Just like raising any child, parenting a child with attention deficit hyperactivity disorder (ADHD) comes with rewards and challenges along the way. When symptoms of ADHD, such as difficulty planning, organizing, and controlling thoughts, feelings and actions, go unmanaged, they can cause stress in a child's life and within your family, too.
While there are several treatments that can help reduce symptoms, knowing the best way to help manage your child's ADHD at home isn't always clear. Catherine Karni, M.D., Medical Director of Outpatient Services at Children's Health℠ and Professor of Psychiatry at UT Southwestern, offers tips that can help you and your child feel in control and on the right path.
Dr. Karni recommends establishing structure with behavioral plans, incorporating a points and rewards system. Identify behaviors your child needs to work on, with rewards attached to the behaviors. Rewards can be different; it depends on what motivates each child. For example, when your child does his homework on time, he can have a playdate or go to the movies with a friend. Be clear about expectations and consequences.
"Children need to accept responsibility and ownership of their behaviors," says Dr. Karni. "Parents can prepare their children for real life by teaching them that there are consequences for not doing what needs to be done and benefits of accomplishing tasks and making the right choices."
She adds that behavioral plans and expectations should apply to the whole family.
"You don't want to make your child with ADHD feel like the black sheep of the family. Everyone benefits from structure and clear expectations."
One of the most important factors in making a behavioral plan work is following it consistently.
"There needs to be consistency across all caregivers — parents, grandparents and babysitters," says Dr. Karni.
Following a behavioral plan sporadically is confusing for a child who's trying his or her best to do what's expected.
Focus on the positive
According to Dr. Karni, it's common for children with ADHD to have self-esteem issues.
"They think, 'No matter how hard I try to be good, I can't get it right,'" she says.
That's why she recommends balancing expectations and consequences with warmth. Dr. Karni explains that children with ADHD can be more sensitive to punishment — which is why it might not be very effective in changing your child’s behavior.
Try using four times as much praise as you do criticism. Recognize appropriate behavior and reward it. A smile, high five or time spent with you, can go a long way.
Make exercise and a healthy diet a priority
Exercise is a healthy way for a child with ADHD to burn off excess energy. Riding bikes and playing with friends outside helps your child wind down at bedtime. Any kind of exercise that's structured, like martial arts for instance, helps your child develop self-control and self-esteem.
When it comes to diet, children with ADHD, like everyone, should eat to be healthy: lean protein and dairy, whole grains and a wide variety of fruits and vegetables. Dr. Karni says it's a misconception that things like excess sugar, artificial colors or gluten contribute to the symptoms of ADHD.
“If eliminating or reducing sugar or gluten helps, then do it," she says. "Eating healthy is an important factor for all children’s development. But there's no research showing that diet influences ADHD."
She says parents need to be cautious about the volumes of information online about vitamins, supplements and alternative treatments aimed at treating ADHD.
“There's a lot of information online and many times, there's no science or proof behind what is stated as fact. If parents read about a new treatment or recommendation I encourage them to check with their pediatrician or a specialist to find out more.”
Promote good sleep habits
Sleep is vital to children being able to focus and learn. Children with ADHD are already working hard to focus, so being sleep deprived only makes it more difficult. Dr. Karni says good sleep hygiene means:
- 11–13 hours of sleep for 3–5 year olds
- 10–11 hours of sleep for 5–12 year olds
- 8 ½ –9 ½ hours of sleep for 13–18 year olds
Dr. Karni reminds parents that electronics can be the enemy of healthy sleep habits. Help your children get the sleep they need by removing televisions and computers from bedrooms and having them hand over phones and tablets an hour before bedtime.
Managing ADHD effectively is a team effort. Talk with your child's pediatrician and other specialists for support and to help you develop the best plan for your child and your family.
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Learn more about ADHD and how the specialists at Children’s Health can help you find a diagnosis and treatment plan. Dr. Karni also recommends the following books and resources for parents:
- Taking Charge of ADHD: The Complete, Authoritative Guide for Parents, by Russell Barkley
- The ADHD Book of Lists, by Sandra Reif
- Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), www.chadd.org; and the National Resource Center on ADHD, www.help4adhd.org.
- Smart But Scattered: The Revolutionary “Executive Skills” Approach to Helping Kids Reach Their Potential, by Peg Dawson and Richard Guare
- Late, Lost, and Unprepared: A Parent’s Guide to Helping Children with Executive Functioning, by Joyce Cooper-Kahn and Laurie Dietzel
- The Motivation Breakthrough: Six Secrets to Turning On the Tuned-Out Child, by Richard Lavoie
- Putting on the Brakes: Young People’s Guide to Understanding ADHD, by P. Quinn and J. Stern
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