Helping Pre-Teens with ADD Succeed

The middle-school years can be turbulent for many children with ADD. Here’s how parents can help their tweens.

by Larry Silver, M.D.

Twelve-year-old Ryan C. had been diagnosed with attention deficit disorder (ADD ADHD) and learning disabilities in the third grade. With the help of tutoring and a stimulant, he had been doing well in school. But things became a little shaky in sixth grade, and got worse in the seventh.

He stopped doing homework, and refused help at school. Some days, he wouldn’t take his meds — or he pretended to take them and then spit them out. He was calling out in class and getting into trouble in the halls.

It was at this point that Ryan’s parents — enormously frustrated and worried about their son and his behavior problems —sought my help.

The power of peer pressure

The problems Ryan had been having, I told his parents, are not unusual for kids 10 to 12 years of age. These “tweens” — no longer children and not yet adolescents — have stopped caring about what grownups think of them. Now they’re focused on what their peers think.

Tweens are so eager to “fit in” that they’ll avoid doing just about anything that makes them seem different from friends and classmates. They dress alike, talk alike, and wear the same hairstyles. Take AD/HD meds? Forget about it. Accept accommodations at school? Work with a tutor? No way. “There’s nothing wrong with me!” these young people tell their parents. “Why do you want me to learn this? I’m never going to use it anyway.”

As tweens refuse the help they accepted a few years ago, their symptoms flare up and their grades go down. How did your sweet grade-schooler become this…this thing? What can you do to make things right again?

How to help your tween

Your child isn’t trying to be difficult. He’s only trying to protect his self-esteem. And as confused as you feel about the changes in his behavior, he probably feels more so. Keep these fundamental facts in mind next time he does something that defies logic.

Here is how to be a better parent for your tween:

• Understand what motivates your child. Elementary school students strive to get good grades, in part to please their parents and teachers. But by middle school, the primary goal of most tweens is to be accepted as one of the gang. Pleasing grownups doesn’t matter so much anymore.

• Make your child’s privacy a priority. Let her know that you understand that it can be embarrassing to be seen taking meds. Explore ways for her to take her doses in private. When she goes to a sleepover, for example, explain the situation to the host parents. (Let your child skip a dose, if necessary, to maintain her privacy.)

At school, your child should be allowed to end her lunchtime visits to the school nurse. Use an eight- or 12-hour dose of the stimulant to cover the entire school day.

Let teachers know that your child may refuse accommodations because they make her feel different. Ask if she could get help in a less obvious way. For example, instead of being pulled out of class to see a tutor or speech therapist, she might meet with the tutor or therapist at home.

This article comes from the October/November 2006 issue of ADDitude.

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Helping Tweens, Part 2

• Don’t be the disciplinarian. If your child is acting out in class, failing to complete his assignments, and so on, let his teachers deliver the discipline. After all, you’ve probably found that battles over schoolwork only cause your child to resent you — and the work still doesn’t get done. If you and your child aren’t adversaries, the lines of communication will stay open.

Meet with the teachers at the start of the year to suggest alternative consequences for missed assignments, and so on. Maybe the teacher could require your child to spend lunch period in the classroom and do his work then — or to stay after school to do the work. After that, don’t get involved unless you feel that the school’s approach has been inappropriate.

• Pay less attention to grades. It’s not easy to watch a child struggle in school — especially one who had been doing well. But criticizing his academic performance will only intensify the stress your family is under. And, before high school, grades are less important than acquiring solid study skills.

• Hire a homework helper. Your child may be more likely to accept academic help from an older student than from you or a professional tutor. If your child needs help, find an intelligent high school student (of the same sex) who is willing, for a few dollars, to come over after school to see that homework gets done and that your child understands the material.

Continue to make yourself available in the evenings, in case your child asks you for assistance. But don’t push him to accept help from you.

Counseling can help

If your tween’s struggles leave you feeling overwhelmed, talk with his guidance counselor. After all, this is someone who spends her days surrounded by kids this age, and so is probably well-acquainted with different ways to meet your child’s needs. Or, like Ryan’s parents, you may wish to bring your concerns to a psychiatrist, psychologist, or other mental-health professional.

What became of Ryan? Initially, he thought that seeing me was “stupid” and refused to come to sessions. So I worked with his parents, explaining why middle school was hard for him and how his LD and AD/HD caused him to feel rejected by his peers. Our discussion persuaded them to stop nagging Ryan about his homework, and to be more accepting of his new clothing and hairstyle, which had been major sources of conflict. On weekends, Ryan’s parents went out of their way to transport him to activities, sports events, and sleepovers with friends.

I also met with Ryan’s teachers. I asked them to provide more structure for his activities, and to avoid punishing him for fidgeting or calling out in class. They agreed to stop Ryan’s “pull-out” tutoring sessions, replacing them with weekly tutoring sessions at home.

Life has improved for Ryan and his parents. I expect that things will continue to get better over the next year or so, as Ryan matures out of tweenhood. As I told his parents, there is light at the end of the tunnel: adolescence.