From my perspective as a clinical psychologist who studies reward and punishment responses in children with ADHD, you are right to recognize a toxic dynamic at work here.

Even if it’s not deliberate, your child’s actions are reinforced every time you stand firm and then step aside to allow her to defy you. (To be clear, I recognize that this is an incredibly frustrating situation.) Your daughter remains oppositional because she has learned that defiant behavior gets her what she wants.

[Free Download: The 15-Day Fix to Stop Defiant Behavior]

Your own actions in those moments are also reinforced, though in a different way. You have learned that stepping away results in the removal of an aversive stimulus — your daughter’s defiant behaviors. It’s how you’ve learned to cope with the stress caused by your child’s defiance.

In short, there are many things to unpack here. It’s clear that behaviors on both sides perpetuate this cycle, and unlearning these behaviors is required to bring about change.

If your daughter’s behaviors cause lots of stress and conflict at home, it may be best to seek help from a psychologist or other health provider who is skilled in behavioral parent training for ADHD. They will help you understand how to encourage desired behaviors in your child, and the factors that intentionally and unintentionally influence behavior.

It will take time to change a dynamic that has been long reinforced. Be prepared to see an uptick in defiant behaviors from your child as you work toward change. In my field, we call that an “extinction burst,” or the principle of “it will get worse before it gets better.” Worsening behavior, in this case, actually means that your new strategies are working. You’ll just have to weather the storm to see the new dawn.

“My Kids Don’t Listen to Me:” Next Steps

• Free Download: What You Need to Know About Parent Training Programs
• Q&A: “What Rewards Will Motivate Good Behavior from My Child?”
• Self-Test: Could Your Child Have Oppositional Defiant Disorder?

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “The Power of Positive Reinforcement: Why Rewards Trump Punishments for Students with ADHD” [Video Replay & Podcast #420],” with Gail Tripp, Ph.D., which was broadcast on September 8, 2022.

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A further complication: youth with ADHD are at higher risk for developing mood disorders, such as disruptive mood dysregulation disorder (DMDD) or oppositional defiant disorder.

During a recent ADDitude webinar on irritability, we asked nearly 1,000 attendees, “What is the most challenging aspect of emotion regulation for your child or patient?” Here are the answers they gave:

• Dysregulation of emotions in the moment (e.g., feelings often subjugate thinking): 37.8%
• Intensity of felt emotions (e.g., sudden, violent outbursts): 34%
• Unrelenting nature of irritability (e.g., always angry, bristly, mean): 14%
• Poor recognition of other people’s feelings (e.g., apparent and/or real lack of empathy): 7.1%
• Frequency of mood changes (e.g., dizzying emotional lability): 6.7%

Comments and questions submitted during the webinar, titled “Emotion Regulation Difficulties in Youth: ADHD Irritability vs. DMDD vs. Bipolar Disorder” provided deeper insight into how ERD impacts youth with ADHD.

Emotion Regulation Manifestation #1: Explosive Outbursts

“My child screams and breaks down over issues with friends.”

“My son is verbally aggressive and used to destroy doors and walls. It is truly hard for me to cope with his crisis.”

“My 11-year-old son’s physical and verbal aggression seems to be reserved for home. He controls himself at school but not at home, where he is very argumentative and defiant. He is easily triggered when he does not get his way (e.g., he pushes, hits, and calls us names).”

“My 14-year-old daughter keeps it together at school but is defensive, aggressive, and explosive with her 11-year-old sister and us (her parents) when we intervene.”

[Self Test: Does My Child Have Disruptive Mood Dysregulation Disorder?]

Explosive Outbursts: Next Steps

• Download: 9 Truths About ADHD and Intense Emotions
• Read: Why Is My Child So Angry?!
• Read: What Is Intermittent Explosive Disorder? 

Emotion Regulation Manifestation #2: Rejection Sensitive Dysphoria

“It is hard for my child with ADHD to not respond in a passive-aggressive, irritating way toward people she feels have rejected her. This might look like getting into others’ personal space by doing things she knows bothers them. This has gotten her in trouble with peers whom she feels are her bullies.”

“My son is 16 and has had explosive emotional outbursts due to environmental factors since he was 18 months old. The emotional outbursts have lessened substantially, but they still happen when he is super frustrated, upset, or gets his feelings hurt by his friends.”

RSD: Next Steps

• Download: Understanding Rejection Sensitive Dysphoria
• Read: How ADHD Ignites Rejection Sensitive Dysphoria
• Self-Test: Could It Be Rejection Sensitive Dysphoria? Symptom Test for ADHD Brains

Emotion Regulation Manifestation #3: Extreme Irritability

“Irritability occurs when there is a change in the child’s expectations of a situation. For example, it is not going to happen or not happening soon enough according to the child’s understanding or expectation.”

“My kid seems to be frequently irritable and grouchy and has angry outbursts.”

“I’ve noticed a big increase in irritability for my 13-year-old son with ADHD.”

“My 12-year-old wants to buy things or have things bought for her. Telling her ‘no’ results in irritability and a major tantrum.”

Extreme Irritability: Next Steps

• Download: 10 Ways to Neutralize Your Child’s Anger
• Read: New Insights Into Emotional Dysregulation and Treatment Considerations
• Read: “My Child’s In a Bad Mood Every Morning!”

Emotion Regulation Manifestation #4: Lack of Flexibility

“My granddaughter is often agitated and gets things stuck in her head, and there is no working around it. Screen time is about all that keeps her focused and calm. Everything is a challenge — routines, grooming, sitting down to dinner. Everything”

“My son is very rigid and has no ability to cope when he doesn’t get his way.”

“I struggle with my daughter’s need to be in control of everything and everyone. So much so, even making doctor’s appointments are hard to do.”

Lack of Flexibility: Next Steps

• Download: Why Is My Child so Defiant?
• Read: What’s Really Behind Your Child’s Bad Behavior?
• Read: Exaggerated Emotions: How and Why ADHD Triggers Intense Feelings

[Self-Test: Does My Child Have ADHD? Symptom Test for ADHD]

Emotion Regulation Manifestation #5: Self-Harm

“I have an 11-year-old daughter who has had explosive outbursts and big highs and lows since age 4. She began expressing suicidal ideation and was self-harming and experiencing intrusive thoughts.”

“During fits, my child makes comments about ‘not wanting to live,’ and ‘can’t take it anymore.'”

Self-Harm: Next Steps

• Download: Easy Mindfulness Exercises for Kids with ADHD
• Read: ADHD & Self-Harm: How to Help the Girls Who Suffer Most
• Read: How Is Your Emotional Resilience? Learning to Cope with Intense ADHD Feelings

Emotion Regulation Manifestation #6: Overly Emotional

“We’re struggling with my son because he’s not combative, just EXTREMELY emotional. He has crying episodes or extended periods of being upset where he cannot regroup for up to an hour.”

“My son does OK in most environments, but at home, he displays a lot more irritability and dysregulation, anger, frustration, and sadness.”

“My son is explosive at times. I remain calm with few words spoken, but he escalates quickly by yelling and running out of the house. This creates a very stressful environment for everyone in the house. I don’t know how to get him out of his terrible moods, where he fixates on ‘small’ things that bother him.”

Overly Emotional: Next Steps

• Download: Evaluate Your Teen’s Emotional Control
• Read: Q: How Do I Teach My Teen to Manage Emotions?
• Read: Calm Starts at Home: How to Teach Emotional Regulation Skills

Emotion Regulation Manifestation #7: Physical Aggression

“My 8-year-old son with ADHD cannot focus or keep still long enough to finish his schoolwork. Then he gets frustrated, which ends with him hitting his peers or teachers.”

“My daughter has a very hard time with aggressive behavior and has had to have the ‘room cleared’ twice this month, along with three in-school suspensions.”

“So often parenting advice recommends setting firm boundaries with kids, such as saying, ‘you can be mad, but I won’t let you throw things/ damage furniture/ etc.” However, with my kid with ADHD, when his lid is flipped, and he’s having a rage outburst, any attempt to say those things seem to ‘feed the fire.’ He just escalates more, often becoming physically aggressive with us.”

Physical Aggression: Next Step

• Download: Free Guide to Ending Confrontations and Defiance
• Read: Anger Is Important — But Only When It’s Managed
• Read: When “Keep Your Hands to Yourself” Doesn’t Work: Fixes for Hitting

More on Emotion Regulation and ADHD

• Free Download: 15 Ways to Disarm (and Understand) Explosive ADHD Emotions
• Read: How Dysregulated Emotions Hijack the Teen ADHD Brain
• Read: ADHD and Emotional Regulation: A Parent’s Guide

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With or without a diagnosis of oppositional defiant disorder (ODD), many children with ADHD can get overly angry, irritable, and argumentative. Home life can feel stressful and out of control when you’re living with an emotionally dysregulated child who doesn’t listen or who seems to consistently misbehave. In these situations, the path toward longer-term solutions begins by focusing on what we can actually control as parents. Follow these steps:

1. Treat ADHD. The more comprehensively we address ADHD, the more likely oppositional behaviors will resolve. ADHD medication, parent training programs, and cognitive behavioral therapy all go a long way toward managing difficult behavior. Minimizing ADHD symptoms alone may break difficult behavioral cycles.

[Download: A 2-Week Guide to Ending Defiant Behavior]

1. Understand executive function. ADHD symptoms may appear oppositional, which is different from being purposely difficult. There’s a difference between “won’t” and “can’t.” Children with ADHD struggle to shift attention, so if you make a request while your child is reading or playing a video game, it may not be heard. ADHD-related symptoms like impulsiveness, emotionality, and forgetfulness also can lead to non-compliance. Seeing ADHD as a delay in executive function allows you to reframe requests and provide structure for success; for example, getting a child’s full attention before talking to them may improve compliance.
2. Maintain a formal behavioral plan: Early childhood behavior often derives from basic cause and effect. I want a reaction from someone, so I will do something to get a reaction. Or, when I drag my feet and fuss enough, I get more video game time. Consistent use of praise and rewards, and dispassionately setting limits, can rein in oppositional behaviors by encouraging compliance or by making sure problematic behaviors become ineffective for a child.
3. Don’t take it personally. When children say the dreaded, “I hate you,” it usually means they are grasping for words to label an intense emotion. If you think there is a reality in what is being said, take it seriously. If a child crosses a line, provide fair consequences. But most of the time, it’s best to ignore those words and seek out the meaning behind them—typically, it’s something like, I’m hurt, frustrated, or angry.
4. Practice managing your own emotions: Ultimately, we can only control our own choices and behavior in any situation. By staying non-reactive when rattled, we create the opportunity to hold onto our best intentions. One option is to practice mindfulness, which helps us to develop patience and resolve through ongoing repetition.

Positive Parenting Solutions with ADHD: Next Steps

• Download: 10 Rules for Parents of Defiant Kids with ADHD
• Read: Never Punish a Child for Bad Behavior Outside Their Control
• Read: The Ultimate List of Mindfulness Exercises

Mark Bertin, M.D., is a developmental pediatrician in Pleasantville, New York, and author of How Children Thrive and Mindful Parenting for ADHD.

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It’s not easy to parent an oppositional child. Your frustration and anger are understandable and completely normal responses. But some insight on what’s underlying your child’s behaviors may help you take next steps.

Significant risk aversion is often about lack of confidence. I don’t know your child’s history, but we do know that children with attention deficit hyperactivity disorder (ADHD) are more likely than children without ADHD to receive negative feedback – from parents, teachers, peers, and others – which damages self-esteem over time.¹

[Get This Free Download: Rules for Parents of Defiant Kids with ADHD]

To build up your child’s confidence, take a page from the Nurtured Heart Approach, a behavior-management strategy that emphasizes a child’s strengths and reinforces positive behaviors, such as bringing a dish to the sink after dinner, pushing in a chair, putting on a seatbelt, and other seemingly “simple” steps that don’t receive much attention and praise day-to-day.

The powerful program isn’t just for families; it has been successfully implemented across schools and communities. One public school in Tucson, Arizona, for example, saw a massive reduction in suspensions and referrals for ADHD assessments after implementing the approach.²

Recognizing what your son does right as frequently as possible will positively affect his behavior and self-esteem, which might make him more inclined to step out of his comfort zone and try new things.

If your child doesn’t show signs of progress, consider going to a family therapist who is trained in the Nurtured Heart Approach and who can help your child see his potential.

Defiant Children & Nurtured Heart Approach: Next Steps

• Free Download: 15-Day Fix to Stop Defiant Behavior in its Tracks
• Read: Why Does Fear of Failure Paralyze My Teen with ADHD?
• Read: Teaching Resilience to Children with ADHD

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “Lifestyle Changes with the Biggest Impact on Kids with ADHD” [Video Replay & Podcast #414],” with Sanford C. Newmark, M.D., which was broadcast on August 4, 2022.

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Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹Mazzone, L., Postorino, V., Reale, L., Guarnera, M., Mannino, V., Armando, M., Fatta, L., De Peppo, L., & Vicari, S. (2013). Self-esteem evaluation in children and adolescents suffering from ADHD. Clinical Practice and Epidemiology in Mental Health: CP & EMH, 9, 96–102. https://doi.org/10.2174/1745017901309010096

²Nurtured Heart. NHA in Action. (n.d.) Retrieved from 2ehttps://nurturedheartinstitute.com/nha-in-action/

Here, ADDitude readers share examples of their kids’ lies — and reasons to explain their fibbing impulses:

“I see this all the time. I ask a simple question to my 14-year-old daughter: ‘Did you brush your teeth this morning?’ Her quick response: ‘Yes, Mommy.’ But, when I go and check the toothbrush, it’s bone dry. I think self-preservation is the primary culprit, followed by impulsivity. She is so used to (and fearful of) being wrong that she automatically says the answer she knows I want.” — An ADDitude Reader

“This was me as a young girl. I think it was about imagining another reality, wanting to appear more ‘normal,’ and achieving self-preservation. Ironically, I’m now painfully, detrimentally honest as an adult. The ADHD conundrum!” — An ADDitude Reader

“My daughter lies about homework being completed and turned in, and simple things like brushing her teeth. Now 16 and diagnosed with bipolar disorder along with ADHD, she lies to avoid consequences or getting in trouble. She even lies to friends online and at school. The root: a need for attention, acceptance, creating drama, fear of abandonment.” — Gail, Washington

[Free Download: Your 10 Toughest Discipline Dilemmas – Solved!]

“Usually it’s because [my son] doesn’t want to disappoint me, so he lies to avoid the truth. Other times, when he avoids telling me something that’s extremely important, it’s because he thinks he should be able to handle certain problems on his own.” — Gayle, Texas

“My son, who’s nearly 12, tends to cover up the truth when he wants to push for that extra bit of independence, especially when he knows he shouldn’t do something. For example, he’ll say he hasn’t been on his phone at his dad’s house at 11pm when I know, and he knows, that he has.” — Harriet, England

“My son does this no matter how big or small the lie. It drives us crazy because we feel like, at age 14, he isn’t trustworthy, even though he is kind, smart, and helpful. We ask him to take a beat before answering, and not to give us the answer he thinks we’re seeking. It’s a self-preservation tactic… If I feel he’s giving me the answer he thinks I want, I ask him to think it over and try again. It’s a fluid process that I hope gets better with time.” — Dawn, New Jersey

“The reason is almost always to cover up a shortcoming or failure. He lies if he makes a bad grade. He lies if he doesn’t succeed in a social setting. He lies if he is afraid to tell us the real story, like not attending therapy.” — An ADDitude Reader

[Read: Fight, Flight, Freeze… or Fib?]

“With my 15-year-old, lying involves self-preservation as well as trying to impress others. If he is caught in a lie, his first instinct is to deny. He will deny right to the point that evidence is presented showing his guilt. He seems to convince himself of the lie and it’s very difficult to discuss the impact to his family and peers when the truth comes out. Sometimes I believe, when confronted, he doesn’t process information and implications quick enough, so he defaults to lying.” — Ken, Massachusetts

“My girl is getting better at telling the truth. She used to lie to keep herself out of trouble. It used to almost make me smile when I asked her if she did something. She would say no, even though we both knew she did it! As she gets older, she does this less. She has also learned that she might not get into trouble if she just comes clean. I remember asking her once, ‘Why did you do that?’ And she was as surprised as I was when she said, ‘I don’t know!’” — An ADDitude Reader

“As a strategy, I’m trying to create a safe space where [my daughter] can tell me the truth or take a moment to verify without falling into automatic responses. Her ADHD memory likely also plays a part. Sometimes she remembers what she did yesterday, and then honestly (and innocently) thinks she did it again today. This is all very challenging for a hard-driving, results-oriented neurotypical like me.” — An ADDitude Reader

“My eight-year-old spins wild tales constantly. We tease him that he should write all these stories down so he can make a lot of money as an author and support mommy and daddy. But truth be told, it is incredibly exasperating. We wish we knew why he does it and worry that he can’t seem to tell the difference between reality and fantasy. We try to emphasize to him how important the truth is because if people can’t trust him to tell the truth, then people may not believe him if something bad happens. But, so far, it doesn’t seem to be sinking in.” — An ADDitude Reader

“It breaks my heart. She thinks she’s always doing something wrong. I think she believes lying by omission, or lying directly, helps her avoid getting in trouble yet again.” — An ADDitude Reader

“She lies whenever she knows that she did something wrong. For instance, she lied about eating the Dove chocolate bars twice. Then, even after we told her to ask before taking them, she did it again and ate the remaining two. It usually involves eating a sweet. Not only does she impulsively snatch it before asking, but she will lie that she took it.” — An ADDitude Reader

“I think it’s mainly due to self-preservation and emotional dysregulation. My son seems to automatically assume he’s being accused whenever someone poses a question to him, and he automatically reacts with an ‘it wasn’t me’ or ‘it wasn’t my fault’ attitude. It’s become so ingrained that even when it’s blindingly obvious that he’s responsible for something, he’ll try and shift the blame elsewhere.” — An ADDitude Reader

“My child with ADHD tends to lie when she forgets to do as she’s been told (I was about to wash the dishes), when she crosses an established boundary (I didn’t know it was past my phone time limit), and in simple situations when she could just say she forgot (I did turn in that assignment). I used to think it was a character trait of a dishonest heart. Now I truly believe that she doesn’t want us to have a negative opinion of her mistakes. Knowing now that she has ADHD has helped us to parent better, recognizing that she truly has trouble remembering, prioritizing, and following through.” — Roz, Alabama

Children with ADHD and Lying: Next Steps

• Read: The Magical Thinking of ADHD Brains — and How It Drives Our Kids’ Lies
• Read: “How Can We Get Our Child to Stop Lying?”
• Download: The Free Guide to Your Child’s Unique “ADHDisms”

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Parents of children with ADHD live and breathe these daily behavioral challenges — and many more. ADHD traits like emotional dysregulation, impulsivity, and poor working memory often contribute to these challenges, but the manifestations are unique to each child and their circumstances. No single discipline approach that will work for every family.

That said, some of our best ideas come from other parents who have walked similar paths. So here are ADDitude readers’ answers to the question, “What is your most effective discipline approach when your child with ADHD acts up or acts out?”

Discipline Approaches: 15 Tips from Parents of Children with ADHD

“My son has the hardest time with transitions, which used to lead to gargantuan meltdowns all the time… We have found that giving him space to have his big reactions — even if it means screaming and stomping — in a way where he doesn’t feel judged has been most effective. We can’t outperform the intensity of his fits, so we make sure he is safe, and then wait a bit before sitting quietly near him to offer support within his control.” – Samantha, Washington

“I created a chart that shows three behavioral and emotional levels. The top level is when he’s feeling out of control and oppositional (‘being a jerk,’ as my child worded it). The middle level is ‘doing OK,’ and the lower level is neutral, calm behavior. We go to the chart often, especially when he’s at the higher levels, and he uses his words to describe his feelings. He knows that he should live in the low and middle levels, but that everyone reaches the top levels sometimes.” – Anonymous

“I tell him to pause and ask him what he needs. Then I suggest that he run up and down the stairs at least five times. It never ceases to work for him. He returns calmer and with a more organized brain.” – Sunny

[Your Free Expert Guide: 50 Tips for How to Discipline a Child with ADHD]

“I remind myself that all behavior is communication, and I try to identify my child’s unmet needs at that moment. I tell them which behaviors won’t work for me and offer a couple of alternative behaviors that will, while leaving room for their ideas. As an example: When my child would have a meltdown while shopping, the choices were to either control the meltdown behavior in the store or go out to the car and have a meltdown. I was fine with both options, just not screaming in the store.” – Cathy, Oregon

“Try to help them understand the rationale behind the tasks we ask them to do.” – Mark, PA

“When my child acts up, I try to run through a series of questions to decide how to handle the situation. 1. Is the behavior caused by an ADHD symptom? If yes, I tell myself: ‘This is how his brain works, give him some grace.’ 2. Was there a trigger that I missed (e.g. over-stimulating environment)? If yes, can it be mitigated now? If not, give more grace and redirect to something that minimizes the impact of the negative behavior (e.g. send him outside if he’s being overly loud). Then, I give him one simple and direct command, and remind him that he gets technology time taken away if he doesn’t follow directions. I also try like hell to give him all the positive praise I can when I see him doing things he’s supposed to without asking!” – Stephanie, Texas

“I remind myself that my child’s brain is developing two to three years behind the brains of kids without ADHD, and I step back and picture how I would handle a younger child. That means I lower my expectations, do more hands-on guidance/teamwork, and anticipate having to remind my child about things.“ – Megan, Michigan

“I use the ClassDojo Beyond app as well as a chores motivation chart to provide her with incentivizing rewards. If she isn’t following our rules, she doesn’t get points for a specific skill.” – Anonymous

[Read: Use Responsive Parenting to Reveal the Roots of Behavioral Challenges]

“Redirection. Take a moment to breathe, to notice the environment. Then discuss the issue.” – Laura, Canada

“Our best strategy is to always review what is about to happen. We remind them of the rules right before an activity or outing, and what we are expecting in terms of behavior. We get a lot of ‘We know,’ but our reminders are helpful.” – Ellen, Georgia

“We ensure that basic needs are met first (hungry, thirsty, tired, hot or cold) and then communicate about the dysregulation that has occurred. We discuss feelings around it, and come up with a plan to address it (e.g. break up tough homework into smaller chunks, do clean up together, etc.).” – Catherine, Canada

“Kids with ADHD need immediate intervention. Delayed discipline methods don’t work for them. We give my son a look that says, ‘Stop.’ Then we explicitly tell him to stop. Then we have him go sit on a mat as a ‘time-out’ for several minutes. (We use a timer to keep track.) If he’s upset, we let him express his feelings and empathize with him. We don’t start the timer until he’s done expressing himself.” – Terri, Missouri

“I try not to use ‘No!’ as my first response. Instead, I ask my child a question: ‘Is that your best choice?’ Or, ‘Have you thought of a different action?'” – Anna, Australia

“The 1-2-3 approach works for us. We clearly state what we want (stop fighting, pick up a mess, quiet down) and state the consequence (you will lose your iPad time, etc), and we start the count slowly. It almost always works, usually by 1, because they cherish their iPad time.” – Sarah, Australia

“Discipline equals teaching, and I know from my classroom experience that the heat of the moment is NOT a good time to teach. When my child is acting out, my focus is on redirection and preventing escalation. Once my child is calm and able to think, we can figure out what triggered the behavior, and how to deal in the future. Eventually, this teaches my child how to independently deal with strong emotions or impulsive behaviors in a constructive way” – Ari, New Jersey

Discipline Approaches: Next Steps

• Free Download: A Guide to Ending Confrontations and Defiance
• Read: The Secret to Better Behavior? No Punishment at All
• Read: The Delicate Balance of Rewards and Consequences for Challenging Behaviors

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Like most cats, my cat will not follow orders to sit and stay — even when so directed by experts who have successfully trained thousands of dogs to do these things on command.

While people understand and accept that cats don’t do dog things, many continue to insist that my cat is a dog, and that my cat can do dog things. They refuse my explanations to the contrary.

People who think I have a dog may “helpfully suggest” compliance training methods, but I know from experience that most dog methods don’t work on my cat. I see and acknowledge that I have a cat (despite his often looking like a dog to others!). Treating him like a dog who can be compliant only results in significant frustration for all involved. Those who treat my cat like a cat early on end up with far more rewarding relationships.

I’ve learned to limit contact with people who insist I have a dog, and especially those who try to force dog methods on my cat while criticizing my cat methods. What has helped is finding people who have cats themselves and asking them what is effective with their cats. Even though cats have similar traits, it’s important to understand that each cat is unique, and to accept that many things that work well for other cats might not work for yours.

[Get This Free Download: 13-Step Guide to Raising a Child with ADHD]

Understanding Pathological Demand Avoidance

I’ve used the cat-dog metaphor to describe what it’s like to raise my son, who is gifted with ADHD and autistic PDA (Pathological Demand Avoidance). The latter is a term increasingly used to describe autistic children who exhibit extreme resistance to demands and requests, no matter how big or small, even if the demands are of obvious benefit and interest to them.

PDA means that, for my son, compliance is impossible. Cooperation, however, is very possible, and far more likely when you relinquish the idea of compliance.

I have accepted that I will never be able to force my child to do anything. Instead, I focus on guiding him toward cooperation. It took years for him to trust that we really weren’t going to try to force him to do things. Now that the trust is established, we treat each other mostly respectfully as equal adults (he’s 12).

We creatively problem-solve for undesirable things that must be done, explaining the logic and science behind solutions. (For example, he hates getting shots, but he cooperates because we explain that they protect him from disease. We have even negotiated a complex shot protocol with several steps, each of which we carefully carry out to his specifications.)

[Related Reading: Why Is My Child So Angry and Defiant? An Overview of Oppositional Defiant Disorder]

Required tasks must be backed by science and logic, and we must give him time to understand and decide to cooperate, even with all the evidence laid out. Sudden demands will nearly always be met with refusal, so we try never to make them. But this is hard, and requires a total change in all thinking about parenting. We try to see ourselves as coaches now rather than parents.

Working with his school to develop and implement a detailed IEP that works for him is difficult, ongoing work. Many school staff remain in denial that children like mine exist, despite the clear evidence in front of them. Sometimes, staff insist on ridiculously inappropriate methods that always fail, leaving them baffled, but still unwilling to try other methods.

A rare handful of the best educators have recognized that we, as parents, know our child best and have actually implemented proven “cat” methods with positive, rewarding results. Still others identify my son as a unicorn — a mythical animal never before seen — and recognize that he does, indeed, exist and need different things for his survival.

I’m deeply grateful for the online groups of parents and adult “cats” that have helped us figure out what kind of a cat we have and how to treat him properly.

Cats simply can’t be trained as if they were dogs. Kids and adults with PDA are cats in a dog world. Still, the vast majority are instead treated “normally” — which can lead to serious consequences. Many parents of children with PDA endure years of parenting classes and professionals’ disbelief about what they’re actually facing. The handful who get an early diagnosis, proper treatment, and accurate guidance (which involves changing the environment and interactions with all people) have the chance at a successful life.

What metaphors help you explain your life to others?

Pathological Demand Avoidance: Next Steps

• Free Download: 10 Rules for Parents of Defiant Kids with ADHD
• Self-Test: Could My Child Have Oppositional Defiant Disorder (ODD)?
• Self-Test: Is My Child Autistic? Signs of Autism Spectrum Disorder
• Read: Is My Child with ADHD on the Autism Spectrum?

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I speak with hundreds of families of kids with ADHD each year and I have noticed a common theme when the child’s behavior is fine at school but very difficult at home, sometimes to the point of being verbally or physically aggressive towards parents. At first, this was perplexing to me, until I recognized this common thread.

To be clear, I am not speaking about kids who struggle with emotional dysregulation after school. That is rather common for kids with ADHD, particularly when stimulant medication begins to wear off.

In some cases, the kids who present the most severe behavior at home do not struggle at school, have a peer group there, and generally like school, which made this more perplexing. Often, I hear a speculative narrative such as, “They’re holding it together in school all day and home is where they can be themselves.” But that explanation is just not applicable in these cases where kids are socially successful in school, nor does that explanation justify being physically aggressive toward family members. What I am talking about here is a long-standing, consistent pattern, often going on for years, and in some cases getting worse.

The commonality I’ve found in all of these families is a pattern of “high giving/low expectations,” meaning kids are given desired items such as smartphones and gaming systems, yet little is asked of them in return (aside from possibly academic performance). The other common variable often associated with “high giving/low expectations” is a permissive/indulgent parenting approach. A permissive/indulgent parenting approach is typically done from a place of love, not neglect. Because kids with ADHD tend to be “black or white” thinkers and do best with “scaffolding” in place, the passive/indulgent parenting often does not work well for them; it is too abstract. Kids (with or without ADHD) feel emotionally safe when they know adults are in control. When they do not feel adults are in control, or they recognize they can control adults with their behaviors, that does not feel emotionally safe. I’ve had multiple kids articulate to me that they feel uncomfortable when they recognize how easily they can control their parents’ emotions.

I understand that, for a lot of parents, being authoritative does not come naturally. Others may not have the emotional energy to utilize an authoritative parenting approach. Others may have had an authoritarian parent themselves and they want to counteract that, so they do they opposite. Parenting styles have been studied for decades and the consistent research findings illustrate that an authoritative parenting approach is the most effective parenting approach for raising well-adjusted adults.

I encourage all parents to think of the authoritative parenting style like scaffolding. The scaffolding around a building supports the structure as it is being built. Scaffolding around behavior helps a child understand how far they can push things; what behavior is tolerated and what is not tolerated. That gives kids a sense of emotional safety because they know their parents are in control. It also teaches them, generally speaking, what is tolerated in life and what is not OK.

If being authoritative does not come naturally to you, or you think it’s ‘bad,’ or you’ve received contradictory messages, you need to know this: In order for your son or daughter with ADHD to be successful with their behaviors, they need to feel emotionally contained. If you think that being authoritative will hurt their self-esteem, you need know that the opposite is actually true — not being authoritative can hurt their self-esteem because if a child doesn’t understand their parameters and limits, they are going to do things that they regret and feel remorseful about. Some parents of kids with ADHD take a permissive parenting approach that all negative behaviors are tolerated because of their child’s diagnosis. I believe there is nothing more disempowering to a kid than to send them the message: “Your negative behavior will be tolerated because I perceive ADHD as a disability, thus I perceive you as being disabled.” I am clear with every kid with whom I work that ADHD is not a disability; it is description of how your brain works.

If you have a child who pushes against the boundaries and is highly disagreeable, they need behavioral scaffolding. You will not hurt their self-esteem by being authoritative, and you’re not doing them any favors by being a permissive parent.

WATCH THE FULL VIDEO BELOW

Authoritative Parenting and Scaffolding: Next Steps

• Learn: How to Address ADHD Anger with Authoritative Parenting
• Understand: How Executive Function Delays Impact Behavior, Memory, Transitions, and More
• How To: Build Scaffolds for a Teen with ADHD

DO YOU HAVE A QUESTION FOR RYAN WEXELBLATT?
Ask your question about ADHD in boys here!

Ryan Wexelblatt, LCSW is the facilitator of the ADHD Dude Facebook Group and YouTube channel.

“How do you get through to a child who constantly shuts down gets angry when you question them about missed homework?”

“What do you do when kids call themselves stupid and useless?”

“What if your preteen claims they are bored every time they are not on a screen?”

In teens with ADHD, emotional dysregulation can seem to take infinite forms. During this pandemic, emotional triggers are more varied and plentiful than ever — as are the manifestations of adolescents’ stress. Unusual and uncomfortable learning settings without typical outlets for energy and socializing, coupled with puberty and too much screen time, has left many teens with ADHD feeling heightened and prolonged anxiety, frustration, fatigue, and anger. The end result is good for no one.

Even if your dysregulated, burned-out teen builds walls to keep you out, you can help turn things around by recognizing how stress uniquely affects them, de-escalating their worries and intense emotions, and connecting with them in productive, healthy ways. Below, are strategies for supporting, stabilizing, and building resilience in your teen during these challenging times.

Dysregulated Teens with ADHD: Signs of  Stress

Puberty alone triggers emotional upheaval in the teen brain. Add ADHD, and the associated symptom of emotional dysregulation, to the mix and you’ve got a potentially explosive mix. Add in unrelenting anxiety to that mix, and you’ve got millions of frazzled families. It may appear otherwise, but your teen is trying their best. Their troubling behaviors are often masking stress and other worries. This stress often appears as:

• Resistance – “I don’t want to clean my room” or “I don’t want to do chores.”
• Tiredness/exhaustion – “I am too tired to do anything!”
• Apathy – “Why should I do my work? School doesn’t matter.”
• Boredom – often code for sadness.
• Displaced anger/frustration standing in for anxiety.
• Numbing out, mostly via screen time, to escape tediousness and find variability.

[Free Download: Evaluate Your Teen’s Emotional Control]

Stress also leads to emotional dysregulation – deviations from normal behaviors and moods that may look like this:

• More movement than usual (pacing, fidgeting, hand-wringing)
• Larger expressions of emotion (yelling, swearing, physical gestures)
• Uncontrolled emotions, which can even include unusual levels of happiness, excitement, and other “positive” behaviors
• Smaller gestures (short responses, stonewalling)

Dysregulated Teens with ADHD: Connect to Regulate

Dysregulated emotions and behaviors impair effective communication. When tempers flare (including yours), no productive conversations will follow. So how can you help your teen alleviate stress and regulate emotions so that you can live in harmony? By creating positive experiences that build connections. The truth is, teens are most likely to fix their problems with help from parents, but if they feel they can’t connect with you, they won’t ask for help.

Operate under these fundamental assumptions to pave the way to productive parent-child interactions:

• Everyone, including your teen, is doing the best they can. If someone is not doing well enough, it’s because they lack skills, not because they don’t want to do well. Your gentle encouragement and support can carry them through.
• You and your teen are on the same team. It’s you and your kid versus the problem. (Even if they caused the problem.)
• It isn’t personal. Your child isn’t seeking to deliberately upset or disrespect you. Remember that emotional dysregulation is real. Don’t let your fuse get lit, and don’t light your kid’s fuse either.
• Unconditional love and forgiveness – even and especially in the toughest of times — is the only way.

[Read: Your Defiant Teenager Doesn’t Need Judging or Lecturing]

Emotional vs. Cognitive Communication

Where we are “coming from” when we communicate is crucial to solving problems rather than escalating them. Generally, people us two types of communication modes:

• Emotional communication focuses on feelings over facts. It is often accompanied by swearing, defensiveness, shutting down, and aggression. This is a valid form of expression, and it frequently occurs when a person is close to the issue at hand. But, this mode of communication is not always the most helpful. When we are dysregulated, emotional communication tends to take over.
• Cognitive communication focuses on problem-solving and facts over emotions. While this mode is usually the most helpful, it can lead to getting caught up in “winning the argument.” This type of communicator may appear dismissive and aloof to an emotional communicator.

Though undoubtedly difficult at time, it’s best to set the example for your teen and engage in cognitive communication as much as possible. Be aware of and try your best to regulate your own emotional state so that your child can match your cognitive approach. To ease the transition from emotional to cognitive communication for your adolescent:

• Validate their emotions by naming the emotions you’re detecting from your teen in a non-judgmental way. This lets them know that you “see” them, and helps them identify their own emotions.
• Use reflective listening (i.e. repeat back a summary of what they said) to validate their feelings and show that you understand their problems. Genuine reflection and validation also helps build trust and comfort around opening up.
• Take a walk with them to get the connection flowing. Movement and a different setting are more conducive to connection and conversation than is an unproductive, interrogation-style approach.
• Take a break from conversation because not everything has to be said in one sitting. You can go back to a tough subject at a later time, when they’re all calmer. The break may even help to get a new perspective.
  
• Gestures of comfort are powerful. No matter how small the gesture, do something for your overwhelmed teen that they will appreciate, like making them a cup of hot chocolate or taking giving them some time to themselves.
• The right kind of pressure can sometimes be the push your child needs. Firmly stating, for example, that you don’t want your own emotions to escalate, can snap your child into a cognitive state. This method, however, depends on your individual child, and should be used as a last resort, and should not be done as a threat.
• Recognize cursing and yelling for what they often are – surface indicators of a deeper problem. Typically, teens who resort to cursing and volatility, especially if it’s out of the norm for them, are communicating their overwhelm with a difficult situation. Keep your calm when this happens and try other ways to engage.

Dysregulated Teens: How to De-Escalate Stress

On the spectrum of anxiety, your teen’s baseline is likely somewhere between moderate and severe at the moment. More stressors push your teen into fight, flight, or freeze mode, leading to dysregulation before your teen can come back down to baseline.

Helping your teen learn to de-escalate stress in the short and long term can make a major difference in their emotions and behaviors. Some helpful strategies include:

• Prioritize physical needs, like sleep, nutrition, and movement
• Engage in temporary escapism. If you’re trying to get your teen off the screen, make sure you can actually offer an engaging alternative, like a fun board game, a scavenger hunt, or a short outdoor adventure.
• Connect with others (calling or texting a friend, visiting family)
• Exercise (playing a sport, bodybuilding, going for a run)
• Enjoy small comforts (eating a favorite meal, hugging a pet)
• Build skills, be it in sport, music, or another hobby, to boost overall confidence
• Allow your teen to identify their own de-escalation strategies
• Turn off the news
• Avoid conversations about personal frustrations and concerns
• Set clear and appropriate expectations for them; remain consistent
• Apologize when you make mistakes and lose your cool with them
• Celebrate accomplishments and support them through difficult problems
• Confront challenges head-on. Sometimes, accepting anxiety and leaning into fears can teach teens that they are more capable than they know.

The content for this article was derived from the ADDitude Expert Webinar “When Teen Stress Ignites Strong Emotions: Teaching Anger and Frustration Management” [Video Replay & Podcast #342] with Brendan Mahan, M.Ed., M.S., which was broadcast live on February 2, 2021.

Dysregulated Teens with ADHD: Next Steps

• Read: My ADHD Teen Always Blows Me Off — How Do I Get Through to Her?
• Blog: 10 Terrible Reactions to ADHD Teen Drama — and Healthier Ways to Communicate at Home
• Q&A: “My Teen is Bottling Up His Emotions. How Can I Encourage Him to Share Them?”

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Hi FrustratedMom:

I answered countless “why” questions while my children were growing up… and I still do. At first, I too was frustrated but, as time went on, I began to understand why “why” was so important for them. Here’s my advice.

1. Respect the “Why.” I don’t see this as defiance. I see it as seeking connection and context to what they are being asked to do. Children, especially those with ADHD, are generally curious and inquisitive. And need to be emotionally vested to activate. We all get asked to do things we don’t want to do. And when we know the reason or the importance of doing something – big or small – we are more likely to be motivated to do even the undesirable tasks. I know I am.

[Click to Read: My Child Doesn’t Listen! And More Frustrating ADHD Discipline Problems]

2. Preempt the “Why.” I tried to answer the why questions before they got asked! So for example, “Can you please take out the garbage now because it’s being picked up in 20 minutes,” got better results than, “Please take out the garbage now.” And if my request was vague — “Can you come downstairs so we can chat” — I worked to make it more concrete: “Let’s check in about your plans for tomorrow before I go out tonight. Can you come downstairs now to talk? It will take 5 minutes.” I found that giving context and a time limit not only helped to reduce the why questioning but promoted buy-in as well.

3. It’s not what they ask but how they handle the No. Since my children were little (they are now grown and flown), this was the running mantra my husband and I had: Our children could ask anything they wanted. And were encouraged to do so. However, as you can imagine, they didn’t always like or appreciate our responses. They didn’t necessarily get their way. And how they reacted was what we focused on and responded to. So, for example, they could ask why they couldn’t go to a friend’s house unsupervised or stay up way past their bedtime on a school night, but if their reaction to our answer was truly inappropriate, we enforced natural consequences.

Even in my student coaching practice I encourage my students to pepper me with why questions. I want them to challenge me, figure out if the strategies we are exploring will work for them, and have a vested interest in their success.

Good Luck!

Defiant Child with ADHD: Next Steps

• Read: A Parent’s Secret Weapon for Better Listening with Less Nagging
• Download: 10 Rules for Parents of Defiant Kids with ADHD
• Read: Q: Where Do I Draw the Line Between Helping and Enabling My Child’s Defiant Behavior?

ADHD Family Coach Leslie Josel, of Order Out of Chaos, will answer questions from ADDitude readers about everything from paper clutter to disaster-zone bedrooms and from mastering to-do lists to arriving on time every time.

Submit your questions to the ADHD Family Coach here!

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The symptoms of ADHD often lead to behavior problems that make parenting very difficult. Our children and teens sometimes lie and throw tantrums. They can be defiant and aggressive, forgetful and disorganized. Typical parenting approaches don’t seem to work, leaving us frustrated and exhausted. How do we help our children and adolescents change these difficult behaviors so they can more fully realize their sweet and creative sides? How can we help to boost their self-esteem — and also our own joy of parenting?

Because ADHD is a neurological disorder, difficult behaviors are sometimes our child’s way of telling us something isn’t working for them. They are confused, overwhelmed, tired, or afraid. To change their response away from lying, defiance, and emotional outbursts, a new approach is necessary.

In this webinar, you will learn to solve behavior problems with a multi-tiered approach:

• Understand the brain science driving ADHD behaviors
• Avoid difficult behaviors by using effective strategies in preventative parenting
• Shape your child’s environment in a way that shapes their behavior
• Take actionable steps to demonstrate the behavior you want
• Increase your compassion, humor, and joy while parenting difficult behaviors

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Google Podcasts; Stitcher; Spotify; iHeartRADIO.

Read More on Behavior Problems and Discipline

The Secret to Better Behavior? No Punishment at All

How to Manage Your Child’s Toughest Behavioral Problems

Positive Charge: How to Reinforce Good Behavior

Obtain a Certificate of Attendance

If you attended the live webinar on May 6, 2021, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker:

Merriam Sarcia Saunders, LMFT, is a family therapist specializing in neurodiversity. She is the author of the picture books My Whirling, Twirling Motor, My Wandering Dreaming Mind (Magination Press) (#CommissionsEarned) and the middle grade novel Trouble with a Tiny t (Capstone) (#CommissionsEarned), all affirming stories of children with ADHD. Merriam is the co-founder of www.ANovelMind.com, a blog and database of 1000+ children’s books focused on mental health and neurodiversity.

#CommissionsEarned
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Webinar Sponsor

The sponsor of this week’s ADDitude webinar is….

Play Attention Virtual Summer Camp! Enhance brain health and performance. For over 25 years PLAY ATTENTION has been helping children and adults thrive and succeed at school, home, and work.  Our NASA inspired technology and cognitive exercises improve executive function and self-regulation. Each program includes a Lifetime Membership and a Personal Executive Function Coach to customize your plan along the way. Click here to schedule your free 1:1 consultation to discuss a customized executive function training plan for you! Plus don’t miss our upcoming Brain Boost Challenge!  Click here to join our FREE Virtual Summer Camp! Children and Adult Campers Welcome!  Call 828-676-2240| www.playattention.com

ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

Listener Testimonials

“Her personal experience with children with ADHD or other conditions adds to my belief in the effectiveness of her 5-step method.”

“Merriam was an interesting and accomplished speaker, and it meant so much to me that she shared stories from her own life.  I really loved her practical, step-by-step directions on how to address problem behavior. I will definitely be sharing the replay of the webinar with my husband and my colleagues.”

“So glad that the speaker had first-hand experience as a parent, not just clinical and academic experience!”

Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
Apple Podcasts | Google Podcasts | Spotify | Google Play | Pocket Casts | iHeartRADIO | Stitcher

The mental health field does a lot of pathologizing of kids with ADHD with various labels, including oppositional defiant disorder (ODD). I want to move ADHD away from being so pathologized in the mental health field, and part of that is changing the language around it. We need to keep using ADHD, of course, because it is a neurodevelopmental challenge, but I think we need to drop the ODD label and here is why.

Why We Should Stop Using ODD to Describe Children

ODD is a description of behaviors; it is not a standalone diagnosis and it is not a neurodevelopmental challenge like ADHD. Those behaviors associated with ODD are rooted in inflexibility, which is an aspect of executive function; or they are rooted in anxiety; or they are rooted in a need for control, which is common among kids with adverse childhood experiences.

When you say your child has ADHD and ODD, it’s just pathologizing them because it’s adding another label to describe an aspect of his ADHD profile that has no biological basis that we know of.

What to Say Instead

Instead of saying, “My child has ADHD and ODD,” say “My child has ADHD and he has a propensity to be inflexible.” Or “My child has ADHD and he’s argumentative a lot.” What that is doing is looking at ADHD more holistically and using terms that describe the behaviors as part of ADHD, which is what I think they are.

Do you agree? Share your viewpoint in the Comments section below.

WATCH THE FULL VIDEO BELOW

ODD and ADHD: Next Steps

1. Understand: What is Oppositional Defiant Disorder?
2. Research: Treatment Options for Oppositional Defiant Disorder
3. Video: Do Kids Outgrow Oppositional Defiant Disorder?

DO YOU HAVE A QUESTION FOR RYAN WEXELBLATT?
Ask your question about ADHD in boys here!

Ryan Wexelblatt, LCSW is the facilitator of the ADHD Dude Facebook Group and YouTube channel.

The emotional fallout from remote learning — a frustrating experience for many children with ADHD — is particularly extreme now because the pandemic has severely limited the social and extracurricular activities that typically allow kids to blow off steam. Meanwhile, parents are nearing a breaking point as they juggle multiple roles while also providing support for their children’s mental health and navigating increased stress levels.

Now more than ever, parents need discipline approaches that go beyond shouting, timeouts, and punishment. They need productive, practical strategies to handle today’s outbursts, meltdowns, defiance, and strong emotions. Here, Dr. David Anderson will provide immediate, evidence-based strategies to improve your interaction with your child or teen and manage his or her problematic behaviors. He will explain how the right discipline approach can not only promote desired behaviors but also preserve the loving bond with your child.

In this webinar, you will learn:

• How the pandemic has exacerbated the expression of ADHD symptoms
• Techniques to increase positive interactions with your child or teen
• Effective discipline strategies to manage problematic behavior at home
• Suggestions for adapting discipline techniques to the challenges of online schooling

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Google Podcasts; Stitcher; Spotify; iHeartRADIO.

Read More on ADHD Behavior Problems

9 Ways to Discipline ADHD Behavior Without Raising Your Voice

“Because I Said So!” (Is That Really the Best You Can Do?)

How to Manage Your Child’s Toughest Behavioral Problems

Obtain a Certificate of Attendance

If you attended the live webinar on March 2, 2021, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker

Dave Anderson, Ph.D., is a clinical psychologist and the Vice President of School and Community Programs at the Child Mind Institute. Dr. Anderson was formerly the Senior Director of the Child Mind Institute’s ADHD and Behavior Disorders Center, and he specializes in evaluating and treating children and adolescents with ADHD, behavior, anxiety, and mood disorders. Dr. Anderson received his bachelor’s degree from Dartmouth College and his doctorate in clinical psychology from Columbia University. | See expert’s full bio »

Listener Testimonials

“I loved how Dr. Anderson created a visual of the steps involved by using the pyramid approach and repeating each step as he progressed to the next level, so to speak.”

“A knowledgeable and accessible expert who gave practical advice with a good balance of humor and reality!”

“Outstanding explanations and applications based on research and current practices.”

Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
Apple Podcasts | Google Podcasts | Spotify | Google Play | Pocket Casts | iHeartRADIO | Stitcher

1. Power Struggles Are Your Son’s Tractor Beam to You

For your son, a power struggle is a way to draw you in. When you’re at a certain level of intensity, he has your undivided attention — more importantly, your emotional reaction shows him that you care. Remember, many kids with ADHD are happy to take negative attention if they can’t get positive attention. And they are happy negative attention if it’s coming from their dads, in particular.

2. Difficulty with Perspective-Taking and Flexibility Are Common

If your son has difficulty being flexible, he is going to get into more power struggles with you because his brain can’t figure out when being flexible may help him get what he wants. You can’t teach flexibility when a child with ADHD is escalated. Trying to reason or argue with him is not going to help.

Also, when a child with ADHD has trouble with perspective taking, they are more likely to get into power struggles because they can’t see your point of view. It’s possible that your son has trouble with both flexibility and perspective taking. If that’s the case, keep in mind that he’s not going to learn anything until you are both calm.

How Can You End a Power Struggle?

1. Don’t Give Attention to Your Son When He Instigates a Power Struggle

Next time you tell your son to take out the trash and he refuses or talks back, don’t react to that. The more attention you give that, the more you reinforce with him that he gets your attention when he behaves this way. If he doesn’t get an intense response from you, he is going to be confused and he’s going to realize, over time, that there are better ways to get attention.

2. Offer Your Son a Restart

If your son is screaming at his siblings or his parents, he needs a restart — a pause where his brain can calm down before he comes back and tries again. When you see a power struggle coming, tell your son to try a restart. If he refuses, then you tell him you’re going to leave the room and he can come get you when he’s ready to restart. That gives him an opportunity to self-regulate, which will help him feel less bad about his behavior.

3. Teach the Importance of Reciprocity in Relationships

One of the biggest problems I find is that parents of kids with ADHD give and give and give, and don’t expect much in return. We have to teach our kids reciprocity in relationships by pointing out the things we have done for them, and asking them to reciprocate in the moment. This is not laying a guilt trip; it is teaching about the give-and-take of a relationship.

We are all going to get into power struggles from time to time, but the fewer power struggles you have with your son, the better he’s going to be able to hear you and the better your relationship will be.

WATCH THE FULL VIDEO FOR DADS BELOW

Power Struggles with ADHD Boys: More Resources

1. Read This: 10 Hard (But Essential) Truths for Fathers of Boys with ADHD
2. Read This: Fathers, Don’t Let a Condition Your Son Didn’t Ask for Define Your Relationship with Him
3. Read This: How to Be a Better Dad with ADHD

DO YOU HAVE A QUESTION FOR RYAN WEXELBLATT?
Ask your question about ADHD in boys here!

Ryan Wexelblatt, LCSW is the facilitator of the ADHD Dude Facebook Group and YouTube channel.

There are developmental stages when children with attention deficit hyperactivity disorder (ADHD or ADD) are more likely to dread going to school: preschool and kindergarten, and the transitions to middle and high school. Reasons for school avoidance vary from separation anxiety in young children to fear of increasing academic demands in middle and high school. High levels of anxiety, peer rejection, or bullying can play a role. Then, of course, there is the COVID-19 pandemic.

Many students with ADHD have “good reasons” for avoiding school beyond virus concerns. Delayed brain maturity, undiagnosed learning problems, and executive skill deficits make schoolwork difficult. If these issues are not addressed, they will fall behind academically, possibly fail a grade, and may drop out of school.

Reasons for ADHD School Avoidance

Stressful home or school situations. At home: marital problems, divorce, death, financial struggles, fatigue related to untreated sleep problems. At school: being bullied (in person, online, or while riding the bus or waiting at the bus stop), being embarrassed by a teacher in front of the class.

Under-performing in the classroom. A child may have undiagnosed learning deficits (in written expression, math), falling behind academically, or failing a class. She may feel anxious about speaking in front of the class.

[Could Your Child Have ADHD? Take This Symptom Test]

Difficult social situations. A child may be rejected by his peers or not have a buddy to rely on in school.

Skipping school because it’s not enjoyable or “fun.” Students who have ADHD that is not well-treated, undiagnosed learning problems, or deficits in executive skills would rather be anywhere else than at school.

Uncomfortable, painful, or untreated conditions. Health problems — toothaches, hunger, asthma, untreated allergies or sleep disorders, Crohn’s disease, sickle cell anemia, or chemotherapy for cancer treatment — make it nearly impossible for students to concentrate and complete work. Untreated anxiety also has a major effect on school performance. Trauma related to abuse, divorce, death, or incarceration of a parent will also impede learning.

ADHD School Avoidance in Preschool and Kindergarten

School avoidance is common in preschool and kindergarten children with ADHD who are separating from their parents for the first time. They may cling to their parents, cry, or have a tantrum.

[Symptom Test for Children: Generalized Anxiety Disorder]

The outward manifestation of their anxiety may appear as stomachaches, headaches, nausea, or “I’m feeling bad.” If there’s a new baby in the home, a young child may want to stay home because he feels insecure and worries that he will be displaced by the new sibling. Frequent trips to the school nurse for no reason or requests to call home may indicate such feelings. A child may act out by running out of the classroom and hiding.

School Avoidance in Middle and High School

Reasons for school avoidance are more complicated when students reach middle and high school. Demands on executive skills (working independently, getting started and finishing work, being organized) increase significantly during these years, and these skills are usually deficient in students with ADHD. Sleep disturbances and delayed sleep cycles occur in more than half of children with ADHD, making them too tired too often. If they have poor social skills, they may be rejected by their classmates, and are at risk of being bullied.

Parents should be on the lookout for signs of anxiety and depression. Many students with ADHD feel overwhelmed during these key transition years and blame their challenges on themselves.

ADHD School Avoidance Responses

After the pandemic, parents can pave the way for the transition to preschool by occasionally taking the child to day care for a few hours or to nurseries at their church, synagogue, or community center. Taking a child for a visit to meet the teacher and see the classroom before the official start of school is also helpful. In situations where the child is clinging to the mother, a skilled teacher will be able to capture the child’s interest by describing fun classroom activities.

For elementary school-aged kids and older, parents need a set standard for determining whether a child is sick enough to stay home. If there are no obvious symptoms, say, “Let’s see if your temperature is over 100 degrees.” In addition, make staying home boring. “If you’re sick, you need to stay in bed and sleep.” Take your child’s cell phone and remove other screens from the room. No company after school or at evening events is allowed.

Make it clear that missed assignments must be made up immediately. Contact teachers to find out assignments, and pick up needed books from school that day, if possible. If your child is feeling better by the evening, have her work on the assignments.

Address undiagnosed school challenges. Request assessment of your child’s executive skills to determine eligibility for either an IEP or a 504 Plan. Talk with the school counselor and psychologist to alert them to your child’s challenges and seek their advice. If your child fears public speaking, talk with the teacher about allowing him to give his speech privately, then, eventually, to the class.

Ask your physician whether your child’s medication needs to be adjusted. The medication dose may be too low for her to do well academically. Medication adjustments are often required during adolescence, as students mature physically and hormone levels change. Stay in touch with classroom teachers to reassess the effectiveness of medication levels.

A parent should also talk with her doctor if her teen is having sleep problems, or if anxiety or depression is affecting her functioning at school.

Chris Zeigler Dendy, M.S., is a former educator with 40 years of experience. She is the author  of Teenagers with ADD & ADHD: A Guide for Parents and Teaching Teens with ADD, ADHD, & Executive Function Deficits. Dendy, with her son, Alex, created a DVD titled Real Life ADHD: A Survival Guide for Children & Teens.

Don’t Forget About the Bully Factor

Regardless of the grade level, if bullying is the reason for school avoidance, it must be addressed. Talk with school officials and solicit their help.

Encourage your school to institute a bullying prevention program. Since adults are not always good at estimating the severity of bullying at school, ask school officials to do an anonymous survey of students: Find out how, when, and where bullying occurs. Once “hot spots” are identified, the school could provide more supervision where bullying is most likely to occur.

If your child is being bullied, find activities outside of school where your child can be successful and receive positive feedback. Identify his interests and strengths, then encourage his participation in activities at which he can excel: sports, theatre, art, debate, or something else.

[Read This Guide to Easy Accommodations to Help Students with ADHD or LD]

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