How Do You Discipline a Child with ADHD?

Ask a Doctor

Sometimes my little boy, who has attention deficit hyperactivity disorder, can’t control himself when we have guests in our home. I know sometimes his ADHD causes him to act out, but some behaviors are simply not acceptable. I don’t want to undermine his therapy, but he needs corrected from time to time. How do you discipline a child with ADHD?

Doctor's Response

Parenting children with ADHD can be particularly challenging. These tips may be useful for parents who have children with ADHD. However, it's important to remember that no two children are alike, and what works best for one family may not be helpful for another. The following tips are based upon expert opinions and strategies that have been useful for many families of children with ADHD.

Embrace structure and predictability. Children with ADHD need clear definitions of routines and expectations. Predictability is also helpful for adults with ADHD. You can help your child use and understand schedules by making a daily schedule that includes time to get ready for school, do homework, free or play time, and bedtime. Older children may benefit from the use of clocks, timers, or charts to help them manage their day. If the child enjoys this, he or she can check items off a checklist as they are completed.

Define rules and expectations. Children with ADHD do not deal well with ambiguity or changes in rules and expectations. As with the daily schedule, it may be helpful to make lists of goals, rules, or expectations for behavior.

Use positive feedback. It is always better to use more positive than negative feedback when talking with your child. Be concrete and specific, and praise your child for the things that he or she does well or completes on time rather than constantly criticizing the behaviors that result from the characteristic ADHD symptoms. Rather than offering costly prizes or incentives, reward positive behavior with rewards such as special time with a parent or a special privilege.

Use appropriate consequences for negative behaviors. Consequences for negative behaviors should be fair and appropriate. Ideally, the consequence for a child with ADHD should be an immediate event rather than something that occurs in the future. As with other aspects of the child's schedule, the consequences for negative behavior should be predictable and consistent.

Be specific when giving instructions. It may be helpful to focus on one task or event at a time when giving instructions to your child. For younger children, breaking a task down into its component steps can be helpful. Specific instructions like, "Put the books back on the shelf," are more helpful for a child with ADHD than general instructions like, "Clean up your room."

Tackle one thing at a time. While you may want to help your child overcome a number of behavior problems, it's best to focus on one or two at a time. Set both short-term ("learn to control interruptions at the dinner table for 10 minutes at a time") and long-term ("stop interrupting at the dinner table 90% of the time") goals and remember to use praise and rewards for achievements.

Help your child eliminate distractions and manage time. Especially tweens and older children may need help establishing a homework routine that is free from distraction. You can help them create a homework space that is pleasing, quiet, and free from distraction. Your child may appreciate the use of a timer to help with homework in order to focus on one subject for a given amount of time, or to schedule 10-minute breaks after every hour of homework. It can also be helpful to look at long-term projects such as term papers and draw up an "action plan" for the project, breaking it down into manageable steps. Older children may appreciate learning to use mobile apps to help them manage their time.

For more information, please read our full medical article on Parenting children with ADHD.

Health Solutions From Our Sponsors

References
Subcommittee on Attention-Deficit/Hyperactivity Disorder, et al. "ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents." Pediatrics 128.5 (2011): 1007-1022.

Texas Department of Mental Health and Mental Retardation. Parenting the Child with ADHD.

United States. Centers for Disease Control and Prevention. "Attention Deficit-Hyperactivity Disorder: Treatment." May 31, 2017. <http://www.cdc.gov/ncbddd/adhd/treatment.html>.

United States. Centers for Disease Control and Prevention. "Attention Deficit-Hyperactivity Disorder: Data & Statistics." Nov. 13, 2017. <http://www.cdc.gov/ncbddd/adhd/data.html#1>.

University of Maryland Medical Center. "Attention Deficit Hyperactivity Disorder-Behavioral Management." Sept. 18, 2013. <http://www.umm.edu/patiented/articles/managing_attention-deficit_hyperactivity_disorder_000030_9.htm>.

Wilkes, Maggie A. "Pediatric Attention Deficit Hyperactivity Disorder." Medscape.com. Apr. 24, 2017. <http://emedicine.medscape.com/article/912633-overview>.