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Wednesday, February 4, 2009

Practical Guidelines for Raising a Child with Adhd

1. Give Your Child Instant Reaction and Consequences More Often

When your child is faced with a job they find boring, tedious or unrewarding, you can guarantee they will find something else to do. If you want them to stay on task, then you will have to find a way to make it more interesting, or rewarding. Positive feedback, coupled with a reward system such as tokens, extra privileges or earning points etc, and mild negative consequences for straying off task are all ways to help keep your child stay focused. Also, if you are trying to change negative behaviours, you must give quick rewards and prompt feedback for good behaviour. Instead of looking for bad behaviour, start seeking out times when your child is behaving well, and give immediate praise.

2. Give Your Child Frequent Response

As mentioned in number 1, immediate feedback can be very helpful, even when given occasionally, but when you give it often, the results are much more beneficial. This doesn’t mean you should run around after your child, finding things to praise him for, no one has time for that. What you can do is instead of waiting until your child has finished his homework or cleaning his room, is to give him some praise and encouragement for what he has accomplished now. Because as you well know, sometimes the completion of a chore can take longer, and is most times accompanied by at least one argument. The more often you encourage your child with positive feedback, the more often he will stay on task.

3. Use Bigger and More Potent Consequences

Being the parent of an Adhd/Odd child, I have had to raise the bar with regard to punishments and consequences. What works for most kids, won’t work for children with this disability. I know there is a school of thought that says we shouldn’t ‘materially’ reward our kids too often because this could replace their feelings of accomplishment and desire to please. But these basic rewards aren’t enough to motivate or stop an Adhd child from inappropriate behaviours. Therefore it is important that more physical attention, like hugs, special snacks or treats, or even small toys and special privileges be considered to induce your child to do chores, homework, follow rules or behave well. (We used to call it bribery, but I find it works well.)

4. Use Incentives More, Punishment, Less

When children misbehave or do something wrong, it is common for their parents to serve up a punishment. However, when you have a child with Adhd who is much more likely to misbehave or act out, this could translate into an abnormal amount of negative reinforcement because they are consistently being punished. This can lead to a build up of resentments on both sides, and cause your child to become more hostile, or avoid you altogether.

Professionals stress “Positives before negatives.” How you do that is simple. When you want to change a negative behaviour with a positive one, such as playing well with siblings, simply watch for times when that behaviour happens naturally, and praise your child. The more often you do this, you will notice, the more often it occurs. However, before you begin to reprimand the opposite behaviour, make sure you have been consistently rewarding the good behaviour for at least a week or longer. A good ratio to keep in mind is 1 to 3. One punishment for every three accounts of praise or rewards. You have to pick your battles. By this, I mean you can’t punish your child for everything when you are trying to change a particular behaviour. You have to be consistent with praise and rewards, and place less emphasis on the punishments. Reward systems are a viable tool to help with this.

5. Segment Chores and Countdown for Transitions

You might have noticed that your child has difficulty completing complex chores like cleaning his room and has trouble shifting from an enjoyable activity to one that is tedious or just plain not fun. Because an Adhd child is focused in the ‘now’, they have a poor concept of ‘later’. By this, I mean they don’t have the same sense of time as other kids. They cannot comprehend the demands that involve timelines, or future results. An hour to them is the same as 5 minutes to us. If you want your child to complete a task in a certain amount of time, the best way to achieve that is have a clock or egg timer set for the desired time limit, and put it where they can see it. The downside to this is you have to keep bring it to their attention for it to work. Some parents use a recording that counts down the time in 5, 10 and 15-minute increments. I use that method vocally.

In order to get your child to finish a complex chore, like cleaning their rooms, the best way to accomplish this is to segment the chore. In other words, break it up into smaller pieces. Instead of having them ‘clean their rooms’, start with having them put their books in the bookcase, or put away all of their Lego. When that is completed, have them put their clothes away, etc. This will help them to keep their focus. The same method can be used to get the child to work on school assignments that require considerable research over a long period of time.

When it becomes necessary to shift their focus from an activity they enjoy to something like eating supper, or getting ready for bed, a good way to do this with a minimum of fuss is to give a verbal reminder, so they are prepared for the transition. Let them know that supper will be ready in a half hour, then again in 15 minutes, and so on. Then when you instruct them to wash up, they are prepared to stop what they are doing and switch gears. This method can be used for everything from getting ready for school, to bath time or being on time for doctor’s appointments.

6. Make Sure They Know the Rules

Adhd children have troubles with their memory. Specifically, the area of the memory, or the ability, to keep an objective forefront in their thoughts, such as retaining data needed to complete a task correctly. Something I have found particularly helpful is to write down important information, as you would important phone numbers in case of an emergency. The same principal applies here.

If your child has trouble with homework, write out a checklist of the steps from start to finish and place it on the table. This way when they start to go off-task, you can remind them to check the card to see what step they are currently working on. Or if your child has a problem playing nicely with others, or his behaviour goes over the top when someone comes over, write down the behaviours or rules that you want them to remember, and have them review the list before playing with friends, or visitors arrive.

An excellent way to reinforce this list of rules is to offer an incentive upon successful completion or remembering and following the guidelines. Whenever possible, have your child use a hands-on, physical approach to remember things. Most Adhd kids respond better when they can see and or touch something rather than just remembering.

7. Be Consistent

One of the most important things you can do to help your child is to be consistent. One of the simplest and hardest tasks a parent of an Adhd child faces is consistency. Do your best to use the same methods to handle your child’s behaviour every time. Regardless of where you are, be it in a store, or visiting, or at your child’s school, use the same tactics as you would at home. And don’t give up, Rome wasn’t built in a day!

A lot of parents think that explaining to their child why they shouldn’t continue with a certain behaviour is better than creating a ‘scene’ when in a public place. I recently had to visit a clinic, and while I was waiting my turn, I watched a 4-year-old run out the door and down the walkway. He was immediately followed by his older brother, who brought him back. As soon as the brother sat down, the little boy dashed out the door again, this time pursued by his mother. This behaviour continued for over half an hour. The mother was obviously frustrated, the father sat and did nothing, and the little boy’s behaviour irritated everyone in the waiting room.

Explaining to this child why he shouldn’t rush out the door was completely lost on him. And this is what I am trying to explain here. Your child isn’t stupid. He or she is intelligent, and generally very articulate. But simply reasoning with him will not stop the behaviour. Action speaks louder than words, especially with Adhd kids.

8. Use Foresight

Whenever you are making plans for an outing, family get-together, shopping, or dinner out, remember to go over the rules of conduct and consequences with your child. Have them repeat them back to you so you know he has heard and understands. This lessens the chances of acting out, or bad behaviour. Use frequent praise for the child’s good behaviour while you are out. This bolsters their self-esteem and reinforces the good behaviours.

9. Don’t Take It Personally

Remember, you are dealing with a behaviourally disabled child. Don’t take his bad behaviour personally. He acts out because he can’t help it, not because you are a bad parent. Try to keep your cool, and your sense of humour when dealing with problems. This can go a long way to relieving the stress and frustration of the situation. And above all, don’t hold it against him. By this I mean, don’t hold a grudge. Tomorrow is another day.

My son could have a particularly trying day, filled with arguments, confrontations, screaming matches, slamming doors and lost privileges. But when he goes to bed at night, all of that is in the past. He wakes up the next morning bright, happy, and loving. Everything that happened the day before is forgotten and forgiven. He starts each day with a clean slate, and so should you.

This doesn’t mean any consequences incurred the day before should be forgotten, but it does mean that the anger, frustration, disappointment or hurt the behaviour carried with it, should. It isn’t easy, but practice makes perfect.