Impulsivness, ADHD and consequences

"My son has ADHD…My main concerns are the impulsiveness…andthe fighting with his brothers- he literally cannot walkpast without hitting them, punching them, teasing them. Car rides can be a real nightmare. (The therapist says "just leave him home sometime"— yah- he's6 years old, I can't just leave him home alone, and leaving him with a neighbor would reward him for misbehaving in the car- ugg). Needless to say- we stay home a lot."

I have had many youth, with many impulses, come to live with me. Each one is uniquely different. This is how I teach youth to control their impulses:

I think of the impulse. (I will use touching aggressively for this example)

Then I think of how a socially healthy person controls the impulse to touch aggressively when he feels like it.

STEPS

When I feel aggressive toward someone, I stop whatever I was doing and recognize that I am aggressive. (This will take some figuring and talking to determine what he feels inside when he is aggressive.)

Next, I leave the situation that is causing me to be aggressive.

Then I go to a place where I can calm down.

After I am calm, I go back to thegroup atmosphere and pay close attention to my behaviors so I can continue to control them.

For a youth, I would add a step right after walking away from the situation. The step would be…go tell an adult that you stopped yourself from touching someone aggressively. Adding this step gives you an opportunity to asses how your child is doing with mastering this skill as well and have a reason to give good praise for good behaviors. They really do need to always see that good equals good. If you say nothing, then they may loose the motivation to care about that particular behavior.

To introduce these steps to your six year old, you should make them as simple and non-wordy as possible. You should have a special counseling session with your son to to explain the problem behavior. Tell him a reason which would matter to him why he would want to stop this behavior, such as, "If you stop touching people aggressively, the other children will want to play with you more often."

Set a goal during the counseling session. Something that will really motivate him. Maybe it' s money or a snack out of the snack bag, or something. Let him know that every time he reports to you that he has controlled the impulse to touch aggressively (you may want to use smaller words) then he will earn something out of the snack bag, or something else that motivates him. Use this system for 2 weeks and then have a culminating reward for mastering the behavior. Maybe the family will have a party in his honor with a cake and everything. This will be his graduation party. After this party, he knows that he doesn't have a problem touching people aggressively anymore. He can own that.

Don't forget to have a negative consequence for him for every time he chooses not to control the impulse to touch aggressively, such as loss of a treat or an extra chore. What ever you family economy has decided.

Another thing that might help is cued practice. At a certain time each day, you and your son schedule to have cued touching practice. You make up situations when he usually touches aggressively, and you act them out together. You alternate which parts you play. Then you talk about the situations. This time is valuable, because your son has to have experience mastering his impulse to be able to remember what to do with himself during an aggressive situation. He can master it, but it takes practice.

"As far as consequences- he doesn't seem to respond to them. He could care less if he loses possessions, privileges, or has to do extra jobs (because the extra jobs he only does half heartedly- and sloppily and it takes all day to finish that one extra job- as I keep calling him back to finish it)"

Since I haven't been able to observe your home, I don't know why he doesn't respond to consequences, but I can guess.

First off, he is not accepting a consequence if he doesn't do it immediately. Then he should earn another consequence for not accepting a consequence.

I have noticed most of the time when children don't follow through with consequences or feel that the consequences don't have a value it is because the parents aren't paying close enough attention to consequences earned at home. I know that we are all busy doing lots of things, but if our child has earned a consequence, we really need to make sure that the child doesn't move on to anything else until the consequence has been accepted and finished. If the child doesn't follow instructions after earning a consequence, then the child needs to do the rule of three, because he is out of instructional control.

Another reason why children don't do their chores, or care about consequences earned, is because the parent forgets what they've earned until way later. This completely devalues you saying that the child has earned a negative consequence. Keep a notebook with you and write down all consequences earned. Make sure that they are done right then as well.

You might also want to use positive consequences to reward good choices just as often as you use negative consequences, so that he will become more motivated to choose good.

Also remember that he is only 6 and has ADHD. This means that he can't do chores that have lots of steps very well yet. He needs one step at a time to complete a chore. He also might not have the skills necessary to do the particular chore yet, so you may have to do it with him first. You will probably need to do each chore with him at least four times before he can do it himself independtly.

The parent's consistencey is the best thing to teach children to effectively accept consequences.