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ADHD 101 - Why Kids With ADHD Need Different Parenting Strategies



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hi i'm aaron qi and felder gonzalez i'm

a psychologist with the pro clinic at

Seattle Children's Hospital outpatient

psychiatry and I'm going to talk about

why children with ADHD need different

parenting strategies than other kids you

may be saying I'm doing all the same

things that other parents are doing I

use the same types of ways of rewarding

my child and using consequences and my

child's just not responding the same way

and you're right they aren't going to

respond the same way because their brain

is processing information differently

than other children so you're in the

five to ten percent of kids who really

need a different strategy in order to be

able to take that information and use it

to change their behavior so you may

already be providing great parenting for

your child but when you have a child

with ADHD it's a lot harder and really

super parenting is what's required you

really need strategies that are kind of

above and beyond what other parents are

having to provide so there are three

core difficulties related to ADHD that

help us think about how to change our

parenting style for a particular tryout

the first difficulty is trouble with

self-regulation and self-regulation

refers to internally keeping track of

what you're doing keeping track of

yourself planning ahead shifting from

one task to the next and and having that

motivation come from within rather than

from what's going on around you this is

how we get ourselves through a routine

or a task during the day kids with ADHD

are gonna have about a 30% lag in their

ability to self-regulate it's gonna look

like a lack of maturity to a large

degree so they may get off-track get

distracted really easily when they're

trying to do a routine even though they

know how to redo the routine the second

core difficulty that we think about is

the inconsistency in behavior so just as

I was saying a child with ADHD may be

extremely bright and in fact we see lots

of kids at a extremely high level of IQ

who have ADHD so they know what to do

they know how to do the task but they're

not consistent in doing it so one day

your child may be able to get themselves

dressed and downstairs and ready with a

backpack ready to go and the next day

all bets are off they need help every

step of the way and it seems like they

can hardly remember what the different

pieces are of their routine this is one

of the most frustrating things about

parenting a child with ADHD it often

looks like they're just not trying or

they're on purpose just not doing their

routine but really the cause of this

inconsistency is that kids with ADHD are

so vulnerable to input from their

environment because they're not

internally self-regulating as well

they're relying on cues around them for

their regulation and that means anything

that's different in the environment from

date from one day to the next is going

to cause them to react in a totally

different way or some internal factors

maybe off from one day to the next you

know how much sleep they got builds up

frustration about something there could

be lots of factors that just lead them

to have an even harder time

self-regulating so they may know what to

do but it's executing and doing that

task that's one of the the key

difficulties with ADHD the third piece

is that kids with ADHD respond to

consequences and rewards differently

than other kids you may have felt like

you were noticing that for a long time

with your child and you're absolutely

right so often the first time you try a

new incentive or a new consequence it

has a pretty big impact so if you're

gonna offer a reward for your child for

finishing homework the first time you

offer it they may be really excited and

really motivated and focus great on

their homework but then when you try to

use the same reward later it loses its

value really quickly kids seem to get

bored with it and just don't care about

it as much

same thing with consequences it may feel

like sometimes what

our consequence you choose anything you

take away it may phase your child for a

moment but then it seems like they

forgot about it all together and that

really comes back to how dopamine is

processed in the brain and the fact that

kids are not getting as consistent of

that sense of reward that reward

chemical from things so they get may get

a burst of it initially but then they're

not getting as much overtime and that's

why they don't seem to care as much

about that reward or consequence so what

do these three core difficulties mean

for parenting the first thing that we

need to keep in mind for parenting a

child with ADHD is anticipating because

your child is not very good at

projecting themselves forward in time

and thinking about what's gonna happen

next

and what's gonna happen if I do X we as

the adults have to think ahead

so think about which situations are

gonna be really tough for your child and

are gonna require more support

what are triggers of certain behaviors

what are tasks during the day what's the

piece of the morning routine that your

child always gets distracted during and

we are gonna try to set up more

structure and things like clear

instructions and more rewards and even

consequences in advance so that we're

not having to try to clean up a mess

after things have fallen apart the

second thing that we want to keep in

mind for parenting a child with ADHD is

that your child is going to need a lot

more feedback than other kids will in

order to regulate their engine so as I

mentioned they're relying on their

environment to self-regulate and you can

be that piece of the environment that

gives them accurate input and we really

want to see a lot more positive input

praise positive attention than

correction and negative attention so we

want to praise jump in give lots of

attention when you see anything positive

happening so instead of waiting until

your child has completed all the steps

of their morning routine we want to jump

in with giving

attention and praise just for getting

started just for getting out of bed

starting to get dressed let them know

that they're on the right track so they

can keep themselves going they are going

to need more correction than other kids

two more reminders and redirection as

well but we want to think about how to

do that in a way that doesn't become

overly negative and make them feel

defeated and like they're not doing a

good job

the third implication is that we need to

build in more powerful rewards

incentives and consequences for your

child so natural consequences often

aren't going to have the effect that we

hope they will you know for example if

your child always forgets to put on

socks and you think to yourself well the

natural consequence is when they're out

at recess they'll notice their feet are

cold that's too far in time really for

it to change your child's behavior we

need to put rewards incentives

consequences in place that happen at the

point of the behavior so that are really

connected to when your child is doing a

task and are things that your child

cares about right so for each child

we're gonna think about what is his or

her currency what motivates and excites

them what gets that dopamine flowing and

can we put in some of those more

exciting things those rewards during the

boring parts of the day one example

would be bedtime it's really hard often

for kids with ADHD to get into bed

because there's nothing fun that happens

once you get in bed right the day the

reward of the day is done so of course

they're gonna stall on getting pajamas

on getting teeth brush getting into bed

but if we can put a special routine

that's exciting for them into place once

they're in bed having that special story

time in bed with parent that might be

exciting enough to help them get through

some of the routines we got to make it

really clear we got to remind them of it

in a way that's that's powerful and

meaningful to them