Oppositional Behavior in Children with ADHD
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Practice pausing before making requests.
What do you anticipate asking? What do you really want to happen? Would it be possible to offer it as a choice—do you want dinner now or in 15 minutes? Is your request important, or could you let it slide? Notice how you are holding yourself, and imagine the tone of voice you would like to use.
Notice what happens after you make a request. What is your child's response? How much does it mirror your behavior? Listen and pause, and find where you can agree while still maintaining your perspective as a parent. When you make a request, is it consistently followed? When you ask for something, be prepared to enforce it. Children are smart—if they learn that by pushing back they'll get their way, why should they stop pushing?
Begin behavior modification by emphasizing appropriate behaviors.
Start by noticing and praising the specific behaviors you want to promote. Then, create plans that reward the opposite of problem behaviors. Not only young children respond; a teenager can have his compliance increased around homework (or anything else) when earning something useful. Even when you are facing extreme behavioral challenges, select rewards that motivate but then can be repeated over time.
Consistently uphold limits and rules.
Consequences are most effective when they are immediate and do not escalate the situation. In the midst of enforcing discipline, there is little point in discussion. That can wait until later. Right now, engaging in a circular debate when you've already decided to enforce a rule only lets the situation build. Consequences may include time—outs or temporary loss of certain toys or privileges, such as television or video game time.
When a behavioral plan isn't working, reexamine the plan.
Does your plan account for your child's true abilities, right now? One common reason systems fail is that a child just doesn't have the skill yet. If they are fundamentally impulsive, you won't accomplish enough by emphasizing the rules (don't hit) without offering alternative skills through other behavioral or medical interventions. The bar needs to be set slightly above their present skill level, with a goal of more success than failure. As well, remember to maintain focus on incremental progress, as change happens slowly.
Seek expert help.
When oppositional behaviors occur in a child with ADHD, try your best, but always remember: You're a parent, not a behavioral management super-genius. Maybe you've read a book that felt useful, but you still don't have a handle on everything. That's entirely to be expected. These situations are immensely complex and clinicians complete years of training to understand them. When you feel stuck, reach out to someone with the clinical background to help.
From "The Family ADHD Solution" by Mark Bertin, MD. Copyright © 2011 by the author and reprinted by permission of Palgrave Macmillan, a division of Macmillan Publishers Ltd.