April 29, 2016
My Kid Has ADHD… Now What?
By James Stone, Psy.D.
Last week, I spoke about the core features of ADHD – mostly, a decreased ability to stop from doing something. This not only explains the impulsive behavior we see, like calling out, interrupting, quick to laugh, etc. but also inattentive and distracted behaviors, when every little thing needs to be attended to, looked at, thought about.
The main take home point of the talk was to develop appropriate expectations. Medication, therapy and parenting techniques can help our children function better, but none of them take away the ADHD. Instead of saying things such as, “You’re 12 now, you should be able to do this.” or, “You have to try harder to pay attention!”, we need to expect that that they will need help getting started, staying on task and shifting from one thing to another. We should expect that they will struggle remembering things from time to time and will forget to turn in homework. The more you know about ADHD – and specifically, your child’s ADHD, the more accurate your expectations will be. Don’t be afraid that helping too much will enable these children and “spoil” them; that they will never learn to do things for themselves. It is simply not true.
If you’re wondering how much support is enough or too much – don’t worry; it’s constantly changing! Instead, my rule of thumb is to provide as little support as is necessary for them to be successful. Note the two important parts: 1) Your support must lead to success. For example, homework will be completed; trash will be taken out (all of it – all the way to the curb). If it’s not done right, you might have helped enough, and 2) Provide only what they need. Think in terms of the executive functioning demands of the task. Are they having trouble getting started, organizing their thought for a paper, turning off the video game? Although setting a timer is good idea (and nearly cliché in ADHD), don’t be afraid to actually turn the game off yourself. Just give them a warning ahead of time so they know it’s coming. Don’t make it punitive – make it helpful.
I gave the example of a boy who was having difficulty taking out the trash completely (he’d always miss something!). Instead of doing it for him (too much) or telling him what he did wrong after he was done (too little – and too late), his mother simply walked with him throughout the process, prompting only when needed. Her presence was all he needed to remind him to stay on task, think about what he needed to do and to know that he had a safety net (mom) in case he forgot. The task was successful and he felt much better about that than always forgetting some aspect of the job. Eventually, his mother faded her help, the routine he established stuck and he did great (or as great as any other teenager does when taking out the trash!).
Lastly, when supporting children with ADHD, it is important to keep in mind what is actually getting in their way? Is it some aspect of the ADHD? It might not be. While a child might have ADHD, it doesn’t define them and there is a lot going on in childhood; normal stress and worries, normal inattention, normal mood fluctuations, etc. Be careful not to define everything through the ADHD. They are not limited by their ADHD, it’s simply something that needs to be managed, much like diabetes. If treated properly and appropriate behavioral changes are made, it can be virtually invisible. However, if left untreated it can cause serious complications. The better educated parents and children with ADHD are, the more they will know what to expect, the more likely they will develop preventive behaviors and they more likely they will be successful.
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