ADHD Behavioral Interventions for the Home

By John M. Grohol, Psy.D.

Parents often hear the words “parental training” and think, “Oh great, like you could teach me something that’ll control my out-of-control attention deficit disorder child!” And yet research has shown that children with attention deficit disorder (or ADHD) respond very positively to such parent training interventions — that parents who learn how to treat their ADHD child actually will help the child with ADHD get better and stay better in the long-term.

Behavioral interventions for the home are generally simple, easy things any parent can learn to do without even seeing a therapist.

1. Create rules for the home.

Develop a set of basic, simple and straightforward household rules. No cursing, no running, no screaming. Keep the number manageable and stick to the largest, most problematic behaviors you’re encountering in your own home (which may be different than Mr. Smith’s home).

2. Ignore mild inappropriate behaviors and praise appropriate behaviors (choose your battles).

Parents too often get into hopeless and minor scuffles with their children about unimportant things. Focus on the big things and the little things, as they say, will take care of themselves. If your child left out his or her toys again, consider ignoring it once in awhile.

3. Use appropriate directives.

While young children are not our pets, they often learn best when parents phrase their directions in the form of a simple yet firm and clear directive.

  • Obtain the child’s attention: say the child’s name before your directive
  • Use command not question language — Not, “Jason, would you mind cleaning up your crayons?” but rather, “Jason, please clean up your crayons before you go outside.”
  • Be as specific as possible — Not, “Maggie, could you take out the trash sometime?” but rather, “Maggie, please take out the trash before dinner.”
  • Command is brief and appropriate to the child’s developmental level — Talk to a 4 year old like a 4 year old and don’t try to reason with them, appeal to logic, or expect their minds to work the same as a 14 year old’s mind.
  • State consequences and follow through — Not, “Larry, clean up your room or else!” but rather, “Larry, please clean up your room before you go to bed or you’ll be grounded tomorrow.”

4. Keep daily charts (e.g., School, Home Daily Report Cards)

Both a home daily report card (PDF) and a school daily report card (PDF) is vital to making any home behavioral intervention work. Children need to see their progress on a day-to-day basis, or else it won’t mean anything to them. It also allows them to achieve rewards based upon such progress.

5. Set up contingencies ahead of time

Everyone works better when they know and understand the expectations ahead of time. If a child always expects to watch TV at a certain time every night, no matter whether their homework is completed or not, then the expectation is that homework completion is not important. If, however, the ADHD child is told “James, no TV until your homework is completed,” they know exactly what to expect in order to achieve TV time.

6. Point/token system with both reward and cost components

Point and token systems may seem complicated to set up and keep running, but they can be something as simple as a calendar and M&Ms. The key is that as a child completes certain items — whether it be a chore, homework, etc. — they rack up points that count toward a reward. Short-term rewards are usually more effective (such as candy or time with their favorite video game system). Not completing certain tasks should also result in points being taken away, although positive reinforcement is always a stronger motivation for children than negative reinforcement or punishment.

7. Try a level system

A level system is a more complicated form of a basic token system, and requires typically more effort on the part of the parents and training to learn how to implement and use such a system effectively. An example of a level system is the Triple P Positive Parenting Program (PDF) by Sanders and Prinz.

8. Homework hour

Homework hour is a good idea, even for children without ADHD, because it sets up a reliable schedule (and expectation) that learning doesn’t simply end with school. It carries over into the home life, and provides the child with the expectation that every evening will have at least an hour devoted to that learning. Plus, homework hour also reminds parents to be there for their child, to answer any homework questions they might have, help them out with a difficult math problem, and just generally support their continued academic efforts.

Ad-hoc homework time, in comparison, teaches a child that the less homework they have, the less time they need to spend on it. This creates a negative reinforcement schedule that rewards a child for having as little homework as possible at home.

9. Contracting/negotiating with adolescents

Teens work different than children, and they should be treated differently. As young adults making their way in the world, they have all of your independence with none of the benefits of your experience and wisdom. As such, you should be willing to be more flexible and work with your teen treating them as the young adult they are. This can involve drawing up a kind of contract, which can be done in an email or handwritten

This article based upon a presentation by Dr. William E. Pelham Jr., October 2008.

 

APA Reference
Grohol, J. (2009). ADHD Behavioral Interventions for the Home. Psych Central. Retrieved on November 26, 2014, from http://psychcentral.com/lib/adhd-behavioral-interventions-for-the-home/0001754
Scientifically Reviewed
    Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
    Published on PsychCentral.com. All rights reserved.