Helping Your Child

Behavioral approaches

Behavioral approaches to ADHD include establishing structure, feedback, positive reinforcement, problem-solving, communication, and self-advocacy skills. It is best to involve older children and teenagers in creating agreements and goals. Some families have had success with using a “report card" approach; parents and teenagers may establish a “contract” for family behavior.

A therapist can work with the child and the family to explore issues, thoughts, and feelings related to family life, school, and self-esteem. Therapy can also focus on developing social skills and learning new behaviors.

Praise and rewards are keys to a behavioral approach to ADHD. Many children with ADHD are used to being scolded, harshly disciplined, and criticized. It is understandable for parents to become frustrated when responding to a child with ADHD. However, harsh discipline and criticism can make the problems of ADHD worse rather than relieve them. On the other hand, setting clear goals for good behavior and praise for achieving those goals can go a long way toward helping a child learn new skills.

Parent education

Even parents who have raised other, non-ADHD children say that raising a child with ADHD is a completely new experience. It can also be very stressful for the parents and other family members. By learning all you can about ADHD and the way your child struggles to process and organize information and control his impulses, you will have more options for how you respond. You will be better able to create an environment that will help your child learn and succeed, and you can reduce stress on the whole household.

Children with ADHD need extremely consistent, structured, positive approaches to their behavior. Therapists can’t provide the day-to-day interventions, feedback, and reinforcement that help a child learn new behaviors. Parent training teaches you how to take steps at home that help your child with ADHD strengthen her own self-management and social skills. This approach incorporates clear limits for misbehavior—such as time-outs and penalties in the reward system—but without yelling, arguments, and other emotion-filled and negative interactions, which are not helpful for the child with ADHD.

Medication

Behavioral approaches alone may not be enough for many children with ADHD. Almost all children with ADHD respond well to medication prescribed by their doctor. Some children show a “night and day” difference; for others, the benefits are more subtle. Medication doesn’t cure ADHD, but it does ease the symptoms, giving the child and his parents some “breathing room” to learn the behavioral approaches that will give the child skills to manage himself long term.

Most of the medications approved for use with children with ADHD are stimulants. These medicines stimulate the parts of the brain dealing with attention and impulse control; they work on the neurotransmitters dopamine and norepinephrine. A healthcare provider can work with you and your child to find the right medication at the lowest dose that provides benefits, and go over any possible side effects to watch for.

To understand which medicine and which doses are most effective, it is often useful for parents and teachers to complete brief rating scales every week or so during a medication trial.

Collaborating with schools

ADHD is with your child wherever she goes; in fact, one of the criteria for diagnosing ADHD is that the symptoms appear in more than one setting, such as both home and school. As a parent you may be diligently following behavioral strategies at home. How do you make sure these strategies are reinforced at school?

You have the right to request that the school work with you in creating the best educational plan for your child. Teachers or school psychologists at your school may be involved in assessing and diagnosing your child. If it is determined that your child is eligible for special education services under the Individuals with Disabilities Education Act (IDEA), the school must work with you to develop an Individualized Education Plan (IEP) within 30 days.

Even if your child is not eligible for special education services (not all children with ADHD are), your child is still entitled to “free and appropriate public education,” regardless of ability, under the law.

You and your child’s teacher may be able to set up a checklist or “daily report card” system. Using lists with specific, concrete tasks and goals and clear feedback (like checkmarks) can provide the clarity and structure your child with ADHD needs. A daily report card can also provide a way to make sure that there is regular communication between you and your child’s teachers. Such communication is essential for ensuring that there is consistency in expectations and feedback between home and school.