the home: The family discusses actions that aren't acceptable and comes up with a sign - holding up an index finger, for example - to signal that a bad behavior is about to, or has already begun to, happen. If your AD/HD child is starting to break a rule, his sibling can raise her index finger to let him know that he's about to get into trouble. She's taking control of the situation, and also helping her sibling avoid a time-out.

Try this: Explain to siblings what's realistic to expect from a brother or sister - and have the AD/HD child follow the rules and take on chores and other responsibilities to the best of his ability. Rules should be consistent for all the kids in a household.

Remember, too, that sometimes the most unexpected (and unapparent) things can lie at the heart of your other child's anxiety. She may be embarrassed to invite her friends over for fear that her AD/HD sibling will act up. She might even worry about you. Kilcarr recalls a session with a father and a daughter in which he asked the girl to talk about what caused her the most tension at home. To the family's surprise, it wasn't her AD/HD sibling, but rather the fact that her dad had started drinking because of all the stress at home.

The moral of the story? Talk to your kids and ask what's bothering them most. You may not be able to solve everything, but working on one issue that's important to your child will go a long way in securing her trust.