Introduction
This section deals specifically with ADHD related issues rather than ODD (Oppositional Defiant Disorder) or CD (Conduct Disorder) which although the advice is helpful for these other co-existing conditions does not necessarily cover all the aspects of those issues.
ADHD specifically is not a bad behaviour condition however is listed and psychiatric diagnosis systems as an Emotional and Behavioural Disorder. ADHD is an Neurological condition and although diagnosis is heavily psychiatric based the condition should be seen as a Neurodevelopmental Condition akin to ASD (Autistic Spectrum Disorder). As previously mentioned on this website under "What is ADHD?" emotion control is a significant issues for ADHD. It is best understood that ADHD'ers are very emotional people and struggle to appropriately control their natural responses to that emotion. Some turn off their entire response to emotion due to their continued difficulties with the controls, especially as they get older and can often be seen to be emotionless to others because they have stopped showing emotions to the outside world. This is as much an inappropriate emotional control as the majority of individuals who continue to fail to control negative emotions
being displayed and the continued lack of ability to control how that negative outburst is displayed.
Negative emotions cross the brain much quicker than positive emotions and the delay in the prefrontal cortex reduces the ability, especially in children, to catch those emotions and control them and their response to them. Often this continues into adulthood because they have failed to learn those controls and what is appropriate in how they are expressed etc. We hope this section of the website will prove helpful in providing methods of how to help children with ADHD learn those controls. As always with ADHD I believe that much of the advice can also be tailored to Adults and significantly help them to cover many aspects which they may have failed to learn as a child.
Key School and Home Advice by Dr Russell Barkley
The following advice is based on the work of Dr Russell Barkley of School Accommodations, who is one of the leading experts on ADHD and provides advice and recommendations to MIND, and is advice that all schools can and should implement for all ADHD'ers. He points out that this advice is like a wheel chair ramp for the physically disabled. Many teachers have asked him how quickly the children will assimilate the information and implement it themselves. The answer he always gives is that you would never ask that question of a wheel chair ramp and like that wheel chair ramp it needs to be in place for the entire time they are in the school.
Please make sure you give a copy of the School Accommodations to your child's teacher/school to ensure they have a copy of this key information. Of course please feel free to also recommend us and our website to them as well.
Framework
Build a framework around the individual to assist with
Executive Functions, remembering
that they need to be sustained
indefinitely. These are to
address the key motivational
deficits in ADHD.
- Prosthetic Cues
Use artificial
prosthetic cues to substitute
for working memory deficits
(e.g. signs, lists, cards,
charts and posters etc)
- Prosthetic
Consequences
Provide artificial consequences
in the large time gaps between
actual
consequences/accountability
(e.g. tokens, points etc)
As previously stated, this is best to be seen as the
disability ramp entering the
building to enable wheelchair
access. You do not question
whether it is needed to be removed
after 30 days, likewise motivational
structures are required long term.
They do not teach the child, they
enable the child to generate the
motivation that allows them to
learn.
Behavioural Instructions
Many instructions given to
children are behavioural related.
We recommend for all instructions
that they are provided in the
positive rather than the negative.
This has been shown on many
occasions to be vastly beneficial.
For example a child keeps running
onto the grass when they are not
supposed to. It is better to
say "Stay off the grass" rather than
"Don't go on the grass".
Short Term Punishments
Punishments need to cover
the short term and be specific, to
the point, clear as to the reason
enacted and not be ongoing
indefinitely or over a long period.
For example avoid banning an
activity for a week, but rather ban
on an hourly or half daily basis
which is then re-given when it
expires when the behaviour has not
been corrected. This allows
the individual to realise they have
control over how long the punishment
lasts. If they stop incorrect
behaviour then the punishment also
stops. Of course the behaviour
needs to remain ended for a set
period of time to prove that it has
indeed deemed as having ceased.
You don't want the opposite problem
of a declaration that they have
stopped to allow the activity they
want to do to restart knowing full
well they haven't any real intention
of ceasing the behaviour but just
starting the desired activity.
No one ever said this was easy but
is very much tailored to your child.
Quantify and keep to
Behavioural Rules
It is important for rules
to those with ADHD remain static and
not alter in any way. Likewise
the associated discipline promised
at different stages must be enacted.
We recommend creating multiple
stages for a gradual increase in the
punishment so that as each stage is
reached the punishment grows whilst
also providing a clear basis upon
which the individual can stop and
the punishment will also stop.
If the child does not feel that they
can change their future they will
not alter their behaviour in the
present.
50% of Discipline is
Praise
Unfortunately when
confronted with repeated behavioural
issues it is easy for us parents to
forget that 50% of discipline is
praise and commending of good
behaviour and actions. Many
people would argue that it is closer
to 80% and they may well be right.
We find that much of the behavioural
issues is based on low self esteem
and self confidence and the
individual can place themselves on a
path of self destruction aiming
directly at obtaining punishment to
fulfill their desire of self
punishment due to that low self
opinion. As parents we need to
be mindful that we are building up
our child into good behaviour not
knocking them down to that point.
Good behaviour is the higher state,
but punishing and knocking the child
down into submission can result in
the child believing that good
behaviour is a lower state of
achievement or add to their already
obtained low self esteem. If
you begin feeling like parenthood
reminds you too much of psychology
then you're in good company.
Further Advice
The following advice is based on our own experience and tried and tested methods of parents in our support group they have found helpful. Much of it is closely linked with the before mentioned advice and is specific to parents and home environments.
Valid Emotions
Remember often the emotional response is from a valid emotion and that their response is the action which is inappropriate in type or extent. It is therefore important to tackle the cause of the negative emotions to reduce the emotional response or help prevent the recurrence of the emotion at a later date. Also providing examples and coaching the child in appropriate ways of expressing their emotions will always pay in dividends.
Expectations Based on Age
As mentioned under our What is ADHD?" section the ADHD brain develops at a different rate to the average person in society. This is not necessarily a negative thing and has been shown to have many positive aspects; however we believe that many problems often occur for the ADHD'er due to being forced to fit in the educational mold. Expectations of parents are also based on the wider society and we believe many of the problems faced by parents is due to this expectation and that parenting needs to be based on the child's own developmental needs.
The ADHD child's development of rule sets and adhering to rule sets spoken and unspoken from teachers, parents and society is behind on average by 3 years. The intelligence and ability of the child is however equal to or often greater than their peers and this can often cause a contradiction with their rule set and control system delay. This often causes parents frustration and in turn aggravates the situation. We recommend that parents reduce their expectations of their children adhering to rule sets and self controls to that expected of children on average 3 years younger. This should not be purely in expectation but also reflected in preparation and execution of events and activities. As above this includes controlling the child's expectation, reinforcing/reminding of rules and expectations of them whilst the activity takes place and also the parents own overview and management of the activity.
Token System Advice
Token systems can be fantastic but the problem often is how they are implemented and run as to why they can often be ineffective.
We would recommend considering the following advice:
It is important that parents explain to children that things like bed, food & water etc are basic rights; however that the nice things in life are not basic rights but are actually rewards. These are things such as playing computer games, spending time with parents in activities, go out with friends and much more are those daily rewards which make life enjoyable. Today many children view a lot of what they do as "their right" and so the only option available to parents is punishment (withdrawal of access).
With ADHD the token/sticker system is described as needing to change regularly however in most situations this change refers to the rewards and punishment aspects of the system rather than the methodology. Often the method can remain for a much longer period if the reward and punishment system is dynamic and regularly updated. Likewise the child's inclusion in the creation of the rewards and punishment is ideal as they then own the rewards and punishment system. The change can therefore be natural in which the child elects new additions to both the rewards and punishments. Ineffective rewards and punishments need to be removed and new ones added. A catalogue of such rewards from which the child can exchange tokens/stickers for a reward is beneficial. Below is just an example of what you could consider setting up:
Example:
You could setup a token system in which the child earns tokens at school for good behaviour and hard work. This can be awarded by the teachers or parents can award themselves based on teacher feedback. They could receive tokens for each hour of good behaviour achieved and many other aspects. The child could earn 10-20 tokens during the day and a further 10-20 tokens at home in the evening. Of course punishment can be not receiving a token for the given hour in which the poor emotional response or bad behaviour occurred. However it can also include more severe and short term punishments which cease when the behaviour is corrected. This for example could be a delay in token exchange by 15 minutes, or be more severe depending on the behaviour and what the child themselves responds too.
The catalogue of rewards can be created with each reward having a different value of tokens for which it is exchanged. Many of the rewards need to be received in the "here and now" and experienced immediately or within reasonable period of the token exchange. The catalogue can be built up of lots of small short term rewards and some larger long term rewards. For example lots of 10 tokens/sticker rewards such as 15, 30 or 60 minutes on the games console, packets of sweets (which don't contain any known problem chemicals). You can then have a couple of 100 , 250 and 500 token options, such as trips to ice skating, ten pin bowling, adventure play grounds or other events. Don't expect the child to save tokens for a later event however the opportunity to be able to do so can be important as they grow up and learn the need for planning for the future and seeing greater
rewards if they save up. We would recommend the majority of changes being to the smaller rewards, and only change the long term larger rewards if they show no interest in the idea of those activities. Of course a parent can announce a special bonus token which earns a large reward even if the child does not save up which can only go to boost the child's self esteem and prevent them getting despondent and belief that larger rewards are outside of their reach.
Summary
The advice on this page is actually mostly common sense but society today can make parents feel that implementing these things as somehow making their child look deficient however we strongly believe the issue is with the expectation of the wider society and parents should have the confidence to implement what they know is needed for their child and not to worry how society may view their parenting skills.
