It is a question every parent asks: How do I know the difference between ADHD symptoms and simple misbehaviors?

It is confusing. Suppose you walk into the living room to find your child bouncing on the sofa or running through the house like an out of control rocket. Is this hyperactivity, combined with impulsiveness? Is this simply a child misbehaving? If you punish your child for jumping on the sofa, are you punishing him for having ADHD? Or, if you don't punish him are you fostering a belief that he can use ADHD as an excuse for misbehaving?

In simple terms, it doesn't matter. Inappropriate behavior needs to have consequences. Children with ADHD need to learn, just as children without ADHD do, that jumping on the sofa is wrong and is unacceptable (unless, of course, in your house jumping on the sofa is okay.) They need to learn to control the impulse to jump and find other ways to manage their hyperactivity, like going outside to play, putting on music and dancing or jumping up and down on the floor, not the couch.

But, as parents of children with ADHD, we know that nothing about ADHD is simple. There is no one answer and since each child with ADHD is different, there is no right or wrong answer. Dr. Kenny Handelman, in a blog post, "Is it ADHD or a Behavior Problem," says, "So the short answer is whenever there is a question is this behavior? Or is this ADHD? The answer is it's both." Dr. Handelman suggests looking at each situation as a combination of behavior and ADHD, for example, if a child doesn't come when called for dinner, what symptoms of ADHD may have caused your child to ignore you? Was it the difficulty in transitioning from one task to another? Was it hyperfocus; he was so intent on what he was doing that he had a hard time breaking away or didn't realize that 15 minutes had gone by since you called him? Was it distraction; he was coming when you called but became distracted along the way?

As you can see, there are two forces coming together. There is the underlying symptom of ADHD, the difficulty transitioning, the hyperfocus or the distraction and there is the behavior that resulted from the ADHD. When you use ADHD as an excuse, you accept that because of the ADHD, your son could not control his behavior. You believe you need to accept his behavior because of the ADHD. When you accept ADHD as an explanation, you use behavioral strategies and set rewards and consequences for behaviors, thereby giving your child responsibility for his actions.

To help a child transition from one activity or task to another, we have suggested in the past that parents use schedules or periodic warnings. For example, using the above example, a parent lets the child know that he has 15 minutes until dinner, then reminds him again at 10 minutes and 5 minutes. This gives the child time to adjust to the next task or activity and gives him time to finish what he is doing first. By using this type of approach, a parent is acknowledging the symptoms of ADHD that are contributing to the behavior but at the same time teaching a child how to compensate for these symptoms and still follow the rules of the house.