How to Help Your Child Deal with ADHD
Attention Deficit Hyperactivity Disorder or ADHD is one of the more common issues mental health professionals see in children and teenagers. The Diagnostic and Statistical Manual for Mental Disorders (DSM-IV-TR) lists criteria for ADHD as: inattention, or inability to stay on task; hyperactivity, restlessness and fidgety behavior; and impulsivity or the tendency to act seemingly without thinking of the consequences. While the criteria is certainly more detailed, if your child has been diagnosed with ADHD, there are options available to help both you and your child cope.
Whether you choose the medication route, a holistic remedy such as Omega three supplements, or decide not to medicate your child at all, setting up a clear and structured behavior-modification program will help your child master the symptoms of this disorder.
Behavior modification is a system or rewards and consequences for target behaviors. With children whose behaviors are out of control due to a disorder such as ADHD, the behavior modification program you put in place should also involve short, clear steps your child will take to gain control over their impulses.
Begin by focusing your expectations: "one step at a time," as it were. For example, a child with ADHD cannot be directed to simply "clean their room". The mess will be overwhelming and there will be distractions at every turn. However, this does not mean that your child should get out of having to do the task! Depending on the age of the child, you can create a structure to the make task less daunting. Suggest that the child first pick up all the “blue” toys or “round” toys, and when that task is completed to let you know. This gives your child a focus. It does not mean they may not still become distracted, but they can easily be redirected back to the specific task. Upon completion, verbal praise and or a small reward should be offered.
Children with ADHD respond well to checklists and rewards for completion of chores and daily routines. Small children can be given a picture checklist that you either draw together or clip pictures from a magazine. These can be laminated and, using a dry-erase pen, checked off as the child completes each task. Adding a system of rewards both encourages the child to complete the chore and instills a sense of responsibility. Some parents may question the reward for positive behavior, believing that the behavior should be expected. While this may be true, for children with ADHD, the behavior and control of it must be learned. We as humans learn, function, and do our best when there is a positive and tangible outcome to our actions. Who doesn’t like getting the paycheck at the end of the week for our work!
Consequences are also a piece of behavior modification and in the case of children with ADHD can be effective; however, we need to tread lightly and remember that the ability to control impulses is a key issue in Attention deficit disorder. Initially, reminders should be given as to how to handle the impulsive and out of control behaviors. Watching our children carefully and understanding what may set off aggressive behaviors will help us to teach our children acceptable alternate responses to difficult situations. Look for the successes and give lots of praise and encouragement for the appropriate responses. When you note a situation escalating, you can give the child time to calm down by counting.
The idea of “magic 1-2-3” has been a wonderful system of giving your child the time to regain control. As you see your child beginning to lose control you can first let them know that this is a behavior that is not acceptable and that if they continue they will, for instance, require a “time out.” Let them know you are going to count to three to give them time to calm down. Use both words and action to count: “This is one,” should be stated as you show them one finger. “This is two,” followed by showing two fingers, and so on. At "three," if the child has not calmed or the behavior continues, the stated consequence must occur. Whether it is time out or leaving a store, your follow-through will be vital. If you do not follow through, your child simply learns to ignore what you say.
For young children, “time out” is effective if the parent or caregiver is consistent. Whether you chose to call it “time out” or “space” or “sitting”, if you do not follow through each time, it will be more difficult to help your child master control of their behaviors. Time out should occur in a quiet place where your child is still visible to you but has no interaction with toys or family members. Often a chair in the kitchen is a good spot for time out. Bedrooms are not recommend for several reasons. You do not want the bedroom to become a frightening place or spot associated with punishment. This could instill fear of the bedroom and create issues when bedtime arrives. Bedrooms also tend be places where children have their toys and possibly a television. Time out is not a time for quiet entertainment, it is time for the child to sit without stimulation and regain control.
There should be no dialogue during time out, and it should last no longer than one minute per age of the child. If, for instance, your child is five, time out should be five minutes. A timer is often helpful for both you and your child to know when time out is over. Your child can watch the timer and when the bell goes off, you both can check in as to whether your child has calmed enough. If not, time out can be resumed. If your child has calmed, he/she should be praised for calming. It is also recommended that the parent or caregiver, give a hug, kiss and let the child know you love them. This action reminds your child that it is not them you do not like, it is their behavior.
Children diagnosed with ADHD often benefit from medications, however whether you choose to try the medication route or not, helping your child learn techniques to master their impulses and focus attention is vital, and not only benefit the child, but will give parents a constructive role in making the family more functional. Using checklists, behavior modification, and lots of patience and love will help your child gain control over what feels uncontrollable to them. These are tools that will stay with them forever.