General Recommendations for Helping Children with ADHD

Learn more about ADHD

The National Resource Center on ADHD provides science-based information on ADHD. Services include a resource center staffed by highly trained information specialists, a website with information and resources on ADHD, and a library open to the public. The NRC is operated by CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder) and funded by the Centers for Disease Control and Prevention. Contact the NRC at 800-233-4050 or visit their website at www.help4adhd.org.

www.ADDwarehouse.com has a wide variety of books on ADHD for parents, teachers, and children.
www.Addvance.com has resource books for women and girls with ADHD.

Join a parent support group such as C.H.A.D.D.
(Children and Adults with Attention Deficit Disorders)

National office ADD Call Center: (800) 233-4050, website: http://chadd.org
Scientifically-based information, parent support and resources for professionals. Has an excellent magazine published quarterly. There are local chapters examples: Metro West Boston.
Contact your school psychologist about other local support groups.

Attention Deficit/Hyperactivity Disorders is a neurological disorder that interferes with the capacity to sustain effortful attention, inhibits actions, organize and to persist. Individuals with ADHD typically exhibit a reduced sensitivity to behavioral consequences. These characteristics are not the result of laziness or moral weakness.

Give immediate and frequent feedback

Occasional praise a few times a day works for children and adolescents without ADHD, but individuals with ADHD require frequent feedback. The adult may find this tiring, but frequency is necessary in order to change patterns of behavior that have developed in the individual with ADHD over time. Adults need to remember to look for behavior for which to give feedback. Children are much less influenced by general rules than by immediate consequences. Positive feedback may take the form of praise or material rewards, but it should be clear, specific, and occur as close to the moment of the behavior as possible.

Use non-verbal rewards

For the individual with ADHD verbal praise is rarely sufficiently potent by itself. The addition of physical affection, privileges, and material rewards increases the effectiveness of positive feedback.

Start with rewards before punishments

First, redefine the problem behavior into a desirable alterative (what you want them to do instead). Then reward it consistently for a week or two before beginning any punishment for undesirable behavior. Punishment, if necessary, should be mild and very selective - only for a specific negative behavior, not for everything that is offensive. The ratio should be three rewards (positive feedback) for every punishment (negative feedback).
For misbehaviors, use planned ignoring for minor behaviors, brief time-outs for rule violations and consider natural consequences (get time out if ball is thrown in house) or logical consequences (lose privilege of riding bike for 1 day if violates bike safety rules). Avoid administering consequences without prior warning or without child understanding why they are receiving them. Administer consequences calmly or even sadly, this allows the child to focus on their behavior rather than parent’s anger. Withdraw from the situation until you can control your emotions. After giving a consequence, quickly acknowledge the correct behavior as soon as it occurs (even a part of the better behavior should be reinforced. Progress is success.)

Use a behavior chart or a token reward system to increase frequency of desired behaviors

Just noting the occurrence of the positive behavior increases the likelihood it will be repeated. Change or rotate rewards frequently in order to maintain a high interest level. Consider writing a contract with the child for specific behaviors with rewards to be earned and consequences for violations. Sign and post it. It helps to have explicit goals to work towards. Everyone in the family can have a list of goals to work on and chores to do.

Rules should be few, clear, and brief

Your child should know exactly what you expect. Remind your child of appropriate behaviors in advance. Let them know what they can do, instead of saying “don’t.” If you say “no” stick with it. Aim for firm, consistent limit setting (consistent for similar behaviors and between caregivers.)

Routines are extremely important for children

Set up regular times for meals, homework, TV, getting up, and going to bed. Follow through on the schedule! Use timers to help gauge time and develop a sense of time. Many children with learning differences have a poor sense of time.

Short lists of tasks are excellent to help a child remember

Post lists or use post it notes for tasks.
Use morning and evening checklists to improve organization.
Everything should be packed up the night before.
Use a plastic luggage tag to write a going home list and attach to book bag where child will see it and remember to check.
Use dry erase or blackboards to record reminders, tasks, schedules, and for children’s “wish lists.”
Discuss the upcoming week’s schedule and arrange play dates each Sunday night. Have a large erasable academic year calendar that shows all the months at once and record all important dates, tests, due dates, etc.

Have a designated “Academic Activity” time each school night

If there is no homework, then other academic or educational activities can be pursued (have a specific list of approved activities). This decreases tendency to rush or forget homework. Consider a regular family board game night. Read together as a family.

Make learning hands on and real life

Children with ADHD often learn best through experiences.
Use cooking, building, shopping and sports as an opportunity for reading, writing and math.
Visit museums.
Giving your child a limited number of acceptable choices helps a child be cooperative, develops better decision-making and decreased conflict. Let them control what they can. Let them make mistakes and learn.

Limit screen time (TV and computer games) and monitor closely

Do not put a TV in child’s bedroom.
Consider limiting viewing to pre-videotaped shows only.
Do not keep the TV on in the background.

Encourage hobbies and exercise

Identify what your child is good at doing (like art, math, and computer skills) and build on it. Develop interests and area of expertise to foster self-esteem and a sense of mastery.

Involve the child (and the family) in volunteer and community service activities

The experience of helping others can be very powerful for someone who is always being “helped.”
Keep it short and positive.

Sports activities should be encouraged to foster a sense of physical competence and a healthy lifestyle

Some children do well with team sports but some do not and individual sports should be considered as well. Consider activities such as martial arts or yoga which stress self-control and concentration.

Encourage healthy eating and sleep habits

Children function better in school if they eat a good breakfast. Establish routines for meals and bedtime. If a child has trouble going to sleep be sure to limit caffeine and chocolate intake. Consider using a fan for white noise or a relaxation tape with calming exercise music, breathing, muscle relaxation and guided active imaginary to soothe and release tension.Â

Example: Ready, Set, Release CD www.readysetrelax.com

Regular, scheduled one-on-one quality time with parent is very powerful, simple technique to establish and preserve a positive relationship with a child especially for a child who has difficulty with behavior or self-control. “Special Time” should be short (so it is easy to do it often) maybe 10-15 minutes (use a timer) with a parent doing something the child chooses to do (not TV). Make it daily if possible for younger children, 2-3 times a week for older children. Special time should take place even if child (or parent!) has had a bad day. It is non-judgmental, non-teaching, just enjoy being together time. Consider it an investment in each other.

Learn more about behavior management strategies with resources such as 1-2-3 Magic: Effective Discipline for Children 2-12. 2nd Revision edition (March 1996) by Thomas Phelan Ph.D.; Child Management; 1-800-442-4453. This book or videotape discusses how to get your child to stop inappropriate behaviors. Also available on audiocassette. It is suggested that parents obtain the video and purchase the book which goes into more detail. It is very useful to have all childcare providers watch the video so that there is consistency in management techniques. The video More 1-2-3 Magic explains how to get your child to increase positive behaviors. Consider parenting workshops or counseling to get “coaching” in behavior management techniques and to decrease stress in the family.

Consider Dr. Phelan’s Surviving your Adolescents for older children.

Come to terms with your child’s challenges and strengths.

Keep a sense of humor and perspective. Forgive yourself and forgive your child. Enjoy your child for who they are. Tell your child that you love and support them unconditionally.

We give this booklet to newly diagnosed ADHD patients:

“Understanding the Child with ADHD: Information for Parents on ADHD”

This new booklet addresses parents' concerns about ADHD by providing up-to-date, accurate information about this much-discussed condition. Organized in a reader-friendly format with extensive question-and-answer material, this booklet recognizes that an effective ADHD treatment plan requires a long-term, multifaceted approach involving medication, school, behavior therapy, and other resources. Also included are safety tips, a guide to brand-name medications, information about related conditions, and more. (Description from the AAP Bookstore website.)