Parenting a Child Newly Diagnosed With ADHD: Taking the First Steps

By Judy Shepps Battle, M.A.

"We were so relieved when our child was diagnosed as having ADHD and placed on medicine. He is doing much better in school, but is still often impulsive, inattentive, and out of control at home. What are we doing wrong?"

This question is undoubtedly the one most frequently asked by parents of children who have been recently diagnosed with attention deficit hyperactivity disorder or ADHD.

It is perfectly normal that children who are newly recovering from ADHD will show greater initial positive behavioral change in school than at home. In fact, it is a favorable sign that your child is beginning to respond to the structure, clear expectations, and constant rewards that are a part of the school day.

Your task as a parent is to start building a comparable home structure that will create and support a way of life that rewards your child for consistent behavior. Recovery from ADHD means learning new skills and replacing old behaviors for all family members.

"ADHD is one of the most common mental disorders among children. It affects 3-5% of all children, perhaps as many as 2 million American children." from National Institute of Mental Health, NIH publication No. 96-3572.

Neurological and Behavioral
Although ADHD is a neurological disorder that is responsive to drugs that re-balance brain chemistry, it also has a strong social or behavioral component. It is important to remember that acting in an impulsive, inattentive, and/or out-of-control way is the only pattern of action that your child has known.

This means that even though medication may reduce impulsiveness, your child will still need to unlearn old patterns of impulsive behavior and replace them with increasingly responsible actions. Family structure will have to consistently support these new behaviors.

It also means that even though drugs may allow your son to focus on a task, he may never have experienced periods of concentration and will need time and instruction to learn this skill. There will be both "good" and "bad" days that will raise the level of frustration in the entire household.

Finally, it means that even though your daughter may begin taking a prescription designed to reduce out-of-control behavior, she will first have to learn many appropriate social skills and behavior. As a parent, this may mean addressing one behavior at a time and realizing that "progress not perfection" may well be the order of the day.

As parents, we can assist the process of recovery from ADHD by affirming accomplishments, building boundaries, and creating consistency for our newly diagnosed youth.

Affirming Accomplishments
A child with ADHD is used to getting negative comments regarding impulsive, inattentive, or out-of-control behavior. As one recovering teen said, "I used to think that ‘Stop That!' was my real name."

A major step in restoring damaged self-esteem is for parents to help their child identify and affirm their child's own strengths.

One strategy is to encourage your child to keep a "success" notebook of daily accomplishments. Items might range from "brushed my teeth without being reminded" to "held my temper even though teased" to "got an A in math." A young child might want to post his list on the refrigerator, while a teen might want to keep hers under lock and key.

Building Boundaries
The inner world of the active ADHD sufferer may be quite chaotic. Assignments often never get finished because of distractions that would not affect a youngster without ADHD.

For instance, your child may be doing homework at the kitchen table when he hears an airplane and "has" to go look at it. While out back he sees the family dog and "must" toss him a ball until he sees a friend riding a bike and "needs" to change to that activity. When we remind him of his original task, he genuinely may be chagrined at his actions.

The newly diagnosed ADHD youth needs an environment with a minimum of stimulation in order to successfully concentrate on and complete a task. This means that a room needs to be set aside for homework that has no other distractions. There is no TV, computer, CD player, telephone, or even view of the outside. The rest of the apartment or house needs also to be quiet.

In addition, even the smallest assignments need to be broken down into small, doable components.

For instance, initial "work" times may only be only ten minutes long, but an agreed upon-goal will be met during that time. The first ten minutes might involve setting up books and papers, the next answering question one in the history book, and the third devoted to answering question two. With each experience, your child gets to set a goal, complete it, and receive verbal praise for his accomplishment.

Of course, we may remind her to add these "accomplishments" to her daily success list!

Creating Consistency
Along with affirming accomplishments and building boundaries it is also important to introduce consistency into the life of your recovering youth. These three factors taken together will bring order into the previously chaotic life of an ADHD sufferer.

One strategy is to schedule major activities, including waking up, eating meals, doing homework or chores, watching TV, and bed time. Although initially the setting of these limits may be met with cajoling, bargaining, or outright defiance, eventually they will become part of household routine.

It is equally important that your child know the consequences of both "acceptable" and "nonacceptable" behavior and what activities fall in each category. It is helpful to post this list in a public area. This empowers your child to make informed choices with regard to behavior and the consequences of his decision.

And yes, it is perfectly fine to make the rewards for "good" behavior better than the punishments for "bad" ones. Just make sure that you and your child have worked together during the process.

Parenting a child who has been newly diagnosed with ADHD is not an easy task. It is important to find support from other adults engaged in this task and to make sure to find time to relax.

Oh yes -- buy a "success notebook" of your own. You will need it!