Behavioral Strategies

Excerpted from
AD/HD - Helping Your Child: A Comprehensive Program to Treat Attention Deficit/ Hyperactivity Disorders at Home and in School
By Warren Umansky, Ph.D., Barbara Steinberg Smalley

Send Your Child the Right Message

When disciplining your child with AD/ HD, it's important to remember that the message you send should be that you love him but don't like his behavior. Granted, many of us feel compelled to explain to our children all of the intricacies of why we do things a certain way. But this strategy appears to do little good and, in fact, may even harm children with AD/HD. Very often, they will try to take advantage of your willingness to discuss disciplinary measures in an effort to manipulate the situation. It's their way of delaying meeting their responsibilities. It's also a way for them to control the situation.

You should recognize, however, that this type of behavior often results from a child's perceived inability to perform a task easily. That is, she recognizes that she has great difficulty sustaining her attention-say, on homework-for a long period of time, and it becomes very difficult and unpleasant for her. Likewise, she may recognize that she doesn't have the persistence to get her room cleaned up and is destined for failure if she is asked to do so. Consequently, her tendency is to battle against this kind of structure.

Nevertheless, your providing consistency, realistic and reasonable expectations, and support and reassurance, should soon result in greater success for her.

Try the Restriction Approach

Think of this strategy as a variation of the contingency approach. With restriction, a valued activity or privilege is taken away, usually for misbehavior or as a result of the child's not doing what is expected. So, fighting with a sibling might mean TV restriction, talking back might mean outdoor restriction, and misbehaving at the dinner table might mean restriction from having a friend over on the weekend. But beware of one common mistake parents make when using restrictions: Avoid putting your child on restriction for more than one day at a time.

For example, Ben's parents recently put him on telephone and computer restriction for one week for not telling the truth. The very next day, he told another lie-which presented a dilemma for his parents. Should they add another week of restriction, or should they take away something else? If they add time, it becomes an even less meaningful consequence. If they take away something else, Ben soon may have nothing left to take.

Let's suppose that the next day, Ben told no lies. Nor did he on the following day. When he asks if he can use the phone or computer, he is told that he has five days left on restriction. So, where's the incentive? The idea is to keep as much leverage available to you as you possibly can. When you take toys away for three weeks because your child is destructive with them, you have given up the toys as leverage for that period of time to help teach improved behavior. In fact, you're practically guaranteed quicker and more efficient results when you say, "You can have your toys back when you're ready to play nicely with them," or, "Your toys will be put away for the rest of the day, and we'll take them out in the morning and see if you can play with them nicely." That's because this approach not only communicates clear expectations and consequences, but also gives your child an opportunity to do better.

Are contingencies and restrictions useful approaches for teaching responsibility? You bet! But not every task or kind of behavior should require applying these approaches. The hope is that, as time passes, your child with AD/ HD will try harder to do the right thing independently-or, at the very least, will respond to subtle verbal prompts or reminders.

Turn to Time-out

Sometimes a child's behavior becomes so disruptive-or you begin to feel so frustrated or angry-that the best approach is to remove him from the situation. The object of time-out is to deprive the child of attention or positive reinforcement. Sitting your child in the comer, however, rarely works, since he need only make noise, rock back and forth, or stand up to get your attention. Moreover, this strategy is likely to encourage the continuation of his unacceptable behavior. Thus, the best location for time-out at home is in your child's room. As with the contingency approach, several principles should be followed.

For starters, before sending your child to his room, follow this three-step approach. First, tell him clearly the kind of behavior you expect him to display or to cease displaying. Some examples:

"Brian, sit on the sofa quietly."

"Erin, stop fighting with Cynthia."

"Mark, go sit down at the table now and get started with your homework."

If he doesn't comply, state the action you want (or don't want) again and indicate the consequences. Examples:

"Tonya, leave the knobs on the stereo alone or you will go sit in your room."

"Eric, set the table now or you won't be able to watch America's Funniest Home Videos later tonight."

"Sally, clean up the mess you made on the kitchen table or you can't go outside and play with your friends."

Of course, while it's nice to phrase all statements in positive terms, a "stop-doing" statement is typically the first thing that comes to mind when a child is obviously not listening. And that's fine, since these approaches should help reduce the number of negative statements you make.

Finally, if your child persists, send him to his room with these instructions: "Stay in your room until you are ready to " Essentially, this approach makes the child responsible for deciding when he is ready to comply, and at that point he can come out of his room.

When using time-out, avoid telling your child to go to his room and think about what he did. Instead, focus on the behavior that you'd like to see rather than what you saw. That way, when the child is in his room, instead of moping about what he's already done, he too can focus on the kind of behavior it will take for him to be able to leave the room. He can also then monitor whether he is ready to exhibit the kind of behavior you've requested or not.

What to do if your child comes out of his room and continues to display the same disruptive behavior? Send him back to his room again with the reminder that he can come out again when he is ready to behave the way you requested. This should be the last chance you give him to change his behavior voluntarily. Should he be sent back to his room again, you then decide when he is ready to come out. Your child loses the privilege of deciding when he is ready to come out of his room.

Again, make it clear to your child that you love him but that his behavior needs to change. Your message must be that you want to be with him but that first he must behave well-and he will have to stay in his room until he is ready to make that decision.