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Eight Principles to Manage ADHD Children

Here are some behavior management tools to help children with ADHD manage their behavior both at home and in school.

Here are some behavior management tools to help children with ADHD manage their behavior both at home and in school.

Over my 17 years of clinical experience, I have found it very useful to distill eight general principles that serve as touchstones in the daily behavior management of ADHD children. From these, parents and teachers have deduced what particular methods might work for their ADHD children, often proving to be quite inventive in the procedures they create. These general principles stem from the recent conceptualization of ADHD as a biological deficit in persistence of effort, inhibition, and motivation. If ADHD involves a reduced sensitivity to behavioral consequences, such as rewards and punishments, as current theorists believe, then certain rules of managing behavior would be predictable from these theories. To date, such principles have proven very useful in designing both home and classroom management programs for ADHD children. Practitioners and educators should always bear these in mind as they advise parents in the management of ADHD children or engage such direct management themselves. Follow these eight principles and it will be hard to go wrong in designing management programs:

1. Use More Immediate Consequences

ADHD children require more immediate feedback or consequences for their behavior and activities than do normal children. Where it may seem acceptable to occasionally praise normal children but a few times a day for particularly positive behaviors they perform, ADHD children require much more frequent feedback about their prosocial or acceptable behavior than this. As Virginia Douglas and others noted long ago, ADHD children seem much more governed by immediate consequences, or moment-to-moment changes in contingencies. I have also noted elsewhere that ADHD children seem less rule-governed in daily situations and more contingency shaped (controlled by the momentary consequences) than their normal peers. This is particularly so where parents are attempting to systematically change the negative behaviors of ADHD children to more positive or productive ones. This feedback must be clear, specific, and occur as close in time after the behavior that is the target of change as circumstances permit, if it is to be maximally effective in developing and maintaining positive behaviors in ADHD children.

The feedback can be in the form of praise or compliments, but if so, should state expressly what the child did that is viewed as positive. It can also be in the form of physical affection or even rewards, such as extra privileges or occasionally a food treat. More often, when the ADHD child's behavior must be altered more quickly, artificial reward programs like token, point, or chip systems may need to be systematically introduced and maintained for several months. Regardless of the nature of the feedback, the more immediately it can be provided, the more effective it will be for ADHD children.

2. Use a Greater Frequency of Consequences

ADHD children will require these behavioral consequences more frequently than do normal children. Thus, although responding immediately is important, caregivers of ADHD children must also respond more often than do those of normal children in letting ADHD children know how they are doing. Admittedly, if this is done too often, it can get irritating and intrusive in ADHD children's daily activities. Although this can also become tiring for caregivers as well, they should be counseled to try to increase their frequency of feedback and consequences to their ADHD children.

One means of doing this is to have the parent or teacher place small stickers with smiley faces on them around the house in locations where the children frequently look each day. Some examples might be in the corner of bathroom mirrors, on the edge of the face of a kitchen clock, on the inside of a refrigerator, on a bread box, and on the back and front doors. Whenever caregivers sight a sticker, they are to comment at that very moment on what they like that their ADHD child is doing. Another way for parents or teachers to achieve this goal might involve simply setting a cooking timer for brief and varied intervals throughout the day. When it rings, this is a reminder to the parents to find ADHD children and let them know how they are doing. If behaving well, then the children should be praised and even rewarded. If violating rules, then a reprimand or mild punishment may be required.

Another device that can be used to train parents to give frequent feedback initially is called the MotivAider. This is a small, vibrating box with a built-in digital timer that can be programmed to go off at various times throughout the day, say, every 20 minutes. (For more information, call ADD Warehouse, 800-233-9273.) The caregiver wears the small device on a belt or in a pocket. Whenever it vibrates, this is a cue for the parents to provide feedback to their ADHD child. This method has the added advantage of being less obvious to the child as a prompt for parental or teacher reward, and therefore the praise prompted by the device may appear to the child as more sincere or genuine. We have used this device in current kindergarten research classes for ADHD children with great success and cooperation by our teachers. In any case, the important point is to act quickly and frequently in giving feedback to ADHD children.


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Last Updated: 10 February 2016
Reviewed by Harry Croft, MD

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