Parenting your ADHD Child / Therapy in Philadelphia: When your child receives a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) or it’s quieter cousin, Attention Deficit Disorder (ADD) you, as a parent, can take it hard. Or, you might have occasion to say to yourself, “I knew something wasn’t right with this kid all along…thank goodness now we know what it is!”

Either way, if you’re like most parents, this diagnosis came about because someone outside the home, most likely school personnel, pointed you in the direction of getting your child tested for it. Many parents know some other family where there is a child who has been diagnosed with ADHD or ADD. A fair number of parents bring their child for treatment for this disorder with the preconceived idea that there is no way she/he is going to take medicine and “become a zombie.” Some parents think the whole diagnosis is modern-day hype for a child (statistically male, though girls are catching up) about whom their own parents would have smiled and said, “he’s just an active boy, is all!” Whatever your inclination, some changes are needed in the way you form your expectations of your newly diagnosed child. Here are some guidelines to help you handle your interactions with your child, your mate, even your extended family, when there is ADHD in the mix:

When parenting your ADHD child, Lower your expectations, but don’t let-on to the child: Perhaps the kindest thing you can do to help your child and your entire family is to acknowledge that you have a child for whom concentration, organization, and social skills come harder than the vast majority of children. You will need to expect that this child may not be able to master tasks, or people, like your other child(ren,) you, or your partner. Expect less—less automatic understanding of even simple instructions, less remembered, fewer friends. Everything may take more—-more time to complete tasks due to concentration problems, more help organizing all aspects of life, more patience dealing with this child than you thought yourself ever capable of.

A child actually struggles living with this disorder; which is neurologically based and will not disappear as the child ages. The child doesn’t intentionally disobey your teachings or forget to do something you reminded her of five minutes ago. This child isn’t being willful when you ask him to sit “nicely” and he can’t stay seated or keeps “accidentally” hitting his sister. (A caveat: Sometimes the ADD/ADHD child becomes so frustrated with the way he feels his caregivers/teachers are reacting to him that he may become willful in response to feeling that the adults in his life are treating him unfairly. This child struggles not only with daily living tasks, but also with self-image. The vast majority of children with this diagnosis develop low self-esteem in resignation to what they feel is fact that they, “can’t seem to do anything right!” A frustrated parent who expects this child to comply to directives in a timely fashion, and conduct herself appropriately with other children in large public places, is only going to display anger towards the child that will serve to confirm the child’s poor self-image.

However, nowhere in this advice am I suggesting that you let your child slide in terms of discipline (see below) or that you suggest to the child that he isn’t expected to be as successful and content in life as possible based on your values and those he later develops as his own.

* When parenting your ADHD child, Use humor generously in your dealings with the child: Nothing will save the day better than dealing with your ADHD child with a healthy dose of humor; especially to help overcome the child’s resistance to “listening” to you. Kids are more compliant with a parent who comes across less intense and controlling.

When you’ve just found out that your kid “forgot,” for the 4th straight night in a row, to brush her teeth before bed, you face a choice: You can (a) yell at your daughter, expressing your frustration at her forgetfulness and the simplicity of the task; or, (b) You can say something light and playful about tooth brushing, give her a moment’s tickling around her waist area, slip the Sonicare into one of her hands, and twirl her around with a flourish toward the bathroom. If you were that child, which approach would be more likely to make you brush at that moment?

* When parenting your ADHD child, Taking medication isn’t a bad choice: If you’re over 20 you may know that the standard medication given for ADHD for decades was Ritalin. No more: Today, psychiatrists, and family doctors (“PCP”s,) can choose from a handful of medications targeted to quiet ADHD symptoms with minimal side effects. In children (or adults, by the way,) for whom there is no change in symptom level or there are bad side effects, experienced psychiatrists can prescribe a “cocktail.” This is a mix of drugs where, individually, each medicine may not have been developed to target ADHD, but taken together, their interaction helps reduce hypo kinesis, increase ability to focus and reduce the interference experienced as constantly being distracted by everything.

Parents express realistic concerns about the unknown effects on health of long-term use of any medicine. And, now that we realize that ADHD doesn’t go away as one ages, (but can be overcome through coping strategies,) medicines are likely to be taken longer for maintenance of gains, not just to stem acute symptoms. However, as witness to the vast improvement in the overall lives of children who have been started on a medication for this disorder, I am convinced that the gains outweigh potential ill effects later in life. When parents balk at any discussion of medicine, I ask them if they would deny their child insulin were he/she a diabetic. If not, (no one answers yes) then why would this parent deny their child the opportunity to experience a better quality of life, overall? Often, when the child’s hyperactivity is curbed, he is more attentive and no longer creates a whirlwind of distraction in the classroom, teachers and parents are pleased, the child gets less negative attention and criticism, and, therefore, it’s a win-win situation for everyone. Think long and hard about at least trying your child on medication for six months to a year if a professional suggests it. Realize that, as with all medications given to address brain function/mood, the prescribing doctor will probably have to tweak the dose, or kind(s) of medication given for a few months until the “just right” combination of drug(s) and dose is achieved. In the interim there may be side effects that concern like sleepiness, sleeplessness or weight gain/loss: These can be addressed at each succeeding medication check with the doctor.

* When parenting your ADHD child, Discipline means structure, not punishment: Children who have an ADHD or ADD diagnosis will need increased levels of structure in all aspects of their lives. They will need consequences for misbehavior that are clear and related to the offense. They will need to be held to a similar standard as their siblings; even if more parental effort needs to go into things like reminders of what’s needing to be done or more hands-on help organizing a day, a room, a backpack. Parenting largely through criticism (which will be dealt with in a forthcoming article) will only expose your own frustrations in raising a child with this problem: Nothing helpful will come from years of the child feeling “put down” because she/he can’t seem to be as independent and dependable as other children.

School and professional counselors can assist you in using behavior management techniques to motivate your child to comply and reinforce compliance so that it’s more likely to recur. Families where there is an ADHD child generally need to be more on the structured side of daily living: The kind of “loosey-goosey” variants in scheduling things like homework, meal and bedtime seen in many harried American families only makes it harder for this type of child to exist. Parents must truly become disciplined in terms of creating a favorable home environment, maintaining lowered expectations of the child’s performance without intervention, and keeping after the school staff to do their part to help the child learn the coping methods needed to succeed in all walks of life.

by Marion Levy-Bergman MSW, LCSW