In the last two columns, we learned that attention deficit hyperactivity disorder (ADHD) is biologically based and that it is a disorder of executive functioning, affecting skills that allow a person to direct behavior toward a future goal. This column will focus on how to manage symptoms.
The standard of care for the treatment of ADHD is medication. So, once a diagnosis is made, it is imperative that you discuss medication options with the primary care physician.
ADHD is not an excuse. It is a reason for a person acting the way he or she does.
The worst thing you could do to help a person with ADHD is to overlook their behavior. They actually require a lot more attention and feedback.
However, the manner in which feedback is presented can determine whether the discipline will work or not.
There are a number of behavioral interventions that can be effective, and I will summarize them in the following points:
Stay calm. People with ADHD can be very frustrating and easily can provoke a lot of emotion. Strong feelings can make a confrontation worse. Yelling more won't make them work harder.
Speak less and do more. When working with a person with ADHD, a person can find themselves nagging or yelling frequently. In this situation, it is best to do the following:
Set limits by giving choices. Don't say they have to do something. Simply state what you want them to do and the consequences if they do or don't do it. Then walk away.
Give the person time to do the right thing. Nobody likes to be demanded to do something immediately. And, ADHD kids have trouble transitioning activities and getting started. So, give them time to do what you ask. Set a reasonable time limit and then allow them to be successful.
Pay attention to the positive, even if it is short-lived.
Be consistent and follow through. Make a list of expectations for the child and the consequences for meeting or not meeting those expectations. Then ALWAYS do what you say you will do.
Make everything external.
A person with ADHD has no internal sense of reward or accomplishment. Their brains only recognize external rewards.
I always tell parents that they only owe their child, in addition to love, food, clothing, shelter and access to medical care and education. Everything else is a reward.
So, you will want to make the child earn time on the television, video game or cellphone.
You also can provide monetary rewards or gifts, though these are not necessary. But, the child always has to be working toward something.
Use external visual aids such as a stop watch or chore chart to remind the child of the time passing or the chores they need to do.
Make consequences brief. I cannot tell you how many children I have met who have been grounded their whole lives. What parents don't realize is that, by grounding for more than a day, they are removing the motivation for that child.
Grounding them for the day and making them earn back privileges for tomorrow is the best option.
There are a number of other strategies that can be helpful in managing the behaviors that go along with ADHD. The good news is that with proper planning, ADHD can be managed.
For more information, visit the website at www.lycominghealthyliving.com.
Seiler is a licensed psychologist and neuropsychologist and sees clients through Associates in Neuropsychology and Collaborative Healthcare, PC.
