In a 1999 study which appeared in the Journal of Attention Disorders (Kitchens, S.A., Rosen, L.A., & Braaten, E.B. (1999). Differences in anger, aggression, depression, and anxiety between ADHD and non-ADHD children. Journal of Attention Disorders, 3, 77-84) it was found that children with ADHD reported themselves to be significantly angrier than non-ADHD children. In addition, a 1994 study by Bird, Gould, & Staghezza Jaramillo found a very high co-morbidity of almost 95% of the children with ADHD studied also had conduct disorder or Oppositional Defiant Disorder. Clearly, dealing with anger can be a chronic issue for children who are diagnosed with ADHD.
How can a parent or caretaker help a child who has problems managing their anger?
Hopefully the following suggestions and tips can help. But I want to preface these suggestions with my belief that if your child is having lots of trouble handling his or her anger then it is very important that you get some support and guidance from a behavioral therapist or psychologist. I can provide general tips but what really needs to be done in most cases is to get a thorough assessment of the situation and your child's behaviors from a professional who can guide you step by step as to what to do based upon your child's unique set of circumstances.
- 1. You want to record your child's typical course of behavior when they lose control. You do this by doing a little bit of data keeping and communicating with school staff if your child goes to school. Divide up a sheet of paper into three parts. Label the first column as "Antecedent" and in this space you or the teacher will mark anything which preceded your child's behavior or angry outburst. This includes the time of day, people involved, and the activity your child was engaged in prior to his meltdown. The next column will be labeled as "Behavior" and this is where you will give a detailed description for what your child does when he cannot manage his anger. Does he swear? Does he get physical? And in the last column you will write "Consequence" and describe what happens after your child blows their cool. What is the school's response? What is your usual response? How do other children in the classroom or at home react to your child's behavior?
- 2. Take this data and begin to look for patterns and triggers to his or her outbursts. Does the behavior always seem to happen during unstructured or structured times at school or home? Is there any correlation between your child's behavior and the length of time which has elapsed between taking their medication and the present? Is the anger more exhibited towards other children or adults? Is your child over stimulated, frightened, or frustrated when these outbursts occur? Try to pinpoint common themes and triggers as this information will greatly help you to develop a plan of action.
- 3. Discuss your child's anger and subsequent behaviors with your child. Explain the patterns you are noticing and try to get clues from your child as to why these situations provoke him or her. Role play the situations which seem to cause the most trouble and provide replacement behaviors. For example, "When you are feeling frustrated because you don't know what to do next with your class work you need to raise your hand and ask for help."
- 4. Develop a feeling vocabulary with your child. There are more ways than one to depict anger. Your child will need to know the difference between words like "irritated" and "enraged." Set up a rating scale of 1-10 where ten is over the top going to blow rage and one is mildly irritated. Have your child rate different situations where he or she has been provoked in the past to give you an idea of the degree of his or her anger depending upon the situation. This will help you to prioritize which situations to counsel your child about first.
- 5. Teach your child how to lengthen his or her fuse. Talk about how, in many cases, it is good to walk away and take a break, and then come back to resolve the problem at hand. Anything which can delay that fuse going off is a good thing. Show your child how use deep breathing for a count of five and then to slowly count to ten silently. The trick is to delay action until they are more cooled down emotionally.
- 6. Teach your child how to recognize his or her warning signs that their anger is escalating. What are the absolute first signs that your child is angry? Do they tense up? Does their heart begin to race? If your child is more conscious of these signs then it is more likely that intervention at these beginning levels of anger will help.
- 7. Try not to focus on telling your child what not to do and instead focus upon what they should do. Brainstorm about ideas of what behaviors can replace the angry meltdowns. Communication is always a behavior one can use instead of getting physical. Tell your child things he or she can say in those situations which seem to set him or her off to having an outburst.
- 8. A lot of children who express frequent anger are looking for some control. Make sure that your child's day includes some choices even if it is between activities that you wish them to do. If there is a struggle over bath time for example, you can offer a choice of when this activity occurs as in "Do you want to take your bath before or after we check over your homework?"
- 9. Use humor to diffuse tough situations if you can. Never minimize your child's feelings about what they are going through but do let them know that you are on their side. Allow your child to save face by saying things like, "I can see why you would be angry about that boy calling you names but he must not be too smart if the best he can come up with is stinky butt."
- 10. There are many children's books out there which focus on the topic of anger. Some of these books include: "I was so Mad" by Mercer Mayer, "When I Feel Angry" by Cornelia Maude Spelman, and "When Emily Woke up Angry" by Riana Duncan.
How about you? Have you found any special ways to help your child to control his or her anger? Please tell us about those tried and true tactics here.
I want to also mention some other articles we have ADHD Central which touch upon similar topics as this one.
Eileen Bailey writes about Oppositional Defiant Disorder
Here is information from ADHD Central about Conduct Disorder
And I wrote the following article some weeks ago as part of a continuing Behavior Management series. "Meltdowns and Tantrums Oh My!