Children and teens with
attention deficit hyperactivity disorder (ADHD) do not
misbehave to spite their parents or other adults. Problems develop because ADHD
often causes children and teens to react impulsively and makes it difficult for
them to learn and to comply with rules.
Many children with ADHD
need behavior therapy to help them interact appropriately with others. Parent
training in these techniques usually takes 8 to 10 counseling sessions for 1 to
2 hours a week.
Behavior therapy is not meant to treat
inattention, overactivity, or impulsivity. But it can help with some of the
behavior problems that go along with ADHD, such as not getting along well with
others or not obeying rules.
For children with ADHD who are
younger than age 18, behavior therapy typically involves two basic
Encouraging good behavior through praise or
rewards. Praise for good behavior should immediately follow the
Be aware of your child's need for routine and
structure. Warn him or her beforehand if something out of the ordinary is
expected, such as taking a different route home from the grocery store. Even
small changes in a normal routine can upset your child.
child exactly what you expect from him or her before activities or events
throughout the day. For example, when you plan to go grocery shopping, make
sure your child knows that he or she is going to sit in the cart or hold your
hand. Also, let your child know before you go in the store specifically what
items, if any, he or she will be able to pick out.
Use a system to
reward your child for positive behavior, such as token jars or sticker charts.
After accumulating a certain number of tokens or stickers, plan a special
activity for your child, such as going to the park.
Use a timer to
help your child anticipate a change in activities and to keep him or her on
task. Set a certain amount of time for activities, such as coloring. Tell your
child that when the timer goes off, that activity will be over and specify what
will happen next (for example, "When the timer goes off, we will be finished
coloring and then take a bath"). Also, you can use the timer for chores,
such as picking up toys. If your child finishes the task in the allotted time,
you can use the token or sticker reward system.
your child in activities that build attention skills, such as puzzles, reading,
School-age children (6 to 12 years)
Give instructions clearly so that the child is
more likely to follow through with the task. Break tasks into simple steps.
This makes it easier for the child to maintain attention.
the attention, praise, and privileges or rewards given to the child for obeying
household rules. A token, sticker, or point system may be helpful for keeping a
record of the child's good behavior.
Anticipate where the child may
misbehave (such as in stores or restaurants or in the home when visitors come
by). Make a plan with the child about how to manage the situation before
problem behavior occurs.
Explain what will happen if the child
misbehaves. When misbehavior occurs, follow through with the consequences as
soon as possible. Your child will usually respond better with consistent
reactions while in different settings, so discuss your strategies with school
personnel. Consider requesting daily report cards from your child's teacher to
get a sense of how he or she behaves outside of the home.
Model good behavior. Demonstrate patience, calmness, and
understanding. Avoid angry outbursts, and don't interrupt others. Pay attention
while someone else is talking.
Allow your child to help plan rules and
consequences. Be willing to negotiate these rules
Anticipate when major changes will occur, such as
starting a new school. Also, recognize other high-stress situations,
such as a heavy class load or final exams. These are all times when symptoms
may be more difficult to manage. Talk about what the child can expect and ways
to meet the challenges successfully.
Be consistent. Predictability
reinforces expectations and will help your child develop positive behavior
When parents start a new system of limits and
consequences, children tend to test those limits. It takes patience,
imagination, creativity, and energy to carry out behavior management. It is
important for parents to apply the techniques consistently. The program is
often successful in helping a child behave appropriately and function well. But
if parents stop using the techniques, problem behavior usually returns.
Parenting programs and books may be helpful for some parents. Ask your
health professional for specific recommendations.
How this information was developed to help you make better health decisions.