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Abstract

Five Consequences that Reinforce ADHD BehaviorThe Behaviors Are Situational and Have Psychological Meaning

It is now possible for concerned parents to treat their child’s attention deficit/hyperactivity disorder (ADHD) without relying on medication. This unique approach strengthens self-reliance and cooperation and helps parents reduce their child’s inattention, hyperactivity, and impulsivity. Parents learn to interrelate in positive ways and identify the five main ways in which they may have unwittingly reinforced ADHD behavior in the past. Far from encouraging parents to strictly manage their child, this approach promotes independence in kids so that less stringency and surveillance is necessary. The therapy works on the premise that ADHD behaviors increase in frequency due to reinforcement. Close examination of the child’s day-to-day patterning shows that the behaviors occur in particular situations and repeat in relation to what happens. Parents learn to alter the consequences that increase the incidence of ADHD behavior, and promote cooperation and achievement by phrasing their requests in specific ways. The child’s preference is acknowledged so that working together is an attractive option. Coercion is kept to a minimum. Ten parenting principles help to regulate emotions and develop the child’s executive functioning. The child learns the value of being knowledgeable without the motivation of punishment or gift rewards so that dependency on contingency management does not occur. The recommended strategies foster caring relationships, resiliency, and autonomy for children with ADHD.  

When Nurturing Self-Reliance and Cooperation

Parents help the child:

•Recognize the pros and cons of particular behaviors

•Identify positive alternative actions

•Explore complications that might be encountered

•Become aware of past successes in similar situations

•Resolve problems that disrupt their relationship

•Function adequately without parental involvement

Conclusions

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Wiener, C. Attention Deficit Hyperactivity Disorder as a Learned Behavioral Pattern: A Less Medicinal More Collaborative Intervention. (2007). Lanham, MD: University Press of America.

Wiener, C. Parenting Your Child with ADHD: A No-Nonsense Guide for Nurturing Self-Reliance and Cooperation. (2012). New Harbinger Publications.

1. Avoidance 2. Attention3. Accommodation4. Acquisition5. Antagonism

Ten Parenting Principles

Craig B. Wiener Ed.D.Private Practice/ University of Massachusetts Medical School/ Family Health Center of Worcester

Helping Parents Nurture Self-Reliance and Cooperation in Children with ADHD

Consumer Reports • ADHD Drugs: • 60%-80% of children and teens• Less hyperactive and impulsive • Better focus• And less disruptive at home and school

• “However, there is no good evidence showing those benefits last for longer than two years.”

•Traditional methods do not nurture self-discipline

•And rarely yield longer-term results

When does ADHD coping occur? Situations associated with loss, restriction, and failure

When is ADHD unlikely?Initiated and Enjoyed Activity

Traditional InterventionBased on Medication and Stringency

Key Benefits: Ease of Use and Rapid Results

Shortcomings

With coercion the child may learn:

evasion/submission/anxiety/minimal conformity/retaliation/selfishness

rigidity/domination/maneuvering procrastination/withholding/reliance

A Learning Paradigm For ADHD

The Shortfalls of Biological Determinism(1)   ADHD is caused by genetics- Too many false positives and false negatives (2)  Brain biology is different- Correlated data not causal data (3)  Medicine works- Treatment does not identify etiology   (4) ADHD is associated with functional delay- No diagnostic markers

3. Take steps to address and resolve problems

• “I haven’t been getting enough time on the computer. Let’s figure out a way to take turns.”

4. Be patient

• It can take many trials to learn a new behavior

5. Suspend judgment

“This report card is terrible.”

“How do you feel about this report card?”

“What do you like about it?”

“Is there anything you want to change?”

6. Say it positively

• Negative: “You can’t have snacks before dinner.”

• Positive: “Let’s keep our appetites. We can eat together real soon.”

7. Treat your child as competent to succeed.

“You have to read the directions.”

• “How c “How can you find out what to do? to do?”

8. Establish “buy in”

• He is more likely to do his part.

9. Assert yourself

• “I’m happy to keep buying these snacks if we figure out a way to share them.”

10. Foster Independence

• For example: Instead of ordering your child’s meal at a restaurant, encourage him to order his own meal.

2. Stay calm

• “I know you’re angry, but I can hear you better if you talk quietly.”

1. Use coercion as a last resort

–Your child is more likely to cooperate when you are not there

Intervention Develops

• Self-Management• Compromising• Sharing • Turn taking • And consistent

routines

Children and parents

–Learn to consider multiple perspectives

–compassion develops

The debate is not about data

• It is about the interpretation of data and ADHD empiricism may be understood within a learning paradigm–Biology may change the

probability of learning ADHD, but it does not cause ADHD

Utilizes “Evidenced Based” Techniques

•Facilitate goal-achievement Latham, Erez & Locke, 1988; Locke & Latham, 2002

•Stop avoidance behaviors (Ehrenreich et al. 2007)

•Nurture positive relationships, resiliency, and empathyHorvath & Bedi, 2002; Martin, Garske, & Davis, 2000; Henry, Schacht, & Strupp, 1986, 1990; Brooks & Goldstein, 2001)

Craig Wiener, Ed.D.508-756-482548 Cedar St.

Worcester, MA 01609www.craigwiener.com

Blurting occurs when vying for attention or provoking but not when there could be incrimination

It’s first in line for scheduled trips to the moviesbut unpleasant appointments are often missed

Distractibility prevails when writing a “thank you” note but not when writing a Christmas list

Hyperactivity occurs when parents are on the phone but not if bedtime is extended while the parent talks