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ADHD Impulsivity — and Its Consequences

Trying to teach a child with ADHD who struggles with impulse control how to think before she acts? The next time you give instructions, instead of focusing on negative outcomes or punishments, try these strategies.

When I was a kid, my mom gave me a Choose Your Own Adventure book. As a dyslexic child with attention deficit hyperactivity disorder, reading was always a struggle. My mom was trying to spark my interest by making it more fun, and I immediately saw the appeal of jumping around in the book, choosing “my adventure,” and possibly not having to read the entire thing. My strategy was to make all the bad choices in hopes that they would lead to the main character’s demise and thus let me be done with the book sooner rather than later. Problem was, the story was unpredictable, and it was impossible to decipher the consequences of any particular choice.

Life is a bit different. On a daily basis, we make choices, the outcome of which we know and understand, especially if we stop to really think about it. Here’s where trouble creeps in for those of us with ADHD. Parents and teachers working with young people with ADHD know that impulsivity and the inability to slow down and think causes kids to make some poor choices. These students are not irresponsible or stupid. It’s just that their brains are moving so fast that choices are made before consequences are fully considered. The flip side, of course, is that people with ADHD may also have the same trouble considering positive outcomes of their actions.

The other night, my youngest daughter was in one of her disruptive moods, and things were heading towards a major blowout as I got fed up. It’s at this point that I usually take a deep breath and explain what will happen if she continues to misbehave: the timeout chair, early bedtime, or fun-activity privilege suspension. This particular night, I was tired from a long day on the road and did not have the energy to list all the dire things that would befall my mischievous child if she didn’t start toeing the line. Instead, I tried a different approach.

[Self-Test: Symptoms of Hyperactive & Impulsive ADHD in Children]

“What do you think will happen if you keep acting this way?” I asked her. I could see the wheels turning. She quickly chirped back.

“I go to timeout?” It was really a no-brainer for her since she and the timeout chair are really close friends.

“That’s right. Now, what do you think will happen if you choose to do what I am asking you to do?” A much longer pause followed. She was having a hard time finding the answer.

“I don’t know,” she finally responded.

It was then that it hit me. I was spending much more time on highlighting negative outcomes for her behavior than positive ones for her compliance.

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This got me thinking about the work I do in schools and how a lot of school assemblies begin with a “don’t do this or this will happen” type of message. What’s interesting is that some kids are just not afraid of a negative outcome. Threaten them, tell them they’ll be grounded for life (or worse), and it’s like water off a duck’s back. My youngest is a little like that. Perhaps it was time to adjust my parenting with this one. Maybe putting more emphasis on the good things that would happen for her would be a better exercise in teaching her about choices and consequences. So I told her in great detail what would happen if she made the right choice that evening. When I felt like she understood both sides of the equation, I asked her, “So what do you want to do?” The night concluded with an empty timeout chair and a lot of fun.

For kids who struggle with making the right choice because they don’t stop and think about the consequences — and are not easily frightened by horror stories of what can happen to them if they do the “wrong thing” — try talking about the good things that can happen in their lives when good choices are made. Sure, there are a lot of children that get it from a very early age, but quite a few — many of them with ADHD — struggle with these concepts. It might be developmental delay. It could be the way their minds jump around. It could be a lack of impulse control. Whatever the case may be, spend a few moments a day telling your child or student with ADHD what benefits they can reap if they do the right thing, and see if that helps improve their ability to make the right choices.