Don’t Mistake Your Child’s ADHD Symptoms for Bad Behavior
Your child is not deliberately willful, disobedient, scattered, demanding, obnoxious, aggressive, or lazy. He or she has ADHD — a neurological condition with symptoms too often mistaken for willful “bad behavior.” But research shows that criticizing your child is likely to make her symptoms worse. Here is a better way.
Study after study shows that the way a parent behaves toward a child with ADHD — the attitudes and strategies the parent brings to bear to control symptoms — is a major factor in the way the child behaves. That’s why the American Academy of Pediatrics (AAP) recommends parent or teacher-administered behavior therapy for ADHD. For some age groups, the AAP recommends medication only if behavior therapy doesn’t provide “significant improvement.”
There are dozens of customized programs for the behavioral treatment of ADHD, and hundreds of books on the subject. (My research assistant counted 492.)
Here are a few behavior strategies for parents — strategies that my three decades of experience have shown will likely help you and your child.
Trust the Top Expert on Your Child: You
Not teachers. Not friends or relatives. Not the doctor. Not even other parents who have a child with ADHD. You live with your child, day after day. You know his unique potential — his energy, passions, curiosity and creativity, qualities that can get buried under distractibility, impulsiveness, and restlessness.
The best strategies for making sure your child gets what she needs to thrive will come from your own instincts, intuition, and intelligence. There are as many approaches to behavioral management as there are children, and you are the one to decide on the best approach for your child.
ADHD Is Not ‘Bad Behavior’
I have asked thousands of children on their visits to my office the same question: “If you could change one thing with a magic wish — and it can be anything at all — what would you change?” Most children wish they could make school disappear or have a recess that’s eight hours long, or get a dog, or a pony, or take a trip to the moon, or eat ice cream.
Most kids with ADHD make the same wish. And it’s not for a daily banana sundae. Nearly every one wishes that his behavior could magically improve or that he could pay attention better. And he wishes Mom and Dad wouldn’t get so upset at him anymore. Hearing this helplessness from so many children with ADHD — hearing how much they don’t want to be “bad” — I realize that kids with ADHD are asking for help for symptoms that they cannot control.
Your child is not deliberately willful, disobedient, scattered, demanding, obnoxious, aggressive, or lazy. ADHD is not a “behavior problem” or a “discipline problem.” ADHD is a neurological, genetic, nutritional, and environmental medical disorder that imbalances the brain.
Bottom line: Your child is not a bad child. You are not a bad parent. Nobody is to blame for ADHD. Therefore, assigning blame for your child’s bad behavior — and trying to correct it with criticism — is useless.
Rewarding Your Child for Better Behavior
Children with ADHD misbehave so often that they receive a lot of punishment, which creates hostility and resentment. Rewards work much better. In fact, kids with ADHD respond better to rewards and positive feedback than kids without the disorder, according to research.
In a recent study on this topic, neuroscientists and psychiatrists at Northwestern University compared short-term memory in 17 boys with ADHD and 17 without the condition, all of whom were asked to remember the location of objects on a computer screen. The boys got immediate results from their performance in the form of rewards (money symbols on the screen) and feedback (green or red squares on the screen).
Boys with ADHD achieved “high performance” only when they got a large reward or feedback. During the memory exercise, the researchers tracked the boys’ moment-to-moment brain activity using a real-time brain scan called a functional MRI. They found that the boys with ADHD had the most brain activity linked to short-term memory when they received large rewards.
What kind of rewards work for kids with ADHD? Anything you think will be appealing to your child: extra time playing a video game or the chance to rent a movie for the evening. Make that reward part of a verbal contract that applies to any task you want your child to do, like finishing his homework or cleaning his room. Other rewards might be physical affection, special snacks or treats, or small toys or collectible items.
Criticizing “Bad Behavior” Worsens ADHD Symptoms
A recent study, funded by the National Institutes of Mental Health, shows that criticizing your child is likely to make her symptoms worse, not better. For the study, the researchers recruited 515 families with children seven to 11 years old — 338 children with ADHD, and 127 children without.
For three years, the researchers tracked the trajectory of ADHD symptoms, using questionnaires filled out by parents, teachers, and children themselves. The results: Sustained critical parenting — a high level of harsh, negative comments about the child — was linked to ADHD symptoms that didn’t lessen over time.
How Parents Can Change Their Own “Bad Behavior”
But how do you stop yourself from being “overly critical?” How do you show your child respect rather than subjecting him to a barrage of negativity? How do you change your behavior to help your child’s behavior? The strategy I’ve used with many parents is called SAIL.
- S is for symptom. I’m sure you could make a fairly long list of ADHD-related behaviors that annoy you. Whatever the annoying behavior, don’t see it as bad behavior — see it as a symptom. Think of it this way: If your child has a runny nose, you don’t say she’s a bad child whenever she sniffles. You say she has a symptom of a medical problem, like a cold or an allergy. If your child is running uncontrollably around the house, it’s the same thing — she has a symptom of a medical problem. Without parental help, your child can no more inhibit her motor activity than she can stop her nose from running.
- A is for ADHD. After you’ve labeled the behavior a symptom, say to yourself: ADHD is a medical problem, not a behavior problem. Whatever the behavior, your child is not doing it to irritate you. Your child wants to behave. But he can’t without your help. And criticism is no help.
- I is for “It’s OK.” In the grand scheme of things — your life and the life of your child — the behavior is probably not that big a deal. Whatever your child is doing that annoys you, tell yourself, “It’s OK.”
- L is for listen. I cannot overstate the value of listening to your child. ADHD children have great strengths and talents — including the insight to help you parent them. If you tap into your child’s intuitive and creative energy, she can help you help her. The best way to do that is to listen to what your child says and to respond positively. When I meet with a child alone and listen, the child is often able to articulate the exact information his parents need. I might ask, “What do you need to help you study better?” She might tell me that she studies best in the dining room, with loud music playing. But her parents may have already decided that she should study in her bedroom without any “distractions.” What you think is best for your child may not be what is best for her.
Let your child guide you to the best possible understanding of how he interacts with the world around him, and what he needs to function at his best.
You might want to add a second L to the end of SAIL: L, for let go. You will probably have days filled with fighting, fidgeting, and so on. Resentment may build up and not go away. But for your child’s wellbeing and yours, learn to let go of anger or other destructive emotions that have arisen during the day and move on.
This advice is emphasized by ADHD expert Russell Barkley, Ph.D., in his book Taking Charge of ADHD. When you find yourself rehashing your child’s behavior in your mind, he recommends three minutes of mindfulness meditation. Conclude the meditation by saying, “I love you and forgive you.”
Excerpted from Finally Focused, by James Greenblatt, M.D., with Bill Gottlieb, CHC. Copyright 2017. Harmony Books.
Updated on February 4, 2020