CARETALK: Strategies to manage ADHD

Q  My eight-year-old son has recently been diagnosed with ADHD and has been prescribed medication to help manage the condition. Although we are relieved that the medication has created a calmer home, I don’t want to rely on medication. Can you recommend any strategies to help us manage the ups and downs that come with ADHD?

A As the parent, you are the expert in your son’s behaviours – positive and negative. This is the starting point for thinking about strategies to move forward. Not only is it important to find ways to reduce or manage the difficult behaviours, it is also important to acknowledge your son’s positive behaviours. Some of the key things to keep in mind when supporting any child with ADHD are:

  • Have patience: we know that a child with ADHD can be up to two years behind his or her peers’ maturity level so try not to set expectations that are unrealistic for your son and your family. Also, consider your own self-care as a parent of a child with additional needs and take some regular time out for yourself. Remember that the healthier and calmer you are, the more focused and present you can be as a parent.
  • Despite the difficult behaviours you may have to deal with, remember to continue to create a positive relationship with your son. Find ways to connect with your son by creating special times.
  • Establish clear routines and rules in your home and be clear about expected behaviours outside your home. Plan ahead so you are ready to face public meltdowns or mischief.
  • Be consistent in rewards and consequences. Verbal praise is a powerful positive reinforcer of ‘good’ behaviour as are reward charts, stickers, hugs and other small tokens of appreciation. Make a big deal when you ‘catch’ your son doing something positive but also be prepared to implement consequences when your son is behaving in a non-tolerable way. Most young children take some time to learn about consequences but this is much more challenging for a child with ADHD. Being consistent will continue to be a teaching tool, in combination with rewards of course.

When deciding which strategy works best for each situation, break down the situation by figuring out why the behaviour is happening and then label the behaviour for your son. Tell him what you are observing. Then you need to ask yourself: do I let this go or do I act on this behaviour?

Reasons to ‘let it go’ may include: the behaviour is only a minor issue and the problem should resolve itself; the behaviour is not ‘good’ but is not targeted this week (eg on the reward chart), or you feel you cannot deal with it effectively right now, due to your own feelings.

If you feel you need to act on the behaviour, you could try:

  • Ignoring the behaviour completely (this works better for lower level behaviours such as attention-seeking)
  • Apply a consequence for the behaviour such as, “If you fight over the toy, we put it away until tomorrow” or “If you spill something, you will need to clean it up.”
  • Using a token reward at times when you see the positive behaviour return or rewarding other positive behaviours not related to the problem behaviour
  • Using a calming strategy such as deep breathing, ‘shaking it off’, jumping up and down on the spot or even a quiet activity like colouring
  • Time out if all else fails.

There are many resources available on the internet. I encourage you to read as much as possible about ADHD and through trial and error, you will find the strategies that work best for you and your family.

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Tanya Russell

Tanya Russell is CatholicCare's Assistant Director and a registered psychologist.

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