24 Attention Deficit Disorder- Behavior Management Strategies

ADD-behavior-management
Simple ADD Behavior Management Skills Every Parent Should Know

Children with A.D.D. or A.D.H.D. can test a parent’s patience to the limits. In the midst of the struggles, it is important to think of A.D.D. NOT as a disorder, rather a way that your child learns and reacts to stimuli in the world around him. Here are some simple ADD behavior management strategies you can implement to help your child be aware of how their actions are impacting those around them.

1. Stop signals.

It’s not enough just to tell your child not to be impulsive. You’ve got to show him how to control his impulses. Give him some “think it through first” tools so he knows what the consequences of his actions will be. Plant this sequence in your child’s mind: Before you do it:

Say to yourself, stop!
Count to ten
Imagine what will happen if you do it.

2. Do it together.

The school-age child with A.D.D. is more likely to cooperate with your request if you do the task together. The three-or four-year- old with A.D.D. is unlikely to complete even small tasks that you assign, since they often can’t pay attention to one task for very long. Don’t be upset! This is a wonderful opportunity to model “helping each other” and teach a positive ADD behavior management strategy.

3. Count your messages.

Remember what we said about how important it is to frame your child in a positive way. Here’s an exercise to help you judge whether you are giving your child predominantly positive or negative messages. Choose a day where you will be spending a lot of time with your child and count the number of positive and negative messages you give. This can be done mentally, on paper, or by using the green counter / red counter technique. Get two golf-score counters, the kind you can wear on your wrist in two different colors. Put one color, say red, on the left wrist and use it to count every time you give a negative message with words, tone of voice, or your actions. Put another color, say green, on your right wrist and count every time you compliment or praise your child or give him any kind of positive message. You can also use this technique to see what kind of messages you and your spouse are giving each other to see what you are modeling for your child. At the end of the day, you may be shocked to see that you scored 20 to 50 red messages, yet only 5 to 10 were green. Now that you’re aware of this, try to change your ways. With thought and effort, you can reverse this! Your child’s self-image will improve, and so will your image of him.

4. Be specific.

A child who has attention differences will experience trouble when given subtle directions, gentle persuasions, and reasoning techniques. When focusing on ADD behavior management changes remember that many children with A.D.D. simply do not understand communication that is not crystal clear and to the point. 5. Identify triggers. Parents of a child with A.D.D. have many job titles, and one of these is detective. Stake out your child’s behavior and, based on your observations, list what situations encourage good behavior and what situations trigger bad behavior. For example, many children behave best in the morning, but behavior may deteriorate when dad goes out of town. Some children do well when playing with one or two friends, but become aggressive in crowds of three or more. Construct a behavior profile to help you recognize in what situations your child behaves best and worst. You might do a behavior profile on yourself. When are you at your best and worst? It helps to know both your child’s limits, and your own.

6. Structure the day.

From your child’s behavior profile you know what situations bring out the best and worst, and you should keep those situations in mind when working on ADD behavior management changes. It’s certainly easier to shuffle your daily schedule than to change the temperament of your child. If your child’s behavior is best in the morning, plan activities such as playgroup, outings, shopping trips, and preschool in the morning. If your child falls apart in the supermarket at 4 p.m., don’t even think about shopping at that time. If your child needs time to unwind after school, save homework for after supper.

Structure the child to fit the day

While it’s often easier to change your plans than change your child, some situations are not very flexible. If dinner at grandma’s house is scheduled for 6 p.m. and that’s not negotiable, play ahead. Think about what you and your child will be doing during the visit and come up with a play-by-play plan for setting your child up for good behavior. Have your child take a late afternoon nap. Talk with your child about what kind of behavior you expect and what activities are going to occur that evening. Take along quiet toys, and be prepared to spend enough time interacting with your child and monitoring his activities, so that your expectations have some hope of being realized. Plan on leaving before your child’s behavior starts to deteriorate.

Occasionally, you may need to lie out the child’s whole day on paper, to create structure where the child sees none. Start with the attitude she has when she gets out of bed, how quickly she dresses herself, brushes her teeth, eats breakfast, gets ready for the school bus, or says “yes” to each of your requests throughout the day. With each step successfully completed, she gets a star or point on a reward chart. Once your child realizes how much happier you both are when a day goes smoothly, this feeling becomes self-motivating.

7. Structure the classroom to fit your child.

If a visit to your child’s classroom reveals distractions in the classroom, see what you can do to restructure his environment. Asking to have your child seated in a less distracting place, away from windows or a distracting classmate, and closer to the teacher are all simple ADD behavior management strategies you can try. If you notice the classroom environment has a rowdy zoo-like atmosphere, ask to have your child transferred to a calmer classroom, where the teacher has a more structured disciplinary system.

8. Hire a model.

When Peter was eight, I hired one of his friends to model some exemplary behavior for him, figuring that if he saw one of his friends acting a certain way, he would be more likely to model it.

9. Match playmates and personalities.

Kids with A.D.D. often choose the wrong friends because they’re attracted to colorful, flashy, interesting things – including people. If you notice Amy plays well with Sara but clashes with Becky, realize that she is not yet ready to cope with a child with Becky’s personality. In time, you can help your child play compatibly with a wide variety of children, but for now, limit play dates with Becky to times when you can supervise the children closely. Remember, circumstances in life are seldom ideal, and you must give your child the tools she needs to succeed. This requires being your child’s facilitator.

10. Match child and toys.

If Brian is a thrower, structure his toy choices. Brian would do best with foam blocks that can’t be turned into dangerous projectiles. If he throws his wood blocks, they get “time out”. If toy squabbles occur between siblings or playmates, time out the toy or teach the children to take turns using a timer.

11. Busy the bored child.

A bored child, especially one with A.D.D., is a set-up for trouble. And a bored child with a busy parent is a high-risk mismatch and sets up the situation for failure instead of being a positive ADD behavior management situation. Many children with A.D.D. are unfairly labeled as behavior problems, when they are simply bored. Busy these bundles of energy with activities that sustain their interest before they deviate into undesirable alternatives. Recognize, too, that the announcement “I’m bored” may mean a child needs your attention, not just something to do.

12. Catch the child in the act of being good.

This commonsense principle is the oldest behavior modification technique around: catch the child in the act of being good and praise him. Your grandmother probably used this technique; you may remember the warm feeling you got as a child when a parent or teacher recognized your good efforts. Yet, this simple technique is often neglected. It’s our human nature to focus on the child’s “bad” way of acting. Bad behavior draws more attention than good behavior. Parents and teachers are more likely to correct or punish misdeeds than they are to praise good ones. To a certain degree, this is defensible. Studies show that parents and teachers are more likely to react negatively to children with A.D.D. than to children without the A.D.D. style. Adults become worn down by the energetic and persistent characteristics of these children. They jump on the negatives, and the positives, which may be infrequent, go unnoticed.

Children must learn that good behavior is expected and that it’s not always praised or rewarded. Yet, they must also learn to like the way they feel when they behave well. Your praise and recognition will help your child prefer good behavior, even when it’s not easy. If only bad behavior draws attention to the child, he will behave badly just to get reassurance that someone is noticing him.The good news is you can change these messages by practicing a few well- chosen words: “Great job!””Way to go!””Yesss!””I like the way you used a lot of color in that picture””Thanks for helping with supper.””That makes me happy.”Basically you are saying to the child, “I like you, I think you’re great!” The child is getting a lot of positive messages from you in the form of genuine praise. And if your child feels that you like him, he will like himself.

13. Try rewards.

Rewards capitalize on the pleasure principle: behavior that’s rewarding continues; behavior that’s unrewarding ceases. Pet trainers use this principle; so do dolphin trainers at Sea World. Kid trainers can use positive reinforcement, too. Yes, rewards are bribes. If the word “bribery” offends you, call them “incentives” or “motivators” instead. You may feel skeptical about reward systems, believing them to be external gimmicks that don’t really change your child from within. This is a valid criticism, since the ultimate goal is to give the child inner motivation and points or prizes alone will not accomplish this. Yet, reward systems are useful as a starting point, especially when nothing else seems to be working. You can use a reward system to redirect a negative child and give him a taste of success. Eventually, the child gets used to the good feelings he gets from all those “points” or “treats”. These good feelings then become the child’s own internal reward and motivate continued good behavior. Eventually, you can reduce the external rewards and just rely on social rewards, like smiles and praise.

A child’s behavior affects the parents’ behavior. Undesirable behavior in children often leads to unrewarding behavior in the parents. You need to shift from that kind of negative spiral to a positive feedback loop. Once your children see how much happier you are when they behave, your attitude toward them becomes another social reward.

MATCHING THE RIGHT REWARD SYSTEM FOR YOUR CHILD

Use social rewards more than material rewards. Choose rewards that bring you and your child together to do something fun. This prevents you from feeling like you’re a behavioral scientist dangling bits of cheese in front of little rats to guide them through the maze, and your child will see that your family values people more than things. Toy rewards seem to be more popular with younger children. As they get older, either combine or replace them with social rewards. Keep the child connected to people (e.g., “This coupon is good for one lunch date with Mommy or Daddy” or “When you finish putting away your toys, we’ll sit down and play a game together.”)
Let your child help choose the rewards. “If you could choose a special place to go or a special thing to do, what would you choose?”
Choose immediate rewards. Children with A.D.D. can’t wait. Rather than a big treat at the end of a week of agreed-upon behavior, issue smaller rewards sooner. You are likely to get better results. The younger the child, the more frequent the payoff should be. Toddlers may need hourly, or at least daily, rewards; preschoolers need daily rewards; school-age children need weekly rewards; teenagers can hit the jackpot at the end of the month.
Use reward games that the child likes. Remember, the child with A.D.D. tends to get bored with the same game. Change the game, or the way you play it, as needed.
Relate the reward to the behavior you want changed. “When you show me you can keep your room tidy for a week, then we’ll get bedroom furniture for your dollhouse.”
Should you take away points? When you’re using positive reinforcement to shape behavior, it’s important to give your child the message that nothing detracts from the good he has done. If you’re making an effort to give your child positive messages rather than negative ones, you may not want to take points off the reward chart. For some children, the two-steps-forward-one-step- back approach may be too frustrating. Others respond well to the “give and take” method. Using both give and take is more realistic in preparing your child for real life.
6 CREATIVE REWARDS THAT WORK

These are systems that we have used in our own families or suggested to parents of children with A.D.D..

Tickets and tokens. Depending on the age and motivation of your child, you may have to give reward tokens every few minutes, hourly, or at the end of the day. Tickets and tokens are particularly useful to keep the wandering little mind on task. Break up a job or a homework assignment into small parcels, and issue a “job done” ticket at the end of each step. Once the goal is reached, present your child with a special double-value ticket.
Connect the dots. This technique provides small, frequent rewards to keep a child on task and to give a visual gauge of how much progress is being made toward the long-term goal. After you have identified the behavior you want to change (“Each time you are dressed and ready for the school bus on time with no nagging…”), have your child draw a picture of the reward you have agreed on. It may be a bike, a toy boat, a doll, a ball or a special outing. Then use dots about an inch apart to outline the picture. With each good behavior, the child connects one of the dots. When all the dots are connected, she collects the treat. You can also use this reward technique to remind children of their responsibilities. Each time they remember to put away their toys, clean up their room, or take out the trash, they can connect a dot. Focus on positive behavior (erasing lines doesn’t work very well). Display the picture in a high visibility location, such as on the refrigerator or on the kitchen cabinet, and at your child’s eye level. This reminds the child of the expected behavior and allows her to proudly display her progress.
Happy and sad faces. Make or buy stickers with happy and sad faces. A grumble or negative response to a parental request gets a sad face on the chart . Cooperation, or a positive response merits a happy face. When happy faces outnumber the sad faces on a predetermined number of days, the child collects the prize. Do not use this approach unless you’re sure the happy faces will prevail. 4. Happy hands. This motivator helps remind the child of his responsibilities and provides rewards for good behavior or a job well done. Place your child’s hands on a piece of paper and draw an outline around each finger. Above each finger write or draw a job (or desired behavior) the child has to complete. The left hand could list morning jobs and the right hand after- school jobs. As the child completes the job he colors in a finger and gets a happy-face sticker above the fingertip. When both hands are filled in, your child gets a special treat for having “so many happy faces on his fingers.” You could also dub this game, “Hands for remembering.”
A behavior bus. Draw a big bus with square windows and write the job (or desired behavior) to be accomplished in each window. The goal is to get a happy face sticker on each window. Once the bus is filled with happy faces, the bus drives on to get the prize.
“Give-and-take” systems. A reward system can be used to accomplish two goals: to encourage desirable behaviors and to get rid of undesirable ones. The give-and-take technique accomplishes both. You put a dime in the jar or a point on the chart for desirable behavior, you take a dime out of the jar or a point off the chart for bad behavior. Or you could start the day with five dimes in the jar, and take one out for every “no” you get from your child and add one for every “yes.” Just be careful you don’t let your child get into a negative balance and end up owing you money.
THE GOOD BEHAVIOR CANDLE

As a Cub scout leader, here’s a trick that I (Dr. Bill) has successfully used to hold the attention of a dozen rowdy nine-year-olds and keep them on task. At the beginning of our meeting, we light the good behavior candle. As long as there are no disruptions the candle stays burning. As soon as someone disrupts the meeting, the candle gets blown out. As soon as the candle burns all the way down the group gets a special treat. Naturally, it’s in everyone’s best interest to keep the candle burning, so they help keep each other in line. You can adapt this technique to get siblings to work together on a job or to improve family table manners at dinnertime. Don’t use this technique, however, if one child is going to be frequently singled out.

14. Shopping strategies.

Supermarket shopping and children with A.D.H.D. is not the best match. Even if you survive the trip up and down the aisles, avoiding the breakables and the junk food, waiting in the checkout line is bound to do you in. Appreciate a basic principle of behavior modification: If there is a major behavior you want to shape, begin with baby steps and progress gradually. Here’s a sequence to set the child up for successful shopping.

Begin with a small store and look in the window before entering to see if it’s busy. Go in the store to purchase one item, say a container of milk. Have the exact change ready when you enter the checkout line and have your child pay the cashier. When the child leaves without whining and has behaved in the store according to the prearranged agreement, he gets a point and a reward. The next day go to the same store and get two or three items.

Generalizing
Many children with A.D.D. have trouble transferring the rules learned in one situation to another situation; they have difficulty generalizing. Your child may know what she may not touch in your house, but don’t expect her to respect the same “no touches” when she goes to Grandmother’s house. You must make your rules exceptionally clear and simple and repeat them when the situation changes. “Just like at home, we don’t put our feet on the furniture at Grandmother’s house.”

Gradually increase the size of the store, the number of items you purchase, the number of points your child gets, and maybe even the size of the reward.
Finally, try the supermarket. Select the time of the day when your child is at his best, usually the mornings. Tell him what you’re going to be doing and the kind of behavior you expect in the store. Set up a point system on your shopping list. List the items you need to purchase on your shopping list in one column and categories of good behavior on the other. You can assign a certain number of points for aisle behavior, checkout counter behavior, and helping behavior. Agree on a reward before you enter the store and write it down and draw a picture of it on your shopping list. This helps prevent tantrums. Let your child help pick out the items, and also let him check off each item on the list. As he does this, award points for good behavior. When you reach the checkout counter, your child will have earned his treat.
Jill, mother of five-year-old Andrew, came in to my pediatric office for counseling and confided to me, “Our whole day is spent in conflict with each other. I find myself constantly saying “no” to him. Andrew won’t obey even when I ask him to do the simplest things. I want to be a happy mother, but I find myself becoming increasingly cranky.”

I suggested she try a reward system. I said, “Tell Andrew exactly the behavior you expect. Say to him: “I want to be a happy Mommy, not a cranky Mommy. Let’s try to have more ‘yes days.’ Then Jill made a chart with Andrew to keep track of yeses and nos. She told him, “Every time I ask you to do something and you say “Yes, Mommy” we’ll put a “yes” on the chart. At the end of the day if there are more yeses than no’s, that’s a “yes day” and we’ll do something special together.” Soon Andrew realized that the happy Mommy was more fun to be with than the cranky Mommy, and they began to have more “yes” days. Also, Jill found that Andrew absolutely hated to lose points, so occasionally she would add a “take-away” slant to the reward system. She began the day with a dish of ten dimes, and for each “no” she took one out. Varying the game and the approach held Andrew’s interest and got more consistent results. Eventually, they were able to have “yes” days without the chart and the reward.

15. Give reminders.

“She’s twelve-years-old! Do I still have to remind her to brush her teeth?”Reminders are words, pictures, checklists, or brief notes that jog a child’s lazy memory and keep them from forgetting rules and routines. Frequent verbal or visual cues can keep an active mind on task. If you know from experience that your child is likely to get sidetracked on the way upstairs to brush her teeth, when she reaches the top of the staircase, call out a gentle prompt, “teeth.” A certain look may remind the about-to-mess-up child that he knows better, or a short verbal cue can steer him toward the expected behavior (“Where do jackets go?”) Reminders could even be in the form of pictures. To remember what he has to take to school help your child draw or paste a picture of a backpack on a piece of paper, and around it draw or paste pictures of items that go into the backpack each day. Tack this poster next to the door he uses in the morning.

Every child needs a few of these prompts every day (so do spouses). The child with A.D.D. just needs more of them. Reminders are more likely to be followed than a barrage of daily orders because they don’t provoke a power struggle. Your child already knows the rules. Your reminders just start the memory process going and prevent a behavior problem from occurring. As you enter the supermarket you say, “Remember, we walk down the aisles.”

“But I forgot.” As lame as this excuse sounds, all children forget. Children with A.D.D. forget more often, so they need more reminders. During a particularly intense day your child may need hourly, sometimes minute-by-minute, reminders. Use all the positive verbal and body language you can muster up: “I need your eyes,” “You’re forgetting…” “You know what to do…” Be sure the art of reminding doesn’t deteriorate into the hassle of nagging. Keep your body language positive, your voice light and happy, and your manner more playful than authoritarian. Then your child is likely to perceive your constant prompts as help rather than nagging.

To avoid nagging, once your child can read, write your reminders on little post-it notes for your child. Try some humor: “Dress the bed, then dress yourself;” “Your lunch is packed and in the refrigerator asking to be eaten.” If you have an artistic flair, illustrate the notes.

16. Count your child.

During your early disciplining, you may have frequently used countdowns, such as, “I’m going to count to three…,” expecting your child to behave positively by the time you hit three. Our four-year-old daughter “hops to” at just the mention of counting. She prefers to behave on her own. She knows that once “three” comes, she’s going to be physically assisted in cooperating, and she will do anything to avoid being picked up and carried like a baby. You can also teach your child to use counting to control his own impulsive behavior. Counting can be a cue to help him “think before he acts.” Help him learn to do this by catching him in the act: “Before you throw the toy, count to five, and then imagine what might happen.” The next time your child is about to act impulsively, issue a reminder, such as, “Count to five,” or “Wait a minute,” or “Imagine what might happen.” Repeat these drills so that eventually he will be able to use this skill on his own.

Remember, one of the main challenges for children with A.D.D. is to teach them to “look before they leap.” Teach your child to internalize his own counting drills and use them to control his impulsive behavior. Psychologists call this process of having an inner dialogue to guide behavior “internal verbal mediation.” Teaching your child to have a dialogue with himself is a useful skill in developing self-control. 17. Card your child. This technique is a sort of warning system that gives your child time and space to change disruptive behavior before it gets worse. It also buys an angry, impulsive parent time to plan a gentler strategy. Get three cards, each a different color, and draw a face on each card, each one sadder than the previous one. You can use these cards as they are, or you can glue a magnetic strip to the back of each one to stick them to the refrigerator. When your child begins a disruptive behavior, give him the first card or stick it on the refrigerator door. If the behavior continues, the second, sadder, card goes up. If this doesn’t prompt him to change his behavior and you have not yet come up with a better strategy, the third and saddest face card goes up. If your child is still misbehaving after all three warning faces are on the refrigerator (or on the table) then it’s time for “time-out” or, preferably, “time-in.” One mother tried a very interesting variation on the three-card method. She let her son put the cards up for her, if she started yelling. She gave her son the message that we all can learn from each other. Big people make mistakes, and they also must correct their errors.

18. Try time-in.

We have noticed that for many children with A.D.D (and other children, too) the classic “time-out” method of behavior modification doesn’t work. Their anger escalates when they are sent to another room for time-out, and they become resentful at being sent away. Time-out reinforces all the negative messages they are accustomed to receiving about themselves. This is why the “time-in” chair works better for many, especially for younger children. In time-in the parent has the child sit in a chair or stand in a corner in the same room as the parent. The child must be silent for a short period of time, but is not isolated. This gives the message that although you will not tolerate the behavior, you are not rejecting your child. Children three and older can be given a count of three to sit down. If your child does not sit, state firmly the one-minute time-in is now two minutes. Repeat this procedure raising the number of minute until the child sits in the chair. Screaming or abusive arguing from the child while sitting adds minutes until it stops. You must decide beforehand how long time-in will last. Obviously, fifteen minutes is too long for younger children. We prefer short times, no more than five minutes.

With the time-in method you don’t have to carry, drag, or otherwise force your child upstairs or into a room. Time-in also spares the child’s room from being trashed out of anger and resentment. While the child is sitting in the time-in chair, stand next to him. This positioning makes it difficult for the child to suddenly move out of the chair. You may even stand behind your child with a hand firmly, but lovingly, on his shoulder. Or you may stand in front of him with your hand on his shoulder. (Some children with A.D.D get upset if they are touched.) The child will find it difficult to get up out of his chair with you standing in front of him. Young children, and particularly young children with A.D.D., dislike doing nothing, even for a very short time. Time-in will get the corrective message across very quickly. One minute for each year of life is a good guideline for the length of a time-in.

Occasionally, parents may have to tell a child in a time-in that they are going to help him by holding him. This gentle, but firm, holding reinforces closeness and caring, not anger and control. This can protect a child from throwing himself into an extreme temper tantrum in which he might hurt himself.

MORE TIME-IN TACTICS

With preschoolers, try the teddy bear chair technique. When a child needs time- in, have her put her teddy bear (or any other favorite doll or stuffed animal) in a chair. Then both of you can talk to the bear about behaving better. This bit of playacting uses “time-in” as simply a break in the action to allow her to think about her undesirable behavior and to change what she is doing. Time-in also gives parents a chance to cool off and plan a better discipline strategy.

The timer alternative. Use a kitchen timer. Tell your child he has to sit quietly for three minutes. Turn the dial on the timer to three minutes. If he fusses or doesn’t sit down by the count of three, then start the timer again. Restart the 3-minute time-in every time the child starts to argue. Children tend to respond to the demonstrative action of restarting the time-in period. Eventually, some children, after acting out, go to their time-in seat and set the timer themselves.

Give bonus points if the child explains his point of view calmly after time- in. Tell your child that you want to understand why he did what he did, but he must sit quietly for one minute first. If he explains his reasons calmly, reward him with points. Then ask: “What would you like to do when we are through?” This may get both of you headed in a more positive direction.

19. Try take-aways.

By the time your child is five years of age, you can increase time-ins to five minutes. Once you reach the five-minute mark, tell the child that you are going to take away something he likes (don’t say what) if he doesn’t sit by the time you count to three. If he continues to be unruly then you say: “I’m now going to take the first ten minutes of your favorite TV program away.” You don’t tell him ahead of time what he is going to lose, because if you do, he will often just snap back that he doesn’t want what you threatened to take away anyway. Think ahead to what you have planned that day. If you are planning to make play dough, that won’t happen. Leave yourself with a lot of ammunition. The privilege you take away should be small. Don’t take away his bicycle for a week for a relatively minor infraction.

20. Assist the child.

“I’m-going-to-do-it-with-you.” Here’s a technique to try that stops short of taking away privileges. If your child is not doing what you’ve asked, try counting to three. If this doesn’t work, say to him, “Do it or I am going to help you do it!” Use a stern voice as if your doing it with him is a very significant happening. Count to three again, and then act by taking his arm or hand and doing the task that was to be done. This method avoids the trap of repeating your request over and over again and the need to make threats about taking things away. It works, in part, because children like to do things themselves and partly because your stern tone has conveyed some urgency.

21. Use consequences to curb impulsiveness.

Choices have consequences, and children must learn this. Because of their impulsiveness, children with A.D.D. are less likely to think before acting. They act before considering the consequences. Making wise choices in life begins with learning one basic lesson: “Think through what you’re about to do.”

“When…then…” “When your teeth are brushed, then we’ll begin the story.””When you finish your homework, then you can go out to play.”

Learning from mistakes. Experience is the best teacher and it’s often the one that makes the greatest impression. Children with A.D.D. often have to learn “the hard way.” If despite your guidance, your child still chooses the wrong path, then let him experience the consequences (as long as there’s no danger). For example, your child leaves his tricycle in the driveway despite repeated admonitions to store it in the garage. The bicycle gets backed over by a car. Let him go without a bike for a while. Your child is dawdling despite your frequent reminders that he is late for his baseball game. He sits on the bench for the first two innings.

Imagining the consequences. Help your child imagine what the consequences of a particular action might be. Natural consequences that you have not arranged are happening in everyday life. You can also set up parent-made consequences, customized for a particular situation, that you hope will have lasting learning value. Here is a logical consequence that parents in my pediatric practice tried:

Judy and Tom had just moved into a new house and their four-year-old son, Aaron, was given his own room. He was feeling very proud and grown-up enjoying the privacy of his new room, but door slamming was becoming a problem, especially when he got angry. His parents repeatedly told him that slamming the door was annoying and must stop. If it didn’t, he would no longer enjoy the privacy of having a door: his dad would remove it. Aaron got a “Yeah, sure, Dad’s going to take the door off” look of disbelief on his face. He continued to slam the door over the next day, so when he went out to play, off came the door. A week later Tom put the door back on, and it hasn’t been slammed since.

22. Teach empathy.

Teaching empathy means helping your child to understand that his deeds have consequences for others. Tell him about the feelings you have as a result of his actions. (“That makes me feel…”) Be sure he makes the connection that positive behaviors from him result in positive feelings in others, and negative behaviors result in negative feelings: “I sure like it when you…” “I feel angry when you…” (Notice we don’t say, “You make me so mad.”) Help your child get behind the eyes of other people, especially those on the receiving end of his behavior. Give your child practice in thinking about his own and others’ feelings: “Do you think she feels sad?” “How would you feel if someone hit you?” Look for the “teachable moments” that crop up nearly every day and give you an opportunity to help your child learn empathy.

One day I saw two eight-year-old neighbor boys perched on the hillside ready to toss water balloons onto cars passing below. Obviously, these children had not thought about the effect of their misbehaviors on the drivers of the cars. This was a teachable moment. I sat down with them and asked them to imagine how they would feel as the driver of a car if a water balloon exploded on their window. They needed to learn to put themselves in someone else’s seat. An accumulation of many such lessons over time will truly “put the child in the driver seat” in terms of being in control of their behavior. You want them to get to the point that they think through what the consequences of their actions will be for others rather than being totally focused on their own immediate fun or needs. You may hear that children with A.D.D. are at increased risk for sociopathic behavior, or just plain winding up in jail. Statistically, this is true. Yet the main quality that separates the child who uses his traits to society’s advantage and the one who gets into big trouble is the quality of empathy – the ability to understand and sympathize with the feelings of another.

23. Give responsibilities.

Giving your child responsible jobs to do is a powerful way to shape behavior. Responsibilities give children direction. When they have jobs to do, they have fewer opportunities for bad behavior. Adults often find their value in their work. They call it “being of use.” Children who are given chores feel they are part of a group. They are depended upon, and the family values them. The child with A.D.D., in particular, needs to feel busy and on the move. Give your child special jobs. The word “special” is a good marketing tool and is likely to promote cooperation. Try these tips:

Give the preschool child jobs around the house: vacuuming, dusting, tearing lettuce for a salad, setting the table, helping with dishes.
School-age children can do their own laundry, help with the cooking, and pack lunches.
Create job charts: some jobs might be for pay, others are done for the privilege of living in the home. Give genuine praise for a job well done. Working alongside children is a useful way to keep them on task.
24. Withdraw privileges.

Besides all the “gives” that shape behavior, taking away luxuries is another way to keep the child on track. For this technique to have the desired result, it’s important that children do not view it as a punishment. If done correctly, what’s taken away should be a logical or natural consequence of the child’s actions: “If you ride your bicycle without a helmet, you lose the use of your bicycle for two days.” Remember to withdraw privileges, not the necessities of life. You don’t deprive the child of a hot meal or a warm, winter jacket, but turning off the TV has never caused lasting harm. Losing privileges teaches the child realistic lessons for later in life: privileges are based on responsibility (e.g., If you want to keep your credit card, you must pay the bills.)

Withdrawing privileges works best as a behavior shaper if you have worked out with your child beforehand a mutually agreed upon consequence: “After you finish your homework, you may watch TV.” Then, if he does not finish his homework, he already knows that he will not be watching television. As your child gets older, the stakes get higher. With increasing maturity come greater responsibilities, which bring greater privileges; however, neglecting these responsibilities brings more serious consequences.