By Linda Aber & MA, Psychotherapist, Sheila Ostroff 

 

Parenting AD/HD Teens: Expectations, Strategies & Staying Connected!

Adolescence is akin to an “out of body experience” – out of a child’s body into that of an emerging adult. The teenage years, as emerging adults strive for independence, are jam-packed with joys and challenges. Parents find themselves wondering, “Where did my loving child go?” Often, parents and teens regard one another as aliens, inhabiting the same planet, yet from two different worlds.  This transitional stage is enhanced for teens with AD/HD, producing even greater internal upheaval.

AD/HD is a neurological condition characterized by underactivity in the prefrontal cortex of the brain, an area responsible for regulating attention, impulse control, motor activity and emotions. It may be diagnosed in childhood and persists throughout the lifespan.

AD/HD symptoms include an overall inconsistency, distractibility, the presence of hyperactivity or underactivity (hypoactivity), impulsivity and difficulty delaying gratification. Often, co- existing conditions (known as comorbidities) complicate the AD/HD diagnosis. Examples of co-morbid conditions are learning disabilities (25-50%), Tourette syndrome (11%), anxiety disorder (37%), depression (28%), bi polar disorder (12%), substance abuse (5- 40%), oppositional defiant disorder (59%) and conduct disorder (22-43%).

Typical AD/HD behaviors, similar for girls and boys, include difficulties in controlling emotions, low tolerance for frustration and deficits in executive functioning which facilitate organization and setting priorities. They tend to display an impaired sense of time and find transitions challenging due to difficulty in shifting mindsets.  Their level of alertness throughout the week is inconsistent, and may not be predictable within a given day.   Sleep and lack thereof plays a significant role in this.  Collectively these behaviours contribute to a possible 4-6 year developmental lag.

Treatment is recommended when the clustering, intensity and persistence of symptoms impact on the teen’s life. AD/HD symptoms require an overall multi-modal treatment plan. The most effective strategies focus on five major areas: medication for concentration, social skills training for social competency, psychological help, remedial tutoring and parenting / adult management strategies (the latter was the focus of the presentation and will be expanded upon below). 

Parents may, on occasion, notice several similarities between teens & toddlers. They both live in a “me” world and interpret the word “no” as negotiable or a choice not to hear it. Both teens and toddlers at times have developed a cluster of brain circuits that may fire off unpredictably.  Parents need to understand that during the teen years, there are massive structural changes occurring in their maturing brain. There is a substantial growth of the corpus callosum, a set of nerves connecting all parts of the brain that must work together, critical for executive functioning, consciousness, self awareness and intelligence. Research reveals that the brain matures by their mid twenties. 

What is normal teen age behavior and what is not? Typical teen behaviors (things they do that drive parents crazy) include messy rooms, moodiness, keeping late hours, sleeping in late, extensive use of phone / computer, choice of music, clothing, hair radically different than that of their parents’ generation and avoidance of family outings.

Serious behaviors that warrant parents’ need to take charge include persistent school problems, anxiety, depression, high risk sexual behaviors, drugs / alcohol, and conduct disorder. Anxiety and depression can be present as secondary symptoms due to the daily stress that are the adolescent’s experience. This is when they become more at risk for substance abuse.

Teens are influenced more by their peers than their parents. They indulge in risk taking activities without thought of consequences. They use pretzel logic. Although teens may want to work part time to earn extra money, the demands of school can be too much to juggle.

Effective parenting is a delicate balance of nurturance and structure, allowing consistency, limit setting and affective connection. Think of your structure as an expanding corral. When the teen is accountable, your corral expands for more autonomy, but when the teen displays difficulty, your corral contracts providing safe limit setting.

The nurturing parent uses a safe tone of voice, gives hugs, uses humor, and is playful. This is the glue that preserves and repairs your parent-teen relationship.  Enjoy your teen and plan time and special outings together. Use active listening, “I” messages and avoid being judgmental.

     The structured parent needs to establish a daily routine, develop house / street rules, use contracts, and pick the right time / place to talk (go for a walk, meal, car ride). It is essential to impose reasonable consequences for inappropriate behavior without obliterating the teen’s self esteem. Consequences should be instructive (to teach them skills they lack) not punitive. Remember to constantly repair and leave the door open, by stating, “I believe in you”. The teen must not lose hope.

Remain positive; catch them being good and responsible, as this helps them learn new skills. Provide feedback immediately and often. (“I saw you help your brother, good job”). Ignore minor misbehavior and talk about the behavior- NOT the teen.  Stay focused on increasing your teen’s self-esteem even though they may push you away and test the boundaries / rules you set; this is completely normal.

When in a highly emotional state, their ability to think becomes impaired and their memory is affected. Parents need to acquire skills to self regulate; to manage their own frustration and anger. Staying centered on what is important, refueling and taking good care of oneself is crucial. We recommend finding something fun to do and try to laugh everyday in order to reduce your own stress. Keep reminding yourself that parents are the key to their adolescent’s success.