Attention-deficit hyperactivity disorder (ADHD) looks distinctly different in every child (and adult) who has it—which can make it a puzzle for professionals and parents alike. While it’s associated with a set of core symptoms—inattention, distractibility, forgetfulness, hyperactivity, and poor impulse control—some people struggle primarily with the inability to pay attention while others deal with hyperactivity.
An estimated 9.4 percent of U.S. kids, ages 2 to 17, have been diagnosed with ADHD, according to the Centers for Disease Control and Prevention, and many others are believed to have it but are undiagnosed. No one knows precisely what causes ADHD but there is a genetic or hereditary component, so it often runs in families. To receive the diagnosis, a child must have symptoms severe enough to interfere with daily functioning in at least two settings, such as school, home, or social situations.
“Children with this condition have less voluntary control over their attention, their level of activity, and how quickly they make decisions, so parents can become frustrated, impatient, and demoralized,” says Richard Gallagher, PhD, an associate professor of child and adolescent psychiatry at NYU Langone Health in New York City. To help out moms and dads, Dr. Gallagher and other pros outlined common challenges and offered problem-solving strategies:
Mornings are hell—you can’t get your child up and out the door in a timely fashion.
Create a schedule with a checklist of tasks your child is expected to complete in the a.m.—getting dressed, making their bed, eating breakfast, and brushing their teeth, suggests Sanford Newmark, MD, a clinical professor of pediatrics and director of clinical programs at the Osher Center for Integrative Medicine at the University of California San Francisco. “Have your child check things off as they’re completed and reward them for being cooperative.” The night before, make sure your child’s pack is ready to go, with homework inside.
It’s often a struggle to get your son or daughter to do what you ask.
Get your child’s attention, using eye contact, and make your requests clear and short, Gallagher advises. Then, ask them to repeat what you’ve said. When they follow through on a request, praise them for a job well done; positive reinforcement can inspire a repeat performance.
At school, your child is fidgety and restless and has trouble sitting still.
Many school systems offer accommodations, so find out if yours does. “Kids with ADHD may do their work better if they’re allowed to move a little,” Dr. Newmark says. Ask teachers if your child can use a wobble chair or get up and walk to the back of the room occasionally to release energy without disturbing other students.
Play dates don’t always go well because your child has trouble taking turns.
Coach them about how to make sure other kids have their fair share of time doing the activity, Gallagher suggests. If your child tends to interrupt a lot, practice at home: Set a goal of waiting until a family member is finished talking at the dinner table, for example, and praise your child when he does it. “The idea is to catch them being good,” Gallagher says. Similarly, remind them to respect other people’s personal space—by standing an arm’s length away and asking permission to give someone a hug, for example. Also, limit play sessions to 90 minutes for preschoolers and two hours for school-age kids.
Your child’s room is a disaster zone and you can’t get them to clean it up.
Break down what needs to be done in a step-by-step fashion, advises Karyn Erkfritz-Gay, PhD, a child and adolescent psychologist and manager of behavioral health programs at the Northwestern Medicine Ben Gordon Center in Dekalb, Illinois. She suggests they start by putting dirty clothes in the hamper, then making the bed, putting books and toys away, and so on. Make it clear where school materials should go, perhaps with a labeling system for desk drawers. Since cleaning their room isn’t inherently gratifying for most kids, develop a reward system, such as earning extra screen time if they do it regularly, says Erkfritz-Gay. “Remember: Parents are the gatekeepers to a lot of things kids want.”
Getting your kid to do homework—and turn it in—is an ongoing battle.
Carefully select a time for homework, Gallagher says. While your son or daughter may need a break right after school, if they’re taking a long-acting ADHD medicine, you’ll want them to do homework before the effects wear off. At the chosen time, have your child sit down and get it done, then praise them for completing it and putting it into their backpack to turn in the next day, says Gallagher. Ask teachers where homework gets turned in—and remind your child of the protocol.
Your son or daughter often misplaces important items, which leads to a mad scramble to find them.
Set up a system so that everything has a place, with specific spots for your older child’s keys, wallet, and cell phone, for example. Designate a special place for backpacks, sports equipment, and shoes—cubbies, a mudroom, or another key spot, Erkfritz- Gay says. Encourage kids early to put items where they belong so they can find them easily.
Your child’s eating habits are erratic because of ADHD medication.
ADHD meds can affect a child’s appetite for lunch, so make sure they have a good breakfast and a healthy dinner (and an afternoon snack if they’re hungry). “Kids who are taking ADHD meds may not get hungry until 7 or 8 p.m.—feed them when they’re hungry and let them eat as much as they want,” Dr. Newmark says. All meals should contain plenty of protein, fiber to slow digestion, and lots of fruits and vegetables. “Avoid processed carbs or sugar because these can cause blood sugar spikes, then dramatic drops, that make ADHD symptoms worse,” he says.
Your child sometimes has emotional meltdowns and can’t calm down.
Don’t yell or let your child get away with bad behavior. Instead, suggest that they take a private break to cool down, and then you can talk. Once they settle, give them positive feedback for calming down, suggests Dr. Newmark, then redirect their attention, perhaps by saying, “Good job calming down. Let’s go do X.” To help with emotion regulation, encourage your kids to recognize and label their emotions and give them tips for how to handle them constructively, Gallagher says. If they’re really frustrated, you might say, It’s okay if you growl but not if you curse or throw things.
You can’t get your child to go to bed at a reasonable hour.
Rule No. 1 is setting a consistent bedtime, based on how much sleep your child needs. Make sure their bedroom is quiet, calm, dimly lit, and conducive to getting rest. “Do not have a TV in the room or access to computers, tablets, or phones at bedtime,” Gallagher advises. Work with them to set a digital curfew 30 to 60 minutes before bedtime, and encourage your child to engage in gentle activities like taking a warm bath and reading a book before lights out.