ADHD Principles For Parent / Teenager Interactions
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Transcript ADHD Principles For Parent / Teenager Interactions
ADHD
Common Behaviors
Elham Shirazi MD
Child & Adolescent
Psychiatrist
Many ADHD :
Act
younger than they are
Are forgetful
Argue or talk back
Hard to wake up
Have a messy room
Don’t learn from discipline
Act without thinking of consequences
If you want to correct every misbehavior
You will be worn out physically &
emotionally !
Pick
your battles carefully
Use reprimands sparingly
Your teenager can learn to
compensate
But it will take time !
Seek Independence & Freedom
1. Encourage independence
Give as much freedom as you feel he can
cope with
Give opportunities to make his decisions
2 . Trust until proven not trustworthy
3 . Be observant of activities & friends
Intervene when isn’t handling independence
well
Take away privileges,but extend them again to
give him a 2nd chance
4. Consider compromise
5. Set up win-win solution
Allowed to go to beach with friends with a
parent supervision
6. Offer an attractive alternative
As interesting , with sufficient freedom
Propose an interesting activity before he has
ideas of his own
Disobey / Conflict with Adults
Don’t
always do as parents & teachers
ask them
but often , their failure is inadvertent !
Variety of reasons :
Forget, don’t listen, don’t hear,
immaturity, impulsivity, can’t focus on one
activity, losing track of time, avoid
unpleasant job
Often oblivious to rewards & punishment
Conflict
1. State rules clearly
2. Post them in writing helps
3. Develop rules jointly
more likely to remember & comply
4. A few stated rules are better
Act Younger
Social development 30% behind peers
LLD
Want privileges of his age
but may not handle them maturely
Impaired communication skills
Trouble following & remembering lengthy
explanations & requests
Trouble finding right words to answer quickly
& organized
1. Adjust expectations
To appropriate age level
Don’t take misbehavior personally
2. Ask his help in solving problems
3. Teach desired behavior
4. Impose consequence if necessary
Act Impulsive
If a thought crosses their mind, they may act on
it
If they think it, they may say it
more likely to say : Ready, Fire!, Aim (& Oosp !!
at the end)
They often say / do things they wish they could
take back
Keeping secrets
terrible time
Live for moment
delay gratification is
difficult
1. Anticipate problems
Buy a small gift to open before christmas
Put car keys away
Put money in saving account
Don’t tell him secrets
2. Avoid tempting to act impulsively
3. Consider medication
Difficulty Paying Attention
View the world through a wide angle lens
Pay attention to every thing at once
Trouble selecting what is most important
Sometimes over focus
Concentrate on single activity for hours
Misleading adults
He deliberately don’t pay attention !
Trying to talk with ADHD can be frustrating
Are you listening to me?
1. Make eye contact / use touch
Stand/sit in front of him
(close proximity)
Place your hands on his shoulder/knee
(touch)
Say his name (sound)
Avoid power struggle
2. Keep comments brief & leave
Can’t remember >2-3 things
Trouble picking important points
3. Avoid preaching
4. Write instructions down
5. Accept his listening style
Sometimes
they hear even appearing
not to listen
Ignore his restlessness & accept his
listening style
Forgetful / Doesn’t Do Chores
1. Make a written list
2. Use post-it notes
3. Help get started / show how to do
4. Ask what help?
Disorganized / Lose Things
1. Put name on possessions
2. Purchase less expensive things
3. Help be organized
Have specific place for belongings
Teach time management constantly
4. Serve as a couch
Give reminders about important
responsibilities
5. List steps for a clean room
Make up bed
Hang up clothes
Pick up thinges of floor
Put them in closet & vaccuum
6. Help cleaning / organization
Work with him on weekly/monthly basis
Make learning pleasant (listen to music,talk
about hobbies,…)
7. Close door to messy room
You don’t have to look at the mess
Lack Of Awareness Of Time
Are
often late
Difficulty guessing how long it will be take
1. Set a wristwatch alarm for key
times
2. Rent or buy a beeper
3. Teach awareness of time
Difficulty Planning Ahead
Prefer
to do things on the spur of moment
1. Teach planning
2. Teach time management
Including
him when planning family
activities
Using a weekly calendar
Estimate
time required for each step
Difficult to Discipline
Don’t
learn from their mistakes
Don’t make connection between
behavior & consequences
Low sensitivity to rewards & punishment
Traditional punishment doesn’t work
parents use harsher discipline
Many
times : Genuinely sorry when doing
something wrong
1. Use positive reinforcement
2. Use logical consequences
3. Reward or punish immediately
4. Create new consequences /
rewards
5. Be consistent
6. Try “Grandma’s Rule“
7. Use behavior charts
8. Use rewards / may include
money
9. Redirect interests
10. Give second & third chances
11. Avoid power struggles
Low Frustration Tolerance
Irritability / Emotionality
Easy
frustrated
Respond more emotionally
Irritable or moody
65% oppositional
Arguing over smallest issues
Never certain what mood to expect
Defensive
& angry at person correcting
him
Respond to stress with angry temper
outbursts
Overreact to crisis
Blame unfair action of others
Direct anger at person they love the most
/ they feel safest
Sensitive to criticism or disapproval
Fear of being embarrassed
1. Use active listening
2. Be supportive
Treat your teenager with respect
3. Teach problem solving skills
4. Teach anger control
He
is learning from family & parents
He will model your behavior
Bragging about things he does well
Verbal Fights / Arguing
Being a parent & not responding
angrily is not easy
1. Ignore minor infraction
2. Walk away from conflict
( I know you are upset, but cursing is not
acceptable around me, I will not stay here &
listen to you talk that way. I will come back later
& we will talk when you have calmed down or
when you can talk without cursing ! )
3. Give space & time to cool
off
Need time alone when had
emotional blown-up
4. Impose a consequence
5. Adjust medication
Don’t Accept Responsibility for
Actions
May blame someone/ something else for their
actions
Trouble admitting they have done something
wrong
Trouble saying they are sorry
1. Deal with problem behavior
2. Don’t try to assess degree of
guilt or excuse
Dishonest
1.If you know the answer, don’t
ask !
2. Don’t create opportunities to lie
3. Eliminate some punishment
4. Develop plan to solve the
problem
5. Impose a consequence
Difficulty With Family Events
1. Keep outings simple
2. Reduce demands
3. Keep outings brief
4. Provide a safety release valve
5. Look for creative solutions
6. Medication may help
Difficulty Participating In Sports
Exercising
is good :
stress
sleep better
restlessness
good for heart
hyperactivity
production of neurotransmitter
50%
poor motor coordination
Poor hand-eye coordination
Gross motor skills may be better
1. Play large muscle sports
swimming , soccer , track , wrestling ,
karate
2. Play an active position that
requires full attention
positions which involve higher activity levels
are more likely to hold attention & focus
3. Consider medication before game
Restless / Easily Bored
Feeling restless
complain of being bored
Wants to do something constantly
Wants to go somewhere constantly
1. Encourage involvement in
community activities
physical activities, organized sports,
religious groups, overnight parties, ski trips,...
2. Plan interesting family outings
schedule
family events that allow your
teenager be active
3. Encourage hobbies & interests
discover
his interests by exposing him to
variety of activities
discuss options & let him pick one out
4. Make special plans for holidays
Difficulty With Family Events
1. Keep outings simple
2. Reduce demands
3. Keep outings brief
4. Provide a safety release valve
5. Look for creative solutions
6. Medication may help