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.
Strategies for Parenting Your Teenager with AD/HD
Youth with AD/HD require a higher level of supervision and clearly defined rules and consequences. In parenting your teen with AD/HD, you must be willing to set negotiable and non-negotiable rules and develop strategies to avoid power struggles. Here are some parenting strategies to try:
- Involve your teen in his treatment. Ideally, your teenager with AD/HD will be an active participant in the decision-making and implementation of his AD/HD treatment program. He should understand how his medicine (if he takes it) and other treatment components will and will not benefit him.
- Be a proactive planner. Try to be proactive in utilizing your understanding of the negative forces and potential risks that affect your teen with AD/HD. Doing so can help you avoid placing him in situations in which he is likely to struggle. If your teenager becomes over-stimulated and overwhelmed in large crowds, for example, you’ll want to help him avoid – or at least limit his exposure to – such situations.
- Communicate clearly and briefly. Many parents attempt to communicate so much information at one time that anyone, including a teen at the receiving end, would become overloaded. Two effective ways of keeping your communication manageable are to “pick your battles”with your teenager and avoid giving him too many directions at once. When you or your teen become angry or overwhelmed, it’s often best to simply table the discussion for another time when everyone has calmed down.
- Provide positive directions. By telling your teenager what to do rather than what not do to, or giving him a “start”rather than a “stop”direction, you can reduce the likelihood of secondary problems resulting from AD/HD. Secondary problems would include conflicts that arise out of the well-meant efforts of parents to manage the behavioral difficulties caused by AD/HD. Thus, the problem occurs when your teen is not doing what he is supposed to be doing. It is further fueled when you provide a “stop”direction which only makes things worse, leading to an increased likelihood of conflict and oppositional behavior.
- Reinforce with rewards. More than their unaffected peers, youth with AD/HD require frequent, predictable, and consistent rewards to reinforce appropriate behavior. While offering praise is important, teenagers may place a higher value on privileges such as permission to visit friends, engaging in a favorite activity in the community, or driving the family car. If you apply rewards and punishment consistently and as soon as possible following your teenager’s behavior, it’s more likely the consequence will have an impact on either increasing or decreasing the behavior.
A modified response cost program is often effective with teenagers with AD/HD. Such a system provides all the “reinforcing privileges”at the start of the day or the week. Your teen must work to keep those privileges. For youth with AD/HD, starting with a “full plate”is more effective than starting with a “blank slate.” For example, you might offer your teenage driver with AD/HD the privilege of using the car for a certain number of hours during the upcoming weekend. At the beginning of the week, you post the full number of hours agreed upon. As the week progresses, that time is reduced each time your teen neglects a responsibility or breaks a rule. Whatever time is left by the weekend, your teen can then use the car for that amount of time.
- Maintain a sense of humor. Humor and playfulness are important ingredients in communication. The more you can call upon humor at appropriate times, the more you will facilitate communication with your teenager. Many studies have found that humor can help children cope with adversity. One caution: If you and your teen are angry with each other, he may interpret your humor as sarcasm. Humor should be used to create a warm environment in which parents and teens feel comfortable and most importantly one in which teens will be more willing to listen and communicate.
- Tend to your teenager. Remember that while your relationship with your teen with AD/HD is likely to be strained, these years will set the foundation for a lifetime relationship. It is important to take extra time to balance the scales and maintain a positive relationship. Find an enjoyable activity and engage in this activity with your teen, at least once a week.
Keep in mind that any professional treatment plan for AD/HD must include the use of effective, research-proven interventions. Reducing the symptoms of AD/HD reduces the level of impairment; consequently, risky behavior and adverse outcomes are also reduced.
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)