How to Encourage Good Behavior in Children with ADHD
Whether your child struggles with following directions or is a chronic name-caller, learn how to communicate and discipline effectively with these tips. Here, a leading parenting expert shares his secrets for dealing with ADHD behavior problems.
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 hyperactivity disorder (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 children with ADHD: 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 children with ADHD 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 children with ADHD 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.
What else can parents do to keep kids from behaving inappropriately?
It’s important for parents to recognize that much of the behavior they call inappropriate really isn’t. It’s just inappropriate for a particular time and place.
Children need to express themselves, and parents need to make it possible for them to do so. If your child needs to roughhouse, for example, you might keep a punching bag in a certain room. If your child enjoys dismantling appliances, it probably won’t work to tell him not to. Instead, give him a box of old vacuum cleaners or toasters, and designate a room or space where he can take them apart. The message to the child should be that “In our home, we will offer you an appropriate way to meet your needs, but we will not permit you to meet those needs in an inappropriate way.”
What about a child who yells and curses?
I encourage parents to sit down with the child during a calm time and say, “I know a lot of things are going to upset you, but right now you’re doing things that can’t be done in the house. So let’s figure out things you can do when you’re mad.”
Well, maybe some name-calling is acceptable. After all, all kids get angry at their parents, and kids with ADHD are more prone to anger and frustration than other children. So it makes no sense to tell your child not to get angry at you. Instead, help him find acceptable ways to express anger.
When my younger son was 10 years old, he asked me, “Can I call you ‘buttface’ when I’m mad?” I thought that over, and decided that was unacceptable. But I told him he could say, “I hate you” or “I don’t love you anymore.” Each family must determine what is acceptable within their home and then teach that behavior.
Isn’t that a slippery slope?
Not really. We all need to learn appropriate ways to express unpleasant feelings. Children with ADHD are slow to learn how to do this without help. One good way to provide this help is via a program of incentives or rewards. For example, my son and I agreed that, for every hour that he didn’t call me bad names, he earned points toward a reward.
I have parents sit down with their child and make up reward coupons. The coupons are for whatever the child loves to do-stay up late on a weekend night, eat pizza, earn $5. The point is to motivate the child to learn self-control.
Aren’t siblings without ADHD going to be jealous of these rewards?
Fairness isn’t the same thing as equity. I define fairness as equal opportunity for success within a family. Every child should have equal access to rewards, attention, and parental approval, but there may be different expectations for each child. Susie might have to clean her whole room, for example, while Ben might only have to clean one corner.
Is it ever too late to impose structure?
I won’t say it’s ever too late, but the longer you wait, the more the child has to unlearn. Provide consistent boundaries as early as possible. If you wait until adolescence, the challenge will be much greater.
How would you characterize your approach to discipline, overall?
If parents help a child feel valued, loved, and competent, he will be more likely to overcome the challenges and adversity familiar to kids with ADHD.