Cindy Lea knows all too well how ADHD affects the entire family. "I had Attention-Deficit Hyperactivity Disorder (ADHD), and I kind of drove my siblings nuts," says Lea, who's a licensed marriage and family therapist in Burnsville, MN. "My sister and I shared a bathroom, and I'd be chitchatting non-stop and she'd be like, just shut up! We can be very annoying. We’re just being our overly energetic selves, but it annoys the hell out of others," says Lea, who now specializes in helping families that have a child with ADHD in the mix.
Kids with ADHD demand attention—lots of attention. Not surprisingly, that often leaves siblings feeling overlooked, says Marit Appeldoorn, L.C.S.W., a Minneapolis-based child and family therapist specializing in ADHD.
"With ADHD, we see a lot of typical sibling dynamics—but at a high-octane level," Appeldorn says. That not only makes keeping the peace hard, but it also can interfere with sibs' ability to form strong bonds. It's not impossible though, which is why we went to the experts to find solutions to some of the most common ADHD-family dilemmas.
Q: When my kid with ADHD routinely gets all the attention, how do I help my other children feel equally loved?
A: Hold an ADHD 101 session for neurotypical siblings.
First, just acknowledging the differences between siblings can go a long way toward understanding, Lea says. Parents should share age-appropriate information about how a neurotypical kid's brain works and how it's different from the way the brain of a kid with ADHD works...and then listen to how the neurotypical sibling feels about it.
You can say something like: "It's not that he’s being extra messy or bugging you on purpose; he can't really help it," Lea says. "We love our kids the same, but different kids need different things. Is there something else you need from us to help you feel supported?" And then, follow through.
Q: When ADHD behaviors disrupt family life, how do I protect my other children from living in an environment of frustration and anger?
A: Try a 5-to-1 compliment-to-critique ratio.
Before Sara (she asked to be referred to by first name for privacy) knew that her daughter had ADHD, "We were so mad at her all the time." she says. "It seemed like she was being willfully disobedient, and we thought she was just a 'bad kid.' And the other two kids have had to be in that sometimes anger-filled environment."
But once her child was diagnosed with ADHD around age 9, it was easier for Sara and her husband to shed the constant negativity and approach her behavior with understanding. Lea often gives new clients this homework: "I send parents home with an assignment to say five supportive, nurturing things before saying anything negative," she explains.
Most people can't take a lot of negative feedback, she says—and the amount of negative feedback kids with ADHD often get can be staggering.
One family reported that after a few days of using this strategy with their ornery 16-year-old, he cheerfully agreed to help his dad rake leaves and told his mom, "I'm really grateful I came out of your vagina." (Indeed!) Don't save this strategy for the kid with ADHD—it helps everyone, she says.
Q: How can I improve negative sibling dynamics—like when my neurotypical kid mimics the impulsive behavior of their older sibling with ADHD?
A: Go for honesty and a chance for a do-over.
"No, you cannot throw the bat when you strike out," Molly finds herself telling her 5-year-old, who argues that his older brother does it all the time.
In another situation, a sibling with ADHD may throw Legos at his sister, looking for some sort of connection.
Both of these scenarios are problematic, but can be managed. In the first situation, Molly focuses on honesty and age-appropriate explanation, as therapists recommend. She says: "I know your brother does this, but we’re trying to teach him it isn't OK. Everyone has challenges in life, and ADHD is his." The neurotypical kid should get the message that he doesn't get a free pass to do whatever his older sibling does.
In the second situation, Appeldoorn suggests a re-do directed by the parent. The parent could say: "It looks to me like you really wanted to play with your sister, so here's what you can do instead." This helps the child understand what was going on in the moment. The trick, she adds, is that the sibling she was trying to play with may need some space before the re-do can take place. After all, no one likes being hit by Legos.
Q: How do I help my kids have fun together?
A: Create fun memories.
Although Sara's children eventually accepted that the eldest's brain worked differently—and that being fair meant each child might be treated differently—it wasn't always fun.
"She can't keep her room neat, so the standards we required of her were different from what we required of her siblings," Sara says. "And that never goes well—yelling at one to clean their room when they can point and say, well, look at hers—even when it was really clean for her."
Parents can go out of their way to help the siblings have fun together to counteract the everyday grind, Lea says, whether that means family trips to an amusement park or a nightly family game.
"After dinner, everybody stays in the kitchen until the mess is cleaned up, and then you get to play a game for 20 minutes. And everyone takes turns picking the game," she says.
And Appeldoorn suggests stocking the house with the sensory tools that often help kids with ADHD. Because though the sibling with ADHD may have a greater need for them, the siblings may benefit from and enjoy them as well. That includes everything from yoga balls to aromatherapy to music to fidgets, she says.
The Happy News? Your Siblings Can Be Great Friends
It may not always feel like it, but there are some benefits to having neurodiversity in the house. Sara believes her daughters have a better bond because of her older daughter’s ADHD. Because of her older daughter's immaturity, the sisters' four-year age difference seemed minimal. "In that way it was a blessing,” she says, especially because she didn’t have that many similarly age friends."
When life was hard at school, she'd come home and watch "Clifford" or direct games with her little sister. Both sisters thrived on that: The younger always wanted to spend time with her big sister, and her big sister loved being looked up to.