A customized plan can teach new skills and reduce problem behaviors at home and school.
Hearing that your child has attention deficit hyperactivity disorder (ADHD) can be scary, especially if you’re not familiar with the condition. It’s a lot to take in, and, naturally, you might worry about what it could mean for your child’s future.
While there is no known cure for ADHD, there are things you can do to help your child succeed and develop.
ADHD is a neurological and neurodevelopmental condition that is most often diagnosed during childhood, usually when kids start attending school.
According to the Centers for Disease Control and Prevention (CDC),
ADHD can sometimes be tough to diagnose because a child may experience varying levels of each symptom: inattention, hyperactivity, or impulsivity.
From inattention to intention
“Children with ADHD don’t intentionally misbehave, but because they have so much trouble meeting expectations, parents or teachers sometimes mistakenly think they are misbehaving,” Dr. Dina Hirshfeld-Becker, co-founder and co-director of the Child Cognitive Behavioral Therapy Program at the Massachusetts General Hospital in Boston, explained.
One thing that can help performance: building around your kid’s strengths.
There is a way to help with that — and it’s called a
According to the American Academy of Pediatrics (AAP), a behavior management plan is a “type of training [that] helps parents learn age-appropriate developmental expectations… and specific management skills for problem behaviors.”
In other words, it’s a structured plan that helps your child learn how to manage their negative impulses and encourage their positive behaviors.
It does this through a reward-based system. What those rewards are can vary from kid to kid, depending on their interests, and the rewards can be stacked toward bigger prizes so kids have something to work for.
The AAP recommends that a behavior management plan be the primary intervention for preschool-aged children with ADHD because a
They also recommend it for children with ADHD-like behaviors because even if a kid hasn’t been formally diagnosed with ADHD, studies show that building a similar plan can benefit childhood development.
For children under age 6, behavior management should be tried before giving kids medications,
It depends on the kid.
For the plan to work for your child, you’ll have to base it around their nuanced issues and interests. There isn’t a set structure that will work for everyone.
“Our focus when creating a plan is to first address one area of your child’s life where you are having the most difficulty,” Dr. Lori Long, a child psychologist and co-owner of The Childhood Collective in Phoenix, explained.
Start with a home behavior management plan
Since your child spends most of their time at home, this is often the first place to focus on to create your plan.
Start with a simple task you may want your child to do as part of their morning routine. For example, maybe have them put their plate in the sink after breakfast.
When they do that task correctly, they get a token (or point.) If they do it every morning, those tokens stack up for an even bigger reward.
Tokens can be anything from marbles in a jar to stickers on a board. Consider creating a visual token system so your kid can track their progress.
For best results, be transparent. Make sure your child can see their progress. Also, on their bad days, you can continue to show support.
Then, as that one positive behavior (i.e., putting the plate in the sink) is adopted, you can expand their routine to include more steps, like washing the plate, running a dishwasher cycle, or helping to clear the rest of the breakfast table.
As your child gets more comfortable with each step of the plan, they will see the value of managing their behaviors. They’ll also see that they’re accumulating tokens and earning rewards, like special outings or more unstructured time.
Some behaviors can also be worth more tokens than others. This will be based on how challenging the task is or how much you value the particular behavior.
You can also implement consequences for not meeting expectations. For example, missing daily goals or negative outbursts can result in tokens being taken away.
Keep your plan simple and easy
“Many families end up giving up on plans because they are too difficult or complicated,” Long said. “[Keep] it simple and easy to implement for your family.”
Also, consider making the plan with your child, so they feel invested and motivated by it, she says.
A plan that clearly details expectations helps kids understand what behaviors earn tokens and what behaviors take them away.
Your child may get a clearer understanding of the effects of their behavior if you explain why they earned or lost a token. Also, take care not to make up new rules as you go.
The sooner your child is rewarded for their good behavior, the more likely they will repeat it. The same can be said for negative behaviors, too.
Making sure the rules for cashing in tokens are clear also helps reinforce good behaviors. Consider including small and large rewards they have to save up to get. This way, your child’s small rewards can be earned daily and the more motivating rewards less often.
Discussing the plan with everyone in your family allows them to participate. Your child will quickly learn if the rules at grandma’s house are looser than the rules at home.
How do you factor in school breaks?
You may have built a formidable strategy for behavior modification for before and after school, but what do you do when there isn’t any school?
“During unstructured time, the factors that lead to unhelpful behaviors increase,” said Hirshfeld-Becker. That’s because “children with ADHD may have a lower threshold to get bored and [they] can have trouble with unstructured time. When bored, they may seek sensation or novelty, even if it means hyperfocusing on exciting video games or teasing siblings.”
That’s why behavior management plans are essential for school breaks.
Try to think of steps to add to your plan that can fill some of that unstructured time during the day when they are usually at school. Then, you could make those tasks worth extra tokens or unique rewards to build in extra motivation.
What are some ideas for school break behaviors you could include in your plan?
Even though your child won’t need to wake up early for school, try to maintain a consistent schedule. If possible, keep your child’s same wake-up times and bedtimes over the weekend.
Examples of positive behaviors that could earn tokens:
Examples of negative behaviors that could lose tokens:
On holiday breaks
Examples of positive behaviors that could earn tokens:
Examples of negative behaviors that lose tokens:
Keep in mind that holiday breaks also offer parents a unique set of rewards that aren’t available year-round. If you can, include seasonal incentives, like going to a drive-through light display, walking around the neighborhood to see spooky Halloween decorations, or going to see Santa.
Over the summer
If possible, try to enroll your child in a summer camp or regular weekly activity (like swim lessons or rehearsals for a musical production). This can help add structure and consistency to their routine, much like school does.
That said, it’s also OK to adjust your plan for road trips, long red-eye plane flights, or family trips, if necessary.
“[If] you can still keep some of the routines the same during those vacations, and if your reward system is easy, bring it with you,” Long said. “If that is too hard, just be flexible and know the situation is temporary.”
“As soon as you are back from vacation, be diligent on starting the system and routines again as quickly as possible,” she added.
Maybe. Talk with your teacher, school counselor, and principal to see if they’re willing to integrate your plan into the child’s school day.
“Reward systems and daily reports are great ways of tracking a child’s progress in school where the parent may be unable to directly observe the positive and negative behaviors,” explained Dr. Mary Gay, a licensed professional counselor and the evening program director of The Summit Wellness Group in Georgia.
“Teachers can also help their students with organization-related skills,” Gay said. “When schoolwork and other tasks are broken down into manageable pieces, it makes it easier for students to concentrate.”
If the staff is reluctant to adopt your plan, consider asking them what can they do to set up your child for success. Not every teacher will incorporate your plan, and that may be a sign that this classroom, or school, isn’t right for them.
If you can explore alternatives, your child might benefit from a school or classroom that is more structured to their needs. Specialized environments can address a kid’s requirement for physical activities or hands-on learning.
The short answer: yes.
A good behavior management plan is age-appropriate and changes as they move from elementary school into high school.
In elementary school
At this age, kids are less able to explain and understand their feelings. If they are bored with an activity, they may react with an outburst that could be misunderstood as a tantrum.
“School behavior plans in elementary school should consider the factors that lead to the unhelpful behavior and the consequences that follow from it and try to modify both to help the child do the best they can,” Hirshfeld-Becker explained.
For example, “in school, if a teacher knows that a child has a hard time staying seated at circle time, the teacher might modify the expectations by engaging that child in something active (such as passing out papers or watering the classroom plants) during that period,” Hirshfeld-Becker added.
In middle school
By the time a child with ADHD moves into middle school, they may have a stronger baseline for following a daily routine and managing their own behaviors, thanks to your plan.
The next step at this age is helping them manage their growing responsibilities, like more textbooks to read, learning harder school subjects, and changing classrooms and teachers over the course of the day.
The hard part at this age for parents is trying to interact with each of your preteens’ teachers.
An option is to consider a self-management plan where your child is responsible for keeping track of their own behaviors. You can reward their transparency.
The benefit of this, Long says, is that “this can help them develop important executive functioning skills, such as self-monitoring.”
However, “by middle school, and sometimes much earlier, many children with inattentive symptoms of ADHD may have trouble fully accessing the curriculum without medical treatment and/or educational supports,” Hirshfeld-Becker said.
“… Parents may consider looking for medication and [a] resource room help to assist with attention and organization,” Hirshfeld-Becker added.
This may also be the right time to consult as a family, get insight from other families in your school district who have children with ADHD, and explore an IEP (individualized education program) or a 504 plan.
In high school
Some kids with ADHD will outgrow their hyperactivity or impulse outbursts — but not all of them.
Still, if you’ve been working with them on a behavior management plan since they were young, you’ve helped them develop the tools for managing their ADHD to navigate their teenage years better.
So, now that they’re a teen consider encouraging them to explore the positive subjects that hold their attention.
As they grow up and find more mature interests, they will find it easier to complete tasks if they are centered around a subject they enjoy.
Parental involvement is important even as your teen moves into high school. If left untreated, ADHD can put teenagers at a higher risk of being
The best way to keep any behavior management plan going is to check in with your child frequently to see how they are doing. It may seem as if you’re constantly making little adjustments here and there, but as long as you can see your little one progressing, you’ll know you are on the right track.
Don’t be afraid to ask for help either. It’s OK to expect help from other members of the family. Building a behavior management plan isn’t easy, and you shouldn’t have to feel as if you’re the only one keeping track.
Asking others to help keep progress consistent builds a community of accountability, continuity, and support.
Above all, keep the focus on your child’s strengths. “Sometimes we spend too much time trying to address their weaknesses that we forget to spend the time in activities where they shine,” Long said.
Just like you have a few bad days, your child will have bad days, too. Try not to get discouraged if things don’t go according to plan, and certainly don’t throw out your entire plan if a few days go off the rails.
However, if you feel that maintaining a behavior management plan is too much for you, it’s OK to seek professional help. Some people specialize in establishing strong behavior modification techniques for families who need help.
But above all: Be patient.
“Be patient with your child and with yourself,” Gay advised. “Not every plan is going to work, and not every piece of advice is going to be the magic solution when it comes to your child.
“Every child with ADHD is different and needs different things,” she continues. But “the end goal is to improve their quality of life and teach them effective ways of coping with their ADHD.”
And sometimes, figuring that out just takes time.