Parenting and Adolescents With AD/HD: An M.D.'s Advice
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By Shashank V. Joshi, M.D.,FAAP
What risky behaviors do some teens with AD/HD engage in?
There are data from scientific research to indicate that teens with AD/HD are more likely to get into car accidents, to have lower self-esteem, and to have more negative risk-taking behaviors (including substance abuse, especially if they go untreated) than their peers without the disorder. This makes it especially important that kids be assessed and treated as early as possible.
What can parents do if their teen refuses to take medication for AD/HD?
It's very important for a teen to feel that he's the "captain of the ship" regarding his treatment, and that his parents and other adults (e.g., teachers) are in more of a supporting role. This is especially true of taking medication, which can have deep psychological meaning for a teen. Selected research assessing teens' perceptions of stimulant medications showed that the two most important factors influencing whether or not they would take the medication are: 1) the perception that taking medication makes them feel as if there's something wrong with them, and 2) feelings of embarrassment about receiving the medication publicly.6 Many doctors believe teens should retain "veto power" over most, if not all, decisions regarding medication.4, 8 However, a system of checks and balances also means that parents can restrict certain privileges if the teen elects not to follow the treatment plan. For example, for safety reasons, parents may withhold driving privileges from a teen who refuses to take his medication for AD/HD.4, 8
How can parents offer their teens with AD/HD independence but still provide necessary structure and supervision?
As discussed earlier in this article, realize that it's natural for most teens to want individuation from their parents; this is a normal developmental task of adolescence. Although teens with AD/HD feel they should have exactly the same rules and privileges as their non-affected peers, parents of teens with AD/HD have good reason to be extra-vigilant. Barkley (1995) and Robin (1998) offer these supervision tips for parents of teens with AD/HD4, 9:
- Be firm but discreet. For example, if your teen's curfew is a little earlier than his peers', you might arrange to pick him up around the corner from the party where all of his friends are hanging out (thus avoid making an unexpected parental appearance).
- Hold regular family meetings to discuss problems and propose solutions to family conflicts.
- Use behavior contracts, especially those which reward positive behavior and voluntary acts of helpfulness by your teen. This is important even if the behaviors are what you "expect your kid to do anyway, without being rewarded" (e.g., doing his fair share of chores, being nice to his siblings, and speaking respectfully to adults).
- Be an authoritative parent with a firm, warm, and loving approach. Set rules which involve your teens in decision-making, provide reasons for rules, and give frequent positive regard and focused (non-lecturing!) time to your teen. Though this is probably the best style for parenting adolescents in general, it is especially good for those with AD/HD, in that it fosters independence, yet still allows parents to provide adequate structure.
AD/HD by Other Names and Acronyms
While Attention-Deficit/Hyperactivity Disorder (AD/HD) is the official term and acronym used by today's mental health care professionals, it is sometimes referred to by other names and abbreviations. For example, it is sometimes called:
ADHD (without the "slash" in the middle)
Attention Deficit Disorder (ADD)