Dear Dr. Darcy:
My 12-year old daughter was diagnosed with ADHD last year and has been prescribed medication ever since. Unfortunately, despite being medicated for 7 months, her behavior still hasn’t improved. She’s at a top private school in Manhattan which is at its wits’ end as her behavior deviates significantly from the majority of my daughter’s classmates. While her extremely high IQ has bought us time, it’s become clear that their patience won’t last forever. We’ve switched psychiatrists twice now and my husband and I just don’t know what to do - nothing’s improved. Our work schedules are demanding and I’m thinking that the solution may involve us spending more time at home with her, though I can’t fathom how that’s possible. Any help you can provide me with is greatly appreciated.
Children with ADHD require attention. Lots of it. And they require behavioral and environmental tools to compensate for their disability. If you’re hoping for a magic pill, you’re going to see these problems multiply before they improve and she’ll likely get tossed out of her fancy school in the interim, so I suggest you silence your cell phone, tell your assistant to hold your calls, close out of your email accounts (all 3 of them) and close your office door so that you can pay full attention. That’s right. I’m implying that you may have it too. There is a large body of research that suggests a strong genetic component to ADHD. If you had properly compensated for yours, your home would be run in a way that enabled your child to get through school (and life) without having the meltdowns that you describe.
The ADHD child requires what any child needs to thrive; except for them, the absence thereof will result in them barely surviving in an academically competitive environment. So what am I suggesting? I’m suggesting that your home and her life be run with a level of consistency and structure that might at first seem militant but which will eventually enable her to potentially get off the stimulants that most of us with ADHD (yes, I have it too) go to our graves taking.
Below are the 4 key areas of life that need modification in the ADHD child’s life:
Structure: She needs a schedule that remains consistent 90% of her life. I’m not going to get into an argument with you about your priorities, but suffice it to say that the nanny cannot enforce what I’m about to prescribe: She needs to wake up every day at the same time, she needs a bedtime ritual (yes, just like when she was 8 years old) in order to wind down and be in bed at the same time every night, and her technology, including her cell phone (which she no doubt sleeps with), iPad, laptop, TV, PC, etc., needs to go off a full hour before she goes to bed. The family needs to have a FAMILY MEAL together every night (it’s the greatest indicator of emotional and academic health) and it needs to consist of healthy foods that are low in sugar. And you need to make doing homework an evening tradition, where your husband and you read in the room in which she’s doing her homework for 2 hours a night.
Organization: Her life needs to be extremely well organized. Erect a shelf by the front door that has hooks on it and have her hang her knapsack on it every night before bed. You’ll need to go through the knapsack with her to confirm that it’s properly organized and that it has everything in it needed for the next day. This is also where her keys, wallet, cell phone and MetroPass go. Ideally, she’ll charge her phone, computer, etc., on the shelf at night so that every day she’s able to walk out the door without thinking twice about whether she has what she needs and whether what she needs has juice. It should be all streamlined for her.
The contents of her knapsack should be color-coded. Even if her school is paperless (some of the fancier schools don’t use notebooks or books, rather, iPads), she’ll need different colored folders for handouts. She needs one for every subject, and no, she can’t use the same folder for 2 subjects…that’s what gets her into trouble. She also needs to learn how to use her assignment pad and calendar. If you need specifics on this, you’ll have to email me.
Home: Your home needs to be clutter-free, particularly the areas of the home where she spends the majority of her time. Clutter is visual pollution for the ADHD person and it undermines our sense of peace, calm and productivity. Toss magazines that aren’t of the current month, donate clothing that hasn’t been worn in 2 years, unpack bags the moment you walk in the door (because you never really get around to it and the housekeeper never does it right).
Exercise: Kids with ADHD tend to have more energy than most. Consequently, daily exercise is imperative to her routine otherwise bedtime will be a losing battle. Organized sports is a great idea, but given her struggles academically, you might opt for a recreation team where the responsibilities will be less. If she’s not a jock, consider gymnastics, dance, ice-skating, or horseback riding. Something. Give her some exercise at least 5 days a week.
OK, now you can turn your technology back on.
Writer's Stats: Female, Heterosexual