Dear Susan,
My 7-year-old is very cranky most of the time. Time outs and taking things away from her don't seem to work. She got kicked off the school bus and sometimes has to sit in the school office at recess. I had her treated for ADHD and she is on meds. They work for a few hours and then we're back to square one. What else can I do to help her make better choices and do better not only at home but school as well?
Signed,
Worried Mom
Dear Worried,
I appreciate the caring tone in your question; you come across as wanting to help your daughter with her impulse issues, rather than angrily trying to figure out how to force her to behave herself. Indeed, children with ADHD can have significant challenges managing their behavior. It takes a strong and understanding parent to help them learn the skills to -- as you say, make better choices.
First, recognize that some medications work better than others, and sometimes one works for a while and then stops being helpful. I would consult with the doctor who is overseeing your daughter's meds to ensure that she's being evaluated and monitored appropriately, and not just given a one-size-fits-all medication for her ADHD.
It is also important to make sure your daughter is well-nourished and rested. All children tend to have a hard time behaving properly when they're hungry, tired, or buzzed out on sugar. Make sure she's getting plenty of sleep and a good breakfast along with mid-morning snacks and lunches that are low on sugar and high on protein and complex carbohydrates.
Many ADD'ish children tend to behave in ways more similar to a child about 30 percent younger than their chronological age, so when you're setting expectations for her, it may be helpful to consider your daughter to be -- in certain respects -- more like a 4 or 5 year old. It's likely that this immaturity is impacting her ability -- or inability -- to stay out of conflict with her classmates, especially if she's being deprived of the chance to run around and burn off excess energy by being kept in the school office at recess.
In addition to the things that you can do to help your daughter deal with frustration, here are a few tips you can use to teach her to make better choices:
• Role play how she should handle herself when someone takes the crayon she was about to use or grabs the ball she wanted to play with, showing her how to ask to use it next, while acknowledging the frustration of not getting it right now.
• Help her develop a vocabulary with which she can express herself when she feels the "volcano" in her belly (frustration, anger) is about to "blow". Encourage her to identify the feelings in her body -- sweaty palms, gurgly stomach -- that signal she's about to do something that may get her in trouble.
• Give her the chance to do the things she enjoys and is good at. Oftentimes, ADHD children are very creative and/or physical, and the buildup of doing deskwork can make it extremely difficult to manage their behavior for hours on end. Whether it's after-school art classes or playtime at the park, make sure she gets to do the things she loves.
Yours in parenting support,
Susan
Parent Coach, Susan Stiffelman, is a licensed and practicing psychotherapist and marriage and family therapist. She holds a Bachelor of Arts in developmental psychology and a Master of Arts in clinical psychology. Her book, Parenting Without Power Struggles, is available on Amazon. Sign up to get Susan's free parenting newsletter.