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Once you and your child have begun to establish a basis of trust and positive support, it is time to look at the ways you hope to improve your interactions with her at home. Parent interactions can be improved, and improved interactions can set the stage for the successful use of parent training tools and techniques.

One of the first principles of parent training is to expand the notion of the word discipline. Many parents assume that the term refers to ways to carry out effective punishment. However, teaching discipline to a child really means teaching self-control—and that is the broad goal of parent training. Fortunately, behavior therapy programs take a more positive approach than just constantly devising punishments for breaking rules. As your child’s “teacher-coach therapist,” you will learn how to choose the most effective response to any given situation.

In most cases, you will find that you have 3 choices when confronted with a particular behavior in your child: you can praise the behavior, deliberately ignore it, or punish your child for it. Behavioral parent training will help you to decide which response to choose, how to follow up on that decision, and how to become consistent about your choices from one event, and one day, to the next. Of course, it is not always easy to decide whether a behavior deserves to be ignored or punished, and it is not always obvious when and how to provide praise.

In the meantime, though, it is important to consider how much more powerful and, in most cases, preferable positive reinforcement and ignoring are to punishment, even though in the heat of the moment this may go against your instincts or intuition. It may help to think about how much more likely you are to work hard when your supervisor at work recognizes and praises your efforts, and how poorly motivated and resentful you may feel if she frequently criticizes you. In the same way, your child is more likely to respond positively to your actions if you react positively to her, while a negative comment or response on your part is likely to lead to more negative behavior. This is why in behavioral parent training, parents are encouraged to praise their child’s behavior whenever possible, and ignore it when necessary, as a strong way of shaping behavior while minimizing the need for punishment.

When Responding to Your Child’s Behavior

Many parents making use of behavior therapy techniques find it helpful to rely on the following simple rules when interacting with their child:

  • If you want to see a behavior continue, praise it.
  • If you do not like a behavior but it is not dangerous or intolerable, ignore it.
  • If you have to stop a behavior that is dangerous or intolerable (for instance, your child hitting a sibling to hurt her, not just to get your attention), punish it.

Giving Clear Commands

The first step in helping your child learn to follow rules, obey your commands, and otherwise manage her own behavior is to make sure that the commands you give her are clear. Adults are often accustomed to couching their commands in a variety of “softening” or ambiguous gestures and phrases. Many of us also tend to react too strongly or impulsively to behavior we consider unacceptable. But children with ADHD need to be told what to do in a clear, straightforward, and nonemotional way if they are to learn to control their actions. You can give effective commands by

  • Establishing good eye contact. You must fully engage your child’s attention by making good eye contact if she is going to hear and follow what you say. At first, you may find it helpful to touch a younger child’s arm or hold her hand before addressing her.
  • Clearly stating the command. You can make commands clear to your child by first stating what behavior therapists call a terminating command—a simple, nonemotional statement of what you want your child to do (“You need to stop pushing your brother.”). If the behavior does not stop immediately, you can then follow up with a warning that includes the exact limit and the consequences (“If you push your brother one more time, you’ll be in time-out. If you stop immediately, the two of you can go on playing.”). When stating a command, keep your tone of voice firm and neutral. Refrain from yelling, or looking or sounding angry. It is especially important to monitor your body language because these nonverbal messages are so easy for parents to overlook. State the command as an instruction, not as a question (Not, “Would you please stop teasing your brother?” or “Stop teasing him, OK?” but “You need to stop teasing your brother.”).

If you are not sure your child heard the terminating command or warning, ask her to repeat it back to you. Then pay attention to whether she carries out your instructions and respond immediately to her behavior. If she responds as you have asked, respond positively with praise, thanks, a thumbs-up, a high five, or other acknowledgment that she has done well. If her response is not exactly what you had hoped for but is in the right direction, offer her immediate praise for the part of your command that she did carry out. If your child does not start to respond according to the limits you have set (“one more time” or “within the next two minutes”) invoke the consequences that you have already set, calmly narrating what is happening as you do so (“You did not stop pushing your brother, so you’ll have the five-minute time-out that we just talked about.”) Keep in mind that because you have given a warning and a terminating command and spelled out the consequences for complying or disobeying, if she does not follow your instructions you have not “put her in” the time-out—she has “chosen” the time-out for herself as an alternative to following your command. This is a key point. If you give your child a command, she doesn’t comply, and you immediately “put her” in time-out, you have skipped the step of her choosing whether to receive the positive or negative consequence. You have lost an opportunity to teach her self-control. Remember the bottom line of whether a parenting principle is sound: DOES IT TEACH SELF-CONTROL?

If you make a point of following through on the positive or negative consequences of each command, every time, you should soon find that you will not have to repeat your instructions over and over as you probably did before. Your ultimate goal will be to give a command only once for it to be obeyed. Parents are often concerned that “I have to say it eight times before she does it.” Children are thinking, “the first seven times are free! Then she gets angry and I finally have to do it.” The elimination of constant pleading, nagging, or threatening is a great relief to most parents and goes a long way toward improving their interaction with their child. If you are tempted to “let it slide” when she ignores a command (telling yourself, perhaps, that she does have ADHD, after all), consider how hard it will be to make up for this inconsistency in the future and carry out the promised consequences. If you are going to try to follow up on each command you give, you will need to consider beforehand how important the command you are about to give is. Limiting the number of commands you give will make it easier for you to follow up on each and every one, thus increasing your chances of success.

At first, as you practice giving commands according to these guidelines, you will need to keep things simple. Make sure that all your commands are achievable by your child, and wait until she has completed one step of your instructions before giving another. If necessary, break a complex command down into smaller steps (“Take off your shoes. Good job! Now take off your socks.”). This can result in your child being able to successfully carry out the command and build on successes, rather than to fail because the command was too complicated and feel like she can “never” do what you ask. While your child is carrying out your instructions, avoid distracting her. Be sure to follow up on each command, avoid giving commands unless you mean for her to follow them (do not tell her to go to bed until it is really time), and stick to commands that you know can be carried out successfully by your child. It is usually best to give a time limit (“by the third time,” “by three minutes”) for each command as well, to help her focus on accomplishing it and to help you both define when it has or has not been accomplished. Keep in mind, however, that children with ADHD often have particular problems with time awareness and time limits. You will need to keep such limits simple, and consider using egg timers or other creative clock devices to make these time limits more concrete. By doing so, you can turn commands that have previously ended in failure and frustration (“Go upstairs and clean your room.”) to commands that end in success and build on your child’s self-esteem (“Put your video game player away by the time this bell goes off in three minutes.”).

 

Last Updated
5/11/2013
Source
ADHD: What Every Parent Needs to Know (Copyright © 2011 American Academy of Pediatrics)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.