Tips for Parents of Children with ADHD
Bonnie Zucker, Psy.D.
(All information in this handout is adopted from lecture by Russell Barkley, Ph.D)
Understanding ADHD:
 The source of the problem (ADHD) is not parenting; it is a biogenetic
condition. Parents often try to solve the problem and this leads to learned
helplessness.
 One in 3 parents of child with ADHD have ADHD as well.
 Impairment with ADHD is in goal-directed behavior, as this type of behavior
requires the child to be able to resist distraction
 Distractability is a motor problem, not a perception issue: children with
ADHD perceive just fine (input), it’s that they cannot manage it
(motor/output). It affects the output part of the brain.
 Working memory is impaired. Working memory is defined as memory put in
the service of action (driving behavior toward a goal). Children with ADHD
have a hard time with the ability to remember because they cannot actively
hold information in the mind; “Remembering to do” is not information-based,
it’s about memory.
 Executive Functioning: defined as “those mental processes we use for
sustained problem-solving toward a goal”. Must be self-directed; relies on 2
broad-band domains: (1) inhibition, and (2) meta-cognition.
 ADHD is not independent from Executive Functioning (it’s the same concept).
 Inhibition: must be able to interrupt the sequences/stop actions; interrupt
what you are doing to function in the world. Children with ADHD struggle
with inhibition (the problem is one of disinhibition). Ex: Your child is still
playing video games as the bus is driving up the street.
 ADHD is a disorder of performance, not skill. It’s a disorder of doing what you
know, not knowing what you do.
 Self-regulation takes effort; each act that requires self-regulation depletes the
pool temporarily. Children with ADHD use so much effort to self-regulate (as
it doesn’t come naturally) so by the end of the day, they are too tired, no fuel
to do homework.
**Requiring someone with ADHD to simply work/try harder may be so
depleting that it sets them up for a sense of failure.
 ADHD: time-blindness: the further ahead the task is, the less they care about
it.
 Sleep deprivation: sets you up for executive failure the next day in someone
without ADHD. Worse for children with ADHD. Sleep is crucial.
 Children with ADHD can be very successful; just need to manage ADHD well.
Treatment for ADHD:
 Medication: 80% of people with ADHD will be on medication at some
point. Treatment with medication should be sustained, continued from
childhood through adolescence.
 Behavioral treatment is essential. Behavioral treatment is needed to
restructure natural settings to help the child with executive functioning.
 The goal is to make children with ADHD be accountable. Children with
ADHD should not be excused for behavior! This does not prepare them
for the world. Rather, give higher standards of accountability: more
consequences, more expectations of accountability. The child’s outside or
external environment needs to provide the structure, the executive
function.
 Externalize important information; externalize deadlines- highlight the
time periods related to tasks; break up long tasks into shorter onescreate many small steps; externalize mental problem-solving- write it all
down; externalize sources of motivation- use a charted reward system.
 This restructuring should be designed to provide necessary cues to
substitute for working memory deficits (ex: make signs, use lists,
notecards, make charts).
 Use sticky notes, signs, cards, etc as prompts- to provide reminders to the
child. Put everything in the child’s visual field: sticky notes all over;
externalize important information.
 For older children, use digital recorders, personal journals, Watch-Minder
watches, personal organizers, computer organizers.
 Make time physical, external, and obvious: use timers, clocks, counters.
 Break down future projects and goals into small, conquerable steps and
do one step a day. Make the Event-Response-Outcome cycle smaller for
the child: right now- do it right now! Don’t give long-term projects- do
shorter ones right now.
 Use tokens, prizes, points, privileges, praise: make the motivation
external. Give positive emotions with the reward.
 At least 80% of children with ADHD meet the criteria for another
disorder (most commonly Oppositional Defiante
 Increase accountability to others: use frequent check-ins, regularly
redirect your child to keep them focused on their work; regularly make
sure the goals are being met. The environment needs to provide the
external continuous reinforcement (as it doesn’t come from the child).
 Exercise is incredibly important. Children with ADHD respond best to
regular exercise. It expands the tank- refuels the pool- so that your child
has more to use to self-regulate.
 Advice from Dr. Barkley: “The compassion and willingness of others to
make accommodations are vital to success.”
 Useful Websites: www.help4ADHD.org; www.russellbarkley.org
 The GOOD NEWS: ADHD is among the most treatable psychiatric
disorders and has greater effectiveness for a larger percentage of cases.
Tips for Managing Motor Vehicle Driving Risks


Significantly higher risk when driving (citations, accidents, suspensions)
Greater adverse impact of alcohol on driving
Recommendations:
 Graduated license approach: daytime with adults, nighttime with adults,
alone, with peers, full independence (3-6 months at each stage, gradual
independence)
 At least 18 months of supervised driving
 NO CELL PHONES WHEN DRIVING!! Get device that blocks cell phone
range in car: the Key2SafeDriving Device- a bluetooth transmitter on car
key that shuts down driver’s cell phone (Professor X. Zhou); Accendo LC,
Kaysville, Utah- $50 plus monthly service plan
 Increase monitoring when driving: chart intended vehicle use; random
spot checking on destinations; critical incident cameras in vehicle
(DriveCam Inc., San Diego, CA) or GPS car monitoring devices
(MobileTeen GPS, AIG Insurance Co.)
 Behavior contracting for safe driving (Barkely Safe Driving Program,
Compact Clinicals, Jones & Bartlett Publishing; Maureen Synder’s book on
ADHD and driving, addwarehouse.com)
 Use medical management: extended release formulations with
supplemental immediate release as needed; Must be in meds to drive
(like Canadian law).
 Avoid alcohol use while driving (already impaired driving so even one
drink will result in bad impairment)
Tips for Managing Dating/Sexual Risks:


At higher risk for earlier sexual activity and greater number of partners;
higher rate of teenage pregnancy.
Recommendations: Greater parental supervision of teen social and dating
activities; delay couples dating and promote group dating instead;
medicate on dates to reduce impulsive behavior and increase self-control;
consider HPV immunization- to reduce risk of cervical cancer from
increased rate of sexual partners. Discuss use of contraception with teens.