Editor's note: This article was sponsored by Seattle Children's Hospital.
Popular parenting books and mommy blogs aren’t written with every family in mind, especially if the family has a child with attention deficit hyperactivity disorder (ADHD).
At the same time, parents of children with behavioral challenges are the ones most likely to be seeking advice. That can lead to a frustrating experience, says Erin Schoenfelder Gonzalez, Ph.D., a psychologist at the Program to Enhance Attention, Regulation and Learning (PEARL) for ADHD at Seattle Children’s Hospital.
“Why isn’t it working?” she says, relaying a common question from a parent of a child with ADHD. “Because It wasn’t designed for your child.”
By the time parents seek help at Seattle Children’s, they’re often feeling stuck in a rut, says Gonzalez, whose work focuses on youths with ADHD. Research shows that parenting a child with ADHD can lead to much higher levels of stress, marital strain and depression. Those parental experiences can create an additional negative impact on children as stressed caregivers don’t have the mental bandwidth for quality interactions and activities. But Gonzalez says that hope lies in tailoring parenting strategies specifically to the needs of these children.
“I can say confidently: If parents do behavior management strategies, they will see improvement,” she says. “I have not seen cases where families use these tools and don’t see a change.”
ADHD is a brain disorder that affects up to 10 percent of the population. Some children experience symptoms of inattention, such as getting distracted easily and being disorganized. Others exhibit hyperactive characteristics, such as always being “on the go” and interrupting frequently. While all children might experience these behaviors to some extent, an evaluation for ADHD looks at whether a child exhibits them to a higher degree, if they’re consistent across settings, if they cause a problem and if they’re present over time.
Gonzalez created a video describing specific parenting approaches for children with ADHD that went “mini viral.” The approaches outlined in the video build on decades of research and the awareness that children with ADHD have less dopamine, the feel-good neurotransmitter chemical that helps facilitate learning and motivation as part of the reward system.
About 5–10 percent of children require a different parenting strategy, something Gonzalez refers to as “super parenting.” These families might already be providing great care, but their children’s brains are processing information differently. A successful parenting approach for children with ADHD acknowledges and addresses these distinct challenges.
Challenges and strategies
Children with ADHD have trouble planning and shifting from one task to the next. This difficulty can seem like a lack of maturity, but it’s really a sign that they’re struggling to regulate themselves.
Since children with ADHD are more influenced by their environment, they often exhibit inconsistencies in their behavior. One day they can get themselves dressed and ready to go for the day, but other times they forget the morning routine altogether. It might appear they are purposely not trying, which can be frustrating for parents. The causes, though, may stem from changes in their environment, from sleep deficits to built-up frustrations. As a result, they might struggle with tasks they managed just fine the day before.
To address these inconsistencies, it’s important to use tools such as visual prompts and incentives for success. It’s all about the dopamine — for everyone, but especially for kids with ADHD. Most people’s days are filled with things they enjoy and tasks that are boring or unpleasant.
“We can stagger [tasks],” says Gonzalez. “After something boring, do something fun, so there’s motivation to keep moving forward.”
For example, try warming clothes on a heater to entice a child out of bed, or let a toddler enjoy a gummy vitamin while sitting on the potty. Breakfast can be served as soon as a child is dressed. Over time, parents can fade out the rewards as the tasks become habitual.
While some parenting advice might caution against giving rewards, Gonzalez says they make perfect sense — especially if a child is struggling with motivation. Rewards give children the opportunity to see the benefits of creating a new habit, such as learning to read. Even adults crave rewards in the form of payment or praise for a job done well.
“Where does intrinsic motivation come from? I would say it comes from successful experiences, gaining confidence and starting to see benefits,” says Gonzalez.
Once you’ve identified the best incentives, consider how you can scatter more exciting things throughout the boring parts of the day. Daily notes can help keep kids motivated while at school. At the end of the day, it’s often hard for kids with ADHD to get into bed because the excitement of the day is finished. To address that reluctance, a parent could read a special bedtime story that’s powerful and meaningful to the child.
Parents of children with ADHD also need to anticipate more. Instead of trying to clean up a mess after things fall apart, think about what situations are going to be tough for your child and how you can offer more support. For instance, what part of the morning routine is a stumbling block? Once you’ve identified these trouble spots, consider how you can set up more structures and offer clear instructions and corresponding rewards at that juncture. For example, instead of waiting for them to complete a morning routine, offer praise (“You’re on the right track!”) for just getting out of bed, says Gonzalez.
While some parenting books might recommend natural consequences, the delay can make this tricky for kids with ADHD. Children might experience cold feet if they don’t wear socks, but that sensation is too far removed from the initial decision to go barefoot. Instead, consider what can be a reward in that moment for your child. What gets their dopamine flowing?
Parents don’t get a specialized manual when they have a child, which means many rely on how they were raised or what they read on social media. There’s a lot of information out there and it may not be well suited to a family’s particular needs. Gonzalez wishes the parenting blogs and popular parenting articles offered a disclaimer: If your child suffers clinical levels of difficulties, this advice may not apply to you.
Through her work at Seattle Children’s, Gonzalez sees hundreds of families a year for parent training. Adjusting a family’s approach to parenting can be labor-intensive, but experiencing results is highly motivating. She’s seen families improve a tough situation in as little as two weeks by changing their parenting approach. Sometimes, seemingly small steps such as spending special time with a child and letting them be the leader can make a big difference. For children used to hearing constant reprimands and redirections, having a positive experience with a parent can be very meaningful.
“That alone can be a game changer,” says Gonzalez. “It’s not going to get rid of ADHD, but it can shift the whole tone.”