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Foundations for Resilience in Teens With AD/HD

Dr. Sam Goldstein tells parents how to reduce risky behavior and foster resilience in their teens with AD/HD.

By Sam Goldstein, Ph.D.

Despite the popular belief that Attention-Deficit/Hyperactivity Disorder (AD/HD) may offer affected individuals some benefit, most of the current research suggests that the vulnerability created by inattentive, impulsive, and hyperactive symptoms leads teenagers with AD/HD toward high-risk behaviors. As I explained in an earlier article, the problem is not that these teenagers do not understand the risks associated with driving, sexual activity, substance use and abuse, and school failure, but rather that the impairments caused by AD/HD make it difficult for them to do what they know is best.

In this article, I will describe how the quality of resilience in a teenager can steer him toward success. I will also explain how you can develop the knowledge and mindset necessary to raise a teenager with AD/HD. Finally, I will present strategies to reduce high-risk behavior in your teenager with AD/HD.

The Role of Resilience

Ultimately the life course for any human being is affected by varied and multiple factors. Having AD/HD is but one. It is not the severity of symptoms and problems related to AD/HD or even how well treatment helps a teen function that best predicts his outcome. Rather, the greatest predictor of his future life success is how resilient he is in dealing with life. A growing body of literature has demonstrated that a number of childhood variables can be used to predict, in a general way, risk of later life problems as well as identifying insulating and protective factors that reduce risk and increase the chances of a satisfactory transition into adult life. Researchers studying teenagers with AD/HD are beginning to examine these protective factors. These thoughts, feeling, and behaviors fall under the umbrella of resilience.

A resilient teenager is able to:

  • Deal effectively with stress and pressure.
  • Cope with every day challenges.
  • Bounce back from disappointments, adversity and trauma.
  • Develop clear and realistic goals solve problems.
  • Relate comfortably to others and to treat him and others with respect.

Resilience provides part of the explanation as to why some teenagers with AD/HD are "victims"of their condition while others overcome overwhelming obstacles. As a parent, there is much you can do - through support, empathy, and nurturance - to help your teen develop resilience.

Develop a Realistic Mindset about Your Teen with AD/HD

As a parent, you must begin by accepting the adverse consequences of AD/HD and being alert and observant to your teenager's emotions and behavior. Here are some steps to help you develop such a mindset:

  • Become educated about AD/HD. It's important to become educated about AD/HD, understanding the risks it presents during the adolescent years, and the co-occurring problems of related disorders. You'll want to understand the impact AD/HD has on developmental, academic, behavioral, and emotional issues.
  • Develop a "learning to swim" mindset. Learning to live with - and overcome - AD/HD is much like learning to swim. Not all children learn to swim with their first lesson. Some children have poor coordination and require significantly more time to master the physical skills required to swim. In such cases, most parents don't challenge their kids to try harder nor do they question their motivation and effort. Instead, they offer empathy, support, and most importantly recognize that for some individuals change and skill development takes time and may proceed in small steps. Similarly, teenagers with AD/HD can develop skills to strengthen their ability to think through and anticipate problems, consider alternatives, and make good choices. However, for these youth, change will take time and must be accompanied by parental support, patience, and symptom-relieving interventions, allowing them to function effectively as they develop skills.
  • Learn the difference between incompetence and noncompliance. Try to develop an understanding of incompetence (unintentional performance and behavioral deficits that result when a teen is inconsistent in applying skills) and noncompliance (intentional behavior which occurs when a teen does not wish to do what he is asked or directed to do). AD/HD is principally a disorder of incompetence. However, since at least 50 percent of teens with AD/HD will also experience other disruptive, non-compliant problems such as Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD), parents must develop a system to differentiate between AD/HD and a secondary problem and develop effective strategies and interventions for each issue. Sorting this out takes time, patience, and careful observation of patterns in your child's behavior. It may also help to enlist the support of a therapist to learn to pinpoint the source of certain behaviors.
  • Consider your needs and those of other family members. Families with one or more teens with AD/HD are likely to experience greater stress, more marital disharmony, and potentially more severe emotional problems in parents and siblings. It is important to understand the impact the behavior of your teen with AD/HD may have upon the family. Try to approach your teen's problems in a positive, preventive way, rather than a frustrated, angry, reactive, and negative way - after you've exhausted your patience.

Sam Goldstein, Ph.D. is a Clinical Professor of Psychiatry at the University of Utah, a Research Professor of Psychology at George Mason University and Director of the Neurology, Learning and Behavior Center in Salt Lake City, Utah. He is Editor-in-Chief of the Journal of Attention Disorders, author, co-author or editor of 26 books and dozens of book chapters and peer reviewed research articles.

Comments from readers

"'Whatever time is left by the weekend, your teen can then use the car for that amount of time.' What do we do when the teen then doesn't return the car on time and just stays out because he's impulsive and doesn't understand the consequences of his actions? That's a problem we run into - the ADHD teen does not seem to understand that their negative actions have caused punishments. It's as if punishments don't phase him at all. He says that he feels he can't stop himself when he goes to do something he knows is wrong."
"My son has had difficulty remaining focused on tasks and following classwork and homework through completion since he has been in school. At teacher conference time he consistently has the same reports year after year. 'Your son is performing below his potential, or He needs help with his organizational skills'. I am totally frustrated. My husband and I have considered holding him back a year. His birthday is 4 days before the school year starts we have always thought that maybe we should have kept him in preschool an additional year. We thought he was immature (developmentally) for his age and that was the reason for some of his inability to stay focused or complete the tasks before him. I need help implementing systems in my household."