Kids With ADHD: At Risk for Risky Behavior?

From the WebMD Archives

The teacher calls you at home to tell you about a playground injury involving your child and another classmate. Or, maybe she doesn't quite believe your child's story about what happened to his classmate's toy. Maybe you notice that some loose change is missing from a jar on the dresser. If you're the parent of a child with attention deficit hyperactivity disorder (ADHD), you've probably heard these scenarios before.

Doctors aren't sure what causes ADHD. But they do know that kids who have it find it hard to control their impulses. And, they may often engage in risky behaviors like aggressive play, ignoring rules, running off, lying, and stealing.

If you're a parent, it's important that you manage your kid's risk-taking behavior. These strategies could help.

Get Assessed

You might be surprised, but kids who fidget in class, lie about their homework, and climb to the highest peak on the jungle gym might not have ADHD.

"These are all normal childhood behaviors," says James McGough, MD, professor of clinical psychiatry at UCLA. "If your child is active or impulsive to a degree that is out of line with their same-age, same-sex classmates, you should get an assessment."

Kids with ADHD have a hard time controlling their actions, McGough says. Sometimes, they take risks without thinking. But, he adds, most of the time, they're not trying to hurt anyone.

This disorder can be linked to a mental disorder that causes children to disobey or rebel. It's also tied to conduct disorder, which often shows up as lying and stealing.

An assessment will help you understand why your child acts the way he does. It'll also allow you and your doctor to create a plan to manage negative behaviors.

Provide Healthy Outlets

Children with ADHD are hardwired to take risks. Don't try to stop them. Instead, try to help them learn the difference between negative and positive ones. For example, learning a sparring routine in martial arts class is a positive risk that you should encourage. That's much different than starting fights on the playground.

"These are active kids; that's their temperament from an early age," says Marco Grados, MD, associate professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine. "It's important to provide structured outlets for [their] high energy."

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Encourage Social Activity

Kids with ADHD may find it hard to make friends.

This can make them feel lonely and isolated. It can also lead to other problems. A 2014 study published in the Journal of Attention Disorders found that children who have the disorder are more likely to bully others or become victims of bullying themselves. It can also affect their self-esteem.

"[ADHD] can exhaust other children socially," Grados says. "They may make friends but will lose them, and that's hard on their self-esteem."

He says parents whose kids have it should try to make opportunities for them to interact with their peers. They should also provide structure, set time limits, and choose activities with easy-to-understand rules to avoid outbursts.

Limit Downtime

When parents provide healthy outlets and encourage their kids to be social with their peers, they're doing something very important: limiting downtime.

"Unstructured downtime isn't great for kids with ADHD because it gives them the opportunity to get into things they shouldn't," Grados says.

The more engaged kids are, the less likely they are to engage in negative, risky behaviors. But Grados says parents shouldn't replace that downtime with time spent in front of the TV, Internet, or video games.

Too much of those things may make ADHD symptoms worse, according to a study in the journal Attention Deficit and Hyperactivity Disorders.

Give Rewards and Set Consequences

This is another way parents can manage their kids' ADHD symptoms.

A feeling of failure might lead some kids with the disorder to act out. It could also make them more prone to other negative behaviors.

To help kids feel successful -- which may limit outbursts -- McGough says parents should provide simple instructions and set goals they're almost sure to meet. Then reward them. For example, your child is more apt to hit a goal to remember homework than to get all As and Bs on a report card.

If you set goals that are too big or whose consequences are too harsh, it could backfire.

"It makes kids give up," McGough says.

When your child acts in negative ways, McGough says it's important to remember, "Impulsive, risk-taking behavior is a manifestation of the circuits in the brain; it's not willfulness, it's how these kids are wired."

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Make a Plan

This is one of the most important things you can do to help manage your child's behavior if he has ADHD.

Grados advises working with your pediatrician or psychiatrist to find a treatment plan to keep symptoms in check. That plan may involve medication and therapy and a healthy dose of positive reinforcement.

"You want to avoid the message that medication is making the change," McGough adds. "Children need to be told that their medicine is helping, but they are the ones doing the work."

Remember, there's no one-size-fits-all approach to managing risky behaviors in children with ADHD.

"Each child is special and different and should have their own program or treatment," Grados says.

WebMD Feature Reviewed by Smitha Bhandari, MD on December 10, 2015

Sources

SOURCES:

Marco Grados, MD, MPh, associate professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine.

Spencer, T. Biological Psychiatry, published online March 2007.

James McGough MD, professor of clinical psychiatry at UCLA.

Wen-Juin, C. Journal of Attention Disorders, published online November 2014.

Weiss, M. Attention Deficit and Hyperactivity Disorders, published online September 2011.

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