Category Archives: ADHD

Take this parenting test if you have a troubled teenager

Take this parenting test if you have a troubled teenager
1 votes

So how are you doing in this parenting job you have?  Score your parenting skills on a test designed for parents of children ages 11-15 with serious behavior problems.  (If you are brave, have someone else score you too and compare notes.)

Always: 5    Generally: 4    Sometimes: 3    Rarely: 2    Never: 1 Your
score
1.    My child’s other parent (or caregiver) and I agree on how to discipline our child.  


2.    My child can depend on me to do what I say I will.
3.    When I say “no”, I stick to it.
4.    I treat my child with respect, even when I’m angry.
5.    I let natural consequences do the teaching whenever feasible.
6.    I am confident my child has everything she/he needs to make
good decisions.

7.    I allow my child to do his/her chores without my reminding.
8.    I allow my child to voice her/his opinions when done in a
respectful way.

9.    I am able to stay out of arguments by disengaging before they
escalate.

10: When I make a mistake in judgment, I’m quick to admit it.
TOTAL

SCORE

45 – 50   Good job!  You are on the right track.
30 – 45   Not bad, just a little more work in those challenging areas.
Less than 30  Keep trying!  Find a support group; a therapist for you and a co-parent; or books (recommendation).

Don’t be hard on yourself if you score low.
Teenagers are difficult.

You might be thinking:  “I agree these are good parenting skills, but practicing them is impossible with my child.  They hate/defy/scream at me constantly.”  Advice: Work on one at a time, and check back in few weeks to see if you’ve improved your score.

This test is drawn from a parenting guide created in 2007 by StandUp Parenting (www.standup.org)
to help parents understand what is needed to maintain authority and model maturity.  

Please add a comment if you have found other skills to be effective,

Margaret

 

How am I doing?  Please rate this article above.

Leave a Comment

Filed under ADHD, bipolar disorder, borderline personality disorder, defiant children, discipline, irrational children, mental illness, oppositional defiant disorder, parenting, Screaming, stress, teenagers, teens, therapy, troubled children, troubled children

Understanding and supporting a child with ADD or ADHD

Understanding and supporting a child with ADD or ADHD
3 votes

Boy-with-ADDLife with a child with ADD or ADHD can be trying and overwhelming. However, as a parent there are practical measures you can take to effectively control and minimize your child’s symptoms without controlling and monitoring their every move.

You help your child overcome daily challenges by redirecting his or her energy into positive activities. You start by having a dialogue with your child and family that honestly communicates the situation in a way that does not accuse them of being “bad”.  Their behavior needs improvement, but speak as if it’s a ‘normal’ problem that must be addressed.

Children with ADD or ADHD typically have shortcomings in executive function: the ability to think and plan ahead, organize, control impulses, and complete tasks. This means that you need to take over as the executive, providing extra direction while your child progressively obtains executive skills of his or her own. With tolerance, kindness, and plenty of family teamwork, you can help your child manage childhood ADD or ADHD and maintain a steady, happy home

You must to be able to master a combination of support and predictability.

Living in a home that provides love and lots of structure is the best thing for a child or teenager who is learning to manage ADD/ADHD. There are effective and simple changes you can make that are easy to implement; we offer four practical tips to help you understand and support your child with ADD or ADHD:

1.  Be honest with your child about ADD or ADHD
distracted girlIt is important not to avoid or ignore your child’s condition. ADD or ADHD is not your child’s fault, it is a brain disorder that causes young people to have trouble focusing, completing tasks, or planning the future. Most parents can reframe things, but don’t look at the negative. Your child should understand it is something they can and should manage. The rest of your family should do this too.

2.  Stay Positive
dad-and-sonWhen calm and focused, you are more likely to get your child’s attention and help him or her to be peaceful and attentive. And keep things in perspective. Your child’s behavior is related to a disorder, so most of the time it is not deliberate. Don’t sweat the small stuff; be willing to negotiate certain matters. For example, if one chore is left undone but your child has already completed two chores and their homework for the day, let it go and appreciate what they were able to complete. Staying positive also means believing and trusting your child. Trust that your child will learn, change, mature, and succeed.  Trust that your child wants to!

Taking care of yourself will allow you to take better care of your child.

It is vital to live a full, healthy life because you are the child’s role model and source of strength. Eat right, exercise, and find ways to reduce stress. Getting involved with organizations related to ADD or ADHD will also provide you with safe places to vent your frustrations and share experiences.

3.  Establish structure, enforce rules and consequences calmly

boy and garden

Help your child with ADD or ADHD to stay attentive and prepared by setting a strict routine. Set a time and place for everything to help your child with ADD or ADHD comprehend and meet expectations. Allow extra time for what your child needs to do, such as homework, chores, and getting ready in the morning.  Keep them busy but not too busy—a child with ADD or ADHD will become more distracted and act up if there are too many after-school activities going on.

Create structure in your home so your child knows what to expect and when.

Children with ADHD are more likely to succeed if they can complete tasks when the tasks occur in probable patterns and in foreseeable places. Children with ADHD need rules because it helps them track time and progress. Make the behavior rules simple and clear. Write down the rules and hang them up in a place where your child can read them. Children with ADD or ADHD respond exceptionally well to prearranged systems of rewards and consequences. It’s important to explain what will happen when the rules are obeyed and when they are broken. Finally, stick to your system by following through each and every time with a reward or a consequence.

4.  Encourage movement and sleep

teenstalkingChildren with ADD or ADHD often have a lot of energy to burn. Organized sports and other physical activities can help them get their energy out in healthy ways, and refine their focus while enjoying the development of new skills and abilities. Exercise leads to better sleep with children with ADD or ADHD, which also reduces symptoms of ADD or ADHD. Children with ADD or ADHD often find “white noise” to be calming when sleeping. You can create white noise by putting a radio on static or running an electric fan, for example.

Guest Post by: Diamond Ranch Academy
Diamond Ranch Academy is one of the premier youth residential treatment centers for struggling teens. Since 1999, the highly trained staff at this facility has provided guidance and support for teens with varying emotional and behavioral issues including; substance abuse, depression, ADHD, impulse control, peer pressure, anger management, oppositional defiance, self-esteem, grief/loss issues, family relationships, communication, and academic struggles.

Note from blog owner, I am not personally familiar with Diamond Ranch Academy and this post is not an endorsement, but this post offers good information for any parent of a child with ADD or ADHD.  For ideas on what to look for in a good residential program, see the post Residential treatment checklist

–Margaret

3 Comments

Filed under ADD, ADHD, anxiety, mental illness, parenting, Screaming, stress, teens, therapy, troubled children, troubled children

Five-minute wisdom for parenting troubled children and teens

Five-minute wisdom for parenting troubled children and teens
6 votes

From many years of  counseling parents with difficult children, I’ve found the following wisdom helps clarify one’s priorities, improve understanding, and help take the next steps.

You are not alone. All families experience the same fears no matter what the child’s challenges: guilt, anger, frustration, failure, and mental and physical exhaustion.

There is a way. The steps to finding peace in the home are the same for all families.

You can start now. You can improve behavior without having a diagnosis, and the techniques work for the majority of difficult children.

There is reason for HOPE. They have the capacity to do better. With support and treatment, difficult children improve.

Have realistic expectations: They may not be ready for adulthood, and may need extra support into their 20’s… but that’s OK. There’s time to catch up with their peers.

Plan ahead for a crisis, brainstorm options for an effective response and create a checklist. We can’t think clearly in a tension-filled moment.

GOOD Things to do for Your CHILD or TEEN

Pay attention to STRENGTHS not weaknesses. Always find something great about them.

Guide them to their gifts. Give them ample opportunity to do what they are already good at.

GOOD Things to do for YOU

o Be your own cheerleader. Silently think, “I can handle this;” “I’m the one in control.

o Regularly talk through your feelings with others who understand and won’t judge.

o Get a life, maintain personal interests, and set thoughts of the child aside without guilt.

o Commit to doing the best you can, and own that this enough – plan to let go someday.

You’ve done a good job when they are able to take responsibility for their own care. This is a monumental personal achievement!

KEYS to CALM

In a neutral patient voice, give directions or requests . You will need to repeat yourself, calmly, several times. Your voice should not communicate strong emotions. Tone of voice, not words or volume, is what creates a bad response.

Don’t rush calm. Give the child plenty of time to unwind and settle. Calm is more important than quick.

Ensure there’s a calm place to go – a time-out space, even for you.

Get an appropriate therapy animal – a calm and durable creature unlikely to be harmed.

Reduce chaos in your home: noise, disorder, family emotional upheavals, the intrusive stimulation of an always-on TV, etc.

Ideas for MANAGING resistance

You want your child to be resistant to the negative things they’ll face in life. It represents willpower, and is a strength to cultivate.

o Be quiet and LISTEN. If you respond, address how they feel, not what they say.

o Use reverse psychology-ask them to do something you don’t want them to do, so they can defy you and do the opposite.

o Choose your battles. Let them think they’ve won on occasion.

o For an ODD child, give multiple instructions at once, including things they do and don’t want to do. It becomes too much work to sort out what to defy.

o Actively ignore – Stay in the vicinity but don’t respond, look away, act like you can’t hear. They eventually give up. Works best for ages 2 – 12.

o Mix it up – Be unpredictable. Give a reward sometimes but not all the time. Try new ways to use incentives or set boundaries and structure.

Nine COMMON Parenting MISTAKES

1. Treat your home like a democracy, let your child have an equal say in decisions.

2. Find fault with them and tell them about it repeatedly. If they do something positive, it’s not good enough.

3. Pretend your child has no reason for their behavior. Ignore his or her needs or challenges. Are they being bullied? Are they having a hard time sleeping? Is your home too chaotic?

4. Make rules and only enforce them once in a while, or have consequence come later.

5. Don’t treat your child appropriately for his or her age. Make long explanations to a 3-year-old about your reasoning. Assume a teen wants to be just like you.

6. Expect common sense from children who are too young (5), or from young adults with a long track record of not showing common sense.

7. Keep trying the same things that still don’t work. Repeat yourself, scream, show how frustrated you are with them.

8. Jump to conclusions that demonize the child. “You are manipulative and deceitful,” “You don’t listen to me on purpose,” “I’m tired of your selfishness…”

9. Make your child responsible for your feelings. If you lose your cool, insist they apologize.

Problem SYMPTOMS, not problem children

– Does not show common sense and is not influenced by reason and logic;

– Has no instincts for self-preservation, and poor personal boundaries;

– Has no well-adjusted friends; has friends who are risky or troublesome;

– Doesn’t respond to rewards and consequences;

– Has limited character strengths: honesty, tolerance, respect for others, self-control;

– Does not make plans they can realistically achieve, hangs on to fantasies;

– Acts younger than their peers. Will not be ready for adulthood by 18;

– Lives in the here and now; doesn’t think about the past or future;

– Does not notice their effect on others.

Your PRIORITIES in Order

1. You and your primary relationship(s)

2. Basic needs and responsibilities: housing, clothing, food, income, health

3. Your challenged child or teen.

Keep your energy in balance so you can maintain your family's foundation. Too much spent on your child affects everything else your family needs to survive.

Keep your energy in balance so you can maintain your family’s foundation. Too much spent on your child affects everything else your family needs to survive.

 

 

 

 

 

1 Comment

Filed under ADD, ADHD, discipline, mental illness, parenting, stress, teenagers, troubled children

Defying ODD: what it is, and ways to manage.

Defying ODD: what it is, and ways to manage.
18 votes

Parenting a defiant ODD child or teen could be your hardest job ever. 

Not only is it exhausting, but you must continually find the compassion and forgiveness to be nurturing, and the energy and doggedness to be consistent.

ODD is caused by abnormal electrical activity in the brain, it is not in the character or ‘soul’ of your child or teen, and not something they can control.  If your child could do better on their own, they would.  You are the one who can make the most difference.

If you think your child or teen’s defiance is oppositional defiant disorder, you have practical ways to manage your child’s exasperating condition.  This information comes from psychiatric, psychological, and child behavior resources– information to help you work effectively with mental health providers or teachers.  You’ll need to ask them focused questions to learn everything they know about ODD.  Professionals pay better attention to knowledgeable parents (which shouldn’t be the case, all parents deserve attention).  Go in armed with knowledge.

This is what ODD looks like.  The pinkish curving region in the center of the 3-D brain image below represents hyper-charged electrical activity in a 13-year-old boy with severe oppositional defiant disorder.  This feature is typical of ODD, but also typical in individuals with obsessive compulsive disorder (OCD), “Road Rage,” pathological gambling, chronic pain, and severe PMS.

The name of this region is anterior cingulate gyrus (ACG), and scientists believe this area is responsible for enabling a person to shift attention and think flexibly, traits which are deficient in ODD kids.  It is also the brain region known to regulate emotions.  Children with a hyper-charged ACG have “a pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which 4 or more of the following are present:

  • Often loses temper
  • Often argues with adults.
  • Often actively defies or refuses to comply with adults’ requests or rules.
  • Often deliberately annoys people.
  • Often blames others for his or her mistakes or misbehavior.
  • Is often touchy or easily annoyed by others.
  • Is often angry and resentful.
  • Is often spiteful and vindictive.” 

–From the “Diagnostic and Statistical Manual of Mental Disorders, 4th Edition,” published by the American Psychiatric Association, 2000.

There are two different medication approaches to ODD:

  • treat it as a form of attention deficit disorder;
  • treat it as form of depression and obsessive-compulsive disorder.

–         The attention deficit approach may use Straterra (chemical name is atomoxetine), Ritalin (methylphenidate), Risperdal or risperidone (for patients with low IQ), and Depakote or divalproex (a mood stabilizer).

–         The depression & obsessive-compulsive approach may use serotonin-based antidepressants such as Prozac (fluoxetine), and Anafranil or clomipramine (used to treat OCD).

At the end of this article are a list of other medical conditions that can cause disruptive behavior.

Unfortunately, oppositional defiant disorder usually includes other disorders, so you may be coping with more than defiance.  Below are common disorders that combine with ODD:

  • 50-65% of these children also have ADD or ADHD
  • 35% of these children develop some form of depressive disorder
  • 20% have some form of mood disorder, such as bipolar disorder or anxiety
  • 15% develop some form of personality disorder
  • Many of these children have learning disorders

–From http://addadhdadvances.com/ODD.htmlAnthony Kane, MD 

Other medical conditions that can cause disruptive behavior like ODD:

  1. Neurological disorders from brain injuries, left temporal lobe seizures (these do not cause convulsions, no one can tell these are happening), tumors, and vascular abnormalities
  2. Endocrine system problems such as a hyperactive thyroid
  3. Infections such as encephalitis and post-encephalitis syndromes
  4. Inability to regulate sugar, rapid increases and decreases of blood sugar
  5. Systemic lupus erythematosus, Wilson’s disease
  6. Some prescription medications:  Corticosteroids (anti-inflammatory and arthritis drugs such as Prednisone);  Beta-agonists (asthma drugs such as Advair and Symbicort)

–From Peters and Josephson.  Psychiatric Times, 2009.

ODD is a disability.  It isn’t easy to manage, but you can do it.  Your child may need multiple medications and a large variety of approaches to therapy and behavior modification.  You will need patience as teachers, doctors, or specialists try different approaches until they discover one that improves your child’s behavior, so hang in there!

Some good news, if your child has these traits, it will be easier to improve or overcome ODD behaviors:

  • A normal IQ
  • A first born child
  • An affectionate temperament
  • Positive interactions with friends their age
  • Nurturing parents who can consistently set clear behavioral limits

–From the Journal of American Academic Child and Adolescent Psychiatry, 2002.  Author J.D. Burke.

You try everything but nothing works.  People’s natural instincts for parenting do not work with an ODD kid—they need completely different techniques than ‘normal’ children.

How to reduce ODD behaviors

First, prepare yourself for the intensity of parenting a defiant kid because you are about to run a marathon.  Get enough sleep, maintain your other important relationships (spouse or partner, children, friends), schedule breaks or getaways, and guard your physical and emotional health.  Don’t expect quick results with these techniques; it may take weeks or months.

Parent Management Training – PMT refers to intensive educational programs that are “evidenced based,” proven to help parents gain the skills they need for extremely difficult children, especially those with ODD.  These programs are intensive, but substantiated interventions in child mental health.  PMTs help parents assert consistency and predictability, and promote pro-social behavior in their child.  A good explanation can be found at the Encyclopedia of Mental Disorders.  Examples include:  the Total Transformation and the Incredible Years.

Find something positive to do together.  Your child has normal needs for closeness and appreciation and joy.  Ask your child about their interests, and if their ideas don’t work for you, try new activities until one brings about a good chemistry between you and your child.

Praise is one of the most powerful tools for managing disruptive behavior.  Take responsibility to inject much-needed positive energy into your relationship with your child or teen.  It’s likely that this relationship has been almost 100% negative, yes?

Set limits – “Consistent limit setting and predictable responses from parents help give children a sense of stability and security.  Children and teens who feel a sense of security regarding the limits of their environment have less need to constantly test it.”  (Webster-Stratton and Hancock)

More praise – ‘Catch’ them doing something good.  Offer praise and make it sound genuine even if they respond in anger, then let it drop.  Spend as much time praising as disciplining!  And don’t expect thanks, it’s not about you.

Active ignoring – This works for best with children between the ages of 2 and 12.  It involves purposefully withdrawing your attention away from your child when they are misbehaving, such as in a temper tantrum, or when whining or sulking, or when making continuous demands or loud complaints, etc.  Pretend you don’t care and even turn your back if possible.  Give attention only after the behavior is over.

–Find out more at http://www.sosprograms.com/chapters/p_eng_chapters/EngParents03.pdf.

Make the behavior uncomfortable for the child/teen.  Example:  If your kid swears, test them, “C’mon, you can do better than that, be creative, I’ve heard all those things before.  Don’t be a copy cat.”  They can become frustrated when they aren’t getting the reaction they want from you, and give up.  Example:  your teen refuses to get out of bed for school.  Don’t nag or repeat, repeat, repeat.  Remove the blanket and set them far enough away that your child has to get out of bed to retrieve them.  (“Managing Resistance,” John W. Maag, jmaag1@unl.edu)

Give multiple instructions at once, where at least one of the instructions is what they want to do, and one is what you want them to do.  “Close the door while you’re yelling at your sister and don’t forget the light.”  Your child will be overloaded as they try to figure out which thing they’re supposed to defy.  Kids tend to get flustered by the mental effort and comply without knowing they’re doing it. (“Managing Resistance,” see above)

Reverse psychology:  Yes, this works, and it’s OK when important.  Example:  your child is bouncing on the furniture.  You turn on music and say “hey, try this, see if you can bounce to the beat, but I bet it’s harder to do on the floor.”  This is a good kind of manipulation.

Surprise rewards – Reward appropriate behavior with something they already like (that is acceptable to you).  They are more likely to do a desired behavior if they expect something they want and aren’t sure when it will be offered.

At the end of this article is a list of things to do to make ODD worse.  Avoid these!

“Why should I have to do this when it’s my kid’s responsibility to behave?”

It’s your responsibility as a parent to do what you can to help your child be successful.  ODD is a genuine disability that negatively affects their life and future.  I’ve seen highly intelligent ODD kids experience academic failure, or enough suspensions and expulsions to hold them back a grade, a can’t-win-for-losing consequence that worsens their behavior.  Wouldn’t this suck?

Warning, once you start consistent enforcement, things get worse at first – Defiant behavior tends to increase once your family system is changing.  This as a good sign—you are regaining your authority!  Your child’s backlash is a common human psychological response, and it’s called an “extinction burst.”  (see diagram below)  As parents change their approach to handling inappropriate behavior, the child becomes more defiant to test their resolve.  View this as predictable and plan ahead.  It won’t last and they will begin to comply with this one rule.  They then find another rule to defy and ramp up their defiance.  As you enforce it, they back off again, and the pattern continues until it’s just not worth it to defy rules anymore.

 

–From “Behavioral Interventions for Children with ADHD,” by Daniel T. Moore, Ph.D., © 2001, http://www.yourfamilyclinic.com/shareware/addbehavior.html .  The author requests a $2 donation through PayPal to distribute his article or receive printed copies.


How to make ODD worse -or- DON’T TRY THESE AT HOME

Don’t treat your child like another adult who has an equal say in how things are done.  Don’t treat your home as a democracy, where everything must be fair and equal.  Don’t answer your child’s accusations by offering reasonable, rational explanations.

Don’t keep finding fault with your child and let them know about it over and over and over.  If they do something positive, let them know it’s not enough.

Don’t ignore your child’s unique needs or the challenges they face everyday, such as bullying at school, or fear of abandonment, or stress from a chaotic home.  Just pretend they have no reasons for their behavior.

Only enforce rules once in a while, or have the consequence come later (Famous example: “I’ll tell your father when he gets home.”).  Don’t get angry about something, then direct your anger to your child and let them know it’s because of the stress they’ve caused you.

Don’t treat your child appropriately for his or her age.  Don’t make long explanations to a three-year-old about why you’ve set a certain rule.

Stop making rational justifications for your rules and stop expecting your child to logically, rationally accept them.  What’s interesting to me when I see parents doing this is that their children can be quite young (4 or 5), too young to be reasonable in the first place, or they can be young adults (early 20’s) who have a long track record of being unreasonable.

Don’t keep trying the same things that still don’t work.  Like making excuses; like screaming.  (Don’t be embarrassed; we’ve all done this.)

Don’t jump to conclusions that demonize the child.  I often hear parents say:  “Why does he keep doing this?, or, “Why doesn’t she stop after I’ve told her not to, over and over again.”  Then they answer their own questions:  “It’s because he always wants his way,” or, “She’s doing this to get back at me.”  As they tell their story, I hear them taking things personally:  “He does this just to make me mad;” “She manipulates the situation because she wants more (something) and I won’t give it to her.”

Good luck with your defiant ODD child.   I WISH YOU THE BEST!

–Margaret   How am I doing?  Please rate this article at the top, thanks.


 

9 Comments

Filed under ADHD, bipolar disorder, defiant, defiant children, depression, discipline, mental illness, oppositional defiant disorder, oppositional defiant disorder, parenting