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How Can I Improve the Behavior of My Preschooler With ADHD?

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Updated August 06, 2013

How Can I Improve the Behavior of My Preschooler With ADHD?

Parenting a child with ADHD can create a mixture of feelings. Educating yourself and gaining a better understanding about ADHD, finding support, taking care of yourself and relationships within the family - all go a long way to making life a bit easier.

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Question: How Can I Improve the Behavior of My Preschooler With ADHD?
"I have a four-year-old son who was recently diagnosed with ADHD. It's been an uphill battle that my husband and I manage everyday. We have been consistent in giving praise for good behavior, consequences for negative behavior, and providing a structured environment. Although it has taken time, I felt we were in a good zone until recently. Our son is now being extremely defiant. Saying 'no' to our requests, screaming, hitting and yelling at his younger sibling, and throwing objects. He is no longer responding to time-out, his toys being taken away, or other regularly used consequences. Any suggestions?"
Answer:

I know this is an understatement to say the least, but raising a child with ADHD is tough…especially when symptoms are already obvious at such a young age. It’s good that you recognized the signs of ADHD early, so you now know what you are dealing with and can get interventions in place. You are already doing a good job knowing about the importance of structuring your son’s environment and using behavioral approaches to shape his behavior in positive ways.

Environmental Changes

Whenever there is an abrupt change in a child’s behavior, the first question to consider is whether or not there have been any recent changes that may create more stress in a child’s life such as a move, a loss, a new baby, changes in the routine, or lack of sleep. Kids with ADHD often have a difficult time adapting to changes or new situations, so you’re likely to see escalating behaviors including increased defiance and tantrums.

Need for More Intense Interventions

It might also be that your son responded initially to your interventions, but now needs more intense interventions. This might include more frequent redirection and feedback and more immediate and more powerful rewards. It also helps to be aware of triggers and plan for problem situations including roleplaying and teaching appropriate skills. Continue to be consistent, as well.

Proactive Parenting Strategies

Kids who are impulsive have a really hard time controlling and inhibiting their behaviors and responses. They react without considering consequences. They also often don’t connect their actions to the consequences that will follow, especially at this young age. That’s why proactive strategies like redirecting, frequent reminders, preparing for transitions, keeping the day very structured, channeling extra energy with physical movement, offering choices to give him a sense of control, giving one-step directions, and teaching calming strategies, can really help.

Close Supervision and Monitoring

Continue to monitor your son closely. He will need constant supervision around his younger sibling. Try to identify triggers to your son’s outbursts so you can intervene and redirect him in positive ways before the behavior becomes destructive and aggressive. Do the meltdowns seem to occur at a particular time? Around transitional times? When he is overstimulated? Overtired? Frustrated with a task or in trying to verbalize or communicate his desires?

Remain Calm, Get Support and Don’t Forget Self-Care

It is hard, but try to remain as calm as possible. Sometimes what happens with kids with ADHD is their behaviors can become so difficult and exasperating that the parents may begin to respond in ways that may not be quite as effective (perhaps responding with inconsistency or disapproval and anger). This, in turn, escalates the child’s acting out. It cannot be reiterated enough that parenting a child with ADHD is tough. It requires even more patience and supervision and creative interventions on the part of the parent. It can be draining, so work with your husband to figure ways to take care of yourself. That way, you have the energy to parent calmly and productively. Make sure you both are consistent and are on the same page around parenting. It often helps to connect with a professional for parent support and training. You can also look for a CHADD Support Group in your area.

Communicate Openly With Your Child’s Doctor

Share your concerns with your child’s pediatrician. A low dose of stimulant medication may be recommended if environmental changes and behavioral approaches are not enough to significantly improve symptoms. If your son is placed on medication, it will be important to monitor him closely and communicate frequently with the doctor to make sure side effects are minimized and your child’s health is good. If your son is already on medication, an adjustment may be recommended. Either way, open communication with the doctor is essential.

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