A chat with Andrea Chronis-Tuscano, PhD
Chronis-Tuscano, who directs the Maryland ADHD Program, is also an adjunct professor of pediatrics at the George Washington University School of Medicine, Children's National Medical Center. She researches the impact of parental psychopathology on the developmental and treatment outcomes of children with ADHD.
After receiving her PhD in clinical psychology from the State University of New York at Buffalo, Chronis-Tuscano completed her training at the University of Chicago, where she received the Zanvel Klein Academic Award for excellence in clinical research and practice. She has also received the American Psychological Association Society of Clinical Child and Adolescent Psychology Junior Faculty Mentoring and Development Award and the CHADD Young Research Scientist Award.
It seems as though kids with ADHD have a good week, then a bad week. As the child’s emotions increase, the emotions of the whole household also go up. Do you have any suggestions on how to de-escalate the household stress?
As difficult as it is, it is helpful if the other family members can find ways not to let the mood of the child with ADHD affect their own moods. Some strategies you can use are to step away for a second, use pleasant imagery or relaxation to help you stay calm, and make sure you are getting needed breaks throughout the week (don’t be shy about asking others for help). Your staying cool and positive is essential—you (rather than your child with ADHD) can set the tone for the entire family. And you can remind yourself that things will get better. They always do!
My daughter gets out of control in the mornings and evenings. It's very disruptive for our family. We tend to yell a lot at those times to try and control things. Can you suggest any better solutions?
Mornings and bedtime are often the toughest times for families. You may dread those high-demand times and be on edge before anything even happens. Ask yourself: Are there certain things that help you stay calm—perhaps exercise, quiet music, or positive self-talk? If so, try to use those things before your child gets up or during the morning routine. The trick is to keep yourself calm and positive, which can have a positive impact on your entire household. And carefully evaluate your morning and evening routines to see if there is anything you can do in terms of structure, rules, and incentives that can make those tricky times go more smoothly.
My question relates to how to avoid getting so angry with my daughter. She never takes no for an answer and will repeatedly ask the same question. I get increasingly frustrated with her and eventually snap at her. I regret it later.
We work with parents on their own thoughts and feelings that may impact their parenting. You may find yourself extremely stressed and thinking negatively about interactions with your daughter, which may make those interactions even more difficult. Here are a few ways you can help yourself stay calm.
First, make sure you schedule some pleasant activities for yourself each day. This may simply mean listening to your favorite music, taking time out to exercise, or working on a fun project. You may need to ask for help to make this feasible.
Second, try to be aware of your thoughts. Often, negative thinking can become automatic and can make us quicker to react negatively in situations with our kids. Try to catch those negative thoughts and replace them with more positive thoughts. It can really make a difference in how you react to your children.
Sometimes my husband and I lash out at each other to avoid confrontation with our son. This often makes the situation even worse. How can we stop this pattern?
This is a common problem for parents of children with ADHD. The key is to avoid disagreement in front of your children. I know it is hard, but trying to present a united front is essential.
Take time out together to have fun, so that your job as parents is not “all work and no play.” Discuss childrearing issues when things are quiet, not only when there is a problem with your child or a disagreement between you. This can help you both to be more rational and oriented toward problem solving, rather than getting caught up in an argument. You may not always be on the same page, but it is important to learn to communicate and problem-solve with one another calmly and effectively.
Parent-child interactions are a two-way street. That is why it is so important to take care of yourself. Being tired is a hallmark of parenting. Make sure you get to bed on time, get enough exercise, and eat right. Pay attention to your relationship and seek help if needed. Do your best to reduce whatever stressors in your life can be controlled.
Of course, there are stressors that cannot be controlled. For most of us, there is something that helps us feel better: listening to music, exercising, seeing friends, staying involved in a hobby. These things often fall by the wayside when we become parents. But it is essential that you schedule at least a little time to do things that help you manage stress and feel good. If you don't take care of you, it will surely impact your interactions with your child.
My fifteen-year-old daughter tries to overcompensate academically so that she doesn't feel different because of her ADHD. She is very bright, but I manage the rest of her life so she can focus on schoolwork. At what point do I let go without her becoming discouraged so that I can have time to take care of myself?
As children with ADHD enter adolescence, it is difficult to know how hands-on to be and how much to let them do things for themselves. Your goal is to give your daughter the skills to eventually manage things on her own. Rather than doing things for her, perhaps you can work on developing strategies with her—things like keeping a schedule book, to-do lists, and post-it reminders.
You can encourage and support her in using these strategies, and gradually fade the extent to which you monitor and structure things for her. Eventually she will have the tools to function more independently. But remember, teens with ADHD may need more support than a typical teen.
As your daughter can function more independently, you should have more time for yourself. And when you take care of yourself, you are teaching her to take care of herself.
My husband and I are involved in family behavioral therapy with our son. While this therapy helps us understand our son's needs, it creates a void in our relationship, which leads to more stress and tension for the entire family. I feel that our needs as parents are not being met in this therapy. How do we shift the focus of our sessions from our son's behavioral needs and our parenting skills to what our family and relationship needs are as one entity?
I recommend that you speak with your therapist about these feelings. A good therapist will take your goals into consideration and shift the focus as your needs change. You will likely need to continue to focus on managing your son's behavior as one major therapeutic goal, but perhaps you can take some time during each session or during alternating weeks to focus on the family as a whole.
Can you address the guilt and second-guessing ourselves that we parents of children with ADHD often deal with? We are often afraid we are going to cause irreversible damage by getting angry with them or by making the wrong choices about treatment.
First and foremost, remember that your child's ADHD is not your fault. A lot of research evidence now shows that the structure and function of the brains of individuals with ADHD differ from those without ADHD. The disorder is not caused by bad parenting.
You often have difficult choices to make about your child's treatment. Be an educated consumer and seek out treatments that have research support. The combination of medication and behavior therapy works best for most children with ADHD. Combined treatment not only reduces ADHD symptoms (like inattention and hyperactivity) but also helps children function better at home, school, and with peers. By getting your child the best treatment as early as possible, you will be helping her or him to have the best possible outcome.
Keep in mind that not everyone will agree with your choices. Everyone has an opinion when it comes to your child's treatment or your parenting. If you seek evidence-based treatment approaches, you can feel confident in your choices.
My son becomes quite emotional when he has to stop something he is doing to join a family activity or do chores. Our other children don't understand his struggle. We spend so much time working through the challenges that we lose family time and the joy of simple things like dinnertime together. How can we help him better move from activity to activity without such disruption to the family?
When children protest, what often happens is that they are able successfully to avoid (or delay) doing whatever it is they do not want to do. It sounds like the whole family is missing out on fun times when this happens.
It may be helpful to try to proceed with meals or activities and ignore his protests. He may decide to join in the fun rather than remain angry. Don't be surprised if his protests become louder as you ignore him. But once he realizes that you are not paying attention to it, he will eventually stop. You may simply say, "If you do not clean up your toys, you will lose TV time after dinner," and then withdraw your attention. This is not easy to do, but works for attention-seeking behaviors.
Attention and avoidance motivate a lot of these types of behavior. It may be helpful to work with a behavior therapist when working on the "planned ignoring" I described.
Our fifteen-year-old son has severe ADHD, and I often feel he won't do anything unless I directly manage it. We have more than a dozen specialists involved in his care, but he either can't accept or doesn't want their help. I feel if one more expert tells me what I have to do or change in order to make things easier for him, I may snap. How do I handle these feelings? How do I get him to take more responsibility for his own functioning?
It sounds like you are doing a lot for your son, and staying on top of all this can be very tiring. As parents, you are the most influential people in your children's lives. You are the manager of all their health providers and also have the task of structuring the home in a manner that helps your child be most successful.
Doing all of this consistently is exhausting, isn't it? That is exactly why we emphasize your taking good care of yourself on a regular basis. If you don't, you may “burn out” and not be able to do as good a job as you'd like. You may need to delegate and let others help you so that you can get a break once in awhile. Everyone needs that.
To help your adolescent with ADHD take more responsibility, start by teaching him skills rather than doing things for him. This will eventually increase his independence and teach him ways to cope with his symptoms. Still, your adolescent with ADHD will need you to be more hands-on than the typical adolescent may need.
How do you juggle the need for individual time to de-stress and also time to de-stress as a couple?
In today's world, we are all pulled in a million directions. It is hard enough to find time for oneself, not to mention time as a couple. The key is to plan ahead and work out a schedule. Some couples take a half-day off work to attend a matinee or go out after their children go to sleep (with a babysitter at home, of course). Some exercise in the morning before their children wake up. Parents can also take turns so that one parent can schedule something enjoyable for himself/herself while the other is with the kids, and vice versa. You have to be committed to making it happen. Be creative and planful in figuring out the best way to schedule things.
No comments:
Post a Comment