Parenting ADHD Adolescents

Teenagers with ADHD often pose challenges to even the most experienced parents. Parents often are so taken aback by the adolescent's behavior or attitudes that it is difficult to consider how to respond at that moment. As a result, parents may sometimes respond impulsively based upon their "gut feelings" or raw emotion. Such responses may make the situation worse. Dr. Russell Barkley (1995) has argued that parents need a set of general principles to keep them on a straight course through the labyrinthine journey of raising a child with ADHD. He has outlined a number of such principles, based upon research and clinical experience.

I have customized and expanded these principles for raising adolescents with ADHD. The principles outlined below are meant to be general guidelines, not rigid rules. They will work some of the time but certainly not all of the time. I would urge you to consider them especially when you are stumped by your adolescent's actions, and derive your reaction from one of these principles rather than reacting impulsively. Readers wishing more a more detailed discussion of parenting the adolescent with ADHD might consult ADHD in Adolescence: Diagnosis and Treatment (Robin, 1998).

1. Facilitate appropriate independence seeking.

Since becoming independent from the family is the primary developmental task of adolescence, and since ADHD individuals need extra guidance and learning trials to acquire new behaviors, parents need to look for opportunities to gradually give their adolescent's more freedom in return for demonstrating responsibility. A parent might break goal behavior into small units, and shape each behavior, moving on

2. Maintain adequate structure and supervision.

Parents often ask when they can relax the increased structure which they have created to monitor their adolescent's academic performance and home behavior. The answer is that they need to maintain structure and supervision for longer than they typically think they should. ADHD individuals need to be more closely monitored for all of their lives, but we expect them to learn to do some of their own monitoring and/or enlist the help of spouses and significant others in monitoring their actions by adulthood. Ideally, parents need to facilitate the transfer of monitoring to the adolescent throughout adolescence, but the reality is that most parents will continue the extra structure until the adolescent graduates high school, and in some cases, beyond that.

Part of the structure involves actively monitoring the adolescent's behavior outside the home. Parents should always know the answer to four basic questions: (1) Who are your adolescents with? (2) Where are they? (3) What are they doing? (4) When will they be home. Research has shown that parents who cannot consistently answer these four questions have adolescents who are at risk for drifting into deviant peer groups, substance abuse, and delinquency. Parents should also develop clear up "street rules" or rules for how they expect their adolescents to conduct themselves in the community outside of the home.

Another aspect of structure and monitoring is to plan ahead for problem situations before they occur. Since many conflicts between parents and adolescents are highly predictable, it behooves parents learn to anticipate and plan in advance to handle these situations. In a family where homework wars occur daily, the parents should develop a comprehensive homework contract designed to regulate all aspects of homework. If arguments over curfew violations have been a frequent problem, for example, the parents should plan in advance for how they will respond at 2:00 A.M. when Sally comes home two hours late. Without such planning, parents and adolescents often react based upon emotion, and do a lot of damage to their relationships in the heat of the moment.

3. Establish "the bottom line" rules for living in your home and enforce them consistently

Regarding discipline, parents need to divide the world of issues into those which can be negotiated and those which cannot. There is an important distinction between issues which can be handled democratically and those which cannot. Each parent has a small set of bottom-line issues that relate to basic rules for living in civilized society, values, morality, and legality, which are not subject to negotiation. Such issues usually include drugs, alcohol, aspects of sexuality, religion, and perhaps several others. Each parent needs to clearly list and present to the teenager those issues that are non-negotiable. Then, they need to enforce the rules around these issues consistently and fairly, through the wise use of consequences (See principle number 5).

4. Negotiate all of the other issues which are not bottom lines with your adolescent.

Parents need to involve their teenagers in decision making regarding the issues which can be negotiated. This is the single most important principle of parenting an adolescent, and is one of the primary methods of shaping responsible independence behaviors. Teenagers are more likely to comply with rules and regulations which they helped to create. Furthermore, they may have novel and creative perspectives on issues because of their youth and unique position in the family. Often, their perspectives lead them to suggest novel solutions. Parents need to remember, however, that involvement in decision making doesn't necessarily mean always being an equal partner with parents, and certainly does not mean dictating to parents. In some cases, parents may retain the ultimate veto over decisions. In other cases, adolescents may be equal partners with parents. Parents need to gradually increase the degree of involvement they give teenagers in decision making, through a shaping process.

5. Use consequences wisely.

Parents need to become experts at behavior management in order to enforce their bottom-lines rules, monitor and structure effectively, and discipline consistently. Barkley (1995) has outlined several aspects of the effective use of consequences with children who have ADHD:

1. Give the adolescent more immediate feedback and consequences. Adolescents with short attention spans and impaired delayed responding are more likely to stay on task when given immediate positive feedback contingent upon performance of boring and tedious tasks, coupled with mild negative consequences for shifting off task. Punishments given long after the misbehavior was committed are ineffective.
2. Give the adolescent more frequent feedback. ADHD adolescents benefit from frequently hearing nice things said about their actions and appearances, as well as from receiving frequent feedback and corrections for their errors. There are so many negatives in the life of the average ADHD adolescent which pull down his/her self-esteem, that s/he desperately needs to hear frequently what s/he did right. We may need to teach busy parents creative ways to remember give their adolescents frequent feedback.
3. Use incentives before punishments. It is a knee jerk reaction for parents to ground an adolescent until the end of the next marking period upon receiving a bad report card. Parents commonly load on immense punishments, until they have used up all of their ammunition and the adolescent has little else to lose by misbehaving. When parents wish to modify a behavior such as poor study behavior, we need to train them to ask first what positive behavior they wish to see the adolescent perform, and to ask next how can they reinforce that positive behavior. Only after taking this step should they select a punishment for the negative behavior. However, we would also note that in many cases, especially extreme oppositional behavior, incentives alone are not sufficient consequences; parents must also administer punishments.
4. Strive for consistency.ADHD parents often give up easily on behavior change interventions at the first sign of failure. ADHD adolescents incessantly bicker with their parents, sometimes warring them down to the point where the parents back off. We need to help parents to stick with their interventions and demands, e.g. maintain consistency over time. "Divide and conquer" is also a motto of many ADHD adolescents, who have learned that if they can get Mom and Dad to disagree, then they can avoid unpleasant effort and/or discipline. The Divide and conquer principle is particularly common in stepfamilies and divorced families, where natural structural changes give the coercive adolescent a golden opportunity to manipulate the system.
5. Act, don't yak. Many parents repeat themselves incessantly when their adolescents fail to comply with their requests. Adolescents quickly learn that Mom or Dad are "all talk, no action." The time to talk is during family meetings and when negotiating solutions to disagreements, but after the rules has been stated and the consequences agreed upon, it is the time to act, not yak. Parents need to state the consequences like they mean them; this does not mean yelling, but adequately projecting authority without meekness or hesitation.
6. Maintain good communication. Parents need to make themselves available to listen when their adolescents wish to talk, but not to expect their adolescent to confide regularly in them. Parents and adolescents need to learn effective skills for listening to each other and expressing their ideas and feelings assertively but without putting down or hurting each other. Parents need to be clear and specific in making requests and giving feedback.

7. Keep a disability perspective, and practice forgiveness. Parents must remember that their adolescents with ADHD have a neurobiologically-based disability, and that there is a "can't do" as well as a "won't do" component to their unthinking actions. Parents must refrain from over-reacting with anger when their adolescents inevitably make mistakes. Part of keeping a disability perspective involves refraining from personalizing the adolescent's problems or disorder.

   Parents need to refrain blaming themselves or losing their personal sense of self-worth over their adolescent's problems. They also need to practice forgiveness. Parents need to forgive themselves for the mistakes they will inevitably make raising an ADHD adolescent, and to forgive their adolescent for his/her mistakes. Adolescents should, however, be held accountable for their actions, and consequences should be administered as planned, but afterwards, parents should not "hold a grudge."

8. Focus on the positive. When in the throes of conflict dealing with very oppositional adolescents, it is very difficult for parents to seriously think about being positive. However, it is important to remind parents to be their adolescent's cheerleading squad. ADHD adolescents need unconditional positive regard from their parents and focused positive time with their parents. Follow-up studies have found that successful ADHD adults say that the single most important thing during their adolescence was having at least one parent, or in some cases, an adult outside the family, who truly believed in their ability to succeed.

   ADHD adolescents need their parents to believe in them, to applaud their every positive achievement, and to generally be their cheerleading squad. They also need their parents to spend focused time with them; busy parents may not have a great deal of focused time to give, but it is the quality rather than the quantity of focused time which really matters.

   A second important aspect of focusing on the positive is for parents to encourage their adolescent to build on his/her strengths. Many ADHD adolescents receive so much criticism that they actually begin to believe that they are lazy and unmotivated. They may be failing at school and in peer relationships, but most usually have at least one thing at which they excel. Parents should help the teenager identify those interests, hobbies, artistic pursuits, sports, and activities which are pockets of strength, and help them pursue and succeed at these pursuits.

References Barkley, R. (1995). Taking Charge of ADHD. New York: Guilford Press. Robin, A. L. (1998). ADHD in Adolescents: Diagnosis and Treatment. New York: Guilford Press.

Dr. Arthur Robin is a Professor of Psychiatry and Behavioral Neurosciences at Wayne State University and a licensed psychologist practicing in Bloomfield Hills, MI, with adolescents and adults who have ADHD. He is the author of ADHD in Adolescents: Diagnosis and Treatment and the co-author of Negotiating Parent-Adolescent Conflict and Defiant Teens. He can be reached at arobin@med.wayne.edu.