Teenagers with ADHD
Reviewed by Dr Chris Steer, consultant paediatrician and neurologist
Dealing with a teenager and ADHD
|Don't focus just on the negatives – look at what he or she can do well and praise the good behaviour.|
Teenagers with ADHD experience the same problems as those without ADHD, such as:
- being part of a group and fitting in with peers, eg clothes, music, friends
- worries about exams and careers
- physical development
- conflict with parents about decision-making and authority.
But teens with ADHD may react to some of the problems more acutely, and because they have lower tolerance levels they’re more likely to go off at the deep end.
They also have more problems with self-esteem.
Research by Russell Barkley and Gwenyth Edwards showed that teens with ADHD have more conflicts with their parents than teens without ADHD, and particularly with their mothers.
Listed below are some common issues with tips to tackle.
Don’t make this a power struggle. If your teen isn’t taking his or her medication, ask them why.
- If they keep forgetting, get them to think of a way to remind themselves to take it.
- If taking medication in school leads to embarrassment because they don't want friends to know, talk to your GP or specialist about a sustained-release formulation, so your teen won’t have to take it at school.
Behaviour management techniques work on children but aren't as good for teenagers. This is because:
- they’re used to techniques, such as star charts and reward chip systems and are bored by them
- teenagers tend to rebel against what they think is parental manipulation.
If you give your teenager a huge list of house rules, they're likely to rebel.
If you talk things through and negotiate the rules as a team, they're more likely to stick to them.
It's a double-win situation because this will also teach skills for dealing with problems: how to compromise.
Tips for tackling problem behaviour
- Don't focus just on the negatives – look at what he or she can do well and praise the good behaviour.
- Try to keep a sense of humour.
- Teach the consequences of behaviour, so they learn why they should or shouldn't do something.
- Pick your battles carefully – ignore the little things and concentrate on the big things, or you’ll be nagging constantly and this will result in hostility towards you.
- Give specific choices – this makes them feel more like an adult and is more likely to result in a positive response.
- Look at your expectations – are they reasonable or are you demanding perfection?
- Be careful with assumptions – anticipating bad behaviour sets up negative expectations. Don’t assume they're doing something deliberately to upset you or that one thing is going to lead to the worst possible scenario, eg not doing a piece of homework.
- Talk through the problems together and when you're calm. Come up with a list of solutions and find a compromise that works for all of you – including what happens if they don't do what you have agreed. It's best if this is a logical consequence, eg temporarily removing the games console if it interferes with studying.
- Keep communicating with your teen – listen as well as talk, maintain eye contact and try to express anger without hurtful words.
- Ask your GP for help if either you or your teens are having problems managing anger.
Peers and friendship
Teens with ADHD may feel ‘different’ from their peers and feel socially isolated, particularly if they’re impulsive and speak before they think about others' reactions.
Other parents may not want their child mixing with a teen who has ADHD and ‘gets into trouble all the time’.
Teens with ADHD can be perfectionists and focus completely on something they’re interested in – which is wearing for friends.
Sometimes they don’t notice what’s going on around them, so their peers may call them names or think them stupid. Your teen may react by becoming the class clown to make themselves popular.
To help these problems:
- encourage friendships and let your teen invite people home as often as possible
- teach your teen social skills, such as how to read people’s body language. It will help them see when they’re at odds with friends and why
- teach your teen to take a deep breath before they say or do something, and think about how they would feel if someone said or did that to them
- praise your teen often, and specifically, to boost his self-esteem and avoid the ‘class clown’ syndrome.
Drugs and alcohol
Research confirms that children with ADHD are more likely to experiment with substances and start at an earlier age.
Factors that make your child more likely to use substances:
- having friends who use drugs and alcohol
- being aggressive, impulsive and not considering consequences.
To avoid this:
- get to know your teen’s friends, and subtly encourage friendships with those who don’t use alcohol or drugs
- keep your teen’s aggression under control – if necessary, ask your GP to help
- read up on the signs of substance misuse, eg money going missing or 'holes' in spending, lying or secretive behaviour, sudden mood changes, loss of appetite, and loss of interest in school, work or friends
- teach your teen about substance misuse – be accurate and don’t use scare tactics
- if ADHD medication has been prescribed, try to make sure that it's been taken. This will help to reduce impulsive behaviour and promote forward thinking behaviour. There's no evidence that ADHD medicines increase the risk of substance misuse, rather the opposite. Taking medication as prescribed may well be protective.
If your teen does start using drugs or abusing alcohol:
- don’t nag
- let them know that you’re worried about them and you love him – it’s the behaviour you don’t like
- help them get professional help to quit.
Sex and relationships
If your teen feels unpopular at school, they may become promiscuous to make themselves more popular.
Sex also releases natural stimulants, so it may be a form of self-medication (as stimulant medication is used to treat ADHD).
Research by Mariellen Fischer shows that teens with ADHD may be more likely to start having sex at an early age and less likely to use contraception.
To avoid this:
- boost your teen's self-esteem, so they feel valued and don’t have to be promiscuous to feel good about themselves
- talk frankly with your teen about sex and relationships, so they value themselves more highly
- teach your teen about why safe sex and contraception are important.
Sources of support
- Parentline Plus is the national charity for parents and offers advice on a range of issues.
- Frank is a government-run website on drugs for children, teens and parents. It has a list of useful tips for parents in the section: 'Worried about someone'.
- Adfam is a charity for families who are dealing with drug and alcohol problems.
All these groups can be found in our support directory.
Want to know more on ADHD?
Worried about your child’s behaviour? Sometimes it can be hard to work out whether a child’s behaviour is normal or the sign of a behavioural disorder.
What is ADHD? Find out what the symptoms are.
What causes ADHD? Scientific research suggests the causes could be largely genetic, combined with some other factors.
Why is ADHD controversial? We look at what the problems are.
Not just a childhood disorder: How is it different to childhood ADHD?
How do I know if I have ADHD? Here are the signs and symptoms.
Getting help: Steps to diagnosis and treatment in adults.
One to one: ADHD can have a marked effect on relationships in the teenage years.
Work and ADHD: Find out about ADHD in the workplace.
Study and ADHD: Listed below are things to consider when choosing a course and some practical tips to help you study.
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Based on a text by Dr Dan Rutherford, GP
Last updated 21.08.2014