Disciplining a Child With ADHD

From the WebMD Archives

If your child has ADHD, should you discipline them in a different way than with your other children?

The answer might surprise you.

"ADHD is a challenge, not necessarily an excuse for kids," says Steven L. Pastyrnak, PhD, of the Helen DeVos Children's Hospital in Michigan.

Still, you might need to be a little more flexible in your expectations.

"We need to be more aware of how the ADHD impacts their ability to listen, follow through on tasks, and control their impulses," Pastyrnak says. "However, having ADHD does not take away the expectation that they will improve in these areas."

So you don't have to discipline them differently. But you may need to do it more often and be more consistent, Pastyrnak says. A lesson may take longer to sink in. "I sometimes tell parents that parenting a child with ADHD is like parenting a child times five."

How to Use Time-out

Carla Counts Allan, PhD, of the ADHD Specialty Clinic at Children's Mercy Hospitals and Clinics in Kansas City, MO, suggests these tips for time out, whether or not the child has ADHD.

Contrast time-out with time-in. That means that if you put your child in time-out for hitting their sister, you should have been praising them earlier for playing well with their sister -- and should praise them after time-out for having a good attitude. "If there isn't a big difference between time-out and time-in, kids don't understand the consequences," Allan says.

Keep time-outs brief and consistent with the issue. "Long time-outs can start a battle of wills," she says. "For younger children, 1-2 minutes is plenty. A minute per year of age is more an upper limit for time-out, but for preschoolers, sometimes a 30-second or 1-minute time-out is plenty if they show me quiet feet, quiet hands, and quiet mouth."

Stay calm. If you tell your child to go to time-out and they ignore you, add 1 minute to their time-out. If they don't go again, add another minute. If they ignore you a third time, don't pick them up and drag them to time-out -- that can make things worse, and the attention, even negative attention, may unintentionally reinforce the behavior.

Continued

"Instead, impose a consequence that means a lot, such as no video games for the rest of the day," Allan says. "Deliver that consequence calmly and don't talk about it further. Even if they say, ‘I'll listen, I'll go into time-out now,' don't give in!"

A prompt such as a timer to signal the beginning and end of a time out may help. If your child won’t cooperate, remind them that the time-out can't start until they are quietly in their time-out spot.

Practice time-outs. Ask your child to pretend that they misbehaved, and that they are being sent to time-out. "Have them practice going to time-out without putting up a fight."

Help Your Child Succeed

Another discipline strategy for kids with ADHD (or any child) is to teach them the skills they need to succeed before they have a problem.

For example, all kids need a schedule or guidance to help them keep up with chores, homework, and other expectations. Kids with ADHD, Pastyrnak says, can't be expected to "just get it" from verbal instructions. Instead, they often respond better to a visual schedule that they can follow.

They also do better with very specific instructions. Instead of telling kids to “clean their room,” be specific, such as "all clothes off the floor," and "all books on the bookshelves.” That way, kids clearly understand what to do.

Rewards work well for kids with ADHD, but they, too, may need to be tweaked slightly.

"For example, one expectation might be to play appropriately with his sister," says pediatrician Mark Bertin, MD, author of The Family ADHD Solution.

"It's probably not realistic to set that expectation for an entire day," Bertin says. "If they mess up in the morning, you've lost the whole day."

Instead, break the day up into thirds and give points for good behavior in the morning, the afternoon, and the evening. Once they’ve earned points, you can’t take them away. Some kids also need more frequent rewards. They may lose interest if they have to wait a week to earn one. Rewards can include praise from a parent or doing something special.

Continued

Adjust Expectations

You can't change everything at once in children with ADHD, Bertin says.

"Choose a few big things that you want to work on, and put other things aside for now. Don't wrestle as much with the stuff you're not working on yet."

That was something RaeLyn Murphy of Milwaukee learned through her son, Josh, who was diagnosed with ADHD when he was 4 years old. "You need to pick your battles. But when you do pick one, stay with it and be consistent."

She developed a four-point strategy she called CARE, which echoes much of what ADHD experts say:

1. Clear away distractions and things that cause bad behaviors.

2. Allow your child to choose an activity.

3. Redirect into a more appropriate activity when things are not running smoothly. Offer them something they can do, rather than just telling them what they can't do. For instance, instead of saying, "You can't hit your sister,” try, “You can be gentle with your sister.” You can also offer an alternate option, like “You can whack these pillows."

4. Exit. When things are out of hand and you know you can't do anything but fight an uphill battle, get out. Go to the park or to an indoor play center. Don't fight with your children.

It seemed to work with Josh, who's now a successful and happy young man. "I focus on positive parenting," says Murphy, who wrote a book, Gifted With ADD, about what she's learned. "If he knows you're on his side most of the time, when you pick the battle, he knows there's a problem."

Make a Plan and Stick to It, Together

Your child needs to know what the expectations, consequences and rewards are. But as they get older, they can help you decide these things. They are more likely to remember and follow rules they helped make.

For example, you may agree to set some guidelines for cellphone or social media use. They may agree to turn in their cellphone during homework/study time, but you may agree to a social media break between subjects to motivate them to stay on task.

Make sure you consistently enforce the rules. When they don’t do as expected, don't embarrass them by disciplining them around others. And don’t dwell on mistakes of the past. Focus on what’s happening now. Help them feel empowered. Older kids need reassurance and praise, too.

WebMD Feature Reviewed by Dan Brennan, MD on June 24, 2016

Sources

SOURCES:

RaeLyn Murphy; author, Gifted With ADD, Milwaukee.

Steven L. Pastyrnak, PhD, division chief of pediatric psychology, Helen DeVos Children's Hospital, Grand Rapids, MI.

Carla Counts Allan, PhD, director of psychological services, ADHD Specialty Clinic, Children's Mercy Hospitals and Clinics, Kansas City, MO.

Mark Bertin, MD, assistant professor of pediatrics, New York Medical College and author, The Family ADHD Solution.

National Institute of Mental Health.

ADDitude: “Discipline Your Teen Can Live With.”

© 2012 WebMD, LLC. All rights reserved.

Pagination