Many parents of ADHD children and teens come into my office and report that nothing really works in terms of discipline and consequences. “My son just doesn’t care what we take away” or “my daughter laughs when we ground her.” While all kids balk at rules sometimes, those with ADHD, because of their ADHD, seem to do this more often and louder. To be successful at reining in and re-directing undesirable behaviors in ADHD kids, parents not only have to be incredibly patient but also consistent, clear and calm. From this firm ground, you can then make well-considered decisions about the rapidly changing emotional meltdowns and behavioral infractions you encounter with your child. Today’s parents have, in general, moved away from physical punishment such as spanking to using Time Outs. But Time Outs still focus on the “wrong-ness” of the action. Time Outs seem to give parents and children a break when they most need it and emotions are running high. But, most kids experience them as punishment which makes them feel worse about themselves. They frequently feel like they are bad people who are engaging in bad behaviors that, because of their ADHD, they often can’t control. In addition, Time Outs usually don’t teach emotional regulation because learning this key executive functioning skill requires interaction not isolation. Kids benefit from discussing ways of managing big feelings and getting help using these techniques at times when they are the hardest to implement. Of course, a child in Time Out will eventually calm down but they usually don’t come away from the experience with the necessary skills they will need the next time they get triggered and have a meltdown. I believe that people need some separation from each other when emotions get high but this separation has to be negotiated and agreed upon before it is implemented. This means making a plan together for those times when things get heated or out of control that works well for everyone. Imposing a physical separation such as sending your son to his room when he is in a meltdown may not be the most effective solution for him even though it would give you some relief. He may need a quiet few moments with you on the couch rubbing his head and reading a book. You may need 20 minutes alone in your room with some deep breathing or mindless television. So, I like to advocate for Time Apart Together: a pre-negotiated break from the problematic interactions that doesn’t banishment your ornery teen to his room out of mutual anger and frustration. The Time Apart Together System (TATS) is based on creating an environment that teaches self-management through collaboration when people are not upset. This technique relies on the parent-child bond that is the main incentive for cooperation in the first place. I am certain that neither you, your ADHD child or teen or anyone else who is resides with you likes the meltdowns, yelling and emotional escalation that often precede a standard Time Out. Here’s how to use Together Time Apart:

1. Identify together what contributes to meltdowns and what types of ‘breaks’ would help everyone slow down and calm down. When you see your child heading towards an eruption, try one: You can even give it a special name. I have worked with people who call them anything from “Pink Elephant”, “Take Ten” to “That Dr. Sharon Thing.” You too can ask for a break when you feel as if you are losing it. In a few weeks, once you have tried out the interventions several times, discuss how your new plan is working.
2. Sometimes a time in—the opposite of what you, as a parent feels like doing when you are in a dither, can be most helpful. Try taking a deep breath, counting to ten and giving a hug, starting an activity like reading a book or having a game of catch. Comfort and distraction can be great antidotes for anger and emotional eruptions.
3. Once the meltdown has started is not the time for any negotiation or teaching. Your ADHD child’s thinking brain has been kidnapped by her emotion brain—it’s fight or flight mode. Stay nearby and stay calm but don’t give in to her demands. Take some mental notes and use them when you re-evaluate the TATS that you have devised.

Good luck on embarking on your family’s TATS today!

How many of us long for our family summer vacations and then feel like they whiz by all too quickly? We return from our days off with that certain “I’ve just had a break glow” only to see it fade too soon and too fast. Vacations offer us a much-needed respite not only from our daily routines but also from the typical ways we interact. These breaks are especially needed by ADHD kids. They can really benefit from a different environment, meeting new people and taking time away from academics. Hopefully, you and your ADHD child or teen have also been able to have fun together. These positive connections enrich your relationship by nourishing the bonds that foster collaboration. Soon, however, your ADHD son or daughter will go back to school and you will be catapulted into the busy-ness of life once again. How can you keep the vacation glow alive? Time functions differently for ADHD kids. They live primarily in the present don’t spend much time in the past. They focus on the future when it is immediately in front of them and they don’t tend to linger on the past. In addition, ADHD kids (and adults too) frequently have working memory deficits. This means that it can be hard to recall or hold onto things in their brain. Information that is recorded in the brain doesn’t transfer efficiently to long term memory storage. Furthermore, many kids with and without ADHD are so often distracted by their technology that they miss out on what is going on around them or forget about it when “an important text” interrupts their current activity. Thus, the glow from the vacation can evaporate much too soon. How can you help them stay connected to the benefits of time off and incorporate them into your home once you get home? Try these tips to recapture and preserve the glow from your family vacation: 1. During a meal or other family time (for instance, being in a car is always a good time to talk because you are all there together), review some of the highlights of your family trip. Be specific. “That double chocolate ice cream cone was the best!” “I loved riding that big wave right up the sand.” Write them down if you can and maybe put a phrase or two around the house on post-its. 2. Together with your ADHD son or daughter, find some pictures or video from the vacation that illustrate or connect to those moments. Try to post some of these images in a common space in the house as well. Maybe watch a video clip or two. Allow yourselves to reminisce. 3. Share some stories about your family vacation with friends or family, encouraging the kids to participate (even with interruptions). The goal here is to rekindle the excitement of the original experience and keep it alive. 4. Do this periodically for the next month or two. It will help all of you remember what fun you had and the closeness you shared. Enjoy your vacation!

How many times have parents of ADHD kids heard them say, “I’m sorry” but it didn’t feel like they really understood what they had done? That it didn’t feel genuine? Most Adhd kids harbor feelings of being wrong or doing bad things from an early age. They likely have been admonished at school and at home numerous times for: impulsivity, being overly active, daydreaming or social awkwardness. Basically, they are reprimanded for doing things which have seemed nearly impossible to be in their awareness or control. Apologies are just one more thing on the long list of what they should do better and usually aren’t a big priority. In my clinical practice, I often play games with ADHD children and teens while we talk about issues in their lives. Yahtzee, Battleship, Checkers, Uno are longstanding choices. But my favorite game to play with my clients is Sorry. I love playing this game because it is always interesting to me to see how each person proceeds to say it. We set the ground rules for saying “Sorry” at the very beginning and they are simple: You must look the other player in the eye and say “Sorry” directly and clearly. That’s all there is. Here’s what is fascinating. Some kids cooperate easily and with good humor. Others have a lot of trouble following through: they will mumble, avert their eyes, say it as fast as they can or omit saying anything at all. Over the years, I have observed that most of the ADHD kids who struggle with simple apologies during the game also struggle at home, at school or with friends with personal accountability. They often harbor such a deep sense of shame about their various misbehaviors or mistakes that apologizing is just too painful. So, when arrive at the “sorry” part of the game and I see them avoid it, I try to turn it into something playful before addressing their discomfort later more directly. Then, we can talk about how to give real apology and mean it: using eye contact, tone of voice and volume. As adults, we realize the importance of accountability, humility and the acknowledgment of our errors and our limitations in the context of maintaining and nurturing our relationships with family, friends, colleagues, etc. Often, it isn’t so easy for us to apologize for own our hurtful words or actions. So, it makes sense that ADHD kids and teens are not only reluctant to be, in their own minds, wrong AGAIN but at some level, very accustomed to having committed yet another mistake. They frequently want to say a quick “Sorry”, get it over with and move on. How can we teach our ADHD children and teens to do better without shaming them further? Sometimes just asking for eye contact and a thoughtful “I am sorry because . . .” can be enough. But at other times, something more may be called for. I like Apologies of Action because they integrate words with doing. Some people call this “Making Amends.” Either way, it is a collaborative, teaching process: your ADHD child or teen learns that their speech and actions affect others and that reparations can be made. When she says or does something hurtful, she needs to make her apology meaningful—not just a throw away. This requires a combination of a verbal apology and doing something to help the person. For example, one ADHD teen I know was driving his parents’ car (with their permission) and backed accidentally into a mailbox in a snow bank. He felt terrible but couldn’t make a real apology which infuriated them. When they sat down to talk about the next day, he shared his embarrassment, guilt and regret about the accident. The parents accepted his apology but also asked him for his participation in repairing the car. He met with his father and the insurance adjuster to report the incident. He went with the mother to get an estimate on the damages to the car. He wasn’t allowed to drive the rental car so he had to bike places instead. In the end, he told me that it “turned out okay. I was surprised. I learned about what to do if this happens again and I showed my parents that I really was sorry.” In another family, if their ADHD daughter breaks her sister’s Lego creations, she has to apologize and then work with her to rebuild something. The actions logically follow the affront. I encourage you to think about how you can assist your children or teen in learning to make sincere apologies and following them with actions when appropriate which isn’t all of the time. These aren’t punishments; they are efforts to make amends. Pick and choose the moments when you use Apologies of Actions based on when a simple, genuine “I’m sorry” is enough.

Many parents who are frustrated with their ADHD children come into my office and complain that “No matter what we do, our son (or daughter) doesn’t change. Nothing works.” As I meet with these families, the heart of the problem usually lies with inconsistency. Sometimes parents can create a plan of action to deal with behaviors and stick with it; other times, they are improvising moment by moment. Too often, they get stuck and feel defeated. With all of these different scenarios, the ADHD kids, who thrive on predictability, can end up feeling confused. How can we change these patterns and create more success? Inconsistent parenting reflects mixed messages and unclear rules that evolve over time and unintentionally. It’s not something people decide to do: it frequently occurs because parents are tired, worn down and out of ideas. Inconsistent parenting can look like this: One school night, you let your 10 year old ADHD son stay up until 11 pm to watch the football play-off game because you don’t want to miss any of the action to put him to bed. Yet, a few days later, when he wants to watch a basketball game with you past 10 pm, you refuse. Here’s another example: You tell your teenage daughter that she will lose her phone for the evening when she doesn’t clean up her room as you both agreed but then you let her keep it when she goes out so you can reach her. Consistent parenting means having the same consequences for the same behaviors over time—again and again and again. They don’t change and can’t be negotiated. It means that you don’t give your ADHD children and teens consequences that you can’t enforce or remember or don’t want to deal with. ADHD kids need to know what is coming so they can learn from their experiences and start to understand that their actions have effects. This is exactly where their executive functioning skills are weak. It takes time and repetition. You have to lay the foundation for this consistency by establishing clear guidelines for behavior with your son or daughter that mean something to them and to you. The process is collaborative but ultimately not democratic; you still have the final and most powerful vote because, after all, you are the responsible adult. How can you begin this process?

1. Get some paper and a pen and sit down with your family. Start with a fair assessment of the basic rules. Ask your kids what they think the consequences should be for not following them. Sometimes they will come up with ideas that are far more impactful that you will.
2. Pick the top 3 issues and create a plan of action for not cooperating. Write everything down.
3. Meet alone with your parenting partner (if you have one) and go through this list. Ask yourselves if you can honestly follow through on the consequences and how you can support each other to do so. If you can’t do them, come up with other ideas that you can enact.
4. Meet again with the family. Go over the plan. Post it in a place where everyone can see it and refer to it when needed.
5. For the next 3 months, meet every two weeks to check in, see how things are going and make any necessary changes to what you are doing that would help things go more smoothly.

Good luck!

As 21st century parents, we want our kids to share their feelings and talk through their problems with us. We encourage them to let out their feelings and believe that this is basically healthy, which it often is. But sometimes this self-expression is inappropriate and we are surprised, even shocked, by what we hear. My clients have frequently reported their dismay when their ADHD sons or daughters (depending on their ages), have said things like, “I hate you!” “You’re a terrible mother. “Don’t you know anything?” “What is your problem?” “You are so stupid.” Then, there’s cursing, slamming doors, eye rolling, or punching the wall. In today’s world, when many parents want their ADHD children to learn to speak up for themselves and strengthen their own voices, it can be hard to know when things have gone too far. The lines between self-expression and disrespect can become blurred really fast. What starts out as a joke can quickly turn mean and what seems like a discussion can turn suddenly into a shouting match. ADHD kids, because they struggle with impulse control, understanding limits and reading social cues can get carried away or inappropriate without always knowing it. What should parents do? I think that parents first have to assess for themselves what constitutes disrespectful behaviors. We all have our limits: what are yours? In my house, eye-rolling and name-calling were at the top of our list. Telling me what a jerk I am just isn’t okay. You can tell me that you are angry, that you don’t like what I said or what I am doing, but you don’t get to call me names. Likewise, I don’t get to call you names either–no matter how frustrated and fed up I may be. Clear boundaries are essential for ADHD kids who can’t always monitor their words and actions effectively. They have big feelings and limited skills in expressing them. They need assistance and feedback based on consistent family guidelines. They also need some concrete tools that reduce disrespectful language and actions and increase more acceptable ones. How can you teach your ADHD sons and daughters to share what is going on for them in ways that other people can hear? Here are some useful tips:

1. Consider what really pushes YOUR buttons as unacceptable ways of speaking or behaving. Write down the top 3 offending actions. (If you have a partner, do this exercise together so you can present a united front with your family.) It’s also important to ask yourself if you engage in any of those 3 behaviors. Be honest because respect goes both ways. Believe me, your ADHD son or daughter will be the first person to point out any of your transgressions.
2. Think about (and discuss) what types of self-expression you want to encourage. Would you like your daughter to use her words when she feels upset instead of going to her room and crying? Would you like your son to control his body and stop slamming doors? Be specific about these goals.
3. Sit down with your ADHD child or teen. Ask them what they consider to be disrespectful–what they do and what others have done to them. Suggest some relevant recent family or school incidents if they are stuck. “Remember when Sam pushed you on the playground and called you ‘a crybaby?” Share some of your own earlier reflections. Decide together which of all of these ideas and observations you would all like to see changed first.
4. Introduce this alternative method of self expression using this formula: “I feel ________ when you ____________.” It may be awkward and corny at first but it’s important to keep using this so it becomes a viable alternative for appropriate sharing. Usually ADHD kids benefit when you post it in a common space like the refrigerator. Refer to it often, especially when things are heating up. If your kids use it, then let them know you appreciate their efforts.

It’s a rainy Sunday morning and you decide to make pancakes for the family for breakfast as a nice treat. You whip up the batter and drop large creamy spoonfuls onto the sizzling griddle. As the golden discs bubble, your 11  year old ADHD daughter bounces into the kitchen. “I’m so hungry. WHEN will the pancakes be ready? I want to eat NOW!” You start to feel the hair on the back of your neck prickle as that familiar irritation sets in and try to stay calm.  “Soon. Why don’t you set the table while they finish? Then we can press the chocolate chips in and make smiley faces.” “No. I just want to eat NOW!” she says turning up the volume considerably. In  turn, you raise your voice: “I am trying to do something nice here and all you have to do is set the table to help out. NOW DO IT!” She yells “NOOOOOOO!” and runs to her room. You shout after her “No chocolate chips for you then” and flip the pancakes with an aggressive thwack. How did a simple conversation escalate into an unpleasant argument? Why can’t your daughter modulate how she expresses herself and just cooperate with your request? Why did you allow yourself to be upset by her in the first place? Families with ADHD children and teens often struggle with emotional reactivity and verbal impulse control. Negative feelings and unpleasant words can intensify in the blink of an eye so that the interaction derails quickly into hostility, screaming and tears. These situations can be easily turned around by bringing everyone’s attention to T.O.V.–Tone Of Voice. So often, ADHD kids don’t really hear how they say things to other people and don’t fully understand the effects of what they are saying on them. They need help learning how to slow down and reflect on what they just expressed. But, since they are usually sensitive to criticism, direct feedback can frequently backfire. Introducing T.O.V. allows your son or daughter to reflect for themselves on how they can say something differently and lets them come up with their own changes on how they are speaking. They learn several executive functioning skills simultaneously: emotional regulation, personal insight and self-control. Here’s how it works:

1. In a calm moment, you explain to your ADHD son or daughter (and perhaps your other children too–it works with everyone!) that sometimes people need help learning how their words and their tone of voice affect others. To that end, you will be saying to them “T. O. V.” when you think they should alter how they are speaking to you and, at times, to each other. Then, you will give them a minute or two to change how their tone of voice and try again. Sometimes, all of us just need to re-calibrate and do something over. 
2. If your child or teen can’t manage to change how they are talking to you, then taking an immediate, timed break for personal space can help. This break allows everyone to calm down and  regroup; it is not a punishment. Usually breaks of up to 5-10 minutes are sufficient but some people need more time. Agree on the time of the breaks when you have the initial conversation.
3. If your son or daughter changes how they are speaking to you by lowering their volume, altering their words from provocative to more neutral or shifting their attitude, YOUR JOB is to respond to their new statements and move forward. Of course, you can appreciate their efforts when the conversation is over which provides positive reinforcement for them.
4. Be prepared that they may call “T.O.V” on you sometimes too, especially if you are yelling. How you respond to this is critical: try acknowledging your feelings or laughing at yourself or admitting that you could do better. However, the goal is not to create a constant calling out of “T.O.V.” in your household. It’s used for helping your child re-group in selective moments, such as once or twice a day. If you overuse it, it will lose its impact.

I hope that you will give this a try!!!