Attention Deficit/Hyperactivity Disorder (ADHD) is characterized by developmentally-inappropriate levels of inattention and hyperactivity/impulsivity that causes impairment in a child’s functioning. Children with ADHD often experience significant difficulty getting through typical daily tasks–  including getting ready in the morning, starting and completing homework, and completing their bedtime routine. Difficulties with routines can lead to parent-child conflict and frustrations as well as problems with confidence and self esteem.  Behavior Modification is a group of techniques supported by research that can be extremely useful in helping children with ADHD and their families get through the daily grind and build skills.

Behavior Modification Basics

Behavior Modification works best when parents and children focus on one task or routine at a time, set attainable benchmarks for that task or routine, are prepared to put in time and effort toward accomplishing the given task, and carefully monitor progress to guide the process. While the child must ultimately accomplish these practiced behaviors on his or her own, parents can help guide children in several significant ways:

1.    Reduce distractions!
Most children are easily distractible, and children with ADHD are even more susceptible to extraneous stimulation. Help your child to accomplish his or her tasks by limiting distractions so that he or she can focus fully on the task at hand. For instance, clearing a workspace and getting out all needed supplies before homework is started can help set your child up for success.

2.    Provide clear instructions and break down multi-step instructions
Parents can help children learn and eventually internalize daily tasks by clearly delineating each step verbally or by teaching children to use checklists. For example, a parent can help a child complete his or her morning routine on-time by making a checklist of all the steps that must take place before leaving the home (e.g. getting out of bed, brushing teeth, getting dressed, packing backpack, etc.).  Parents can then prompt their child to use the checklist if he or she becomes distracted.

3.    Reward successes and accomplishments by providing access to privileges, rewards, and specific, immediate, and age-appropriate praise
Rewards and praise are extraordinarily useful tools in reinforcing positive behavior and successes.  Praise is most effective when parents let the child know exactly what behavior they like and use praise frequently to highlight their child’s effort. For instance, a parent whose child has trouble getting dressed independently should praise the child for putting on articles of clothing by himself or herself. Rewards as well as access to preferred activities also can be powerful motivators. To establish rewards, pay attention to what your child is motivated by, what he or she asks for during free time.  Even small rewards can be powerful as long as it’s something the child enjoys. For instance, some children are motivated by a special breakfast after completing their morning routine or for staying in their bedroom after lights out the previous night. In general, daily rewards are best but weekly can be used if there is a visual display of progress that can be reviewed with the child.

4.    Develop a system to monitor progress
Progress is often not linear and children with ADHD often engage in inconsistent behavior. Before implementing a plan, track how your child performs the desired before to find out their baseline. After starting the plan, continue to track progress to see if the plan is having the desired effect. Behaviors tracked should be observable and concrete. For instance, a goal for a child who resists bedtime might be getting into bed by 8pm.