1. Acquire current and credible information about ADHD and its effects on families by reading pertinent literature, attending informational forums, and seeking professional guidance. (1, 2, 3)
1. Review basic information about ADHD with the parents and begin the process of educating them concerning the implications of ADHD.
2. Advise the parents to read current literature that defines ADHD, its effects, and treatment. (See Driven to Distraction by Hallowell and Ratey or Taking Charge of ADHD by Barkley.).
3. Refer the parents to Web sites or informational resources that distribute credible and current information about ADHD and its effects on families (e.g., Children with Attention Deficit
2. Attend regular consultations with the child's doctor and/ or a family therapist to discuss ADHD and its effects on children and their families. (4, 5)
3. Read and discuss current law pertaining to children's disabilities and available accommodations in the school and the community. (6, 7)
4. Advocate for the child's right to accommodations and support in school and in the community. (8, 9, 10)
4. Assign the parents to meet with the ADHD child's doctor to review pharmacological interventions available for treatment.
5. Schedule a time-limited series of family counseling sessions with the parents and other family members to continue their educational process, resolve specific areas of frustration and conflict, and offer support in their efforts to cope with the effects of ADHD on the family.
6. Assist the parents to become familiar with the laws pertaining to ADHD and related disabilities by providing them with copies of the law and/or literature that summarize it (e.g., Section 504 of the Rehabilitation Act of 1973, The Americans with Disabilities Act, Title II, and the Individuals with Disabilities Education Act [IDEA]).
7. Instruct the parents to contact their state and district education departments to obtain information about educational programs and accommodations available to the ADHD student; discuss the applicability of these programs to the success of their child in school.
8. Assist the parents in preparing a written statement for those educators and others working closely with their ADHD
5. Join a local support group for families dealing with ADHD. (11, 12)
6. Build a system of support that includes school personnel, extended family members, medical and/or child who would benefit from specific information regarding ADHD and its effects on the child.
9. Brainstorm with the parents to create a list of accommodations, programs, and support strategies that would assist the child in the school or community (or assign the "ADHD Accommodations Request Form" from the Parenting Skills Homework Planner by Knapp).
10. Role-play interviews with the parents that they will have with educators and other adults working directly with their child; guide the parents to develop assertive and cooperative skills for advocating for their child at school and in the community.
11. Refer the parents to a local support group that assists families and children coping with ADHD; or contact the national office of Children with Attention Deficit Disorders (CHADD), (301) 306-7070 or www.chadd.org, for a list of support groups in the community.
12. Refer the parents to a parenting class (e.g., Becoming a Love and Logic Parent by Fay, Cline, and Fay) to acquire techniques of positive discipline to use with their ADHD child.
13. Assist the parents in developing a list of resources available to provide day care and occasional relief from the intensity of mental health professionals, and community members. (13, 14)
7. Implement recommended strategies for parenting and disciplining the ADHD child. (15, 16)
Avoid power struggles and set limits using controlled choices and logical consequences. (17, 18)
parenting an ADHD child (e.g., after school programs, summer programs, respite programs, community activities).
14. Ask the parents to identify areas where family assets are lacking (e.g., housing, financial, medical, school-related, extended family, or social outlets) and help them build a list of advocates and supportive resources.
15. Ask the parents to assume the role of a Parent Coach when directing and disciplining their child by determining the skill they wish the child to develop and initiating practice sessions to help their ADHD child acquire that skill; suggest the parents develop or purchase a series of Parent Coaching Cards (see www.parentcoachcards .com/home1.html and Parent Coaching Cards by Richfield) that colorfully illustrate the skill to be developed on one side of the card and offer self-talk coping messages for skill development on the other side.
16. Brainstorm with the parents a list of proactive strategies they can implement that will help them cope with the frustration, stress, and intensity created by the ADHD child (e.g., humor, redirection, classical music, physical activity, relaxing baths or showers, and healthy snack food).
17. Assign the parents to use limited choices with the ADHD child by giving two options either one of which is acceptable (e.g.,
9. Use structure, consistency, and a combination of kindness and firmness to promote appropriate and responsible behavior in the ADHD child. (19, 20, 21)
"Would you like to go to bed with your blue or red pajamas on?") to teach responsible decision making and to allow the child to experience some limited control.
18. Instruct the parents to use logical consequences that are related to the rules infraction (e.g., the child whines and cries for half an hour at bedtime and therefore must go to bed half an hour earlier the next night).
19. Emphasize to the parents the importance of close supervision and a structured environment that allows little opportunity for problematic behavior to go unnoticed until the ADHD child has demonstrated an adequate degree of self-control and responsibility.
20. Encourage the parents to tackle behavior problems one at a time and to approach the ADHD child with a combination of empathy, kindness, and firmness in order to maintain a supportive and loving relationship while setting limits.
21. Assign the parents to predict potential problems that may occur during the following week and determine methods of averting a negative outcome (e.g., bedtime resistance—allow more time to prepare for bed); ask the parents to record the results of their planning for discussion at the next counseling session.
10. Create a total family treatment plan for managing the ADHD child and collateral family issues. (22, 23, 24)
11. Develop a system for recognizing and focusing on the positive attributes of each family member. (25, 26)
12. Child and parents implement the use of planners and organizing strategies to assist the child in completing tasks successfully. (27, 28, 29)
22. Assign the ADHD child and siblings to read children's literature that describes the syndrome (e.g., Jumpin ' Jake Settles Down by Shapiro) to gain a better understanding of ADHD from a child's perspective.
23. Brainstorm with the parents and other family members five to ten problem issues they are experiencing as a result of ADHD and prioritize them in order of need to resolve (or assign the "Family Problem Resolution Worksheet" from the Parenting Skills and Discipline Homework Planner by Knapp).
24. Assign the parents to begin a journal that documents the family's efforts in coping with ADHD and related family issues.
25. Assign all family members to remain watchful for positive behavior from one another and to recognize and reinforce it by identifying the specific behavior and describing how it benefits the family or the person involved.
26. Encourage the parents to initiate weekly family meetings where family issues are discussed and time is designated for stories reflecting the positive contributions of each family member.
27. Assign the ADHD child and the parents to develop a management system for schoolwork by designating a specific color for each academic subject and color coding all information and related resources.
Give instructions to the child in a clear, direct, and calm manner. (30)
Child and siblings accept responsibility for developing resolutions to their conflicts.
Engage the child in positive extracurricular activities that develop self-confidence, empathy, responsibility, and independent functioning. (32, 33)
28. Instruct the ADHD child and other family members in the use of calendars, organizers, and written reminders to assist the child in the daily organization of tasks and activities.
29. Assign the ADHD child to use a planner to list all assignments, record working time, and check off when completed; instruct the parents to monitor the student's assignment planner daily and give encouragement and direction as needed.
30. Discuss with the parents strategies for assisting the child to successfully complete tasks and assignments (e.g., maintain eye contact when delivering calm instructions, encourage questions, offer guidance on an as needed basis).
31. Assign the ADHD child and the siblings to identify five to ten issues of conflict in their relationships and to brainstorm possible methods of resolving these conflicts (e.g., take turns, play separately, share, write a plan).
32. Advise the parents to encourage participation in activities that develop self-confidence, social skills, persistence, and offer positive role modeling (e.g., team-sports, karate, Tae Kwon Do); assign the parents to enroll the ADHD child in one positive extracurricular activity.
33. Instruct the parents and the ADHD child to avoid or
16. Plan for leisure activities the whole family can participate in and enjoy. (34, 35)
17. Celebrate each accomplishment, milestone, and success achieved by the ADHD child and the family unit. (36, 37)
substantially reduce the time spent in activities that are passive, reduce productive brain activity, and involve long periods of inactivity (e.g., TV, videos); encourage the parents to promote quiet activities that stimulate logical thinking and problem solving (e.g., reading, board games).
34. Assign the family members to take turns planning family meals and sharing the work involved in the preparation and clean up; the meals should include all family members seated at a table with no TV or loud music playing.
35. Instruct family members to plan for a bimonthly family fun night when individual family members are responsible for providing the at-home entertainment (e.g., live music or drama, video, reading from a book aloud, or a special TV program followed by family discussion) and refreshments.
36. Teach the parents and other family members the importance of giving frequent affirmations to the ADHD child for progress noted in a private, low-key manner.
37. Assign the parents, the ADHD child, and the siblings to affirm themselves and one another for each victory, large or small, in managing both personal and family challenges.
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