We have a 5-year-old son who has been diagnosed with ADD. He is really difficult

Question and Answer

We have a 5-year-old son who has been diagnosed with ADD. He is really difficult to handle, and I have no idea how to manage him. I know he has a neurological problem; I don't feel right about making him obey like we do our other children. It is a big problem for us. What do you suggest?

Answered by James C. Dobson, Ph.D.

I understand your dilemma, but I urge you to discipline your son. Every youngster needs the security of defined limits, and the ADD or ADHD boy or girl is no exception. Such a child should be held responsible for his or her behavior, although the approach may be a little different. For example, most children can be required to sit on a chair for disciplinary reasons, whereas some very hyperactive children would not be able to remain there. Similarly, corporal punishment is sometimes ineffective with a highly excitable little bundle of electricity. As with every aspect of parenthood, disciplinary measures for the ADD child must be suited to his or her unique characteristics and needs.

How, then, is such a child to be managed?

Let me share a list of 18 suggestions that were provided in a book by Dr. Domeena Renshaw entitled The Hyperactive Child. Though her book is now out of print, Dr. Renshaw's advice on this problem is still valid.

Be consistent in rules and discipline.
Keep your own voice quiet and slow. Anger is normal. Anger can be controlled. Anger does not mean you do not love a child.
Try hard to keep your emotions cool by bracing for expected turmoil. Recognize and respond to any positive behavior, however small. If you search for good things, you will find a few. Avoid a ceaselessly negative approach: "Stop" "Don't" "No."
Separate behavior which you may not like, from the child's person, which you like, e.g., "I like you. I don't like your tracking mud through the house."
Have a very clear routine for this child. Construct a timetable for waking, eating, play, TV, study, chores, and bedtime. Follow it flexibly when he disrupts it. Slowly your structure will reassure him until he develops his own.
Demonstrate new or difficult tasks, using action accompanied by short, clear, quiet explanations. Repeat the demonstration until learned. This uses audiovisual-sensory perceptions to reinforce the learning. The memory traces of a hyperactive child take longer to form. Be patient and repeat.
Designate a separate room or a part of a room that is his own special area. Avoid brilliant colors or complex patterns in decor. Simplicity, solid colors, minimal clutter and a worktable facing a blank wall away from distractions assist concentration. A hyperactive child cannot filter out overstimulation himself yet.
Do one thing at a time: Give him one toy from a closed box; clear the table of everything else when coloring; turn off the radio/TV when he is doing homework. Multiple stimuli prevent his concentration from focusing on his primary task.
Give him responsibility, which is essential for growth. The task should be within his capacity, although the assignment may need much supervision. Acceptance and recognition of his efforts (even when imperfect) should not be forgotten.
Read his pre-explosive warning signals. Quietly intervene to avoid explosions by distracting him or discussing the conflict calmly. Removal from the battle zone to the sanctuary of his room for a few minutes is useful.
Restrict playmates to one or at most two at one time, because he is so excitable. Your home is more suitable, so you can provide structure and supervision. Explain your rules to the playmate and briefly tell the other parent your reasons.
Do not pity, tease, be frightened by, or overindulge this child. He has a special condition of the nervous system that is manageable.
Know the name and dose of his medication. Give it regularly. Watch and remember the effects to report back to your physician.
Openly discuss with your physician any fears you have about the use of medications. Lock up all medications to avoid accidental misuse.
Always supervise the taking of medication, even if it is routine over a long period of years. Responsibility remains with the parents! One day's supply at a time can be put in a regular place and checked routinely as he becomes older and more self-reliant.
Share your successful "helps" with his teacher. The outlined ways to help your hyperactive child are as important to him as diet and insulin are to a diabetic child.1