Dr Rachel V Gow Inside ADHD

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Dr Rachel V Gow Inside ADHD > ADHD > Interventions and behaviour management > Tips on structure, routine and reward

Tips on structure, routine and reward

  • Young children with ADHD often have improved behaviour when their expectations in terms of routine are met.
  • Structure needs to be built into their daily lives and can be best organised by creating a simple timetable/planner and by being persistent.
  • The more variable you are in discipline the more confused your child will be and the worse their behavior will become.
  • So, boundaries need to be firmly in place and your child needs to have a clear expectation of the consequences for crossing them.
  • Daily planners can be mounted onto the wall with after-school activities pencilled in. It is advised not to take away after-school activities as a means of discipline because they are so important for building social skills, improving communication and learning to work as part of a team.
  • In addition to the Daily Planner – smaller posters can be mounted onto bedroom walls to help get through the school week. You can create individual posters for Monday – Friday or create one large planner. Each day should be clearly marked with a list of instructions.
  • Posters can be made and titled according to the time of day (e.g., Jobs to do in the morning / after-school / evening. The posters should be organised so that only the occasion in question at that given time is up and present.
  • It is important that all posters are worded positively so best to avoid words such as “don’t” or “shouldn’t”.
  • Motivation can be improved by encouraging your child to tick off or place a sticker next to each task when achieved.
  • Rewards are very important and it is critical to remember that children with ADD/ADHD often respond better to immediate rewards rather than future delayed ones. There is little point saying well done – you can have your reward at the end of the month to a child with ADD/ADHD; it will just create immediate frustration and potential upset.
  • Children with ADHD often have low self-esteem and so in order to nurture and improve their self-esteem, praising, recognition and encouragement is needed at every available opportunity.
  • As parents, we tend to over-look occasions when our child is playing quietly. But this is an opportunity to tell the child how pleased you are that they are playing so nicely or something to that affect.
  • Our focus is often drawn toward negative behaviors. However, a series of: “No!”, “Stop” or “Please don’t do that” is draining and avoidable. How you frame the instruction is critical.
  • An example, of negative to positive:
      • “Will you shut up and stop that awful noise” could be replaced by
      • “Can you hear that?” [lowering the tone of your voice into a hushed whisper] “the birds are singing outside right now?”
  • Often easier said than done but finding alternative and inventive ways to redirect attention and change behaviour using humour or reflective language works much better than responding on auto-pilot and creating unhealthy communication patterns that can last a lifetime.
  • Reflective listening and changing communication styles takes a lot of hard work and practise. It won’t come easy at first but the end result is incredibly rewarding for both you and your child. So stick with it!
  • It is recommended to ignore as much (involuntary) low-level disruptive behaviour as possible. Of course anything that comprises the safety of the child or others cannot be ignored. But if it is just a behaviour that simply tests your patience or annoys you, for example, humming or tapping try to practise the art of ignoring. Sometimes the child is simply waiting for your reaction. They will be surprised when they don’t get one, become bored and/or distracted and drop the “annoying behaviour”.
  • Some types of behaviour unfortunately do become conditioned and children are very quick to learn which ones will provoke a reaction. Unfortunately, these types of negative behavioral patterns become cyclic with child and parent each playing their role. It takes reflection and self-discipline to break a pattern of reciprocal negative behaviour.
  • Remember, most children with ADHD receive more negative attention than their peers at school. Therefore, it is important that the home provides a safe and comforting environment. Children with ADHD can often arrive home tired and drained after a day of negative attention only to start the cycle again but this time with their unknowing parent.
It wasn’t long before I became known as the naughty boy. My mum called me a naughty boy and my grandparents called me a naughty boy. The teachers at school called me a naughty boy and even the children at school began to call me a naughty boy, especially the girls. Even once when I went shopping with mum in Sainsburys I did a cartwheel down the shopping aisle by the cereals and an old lady stopped and gave me this horrible look and shouted at me ‘What a naughty little boy!’

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