ADHD in Children

ADHD is one are of specialty in my practice of psychology.

Many years ago, I had the opportunity to attend a two-day seminar given by one of the most well-known authors, researchers, and experts in the field, Dr. Russell A. Barkley. Dr. Barkley presented updated information about his theory, research, and about the most effective types of treatment for ADHD. He reassured the professionals that the number one treatment for ADHD is medication because this is a neurodevelopmental disorder.

Another area of education and treatment that Dr. Barkley talked about was on teaching parents about the best parenting techniques to help their children improve their behavior in school, at home, and in other social situations.

I would like to use some of Dr. Barkley’s ideas and recommendations for parents added to some of my common suggestions to parents in my work with families.

  1. Dr. Barkley presented the idea that “parents are shepherds, not engineers”. He talked about the fact that children are born with a predisposition (genetic, biological) for certain characteristics, and for displaying certain behaviors. Parents can help children develop their most socially appropriate behaviors by providing the field, food, and shelter, but they need to know that their children also come with a genetic/biological package into this world. It is the ever-lasting discussion of “nature versus nurture” as these two factors contribute to children’s developments.
  2. Dr. Barkley insists on parents being very consistent with their actions. If parents tell children that a certain behavior will lead to a specific consequence, they have to follow up with that statement. For instance, if a parent says: If you do not interrupt your Hebrew teacher tonight, we will read one more book tonight as a reward.
  3. Note that I stated the “condition” in a positive manner. Make sure that when you tell your children about consequences of their behavior, that you state it in a positive rather than negative way. However, sometimes you have to make some conditions based on a negative behavior that you want to eliminate.
  4. Try to develop rules for the household whenever there is difficulty in following up with directions on a daily basis. For instance, if your children are having having a hard time with taking showers and getting ready for bed every night, develop a “plan” that will be proactive rather than reactive. You may have a “family meeting” and develop rules using “natural consequences” for their behavior. For instance, if your children take too long for bedtime (beyond their curfew), then they will have to get ready for bed earlier the next night, and maybe miss a television show that they like, or not talk on the telephone so much. Another example is getting ready for school in the morning. If children are late for school, a natural consequence is for them to go to bed earlier the next night.
  5. You should always remember that you need to take into account your children’s ages and developmental stages in developing plans such as the ones above.
  6. Also, you need to pick “one battle at a time”. Decide which areas you want to work first, and once you resolve that one (like bedtime), you address another issue.
  7. It is also very important to not beg children to follow your instructions. Instead of saying “how about we pick up the toys now?” you should say: “I need you to pick up your toys now”. You can say “please” (to teach them to be polite), but your voice needs to be firm. You will benefit from using “imperatives” rather than questions.
  8. It is very important to not repeat a request and an instruction more than one time.
  9. Dr. Barkley often states: “Act, don’t Yak”. He recommends parents to make a plan for action, to inform their children, and to not talk about it anymore, but to just put the plan into action. (See example above with bedtime).
  10. I like to use the term “emotional thermostat” to explain to parents that when a child hears a “no, you can’t don that”, and starts screaming or yelling (or having a temper tantrum), that the parents have to keep a “cool emotional front”. In doing that, the parents will not escalate the “emotional roller coaster” with their children. If parents are emotionally reactive, they will end up being more extreme in their punishment, and they will not think clearly when they interact with their children.
  11. I often recommend parents and teenagers to leave notes for each other rather than suddenly talking about a “delicate” issue. For instance, if a teenager wants to ask the parents if she can go to a specific party in the weekend, she has to let the parents know by, for example, Thursday night. Some parents also like to know the person’s parents name, address, etc. But parents have to explain all these factors to their children beforehand so that their kids have indeed a chance to comply with the guidelines.
  12. In sum, develop guidelines for your family, explain the expectations clearly to your children (taking into account their age, and receive some input from older children), implement the more specific rules in problem areas, and be consistent. Always focus on positive aspects of your family life, and remember to recognize your children’s wonderful accomplishments and attitudes toward everything, not just their grades, but their kindness with others, helping you and their siblings, and their self-care.

Vera Joffe, Ph.D.