Parenting Adolescents with ADHD:

  Tips & Insights to Ignite Success    

by Linda Aber  

Adolescence is akin to an "out of body experience" - out of a child's body into that of an emerging adult. The teenage years, as emerging adults strive for independence, are jam-packed with joys and challenges. Parents find themselves wondering, "Where did my loving child go?" Often, parents and teens regard one another as aliens, inhabiting the same planet, yet from two different worlds. This transitional stage is enhanced for teens with AD/HD, producing even greater internal upheaval.

AD/HD is a neurological condition characterized by underactivity in the prefrontal cortex of the brain, an area responsible for regulating attention, impulse control, motor activity and emotions. It may be diagnosed in childhood and persists throughout the lifespan.

AD/HD symptoms include an overall inconsistency, distractibility, the presence of hyperactivity or underactivity (hypoactivity), impulsivity and difficulty delaying gratification. Often, co- existing conditions (known as co-morbidities) complicate the AD/HD diagnosis. Examples of co-morbid conditions are learning disabilities (25-50%), Tourette syndrome (11%), anxiety disorder (37%), depression (28%), bi polar disorder (12%), substance abuse (5- 40%), oppositional defiant disorder (59%) and conduct disorder (22-43%).

Typical AD/HD behaviors, similar for girls and boys, include difficulties in controlling emotions, low tolerance for frustration and deficits in executive functioning which facilitate organization, memory and setting priorities. Adolescents tend to display an impaired sense of time and find transitions challenging due to difficulty in shifting mindsets. Their level of alertness throughout the week is inconsistent, and may not be predictable within a given day. Sleep and lack thereof plays a significant role in this. Collectively these behaviours contribute to a possible 4-6 year developmental lag.

Treatment is recommended when the clustering, intensity and persistence of symptoms impact on the teen's life. AD/HD symptoms require an overall multi-modal treatment plan. The most effective strategies focus on five major areas: medication for focusing, concentration, social skills training for social competency, psychological help, remedial tutoring and parenting management strategies.  

Parents may, on occasion, notice several similarities between teens & toddlers. They both live in a "me" world and interpret the word "no" as negotiable or a choice not to hear it. Both teens and toddlers at times have developed a cluster of brain circuits that may fire off unpredictably. Parents need to understand that during the teen years, there are massive structural changes occurring in their maturing brain. There is a substantial growth of the corpus callosum, a set of nerves connecting all parts of the brain that must work together, critical for executive functioning, consciousness, self-awareness and intelligence. Research reveals that the brain matures by their mid- twenties.

What is normal teen age behavior and what is not? Typical teen behaviors (things they do that drive parents crazy) include messy rooms, moodiness, keeping late hours, sleeping in late, extensive use of phone / computer, choice of music, clothing, hair radically different than that of their parents' generation and avoidance of family outings.

Serious behaviors that warrant parents' need to take charge include persistent school problems, anxiety, depression, high risk sexual behaviors, drugs / alcohol, and conduct disorder. Anxiety and depression can be present as secondary symptoms due to the daily stress that are the adolescent's experience. This is when they become more at risk for substance abuse.

Teens are influenced more by their peers than their parents. They may indulge in risk taking activities without thought of consequences. Although teens may want to work part time to earn extra money, the demands of school can be too much to juggle.

Effective Parenting is a Delicate Balance of Nurturance, Structure,  

Consistency, Limit setting & Positive Connection.     

• Use a safe tone of voice, gives hugs, use humor, and be playful. This is the glue that preserves and repairs your parent-teen relationship.

• Enjoy your teen and plan time together whether going for brunch or on special outings.

• Teens need to be seen for all the positives they do. Recognize their everyday successes - say for example, "I saw you help your brother. You are so kind and compassionate." This helps them recognize their strengths and builds resilience.

• When they break rules or make mistakes, validate something that they did right. Remember that even in their most difficult moments, they are always doing something right.

• Teens need to refuel from the everyday hardships of the outside world. Be their safe harbor, their soft place to fall.

• Use active listening. Before you nag, remind, criticize, advise, chime in, preach, or over-explain say to yourself: "W.A.I.T." or "Why am I talking?" Listen with your heart before you talk.

• Help them establish daily routines. Your role becomes one of Adviser/Consultant not Dictator.

• When it's time for a serious talk, pick the right time and place to have a discussion such as a walk, meal or car ride.

• When you need to impose consequences for inappropriate behavior, do so without obliterating the teen's self-esteem.

• Consequences should be instructive (to teach them skills they lack) not punitive. Remember to constantly repair and refuel your relationship. Stating, "I believe in you" allows the teen not to lose hope.

• Know when to rescue. Understand that disappointments are a necessary preparation for adult life. Without these experiences your teen will be ill-equipped for the real world.

• Don't take it personally when your adolescent appears irritable with you, does not give you eye contact or is not polite. Judge their character on what teachers say, whether they are welcomed by friends, friends' parents, manners towards their grandparents and neighbors.
   

In today's world, the stage of adolescence is getting longer as more young adults live at home with their parents. They need and value your support and mentoring, even when they say they don't or push you away. The words you chose profoundly impact daily interactions and remain etched in your adolescent's mind and heart. Words can either inspire and lift one up to greatness enhancing resilience or pull one down into devastating shame and sadness. Let words of positivity always be your default language. 

Parents, it is crucial to acquire skills to self-regulate, to manage your own frustration and anger when your buttons are being pushed. Staying centered on what is important, refueling and taking good care of yourself is vital. Find or create something fun to do and laugh every day in order to reduce your own stress level. Keep reminding yourself that your relationship, what you say and model are key to your adolescent's success.