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Effective Parenting of Teenagers with ADHD

Achieving independence is every adolescent’s primary developmental goal. Your teenager will experience this urge as strongly as his peers without ADHD, but his impulsivity, inattention, and aspects of delayed maturation mean that he may need to move more slowly toward full self-supervision. Specifically, you may need to

  • Remove limits and loss of privileges at as rapid a pace as possible, as your adolescent shows that he can take responsibility. Long-standing loss of privileges harbors resentment and has little teaching value.
  • Work harder at consciously modeling responsible behavior.
  • Break down tasks and responsibilities into smaller steps and reward him systematically for accomplishing them.
  • Develop a plan for systematically transferring responsibilities over to your teenager as he works on his own independence.

In short, sensitive monitoring and limit setting will be critical as your teenager works his way toward mature self-management and autonomy.

Of course, any adolescent would resent a 10:00 pm curfew, for example, if his friends are allowed to stay out until midnight. You should address your concerns directly—talk with him about the reasons if you worry about his staying out later. You may be concerned that parties tend to get wilder after about 10:00 pm, a time where you have observed that his impulsivity usually increases, or that driving is potentially riskier late at night because his medication will have worn off by then. If he counters that he is ready to take responsibility for staying out later, and you believe that this may be true and have made the necessary adjustments to ensure success (in this case possibly changing his dosage routine to enhance attention while driving), extend the curfew for 1 hour. If he arrives home on time with no evidence of high-risk activity, praise him and reward him with a continued 11:00 pm curfew.

Moving in these smaller steps allows you to continue to systematically build on these successes while giving him the chance to extend the boundaries of his independence. Such triumphs in mutual trust and respect are vital for a teenager’s self-esteem and positive attitude.

Providing Structure and Support

During your child’s earlier years, you were encouraged to actively monitor his behavior in the classroom and at home, providing frequent rewards and, when necessary, punishments. Now that your teenager is growing more independent, you may feel it is time to stop this type of monitoring. However, many teenagers with ADHD continue to need more parental monitoring and structure than their peers without ADHD.

While it is best for parents of many other 15-year-olds to back off and let their child manage his own homework production, for instance, adolescents with ADHD may need continued monitoring to see that he is completing his work and turning it in on time. While other parents may grow more lax about knowing where their older teenagers are every minute, you may have reason to continue monitoring where your teenager is, with whom, what he is doing, and when he will be home, particularly when you sense that he might find himself in a high-risk situation that may be difficult for him to manage. This must be done, however, in a manner respectful of your teenager and his developmental needs.

Establishing and Enforcing Rules

Teenagers with ADHD may have an argumentative style, and your teenager’s resistance to your continued monitoring is likely to lead to a great deal of boundary testing, negotiating, and possibly outright rebellion. When warranted, you may feel better—and will be able to save some energy—if you identify 4 or 5 nonnegotiable rules based on the issues you consider essential for your family. You may decide, for example, that use of illegal drugs of any kind—including marijuana, alcohol, and cigarettes—will not be tolerated in your house, or that driving can only be done at times when stimulant medication still has an active effect. These strict, nonnegotiable rules should be reserved for critical issues of safety or family functioning.

When you have arrived at the 4 or 5 basic rules, write them down and discuss them with your teenager. Explain that the trust built through compliance with these rules can open the door to negotiating the other freedoms he craves. His efforts to respect these few bottomline demands will improve communication and pave the way toward that greater trust. Finally (and this part can be negotiated), discuss with him the rewards for compliance (extended privileges in other areas) and the consequences (increased restrictions) for breaking these rules, and then enforce these consequences consistently.

Negotiating With Your Adolescent

Once your teenager has agreed to follow these few essential rules, you are likely to feel more at ease when negotiating other issues with him. As the parent of an adolescent with ADHD, you will need to become adept at using negotiation to shape behavior and to resolve conflicts as they occur, while at the same time respecting his need for independence. Negotiation is based on the assumption that, as an adolescent matures, he will take a more active role in creating the rules by which he lives. While your goal should be to gradually lead him toward a thoughtful independence in managing his behavior, it is important to establish the fact that as the parent, right now you assume the final responsibility for rules and consequences around selective critical issues.

A good way to negotiate rules or solutions to family conflicts is to use a technique called
problem-solving training. This technique consists of the following steps:

  • Define the problem and its effect.
  • Come up with a variety of possible solutions to the problem.
  • Choose the best solution.
  • Plan how to implement the solution.
  • Renegotiate a new solution if necessary.

Your teenager may resent the fact that he is not allowed to watch television on school nights, for example. To resolve this conflict, you could hold a family meeting to discuss the issue. First, you would define the problem and allow him to explain why it upsets him. (“Steven, you want to watch three to four hours of TV on weeknights like you say all your friends are doing,” and then you might add, “but I see that when you do that you usually only get about half of your homework finished.” Steven might respond, “Everybody talks about what they watched the night before, and I never have anything to say. It makes me feel left out and like a loser.”)

Next you, your partner, and your teenager would contribute ideas to resolve this problem. Usually 6 to 8 ideas are sufficient. No one should express judgment or respond to any of the suggestions in any way, positively or negatively. Each family member should contribute whatever solution comes to mind, even if it seems somewhat unusual or impractical—taking turns, if necessary, to allow each person to contribute his or her share. Your adolescent or you should write down each potential solution until all suggestions have been recorded.

Next, each family member should take a turn evaluating each solution in order. He should consider whether a particular solution would work for him, whether it would work for others in the family, and then assign it a plus or a minus. As the family works down the list of solutions in this way, each solution will accumulate a series of plus and/or minus ratings that can be used to choose the best idea.

To choose a solution, you and your family can select any idea that has received all “pluses” and discuss its benefits and weaknesses. If more than one solution has received all pluses, you might be able to pick the one that seems most reasonable to your adolescent. If none has received unanimous approval, choose the one that was best liked and discuss how you might make it acceptable or brainstorm again to find a solution acceptable to everyone. (For a solution to work well, it needs to create a “win-win” situation.) In this way, you will end up with a solution that you can all live with—even if none of you consider it perfect.

Once you have chosen the best solution, you will need to agree on how it will be implemented. Who will be responsible for seeing that rules are followed? Who will remind your teenager to comply with the rules when necessary? What are the consequences for breaking the rules and the rewards for complying? If you have agreed, for example, that Steven can watch television for 1 hour each school night as long as he has completed his homework, you must jointly decide how late at night he can watch television, who will be responsible for reminding him that his homework needs to be finished first, who will check to make sure it is done, what privileges he will lose if he breaks these rules, and what rewards he will enjoy if he follows them. The more airtight you can make this part of the agreement, the less time and energy you will spend arguing about the rules later. The entire agreement should be written down and, if appropriate, signed by everyone present.

When first attempting to solve problems in this way, it is best to start with issues that are important but not emotionally intense for your teenager or for you. Once you have practiced these new techniques with one or more easier topics, you can move toward resolving more volatile conflicts. Eventually you may become so adept at this rational form of problemsolving that you and your teenager will be able to resolve arguments on the spot, in most cases, using informal versions of this technique.

Providing Appropriate Consequences

You will need to “stick to your guns” in enforcing the rules and procedures on which you have all already agreed. Provide rewards and consequences consistently, and as soon as possible after the behavior has occurred. Measures such as time-outs are no longer ageappropriate for adolescents. More appropriate consequences include pre–agreed-on losses of privileges, such as temporarily losing car key rights for coming home late. Try to let these negotiated consequences take the place of argument, recrimination, yelling, or nitpicking. Keeping the conflicts and emotions out of it, and simply providing the appropriate response, is one way to keep family life relatively pleasant and upbeat.

Fostering a Positive Attitude and Giving Each Other Breaks

Your support and sensitive parenting can make all the difference to an adolescent who may meet with rejection, frustration, or even failure at school. Research suggests, in fact, that the presence of one fully supportive adult in the life of a child with ADHD is one of the key factors in determining that child’s future success. Be sure to invest plenty of quality time in your teenager—and make it fun and rewarding for both of you. Sometimes, when things get too tough at home, it is a good idea to take a break from one another. A weekend that you spend away can restore your awareness that your problems at home can be solved, and can give all of you the space you need to maintain a healthy relationship. Parents need support too!

Adolescence is an exciting period. It is a time of exploration and emerging independence, the transition from childhood to adulthood. This can be both a highly rewarding and tumultuous journey. As any teenager explores newly accessible choices, he or she will inevitably make some good and bad decisions. This is a normal and important part of becoming a responsible adult. As your family negotiates this developmental stage, it pays to keep in mind that your adolescent is a teenager first, and a teenager with ADHD somewhere down the line. Allowing this exploration is a critical element for arriving at the other end as a capable, responsible adult.

Last Updated
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.
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