ADHD–a good excuse or a reason to take responsibility?

ADHD presents special challenges to both the kid that has it and to his or her parents.  Being the parent of a typical kid these days is challenging enough.  When you throw in the distractibility, impulsivity and academic struggles that come with ADHD, it can magnify other issues that are hard all by themselves (like sex, drugs and rock n’ roll).  One of the frequent questions that I get from parents is how to modify the expectations they have for their kid.  Can they expect as much from them as they did from themselves or from an older sibling. 

This is a challenge whenever you have a kid.  How much do you push?  How much do you back off?  How angry do you get?  How understanding should you be?  With each kid being different . . . how is a parent to know?  Again, putting the overlay of a psychiatric issue on top does complicate it somewhat . . . or does it?  Let’s think for a moment what expectations you should have for any child.  Should every child be expected to get straight A’s in school all the time?  Should every child be expected to get every assignment done on time without ever forgetting or losing something?  Should every child be expected to NEVER fail a test?  I suggest that the answers to the above questions is “no”.  What is school if not a learning experience.  And what better learning experience (for many of us) but failing or doing poorly when we know we could have done better . . .

. . . when we know we should have done better . . .

. . . aaaaahhhhhh . . . I think I have stumbled onto an answer.  Perhaps it is not so much about succeeding as it is about doing your best.  When I think back to when I felt really good about an academic achievement, it is not always the “A” that I got.  As a matter of fact, the grade that I am most proud of in my life is the C+ I got in Biochemistry in college.  The fact that I could say that I tried as hard as I could made that “C+” feel like an “A”.  SOOOOOooooooo, perhaps the issue that we need to cultivate in our kids is a need to do your best.  Perhaps what we need to teach them is how to know when you try your best.  What does it look like.  What does it feel like.  And what do you do when you try your best and fail.  People in general (and kids in particular) are always good at making excuses for themselves.  If you do poorly at something and don’t find an external excuse for it, then it must mean that there is something wrong with you. “I’m stupid” . . . “I’m lazy” . . . “I’m a f*** up” are the internal tapes that tend to run in your head, and these are hard to hear and don’t make you feel so good.  It is way easier to think . . . “that teacher is stupid” . . . “that teacher doesn’t know how to teach” . . . “this school is f***ed up” . . .because that takes you off the hook.

The approach that I use with my kids with ADHD is to clearly talk to them about how all kids need to try their best.  All kids need to deal with differences in themselves that can make getting good grades more difficult.  All kids need to deal with differences in their family or social circumstance that make getting good grades difficult.  In life, we are all faced with challenges.  It is how we respond to those challenges that . . . determines . . . or is a reflection of . . . who we are as a person.  There is, without exception, a way to overcome most difficulties that are presented to you in life.  There are ways to maximize your abilities in the face of adversity.  If you have trouble paying attention, you may have to sit in the front of the class instead of in the back with your friends.  If you have trouble keeping track of your stuff, you have to work with a tutor on organizational skills.  If you tend to get angry, you may have to learn better anger management skills.  If you get dealt a bad hand in poker, you don’t get mad at the dealer.  You might win a few hands by bluffing, but the other players in the game will quickly learn that you don’t have a full house every time you bet high.  Ultimately, you must take responsibility for the cards in your hand and do what you need to do to better them.     

What is the parents role in this?  It is to keep the kid focused on doing their best.  Yelling at them rarely works.  They just get resentful of you and figure out how to get what they want behind your back.  Keep the conversation focused on how to do your best.  How to learn what needs to be learned to make school easier and more successful for you.  There are certainly times where restrictions must come into place but it is the presentation of those restrictions that is the most important.  It is not “you failed and you are bad so no Nintendo for you!!!”  You just look like a jerk to your kids, and they feel bad about themselves.  What you are really saying to them is that they cannot manage the distractions well enough so you must take some away.  It would ultimately work better if you are actively involved with them on their homework and encourage good communication and active participation and reward their efforts with what your kid feels good about afterward. Perhaps, even, play the video game WITH your kid (imagine that!!).  Parenting is nothing if it is not a creative adventure with a host of challenges.  If you try to view yourself as a “teacher” of skills rather than “the disciplinarian”, you may be able to turn an episode of difficulty into a positive learning experience rather than a conflict.

–Dan Hartman, MD