If you're a parent and your child has been diagnosed with attention deficit/hyperactivity disorder (AD/HD), or you suspect your child may have it, you're not alone and there's a lot you can do to help. This guide walks you through what AD/HD actually is and offers practical ways that parents can support their children through it.

AD/HD is best understood as a problem with attention and self-regulation as illustrated by difficulties monitoring and adjusting one's focus and level of arousal. Researchers point to several possible contributors including differences in certain neurotransmitter levels, reduced glucose metabolism, reduced cerebral blood flow and differences in the brain regions responsible for inhibition, sustained attention, motivation and memory. Emotional difficulties are often secondary as they tend to follow from the core attention and regulation struggles rather than cause them.

In practical terms, AD/HD tends to affect 4 areas:

Memory

Internal monitoring (reflecting on one's own behavior and its effects)

Motivation

Planning and organization

The 3 Subtypes of AD/HD

Although AD/HD used to be categorized as either ADHD or ADD, today it is simply AD/HD and it shows up in 3 recognized patterns:

A predominantly inattentive type: no significant symptoms of hyperactivity or impulsivity in the past 6 months

A predominantly hyperactive-impulsive type: no significant symptoms of inattention in the past 6 months

A combined type: both sets of symptoms are present

To meet the criteria, an individual needs at least 6 symptoms of inattention, hyperactivity, or both and the symptoms need to be present for at least 6 months.

On the inattentive side, this can look like making careless mistakes, trouble sustaining attention, seeming not to listen and not following through on tasks, among other things.

On the hyperactive-impulsive side, it can look like fidgeting or squirming, difficulty staying seated, restlessness and seeming to be “on the go”, among other things.

A few additional conditions apply: the symptoms need to be inconsistent with the teen's developmental level, need to have been present before age 12, need to show up in two or more settings (for example, both home and school) and need to cause clear impairment.

What Makes the Teen Years Especially Challenging

AD/HD doesn't look the same at 15 as it does at 7. Adolescence brings its own set of complications:

1. The power of peers: social immaturity becomes much more noticeable and consequential.

2. Rules: make sure rule-breaking isn't actually an attention problem. Teens with AD/HD are often genuinely oblivious to reward and consequence, so be clear, be brief, be consistent, use eye contact and write things down.

3. Substance use risks: tied to impulsivity, self-esteem struggles and social pressures.

4. General impulsivity: teens with AD/HD often struggle to predict outcomes. Anticipate and prepare together and remind without nagging.

5. Disorganization: break tasks into steps and reduce environmental distractions (like closing the bedroom door).

6. Impaired sense of time: lateness and poor planning are common; timers, alarms and breaking tasks into manageable “chunks” helps.

7. Underachievement or uneven achievement.

8. Low frustration tolerance.

9. Procrastination driven by avoidance.

10. Getting bored easily.

11. “Hyperfocusing”: when something is interesting, interactive and self-reinforcing, sustained effort suddenly becomes possible.

12. Sleep disturbance: which often creates its own problems getting going in the morning.

13. Coordination difficulties: which can affect success in sports.

14. Lower energy and slower processing speed.

15. Attention-seeking behavior or “class clown” tendencies: often attempts to compensate for social problems, but end-up making things worse.

Early Support Matters!

Left unaddressed, AD/HD can carry real long-term costs: strained friendships and family relationships, low self-esteem, job loss or underemployment, dissatisfaction in the workforce, school retention, dropping out after repeated struggles, elevated risk of substance use tied to a need for stimulation and risk-taking, depression and acting-out behavior that can lead to injury or legal trouble.

So What’s a Parent To Do?

1. Give more immediate feedback, reward and consequence.

2. Give more frequent feedback.

3. Try reward before punishment.

4. Use timers and alarms and break tasks into smaller “chunks.”

5. Place reminders near where the task actually happens.

6. Make abstract ideas more concrete by writing things down.

7. Be consistent.

8. Follow through.

11. Plan ahead and anticipate problem situations.

12. Remember that this is a disability. Adjust expectations and reactions accordingly.

13. Don't take the behavior personally.

14. Let go, apologize when needed and welcome your teen back into the fold when they make mistakes.

What Treatment Might Look Like

Every treatment plan is different since it depends on the therapist's approach, the teen's and family's goals and the nature of the issue. However, therapy for AD/HD often includes some combination of the following:

1. Getting an accurate diagnosis, including psychological testing where appropriate and screening for co-existing conditions

2. Arranging for a medication assessment

3. Ruling out medical issues, medication effects, substance use or other psychosocial contributors

4. Building rapport, trust and safety in the therapy relationship

5. Creating behavioral contracts with parents to build routine and support

6. Using the behavioral contracting to help teens practice predicting and planning

7. Helping teens organize, prioritize and manage their time

8. Monitoring sleep and nutrition, especially if on stimulant medication

9. Tracking of medication effectiveness, side effects and compliance

10. Checking-in on your child's self-esteem

11. Building confidence through other strengths and sources of success

12. Managing stress for both your child and the family

13. Improving support and communication

14. Making use of school supports like teacher feedback and Individualized Education Plans (IEPs)

15. Bringing in educational specialists when needed

16. Teaching your child self-monitoring skills

Looking Ahead

As your child gets older, a few things can make the transition smoother:

1. Knowing your rights and the services you may be entitled to

2. Making use of the services and accommodations available

3. Teaching your child that asking for help is okay

4. Considering all the options ahead like college, the workforce, or trade school

5. Considering all of your teen's strengths and interests, not just the challenges

6. Building a support network, both professional and personal

7. Making sure daily living and independent living skills get attention too

If you'd like support for yourself or your child, schedule an appointment with Dr. Sina today.