Successfully managing ADHD takes a great deal of time and effort on your part as well as your child’s. If you, your partner, or any of your other children also have ADHD (not unlikely because the condition can run in families), the amount of time and effort spent is further compounded. Family members without ADHD may resent the time and attention that they feel are taken from them to meet the needs and address the issues of those who have it. It is no surprise, then, that the pressure to satisfy everyone’s demands sometimes becomes overwhelming.
One way around this is to formally schedule regular personal time with each child and with your spouse as well. These periods do not have to be lengthy—half an hour at a time may do—but they should be frequent and as predictable (daily, for example) as possible, and you should make sure they actually happen. When you are spending time with one of your children or your spouse, make it a policy not to bring up divisive issues.
Try to keep your time positive and focused on the present relationship so that both of you will have more emotional energy for the rest of the family later on. If you are the parent taking most of the responsibility for dealing with issues related to ADHD, it is also a good idea to try to delegate other daily chores as much as possible. Allow your partner, older children, or other relatives to take over duties that free up your time and, when possible, take advantage of time-saving services such as online banking, drive through services, and so on. Every minute you save from these errands is a valuable minute you can give to your child with ADHD, other family members and, just as important, yourself.
Partnering in Your Child’s Care Management
Becoming your child’s care manager means serving as the vital link connecting all aspects of his treatment plan at home, at school, and in the community. This requires a great deal of thought, organization, and support, and can make an enormous contribution to your child’s progress and your family’s welfare. Organization needs to extend beyond some of the aspects already discussed, such as calendars and time management.
For example, a child with ADHD accumulates a lot of records—from teachers, physicians, mental health professionals, medical insurance companies, and so on. Keep these papers neatly filed and available when you need them. By organizing reports and treatment decisions chronologically, you can create an excellent database for future discussions with treatment providers and school personnel about how your child is progressing. Always keep a pen and pad of paper or your handheld device available as well to record any information you feel might be useful at the next treatment review meeting with your child’s pediatrician.
Because concrete, quantitative information is so valuable in evaluating his progress, you will want specific notes on your child’s behavior rather than general, half-remembered impressions. Once you have instituted these organizing principles, you will likely find that you have more complete records than any of your child’s physicians, psychologists, or teachers, and that you have indeed become the true care manager. Whenever possible, partner with the care manager in your medical home.
In caring for your child with ADHD, the American Academy of Pediatrics recommends creating a “medical home." This term and concept is gaining increasing attention among pediatricians and parents. Despite the name, a medical home is not a building, nor is it a house. Instead, it is an approach to providing your child with high-quality, comprehensive care. It is an ongoing partnership between your family and your pediatrician and other members of your treatment team, and is based on the needs of the whole child and his family. It is defined as care that is coordinated, accessible, continuous, comprehensive, family-centered, compassionate, and culturally effective.
Educating Family Members
While you, your child with ADHD, and other adults involved in his care have probably focused a great deal of attention on learning about the nature of his condition, it is important to keep in mind that your other children and relatives are likely to understand much less. They will need your help in learning how to respond to your child’s behavior and to support his efforts to function successfully. If family members seem to resent or blame your child for his actions, take the time to talk privately with them about the challenges he faces.
Discuss treatment decisions with everyone in your family, explaining the reasons for your choices. If you are implementing behavior therapy techniques in your home, other family caregivers will need to learn to implement them as well. (Fortunately, all the tools and techniques you will learn through parent training apply equally well to other children in the family and can be equally helpful.) Teach other family members to frame ADHD-related challenges positively and to work with your child to solve problems. You might ask them to write down any issues they have (such as, “Frances interrupts me all the time!”) and then think about how to rephrase them in ways that will help solve the problem (“I need for Frances to wait until I’m finished talking before she talks.”). Once this is done, family members can discuss possible solutions, try one out and evaluate it, and move on to another solution if that one does not work.
Sometimes family members refuse to cooperate, express chronic resentment, or seem unable to act in positive ways. These are common issues; you might consider locating an ADHD support group in your area and/or seeking family therapy to help everyone adjust. In the meantime, let your child communicate directly to his other family members whenever possible instead of always “defending him” yourself. Such conversations can be quite effective in smoothing relationships and helping your child become a respected part of the family.