18 Great Ideas

18 GREAT IDEAS FOR MANAGING CHILDREN OR TEENS WITH ADHD

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1. Reduce time delays and externalize time.
Keep waiting times to a minimum if possible. Use timers, clocks, counters, or other devices that show time as something physical whenever there are limits to completing tasks.

2. Externalize important information.
Post reminders, cues, prompts, and other key pieces of information at critical points in the environment to remind the child or teen of that must be done.

3. Externalize motivation (think “win/win”)
Use token systems, reward programs, privileges or other reinforcers to help motivate the child or teen with ADHD.

4. Externalize problem solving.
Try to reduce mental problems to physical ones or manual tasks, where the pieces of the problem can be manually manipulated to find solutions or invent new ideas.

5. Use immediate feedback.
Act quickly after a behavior to provide more immediate positive or negative feedback.

6. Increase frequency of consequences.
Give more feedback and consequences for behavior more often than is necessary for a child or teen who does not have ADHD.

7. Increase accountability to others.
Make the child or teen publicly accountable to someone several time across the day (or task or setting) when things need to get done.

8. Use more salient and artificial rewards.
Children and teens with ADHD need more powerful incentives to motivate them to do what others do with little external motivation from others. You may need to use food, toys, privileges, tokens, money or other material (artificial) rewards to help motivate them to work.

9. Change rewards periodically.
People with ADHD seem to get bored more easily with certain rewards, so you may need to find new ones periodically to keep the program interesting.

10. Touch more, talk less.
When you must give an instruction, approval or reprimand: Go to the child or teen, touch him/her on the hand, forearm or shoulder. Look him/her in the eye
Briefly (!) state your business then encourage the child or teen to restate what you just said.

11. Act, don’t yak.
Provide more immediate consequences to deal with both good and poor behavior, rather than “talking the issue to death” by nagging, nattering or lengthy moralizing about the problem.

12. Negotiate rather than dictate.
Follow these six steps to effective problem negotiation:

* Define the problem: Write it down and keep family members on task.
* Generate a list of all possible solutions. No criticisms are permitted at this stage.
* After all solutions are listed, briefly let each person critique each possibility.
* Select the most agreeable option.
* Make this a behavior contract (all family members sign it).
* Establish penalties for breaking the contract.

13. Keep your sense of humor.
Find the humor, irony, levity or comical things that happen in daily life with children or teenagers, and laugh with your child or teen about these things.

14. Use rewards before punishment.
Want to change a behavior problem?
Identify the positive or prosocial behavior you want to replace the problem behavior.
Strongly reward (praise, approve) the new behavior every time you see it.
After 1 week of doing so, use a mild punishment (a time out, or loss of a token or privilege) when the alternative problem behavior occurs.

15 Anticipate problem settings (especially for younger children), and make a transition plan:
Before starting a new activity or task or entering a new place, stop!.
Review two or three rules the child needs to obey.
Have the child repeat these rules back.
Establish an incentive or reward.
Establish the punishment to be used.
Give the child something active to do in the task or the new place.
Start the task (or enter the new place), and then follow your plan.
Reward throughout the task or activity.

16. Keep a sense of priorities.
As one popular book says, “Don’ sweat the small stuff”. Much of what we ask children or teenagers to do is pretty mundane, boring, unimportant stuff in the larger scheme of their development. Focus your efforts on the important activities or tasks that matter most in the long run (school, peer relations, etc.) and not so much on the smaller, less significant tasks (cleaning up, picking up, etc.) that contribute little to long-term development.

17. Maintain a disability perspective.
ADHD is a neurogenetic disorder; your child or teen did not choose to be this way.

18. Practice forgiveness (of your child or teen, of yourself, and of others who may misunderstand your child’s/teen’s behavior).

C:18 Great Ideas for managing children or teens with ADHD Jan 2008 Dr Griessel.doc

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