Helping a Child with ADHD

Helping a Child with ADHD

No matter what type of ADHD a child has, he or she may often have problems paying attention to instructions, finishing tasks, relating to others, or staying calm. It is important to help your child get past the difficulties of ADHD. You can help by providing a stable environment and clear expectations for your child.

ENVIRONMENT

Clarity, structure and predictability help those with ADHD live normally. This section will give you some suggestions to make your child’s environment as stable as possible.

oDefine rules, consequences, and rewards: All too often, it seems like the child with ADHD is getting into trouble. Despite your efforts to outline the rules, they continue to break them and seem surprised when punished. To avoid these problems, make sure you have discussed the rules with your child. Then, write down the rules and make sure he or she understands them. For instance, you may write down “be clean”, but your may not understand “be clean”. Define “clean” for them: “Your room must be cleaned every week, the toys must be put away before bed, you must take a bath every other night.” These rules have a very distinct meaning that can not be interpreted differently. Write down the rules, consequences for breaking them and the rewards for following them. For younger children, use pictures and symbols. Post them in a visible place, where everyone can see them. Allow your child to assist in creating the rules, so they feel some “ownership” in them.

oHelp the child understand the steps of a task: A child with ADHD often has trouble finishing a task. He or she might take out the kitchen trash, but forget to empty the trash from the bathroom. For common chores, it is helpful to have a list posted near the task. Again, use pictures and symbols for younger children.

1. / Empty the bathroom trash into the kitchen trash.
2. / Put the kitchen trash in the garbage can.
3. / Take the garbage can out to the street.
4. / Put new bag into the trash can.
5. / Take the bathroom trash can back to the bathroom.

These lists can be used for a variety of tasks such as cleaning a room, feeding the pets, or washing the dishes. The lists are also helpful for daily routines such as getting ready for school or bed.

oHave a place for everything: Think of something that you would like to have organized – like your child’s toys or the things you need for the morning rush to school- then create a place for it. For example, have everything your child will need to get out the door in the morning in one spot. Have a place for your child’s jacket, lunch money or lunch box, and backpack right near the door. As soon as your child comes home, have him or her put the items in their place. Make sure the backpack is ready the night before with all homework and books in it. This can help to eliminate the stress of the morning run around looking for items scattered throughout the house.

oUse lots of times and alarm clocks: ADHD children often do not pay attention to time. The concept of “we are leaving in 10 minutes” has no meaning to them. They may also have trouble remembering to feed the dog at 6:00. On top of that, they hate being nagged about the time or what they need to do. Timers and alarm clocks can help fix these problems. If your child has fifteen minutes to eat their breakfast, set a kitchen timer so he/she can watch the time approach zero. If your child has to feed a pet every night or do their reading at a certain time, an alarm clock can be a simple and effective reminder to do chores or homework.

oHave a consistent schedule and warn about changes: A daily schedule can be very reassuring to a child with ADHD. If there is a regular sequence of events, it’s much easier for him/her to remember what to do and when to do it. This applies to day-to-day activities like getting ready for school, weekly events like scouts or sports, and less regular events like going to Grandma’s house for Thanksgiving. If may even be helpful to write out this schedule so everyone can see it. However, an ADHD child may be firmly entrenched in this schedule and it is important to warn them of changes well in advance. This may mean reminding him/her a few days in advance and a few times the day of the event.

oRemove unpredictable noise and traffic: When a child finally seems to settle down enough to start working on something, it may seem he/she is quickly distracted by an airplane flying overhead, a dog barking, or a conversation in another room. Obviously, if you want your child to work well, it’s not a good idea to have them sitting in front of a window or in the busiest part of the house. Help your child to find a place that they work well in, but make sure he/she is involved in the process. They may have preferences that you never thought of. However, don’t isolate your child in an attempt to place him/her in a less distracting place. Your child is more likely to stay on task if you’re nearby to check on his/her progress.

BEHAVIOR

Your child may already have set behavioral patterns like can sometimes cause problems for them (and you). The following techniques change one behavior at a time by rewarding good behavior while ignoring bad behavior. Providing the tools to change bad behavior is essential to the child with ADHD. You can use these principles yourself, but a health care worker with background in behavioral change can be helpful in this process.

oHow to change behavior: There are three steps to behavior modification:

1. Define the problem in a positive way – The real trick here is not the mention the problem, but talk about the desired behavior. Work towards a desirable behavior rather than remove an undesirable behavior. Be very specific. For example, don’t try to stop your child from fidgeting, instead try to have him/her sit the whole way through dinner. Don’t try to correct disorderliness, but instead focus on putting school supplies in the right place.
2. Set a reasonable goal – When you’ve defined the problem in a positive way, you’ve defined the goal. However, it may be overwhelming to the child. Break the goal into smaller mini goals. If you’re working on sitting all the way through dinner, start with sitting through 5 minutes, then 6, then 7, then 8. If you’re working on putting school supplies in the right place, first work on putting the jacket and lunch box in the proper place. Then, add getting the backpack ready before bed, then add a place for homework to be stored, then add keeping their desk neat.
3. Work toward the goal – ADHD children respond best to immediate rewards and consequences. Praise the child often, even if he/she does not complete the goal, but makes some level of progress. Remind them, “I really like the way you’re sitting there quietly and doing your homework.” Use specific comments and avoid generalizations like “you’re such a good kid,” which will confuse the child if they are reprimanded later.

oEncouragement: Stars are a great way to encourage a child. Another idea is a reward ladder that the child can“work their way up”. Every time a child does well, reward him/her with a star or a level on the ladder. A certain number of stars can be traded for specific activities (such as going to the park, a movie, reading with Mom or Dad, or playing a favorite game). Levels on the ladder can represent specific privileges that they have “earned”. Try offering more stars or levels for harder tasks: ex: one star for a clean room, two stars for a clean room without being asked.

Level 10: Have a friend spend the night.
Level 9: Do a special activity with Mom or Dad.
Level 8: Play video games.
Level 7: Invite a friend over to play.
Level 6: Watch TV after dinner.
Level 5: Play outside after homework. /
Level 4: Play with action figure or dolls.
Level 3: Play a game.
Level 2: Read in bed for ½ hour before bedtime.
Level 1: Draw or read quietly after homework.
John’s Reward Ladder

Write out a list of tasks and how many stars or levels it will be worth. Include removing stars or moving down levels for bad behavior. The child must earn more stars than he/she loses or they will be frustrated by the system.

oDiscipline: Children with ADHD must receive consequences immediately or they will forget what happened. One type of consequence is a “time-out”. During a time-out, put the child in a quiet place with minimal stimulation, but do not isolate them. A chair in a corner or a time out room is a good option. Offer “three strikes” – the first time a rule is broken, hold up one finger and say “that’s one!” The second time, hold up two fingers and say “that’s two!” The third time, hold up three fingers and say “that’s three! Time-out!” The three strikes are not necessarily for behavior like hitting people or throwing things. These should automatically result in a time-out.

A time-out’s length should equal your child’s age in minutes. A six year old will have a 6 minute time out. Set a timer and leave it so the child can watch the time go by. Stay near the area to make sure he/she does not try to leave, but do not interact with him or her. Don’t answer questions or offer comments. Add one minute each time he/she tries to leave.

A time-out gives the child a sense of action and consequence, removes him/her from the situation, and can be implemented anywhere. Make sure you’ve discussed what a time-out is and what behaviors will result in the time out with your child. If it happens outside the house, the time-out area can be in a car, but do not leave your child unsupervised.

As you can see, providing some structure and clear concise rules can make life with your ADHD child much more enjoyable. It can provide them with the tools that they need to make their day to day routines easier and make them happier children in the end!