ADD/ADHD Behavior Management Help for Parents and Teachers

image via Flickr, Rober Arévalo

image via Flickr, Rober Arévalo

How can parents, teachers, and childcare providers best manage behavior in children with ADD?

There is no simple technique that is effective in managing all children with ADD. Each child is unique and requires an individualized approach to promoting positive behavior change.

It begins with first really knowing who the child is and then setting realistic expectations.

When we discipline ourselves to do these two things, we minimize the likelihood that difficulties arise in the first place. Furthermore, when we reflect upon the child’s unique characteristics and set realistic expectations based upon these characteristics we equip ourselves with information essential to managing problems when they do occur:

STEP 1. Knowing who the child is

To understand the child’s unique pattern of individual characteristics, we must reflect on the answers to the following questions:

  • What are his strong and weak skills?
  • What are his attentional characteristics?
  • What are his physical abilities and limitations?
  • What stresses is he facing in his life?
  • What are his basic attitudes and beliefs?
  • How does he feel about himself?
  • Who are the significant people in his life?

STEP 2. Setting realistic expectations

Based upon the child’s unique pattern of individual characteristics, we must identify the appropriate expectations for academic achievement, social interaction, and independent functioning.

Encourage Independent Functioning

Only when these two steps have occurred can we effectively manage behavior, promote responsibility, and encourage independent functioning.

image via Flickr, Brad Flickinger

image via Flickr, Brad Flickinger

When problems emerge, we should take the actions described below (steps 3, 4, and 5) to ensure that individualized, effective management occurs.

These steps include determining the factors which are contributing to the problem, developing a plan which takes these factors into consideration, putting the plan into action, seeing what happens, and making changes in the plan as necessary:

 STEP 3. Determining the factors that are contributing to the problem behavior

To do this, we use our knowledge about the child’s unique characteristics to determine the following:

  • What specific expectation did the child fail to meet?
  • What characteristics of the child contributed to this failure/the problem?
  • What aspects of the child’s life circumstances contributed to the problem?

STEP 4. Developing a plan and putting it into action

In order to develop an action plan, we must reflect and act on the answers to the following questions:

  • Given who the child is and the factors contributing to the problem, does the expectation need to be modified? If yes, then how?
  • How is the expectation(s) best communicated to the child so that he understands it?
  • What can the child do, think, or say to increase the likelihood he will be successful in meeting the expectation?
  • What should happen if the child fails to meet the expectation; that is, should there be a consequence and what should it be?

STEP 5. Seeing what happens and making changes in the plan when necessary

image via Flickr, Simply CVR

image via Flickr, Simply CVR

We must reflect on the success of the plan; that is, we must determine whether or not the child is now behaving more appropriately. If he is not, we must identify what went wrong by answering the following questions and revising the action plan accordingly:

  • Were the expectations unrealistic?
  • Was the identified set of contributing factors inaccurate or incomplete?
  • Was the action plan–the method of communicating expectations, the structuring the environment, the child’s strategy, and the use of consequences–ineffective?

You’re not alone in struggling to identify and cope with the behavior challenges of ADD/ADHD!  Parenting and teaching children with Attention Deficit Disorder requires extra reserves of patience, reflection, and determination.  If you found hope in these questions, Dr. Liden provides more detailed guidance in his book, Accommodations for Success: A Guide and Workbook for Creating 504 Agreements and IEP’s for Children with ADD/ADHD.

Do We Need Special Classes for Kids with ADD?

image via Flickr, Jirka Matousek

image via Flickr, Jirka Matousek

The benefits of special classes or tutoring for kids with ADD…

All children, particularly those who are distractible, can benefit from the low teacher to student ratios that are characteristic of special classes and tutoring services.

Furthermore, some children with ADD require tutoring or special education services when their skill deficiencies in reading, spelling, writing, or math interfere with satisfactory academic progress.

…On the flip side, how special services can harm rather than help…

However, associated learning problems seen in children with ADD are often the result of inattention rather than basic skill deficits. When this is the case, academic performance improves as attentional weaknesses are appropriately treated.

Therefore, quickly jumping to tutoring or special education services when academic problems arise can temporarily cover-up the underlying attention problem.

When this band-aid approach is used, the problem inevitably resurfaces in a magnified form later.


Have you found special classes or tutoring have helped or hindered your child?

Looking for a comprehensive, action-oriented guide to navigating the confusing and often frustrating IEP or 504 Agreement process?  Dr. Liden’s Accommodation for Success is the answer you’ve been hoping to find!  Get a copy for yourself or a friend.  No better gift you can give than a guide to school success!

How a Teacher makes a difference with an ADD Student

image via Flickr, Ilmicrofono Oggiono

image via Flickr, Ilmicrofono Oggiono

The educator’s role is similar to the role parents assume in treating ADD.

It begins by learning to understand and accept the problem, rather than making superficial judgments about the child such as “bad,” “lazy,” or “underachieving.”

A primary responsibility of school personnel and childcare workers is to function as team members in treating ADD. This involves setting appropriate expectations, clearly stating limits for behavior, giving feedback, providing effective consequences, reinforcing self-awareness and self-control, and communicating regularly with parents.

In addition, professionals in schools and childcare settings can help to develop and implement compensatory strategies and to identify and remediate associated learning problems.

As team members situated in the structured school environment, teachers and other educational personnel are in an ideal position to monitor the effectiveness of the other treatments (e.g., medical therapy, counseling, etc).

It is also possible for professionals in a childcare setting to provide help with the monitoring of various treatments.

While educators are essential team members, it is never appropriate for them to diagnose ADD or to recommend or modify medical therapies. These are medical decisions that must be made by an experienced physician in consultation with others.


Dr. Liden examines the vital roles parents and teachers play in his book, Accommodations for Success.  The 10-Step book gives parents power to create a highly personalized, effective IEP or 504 Plan.

Does Your Age Matter in ADD Medications?

At what age can you start using ADD/ADHD medications?

image via Flickr, David Robert Bliwas

image via Flickr, David Robert Bliwas

None of these medications have a formal “indication” (i.e., approval by the FDA) for use in children under the age of 6 years. However, experienced physicians like myself are frequently called upon to evaluate and treat preschoolers. Oftentimes, these are some of the most challenging situations.

Children who present with ADD at this age often have profound attentional weaknesses that are associated with extreme temperamental traits and significant developmental delays.

In my experience, if the attentional component of these children’s problems is not treated with medication, it is unlikely progress can be made to correct or remediate other associated difficulties.

Therefore, in many of these circumstances, I have carefully and successfully used the stimulants and the non-stimulant, Strattera. I have had particular success using the stimulants Dexedrine and Dextrostat in ADD preschoolers who have associated language delays. Because children at this age generally can’t swallow pills, it may be necessary to use medications like Metadate that can be sprinkled on food. It is my opinion that only the most experienced clinicians should take on this difficult population.

Equally challenging are those ADD preschoolers whose behaviors are difficult to distinguish from normal. Some degree of distractibility, short attention span, and impulsivity can be the norm in children 3 to 6 years.

When is it a problem?

Do we just wait and hope he grows out of it?

Does failure to identify and begin treatment put the child at risk for learning failure, behavior control difficulty, poor peer relationships, and low self-esteem?

These are difficult questions. Again, my bias is that they require the expertise of a physician highly experienced with ADD. If, after a thorough evaluation, such a clinician is able to make the diagnosis of ADD, then there is no good reason to delay treatment with these medications.

Can these medications be used in adults with ADD?

image via Flickr, Steve Wilson

image via Flickr, Steve Wilson

All of the medications used to treat ADD are just as effective in adults as they are in children and adolescents. The underlying biological differences that cause the symptoms of ADD remain relatively stable from childhood through adult life.

Therefore, it makes sense that if the medications can help correct these differences in childhood, they should be able to do the same in adults.

At the present time, Strattera is the only medication that has a formal indication for use in adults. However, all of the stimulants have been used safely for many years in the treatment of ADD adults.

Obviously, the dosage levels required for adults are often different from those that are effective for children. Similarly, some of the side effects children and adults experience are different. In all other respects, however, use of these medications is the same in adults and children.


You’re not alone if you’re nervous about ADD/ADHD medication.  Public debate, often fueled by bias and misinformation, has stirred up a cloud of fear around effective medication treatment options.  In our practice, we’ve seen time and again that medication can be a powerful tool in treating ADD.  Don’t miss 7 Keys to Successful (and Safe) Medication Treatment for ADD!

No Pill, No Problem: Why I Denied My Son Had ADD/ADHD

image via Flickr, Angel Breton

image via Flickr, Angel Breton

There has been a great deal of heated public debate about the use and misuse of medication in the treatment of ADD. This debate has been clouded by intense reactions rooted in strong attitudes, beliefs, and misconceptions. As a result, many people, unnecessarily, fear the use of medication. It is my hope that an objective, comprehensive, and responsible discussion of medication will open some closed minds, dispel fears, calm anxiety, provide new perspectives, and clarify misunderstanding.

If the medications are so important, what stands in the way of people using them?

In my experience, one of the most common reasons people hesitate to use medication in the treatment of ADD is lack of acceptance.

There is no escaping the fact that you have a problem when you take a pill for it and, frankly, nobody wants to have a problem.

In my own circumstance, I saw the signs of ADD in my older son when he was 9 months old, but the words “Attention Deficit Disorder” didn’t touch my lips until he was 9 years old!  This was a reflection of my struggle with acceptance . . . he looked perfectly normal on the outside and I didn’t want him to have a problem on the inside. I wrote off his impulsivity and distractibility as immaturity or his being “all boy.”  In turn, I constantly nagged him and tightly structured every part of his life. By the time he finally got proper treatment with medication, I had inadvertently contributed to deflating his self-esteem.

When one of the most important people in your life is repeatedly saying, “You could do better if you tried harder” and despite your best efforts, you don’t measure up, you’re left thinking you must be either “lazy” or “stupid.”

So, by allowing things to get to the “last resort” before using medication, we run the risk of contributing to the development of a vicious failure cycle. The resulting low self-esteem and poor motivation make effective treatment much more difficult.

Furthermore, without the medication as an aide, the ADD individual is at high risk for over-relying on his parents, spouse, teachers, boss, and others in his life for reminders and structuring.  This promotes an unhealthy co-dependency and enables the ADD individual to avoid taking responsibility for his behavior.

Get Help for ADD in School

School Success for ADD | The Being Well Center

image via Flickr, Jekino Educatie

There are two ways that students with ADD may receive support and accommodations in school. When ADD severely impacts upon learning and academic performance, the child may be eligible for Special Educational services through IEP law.

When a parent believes a child is struggling academically, the first step is to express his concerns to the building principal or guidance counselor. I always recommend that the parent put his concerns and a formal request for a thorough evaluation in writing addressed to the principal. In my experience, it is important that the parent keep a copy of all written documents for himself; creating a paper trail may be critical in insuring future educational accommodations for the child.

After a formal evaluation by qualified school personnel, the child with ADD may meet the criteria for being identified as learning disabled, emotionally disturbed or “other health impaired” and therefore qualify for special education services. At that point, parents and school personnel work together to define in writing an Individualized Educational Plan (IEP) to meet the unique educational needs of the child.

Section 504 of the Rehabilitation Act of 1973 states that any institution receiving federal fund must make accommodations for people with recognized disabilities. Because ADD is such a recognized disability, children with ADD are eligible for accommodations in any federally funded school.

Accommodations in school include allotment of extra time to complete tasks and tests, use of teacher signed assignment book, preferential seating and increased frequency of feedback to parents.

The first step in pursuing accommodations under Section 504 is for the parent to express his concerns and accommodations request verbally and in writing to the principal, guidance counselor, or, in college, the disabilities services office. As the appropriate accommodations are defined, it is important that they be formalized in writing; this ensures compliance, accountability, and future accommodations.

Are there other services available for the ADD child who experiences difficulties despite the usual interventions?

image via Flickr, Bart Everson

image via Flickr, Bart Everson

When ADD severely compromises the child’s functioning at home and school despite intervention, he may be eligible for Wrap-Around or Therapeutic Staff Support (TSS) services through the county or state mental health department.

These services assume different names and forms across the country and are dependent upon the unique needs of the child. For some children, the service involves access to a trained support person in the home to help with behavior management and independent functioning. For others, it involves having a support person accompany the child to each of his classes to facilitate his meeting school expectations.

While it varies from state to state, access to these kinds of services generally require the child be assigned a mental health or medical assistance case manager and to participate in additional comprehensive testing. I recommend to parents whose child can benefit from these services to begin the process by contacting the county or state mental health office.


Accommodations for Success | Dr. LidenIf you’re ready to secure educational support for your child, you will find Dr. Liden’s book, Accommodations for Success, invaluable.  Dr. Liden walks you through every step necessary to get the customized support you need for your child to achieve and succeed.

ADD: High Risk for Poor Communication?

ADD and Poor Communication | The Being Well Center

image via Flickr, Jesper Sachmann

Good attention is critical for efficient communication. In order to understand a message–to break it down and to process the elements–we must first pay attention to it. Similarly, to generate a response, we must focus on our own thoughts, translate them into words and sentences, organize them into a coherent message, and reflect on their appropriateness.

Attentional weaknesses, therefore, place the individual with ADD at high risk for poor communication skills.

The requirements for effective communication are at odds with the characteristics of ADD. Poor focus, distractibility, and short attention span lead the person with ADD to miss, get only part of, or totally misinterpret messages. The result is that he is frequently in a position where he must ask for repetition, request clarification, fake his understanding, or present himself as “out in left field.” Further, impulsivity, distractibility, and poor monitoring lead the person with ADD to produce messages that are disorganized, incomplete, and characterized by on-going revision.

Throughout the process of communicating, we must forever monitor our language and our behavior in order to be certain that we adhere to the unstated rules of communication such as being polite and using appropriate body language. This represents one of the biggest challenges for the person with ADD as these rules are rarely, if ever, explicitly taught.

Generally, we learn communication rules by paying attention!

We watch the people around us follow the rules and see the subtle signals we get when we break the rules. These critical rules include the following:

  • Take turns while you talk.
  • Do not monopolize the conversation.
  • Look at the person to whom you are listening or talking.
  • Talk on the topic.
  • Talk politely to adults.
  • Do not interrupt.
  • When changing the topic, introduce the change.
  • Let the person who is talking know that you are listening, that you understand, and that you are interested.
  • Carry your share of the conversation.
ADD and Poor communication | The Being Well Center

image via Flickr, Bruce Wunderlich

Because he has failed to learn the rules of the game, a person with ADD is frequently behind the eight ball even before the conversation begins!

For a person with ADD who has learned the rules, the challenge is no less–following the rules of communication, even when they are known, requires constant and efficient impulse control, filtering, and monitoring.


Successful treatment of ADD includes addressing all areas of an individual’s life, including communication.  Dr. Liden has been helping patients overcome the challenges of ADD through conscientious medication and creative approaches to life coaching for the past 30 years.  A more in-depth exploration of ADD/ADHD can be found in Dr. Liden’s best-selling book, Pay Attention!