have been diagnosed with ADHD are at
a much higher risk of developing noncompliant
or negative behaviors than a child who does
not have ADHD.
The very nature of ADHD implies
that the child will have difficulty with self-control,
paying attention, listening to instructions
at home and school, and following directions.
Some children seem to be predisposed to develop
behavior problems by their temperament; however,
the symptoms of ADHD—including hyperactivity,
impulsivity, or inattention—seem to exacerbate
these negative behaviors. Managing these negative
behaviors often becomes a full-time job for
Treatment for the ADHD child
usually requires a comprehensive approach. It
includes school support, medications
if needed, parent/child education regarding
ADHD and its treatment, and behavioral management
techniques. Managing the negative behaviors
of a child with ADHD often seems like an overwhelming
and daunting task; however, such behaviors can
be managed effectively with a good plan in place.
rewards positive behaviors and aims to decrease
Setting Up a Behavior
1. Choose a negative
behavior that you want to change and a positive
behavior that you would like to see start or
continue. Start by choosing a behavior
that your child can begin to work on immediately
and that he or she realistically will be able
to change. It is not very motivating for children
to fail in their initial attempts. Your child
will want to give up right away.
Make sure you set specific goals.
For example, you would like to see your child
make the bed each day, unload the dishwasher,
come to dinner on time, or get an A in math.
You would like to see your child stop refusing
to get out of bed in the morning, interrupting
when others are speaking, refusing to complete
homework, or talking back.
2. Set up a Home Token
Economy to implement your behavior management
plan. A token economy is simply a contract
between the child and parents. It states that
if a child acts or behaves in a certain way,
the parents will agree to trade tokens for a
particular reward or privilege.
In setting up a token economy,
focus on only a few goals at a time. Your behavior
plan can be as short or as long as you want;
however, I have found that more complicated
plans are less likely to succeed.
Allow your child to be involved
in setting up the behavior plan but don’t
let yourself be manipulated. Make sure you are
firm and clear regarding the behaviors you want
to see started and stopped. When a child becomes
part of the plan and is able to pick the rewards
and the consequences he or she usually will
work harder to achieve it.
For the plan to work, token
values need to be high enough to be motivational.
Assign each behavior a value between 1 and 25.
The behaviors you really want to see changed
are those that have a higher token value—and
also are those that are more difficult to change.
For example, you might assign a value of 5 to
making the bed each morning, 10 to unloading
the dishwasher, and 20 to getting out of bed
on time. You would subtract tokens for negative
behaviors such as interrupting others, refusing
to do homework and getting poor grades.
The behavior plan is to be implemented
each day. Set up a convenient time to review
your child’s performance and determine
how many tokens have been earned or lost. Keep
a running tab on the total number of tokens
and how many have been “cashed in”
for privileges or rewards.
After you set up a token economy
program, explain the program to your child in
language he or she can understand. Be positive
and tell them that you have developed a program
where he or she can earn rewards or privileges
for behaving in a positive way. They will probably
balk at this at first—after all, they
have been receiving rewards all along that they
really did not have to earn.
Go over with your child the
number of tokens to be given or lost for positive
and negative behaviors and tell them it will
be tallied each day. Explain that the tokens
can be “cashed in” for privileges
and explain the “cost” of each privilege
and when and where the rewards or privileges
can be used. Give frequent opportunities to
exchange the tokens for rewards or privileges.
Rewards or privileges that I
have found to be effective with children and
adolescents when I have set up a behavioral
plan with them and their parents are:
- seeing a movie
- going for ice cream
- going to McDonald’s
- getting to buy a new outfit
- having friends come over
- going out with friends
- more time to watch television
- more time playing video
The number of tokens required
to receive a particular reward should vary with
the reward’s importance. For example,
sleeping over at a friend’s house might
cost 35 tokens, whereas going to McDonald’s
might cost 10 tokens. Keep the costs of the
rewards low so that the child can use a reward
Make sure you reinforce positive
behaviors immediately. Don’t give second
or third chances. Negative behaviors should
result in the loss of tokens. If you give second
or third chances you are weakening the behavior
plan and are sabotaging yourself.
How to Keep the Program
- Make sure the child
is able to see their progress.
- Modify the behavior
plan if you see that your child is not meeting
any of the goals. Discuss the plan
with your child.
- Educate the entire
family. Answer everyone’s questions.
If everyone in the family is educated about
ADHD and they understand the goals, everyone
is more likely to cooperate. Everyone needs
to be on board. ADHD is an issue for the entire
- Have a backup plan
if the behavior plan is not working.
If goals are not being met then rework the
- Expect to achieve
your goals. A positive attitude goes
a long way toward achieving success.
- If you feel ready to give
up on the behavior plan, obtain outside
support from mental health professionals,
family, friends, and teachers. Get everyone
on board with you. Nobody expects you to do
- Approach the problem
from a team perspective. Brainstorm,
brainstorm, brainstorm. Everyone in the family
should be involved in keeping this going.
The old expression, “two heads are better
than one” definitely applies here.
- Target the most
pressing problems. Avoid trying to
fix too many things. You will get bogged down
- Remain consistent
and do not yell.
There is no surer way to backslide
than to get into prolonged arguments and discussions
with your child over the behavior plan. Of course
they are going to want to change or get rid
of the behavior plan. Anything new or different
usually is met with resistance.
- Accept that your
child has ADHD. It is not the end
of the world. If you remain positive and calm,
your child will have a much easier time changing
his or her behavior. Maintain perspective.
- Get support from
everyone you can. Join a support
group in your community or an online forum
- Keep your goals
in sight. Remember tomorrow is a
new day and the sun will still shine. Nothing
- Educate yourself
about ADHD and read whenever you can. Ignorance
is not bliss.
- Practice forgiveness.
Double your efforts when you feel
like giving up.
- Give the plan time
to work. Remember that change takes
time if it’s to be long-lasting. Nothing
Kara T. Tamanini is a licensed
therapist who works with children and adolescents
with a variety of mental disorders. Visit her
website at www.kidsawarenessseries.com