Connecting Behavior and Consequences for Kids With ADHD

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Children with attention deficit hyperactivity disorder (ADHD) are often constantly moving or fidgeting, have trouble focusing, and struggle to process information as rapidly or correctly as other children. This can affect how they interpret the consequences of their behavior, which can be frustrating for ​parents and teachers.

Let's take a look at why there is often a disconnect between behavior and consequence in children with ADHD, and how to best help them make the connection.

Disconnect Between Behavior and Consequence

Kids with ADHD often have difficulty delaying or inhibiting their responses. Instead, they tend to live in the moment, reacting immediately to that moment without thought. For a child to make a connection between a specific behavior and consequence, they need to be able to pause, think through the events and their emotions, weigh the consequences of their behavior, and then allow these thoughts to guide their decision making about the behavior.

For many children with ADHD, there is often a disconnect between thinking and reacting. When everything seems to happen all at once, they respond impulsively without using information about past experiences to guide their behavior. This is why kids with ADHD do not seem to learn from past mistakes as easily as their peers.

Impairments in working memory can also result in problems being able to "see what lies ahead." In other words, a child may have trouble keeping relevant information to help make decisions about future behavior.

In addition, kids with ADHD may experience a delay in the development of internal language—the voice inside our head that helps us "talk" to ourselves, contemplate what we should do, and then regulate our behavior.

Connecting Behavior and Consequences

When you have a child who thinks and reacts impulsively, it's helpful if you can intervene and provide cues, reminders, incentives, and guidance at the point of performance—the moment in time when your child must inhibit behavior to meet the demands of the situation.

Your immediate feedback about their behavior—pointing out, reinforcing, and rewarding a child when they are displaying the behavior you want to see, and providing mild reprimands and redirection to help get them back on track when they begin to engage in inappropriate behavior—will help your child "stop and think" or "put on the brakes" before responding.

Your teaching and training in this area will also help your child develop greater self-awareness. The more aware of and in-tune your child is with the situation, the more likely the child will be to connect cause and effect and use the knowledge to guide their behavior.

Be sure to follow through with consequences in a consistent manner. Feedback needs to be provided immediately and frequently. Guidelines should be readily identified to help your child know what to expect. These strategies help keep your child's environment predictable.

3 Sources
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  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®) Fifth Edition (2013). Washington, DC: American Psychiatric Association Publishing 2020 https://www.appi.org/diagnostic_and_statistical_manual_of_mental_disorders_dsm-5_fifth_edition

  2. Colvin MK, Stern TA. Diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2015;76(9):e1148.  doi:10.4088/JCP.12040vr1c

  3. Jonkman LM, Markus CR, Franklin MS, van Dalfsen JH. Mind wandering during attention performance: Effects of ADHD-inattention symptomatology, negative mood, ruminative response style and working memory capacity. PLoS One. 2017;12(7):e0181213. doi:10.1371/journal.pone.0181213

By Keath Low
 Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD.