Terry Illes, Ph.D., knows it’s not easy to discipline children with ADHD behavior problems. Growing up in the Chicago suburbs, he was one of those spring-loaded kids himself. Never formally diagnosed with attention deficit disorder (ADD ADHD), he had severe emotional and behavioral problems until his late twenties.
Today Illes is thriving. Married for 28 years and the father of three, he works as a school psychologist in Salt Lake City. In addition, he teaches classes on parenting ADHD children and serves on the CHADD board of directors.
Illes’s personal and work experiences have helped him to understand a common challenge facing the parents of ADHD children: compliance. That is, how can parents get their kids to do what’s expected of them?
You work closely with children who are struggling in school. Why do you get the parents involved?
ADHD is a chronic disorder that causes behavior problems not just at home, but at school, on the playground, and so on. It takes a team of people to help these kids learn to behave appropriately in all these settings, and parents should view themselves as the heads of the team—the ones who are driving the process.
When parents come to me for help, one of the first things I do is take a parent history. That means sitting down with them for 45 minutes or so to discuss the specific behavior problems their child is having, the discipline strategies they have tried, and what might be triggering the problems.
Given the fact that ADHD often runs in families, I’ll bet many parents of ADHD children have behavior issues of their own.
They certainly do. And so they often need formal instruction in the most effective strategies to parent a child with ADHD. This is called parent management training. PMT provides parents with the tools to change their own behavior so they can better help ADHD children change theirs. These kids are more likely to comply when their parents listen, express empathy, clearly communicate their expectations, and follow through with immediate consequences.
Can you give an example?
When parents ask a child to do something, they tend to ask it differently each time. On one occasion they might say, “Turn off the TV,” on another, “What did I tell you about watching TV this late?” or “Would you please turn off the TV?” Most kids have no trouble getting the basic message. But when a child has ADHD, his judgment may not be very good, and he may not be adept at recognizing the tone of voice and other cues that indicate that his parents mean business. So he fails to comply, not because he’s being defiant, but because he doesn’t realize that what’s being said constitutes a command. He might think, “Do I really need to do this?” Or the words might simply seem like background noise—like a running fan.
How can parents make sure their child hears their commands?
The key is to use the same basic sentence structure for each command. For example, “Justin, you need to turn off the television” or “Justin, you need to put your shoes in your closet.” When parents do this consistently, the child soon realizes that anytime he hears his name followed by “you need to,” he must comply. If he does, he earns one point toward some reward. If the child doesn’t comply, he faces a negative consequence. Typically, this is a time-out, or, for older kids, the loss of privileges.
How long should time-outs be?
I usually recommend no more than 60 seconds for each year of the child’s age—for example, five minutes for a five-year-old. Often, 30 seconds for each year makes better sense. The important thing is not how long the time-out lasts—it’s showing the child that you, the parent, are in control and that you can interrupt the inappropriate behavior and gain compliance.
Next: Newsmaker, Part 2