Parent to Parent Family Training on ADHD Session

Parent to Parent: Family Training on AD/HD® Session Four Developing Parenting Strategies and Interventions that Strengthen Family Relationships

Discussion will include § § § Review Homework Compliance Training Time Out Free Response Cost House Rules–worksheet 7 Criticism/Empathy Behavior—Teenagers Challenging Behaviors Love & Logic®—One Liners Questions & Answers Homework Assignment CHADD Parent to Parent © 2005 4 -1

Compliance Training How to Give an Instruction: Precision Instruction 1. State child’s name — “Alex” 2. Follow with — “You need to…” 3. Be specific — “Put your glass in the sink” CHADD Parent to Parent © 2005 4 -2

CHADD Parent to Parent © 2005 4 -3

Guidelines for Compliance Training 1. State the precise instruction: “Alex, you need to put your glass in the sink. ” 2. Allow your child a brief period of time to comply (count silently to 10) 3. If your child complies within this time period, provide a token (cont'd) CHADD Parent to Parent © 2005 4 -4

Guidelines for Compliance Training (cont’d) 4. If your child does not comply within this time period, repeat the instruction stating an additional consequence for noncompliance: “Alex, you need to put your glass in the sink before I count to 10 or you will have to go to time out for minutes. ” 5. If your child complies before you count to 10, provide a token (cont'd) CHADD Parent to Parent © 2005 4 -5

Guidelines for Compliance Training (cont’d) 6. Repeat the procedure until you obtain your child’s compliance 7. Do NOT provide a reinforcement token for compliance if you needed to use time out to obtain compliance CHADD Parent to Parent © 2005 4 -6

Benefits of Compliance Training § Teaches the child to comply within specific behavioral limits § Provides the child with a verbal cue that signals to pay attention to something of importance (i. e. , “You need to…”) § Helps prevent parental instructions from becoming “background noise” (cont'd) CHADD Parent to Parent © 2005 4 -7

Benefits of Compliance Training (cont’d) § Provides consistency with parental request and expectations § Children quickly learn to recognize when an instruction is being given § The immediate consequences of compliance and noncompliance are clear to the child CHADD Parent to Parent © 2005 4 -8

“Time Out” from Reinforcement Definition: A punishment technique in which the child is removed from a situation that offers reinforcement and is placed in a situation in which no reinforcement is available CHADD Parent to Parent © 2005 4 -9

Guidelines for Using “Time Out” § Do not overuse “time out” § Use it primarily with children of elementary school age § For older children, loss of privileges is generally more effective § Designate a “time out” location in your home. Set a chair in a location that is free from busy family traffic, but in a place that you can monitor (cont'd) CHADD Parent to Parent © 2005 4 -10

Guidelines for Using “Time Out” (cont’d) § Assign a short period of time to “time out” § One minute per year of age of the child (e. g. , six minutes for a six-year-old) § For a hyperactive child, less time may be effective § “Time out” rules: § Your child may not play with any objects, and hands should be empty during “time out” § Your child must stay on the chair throughout the time out period. (No bathroom breaks during “time out”) § Do not speak with your child or respond to any questions or comments while in “time out” § Review the “time out” rules with your child during a quiet time CHADD Parent to Parent © 2005 4 -11

What to Do When Rule Violations Occur § We suggest the following: § Reset the timer. If your child has served five minutes out of a six-minute session and has broken one of the “time out” rules, reset the timer for six minutes § For children who refuse to remain in time out, remove privileges until the “time out” session is successfully completed § Do not allow your child to take control of the situation (cont'd) CHADD Parent to Parent © 2005 4 -12

What to Do When Rule Violations Occur (cont’d) § If your child will not stay in “time out, ” tell him that he has lost privileges for a designated amount of time (30– 60 minutes) and that you will give him the opportunity to finish his “time out” ONLY after that time period has expired § Do not let the child decide when he/she is ready to complete “time out” § Remember: You and not your child are in control of the “time out” session CHADD Parent to Parent © 2005 4 -13

Free Response Cost § Target inappropriate behavior (e. g. , hitting, throwing, jumping) § Collect data—how often does it occur within a certain period of time? § Distribute tokens on a scale that matches the behavior (Hitting 10 times per hour—give 7 tokens) § Determine an appropriate monitoring time (i. e. , one hour) § Select a reinforcement to be given if child has one token left Optional: § Select a consequence if your child loses all of the tokens (cont'd) CHADD Parent to Parent © 2005 4 -14

Free Response Cost (cont’d) § Carefully explain the plan to your child § Begin the monitoring session § At the end of the monitored session… § Give reinforcement or consequence § With consistent improvement—reward has been earned at least 90% of time § Gradually reduce the number of tokens freely given in each time period CHADD Parent to Parent © 2005 4 -15

Advantages of a Free Response Cost Program § Easy to design and implement. § Practical to use in public places § Tokens are freely given at the outset so that the loss of a token is less frustrating § The child does not feel that something that has been earned is being unfairly taken away § Tokens provide your child with a firm behavioral boundary and permit the visual tracking of how close he/she is to that boundary CHADD Parent to Parent © 2005 4 -16

Selecting the Tokens § § Coupons Raffle tickets Coins Candy § Using highly valued tokens allows the child to work harder to retain all of the tokens CHADD Parent to Parent © 2005 4 -17

Pick Your Battles: Make Only a Few “House Rules” § Make a list of non-negotiable house rules § Rank them—most important to least important § The top three are the house rules (non-negotiable rules) § Type or write them up, make several copies and post everywhere needed–kitchen, bathroom, bedroom, playroom § Establish consequences for violations of house rules § Type them up and post them next to the house rules § Monitor daily § Be consistent, be consistent! Beth A. Kaplanek, R. N. CHADD Parent to Parent © 2005 4 -18

3 Rs of Misbehavior Rules – Relationship Rebellion Helen Glass, M. S. Ed. CHADD Parent to Parent © 2005 4 -19

Criticism—When and How? § Criticism is the opposite of praise § Should not be used too often as it can be damaging to the child’s self-image § Could weaken parent-child bond § Conversely, can provide your child with important feedback that can be used to correct inappropriate behavior CHADD Parent to Parent © 2005 4 -20

Guidelines for Criticism § Identify the specific behavior that you do not want from your child § Identify the specific behavior that you want from your child § Criticize the behavior and not your child § Be sincere—avoid sarcasm § Use a calm tone of voice § Praise your child much more often than you criticize him/her § Stay in the present; avoid dredging up past mistakes CHADD Parent to Parent © 2005 4 -21

Guess which child is in trouble CHADD Parent to Parent © 2005 4 -22

The How to: Wrong: “Carol, I hate it when you are so irresponsible! You are lazy and are behaving like a spoiled brat. ” Right: “Carol, it makes me upset when you don’t make your bed when I tell you to. You need to make it immediately. ” Wrong: “Felicia, I hate it when you don’t do what you are supposed to do. You never listen to me. You’re just a spoiled brat. ” Right: “Felicia, it makes me angry when you leave the kitchen without putting your dishes in the dishwasher. I need you to put your dishes in the dishwasher immediately. ” CHADD Parent to Parent © 2005 4 -23

Empathy — Reflective Listening What does it mean to be a reflective listener? § It is a form of communication where you paraphrase what you believe your child is actually feeling “It seems as if you had a really bad day at school today. It must be hard to go to school when you feel nobody likes you. ” “I understand that you think we love your sister more than we love you. ” “I can see you really feel bad about getting an F on that paper. It must be hard to know that many of your friends did better. ” CHADD Parent to Parent © 2005 4 -24

Cautions When Using Reflective Listening § Don’t be a parrot § Child says: § Parent doesn’t say: “I’m stupid. ” “Sounds like you think you’re stupid. ” § Don’t be afraid of your child’s feelings § Child says: § Parent doesn’t say: § Parent should say: CHADD Parent to Parent © 2005 “I’m really ugly. ” “No you’re not; you’re really pretty. ” “It must be hard to feel you are not as pretty as the other girls. ” 4 -25

Bad Reflective Listening from Homer Simpson CHADD Parent to Parent © 2005 4 -26

Behavior Techniques for Teenagers with AD/HD — There are Differences! § Focus is on preserving the relationship by being flexible § Increasing focus on the adolescent’s agenda/values (e. g. , your teen wants to choose Tech school vs. four-year college) § Providing your teen more opportunity for choices and responsibility for his/her own decision-making § The parental role changes—from primary manipulation to including the teen as a partner in the problem-solving process § The primary consequence—changes to loss of privileges § The primary form of reinforcement—changes to additional privileges CHADD Parent to Parent © 2005 4 -27

How to Respond to Your Teenager § Listen without responding § Sympathetic listener with no communication § Empower the teen to make a choice to accept or reject parental advice § Then the teen discovers the “power” of natural consequences § Negotiate for a change when the behavior or pattern negatively affects others § The give and take between parents and teenagers in these situations is necessary in order to motivate the teens to work with the parents to make changes in their behavior (cont'd) CHADD Parent to Parent © 2005 4 -28

How to Respond to Your Teenager (cont’d) § CEO of the family—shared between mom and dad § Pick your battles, make them few § Prioritize issues § Determine specific consequences for nonnegotiable issues § House rules § Attendance at school § Verbal abuse § Curfew, etc. CHADD Parent to Parent © 2005 4 -29

Tips for Challenging Kids § Emphasize strengths when giving feedback § Praise the part of the job that was done well § Don’t initiate conversations with a question § Focus on the facts of an incident § Don’t draw conclusions about the kid’s motives or morals § Don’t give a real, meaningful consequence that wasn’t discussed and planned (cont'd) CHADD Parent to Parent © 2005 4 -30

Tips for Challenging Kids (cont’d) § Remember to praise your child’s efforts often, regardless of his/her results § You can’t solve all of your child’s problems, especially those occurring in social situations. It is human to struggle. Struggling builds character § Solicit a consequence from your child § What do you think is a fair consequence? § Don’t call it a “punishment” § “How can you make up for this? …make it right? ” (cont'd) CHADD Parent to Parent © 2005 4 -31

Tips for Challenging Kids (cont’d) § Think before you say “yes” or “no” § “I have to think about it, ” or “I’ll give you an answer when I come back in the room. ” § Give your opinion, but don’t belittle theirs; agree that it’s all right to disagree § Open your doors and windows § One or both of you may be less likely to yell § Avoid debating who’s right § e. g. , “I know we don’t agree, but here’s what I think. ” § “Don’t say it, display it” § Visualize more than verbalize CHADD Parent to Parent © 2005 4 -32

Averting & Defusing Power Struggles § “This isn’t working” § “I’m only making it worse” § Can you offer a solution we could both live with? § Invites the language of problem-solving and makes clear that both parties needs must be reasonably met/accommodated § Why tell an explosive child, “No, ” multiple times? (cont'd) CHADD Parent to Parent © 2005 Revised 4 -33

Averting & Defusing Power Struggles (cont’d) § “Listen to me and I’ll listen to you” § List your child’s position in writing with the heading defining the problem as “Inability to find agreement” § See next slide for sample (cont'd) Revised CHADD Parent to Parent © 2005 4 -34

Inability to Find Agreement-example Chris-wants to go to Madison Square Garden by train to the Dead Head Concert § When stuck in disagreement, this strategy can help in a variety of ways. It tells the child you realize he or she has a heartfelt position he or she is pressing for, that you’re willing to help organize it/clarify it/look at it from his/her point of view, and that disagreements can be addressed in a controlled fashion. § This means we are taking this issue from an Argument to a work task § This buys time and changes the environment § These are statements parents can use while working with their child “Can you live with that”? “Was that a good choice or a bad choice”? “Tell me what we just agreed to”? Revised CHADD Parent to Parent © 2005 4 -35

Averting & Defusing Power Struggles “Language” yourself out of a power struggle” “This is so important to you that you need me to cooperate even though I don’t understand. I’m going to let you do this, and I’m going to think about how we can avoid this situation next time. ” § Allows you to “give in” to child on your terms, with you the parent assuming an authoritative stance. It’s telling the child that it is your rational decision to allow him or her to do X because you’ve acknowledged he or she is not very capable of handling the alternative. It beats: § “You’re impossible. Just go ahead, I don’t care anymore Revised CHADD Parent to Parent © 2005 4 -36

Averting & Defusing Power Struggles (cont’d) § “Listen to me and I’ll listen to you” § List your child’s position in writing with the heading defining the problem as “Inability to find agreement” § “Language” yourself out of a power struggle § “This is so important to you that you need me to cooperate even though I don’t understand. I’m going to let you do this, and I’m going to think about how we can avoid this next time. ” CHADD Parent to Parent © 2005 (cont'd) 4 -37

Averting & Defusing Power Struggles (cont’d) § Tag team § You leave, your spouse takes over, but NOT as the “enforcer” or the heavy § Leave the area, the house § Cite the importance of the relationship § “I can’t argue with you like this…I don’t like bad feelings between us. ” § After outbursts, assess for skill deficits and antecedents § Ask yourself: “What made him do that? ” The child is not going to tell you (cont'd) CHADD Parent to Parent © 2005 4 -38

Averting & Defusing Power Struggles (cont’d) § Let the child go to his/her sanctuary (tree fort, end of driveway, woods in yard, trampoline, room, closet, basement) § “It’s not him, it’s his brain stem” Michael Hurley, Ph. D. CHADD Parent to Parent © 2005 4 -39

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Power Struggles and Control Battles § Perceived control is a basic human emotional need § No one wins a power struggle, but everyone wants control, so expect them to occur § We do not do our best thinking when we are in an emotionally charged state § Be aware of red flag behaviors § Know when you have lost them and instead try saying, “Okay, let’s take a break, then we’ll get back to it. Do anything you want for the next two minutes. I’ll set a timer so we can keep track of the time. ” (cont'd)

Power Struggles and Control Battles (cont’d. ) n If you think you might be in a power struggle, You Are! Don’t get caught responding to situations immediately n Delay consequences and disengage Then, THINK It is okay to say, “I don’t know what to do about that right now. I’ll get back to you later. Try not to worry. ” n

Why Do We Need Three Elements of Human Bonding? Smile, Eye Contact, Friendly Touch § Parents who are stern guards develop kids who become too sneaky to catch “Children who feel loved and accepted will allow you to teach and receive your advice” § The happiest kids are those with parents who set and enforce firm, reasonable limits—and can do it without raising their voices Helen Glass, M. S. Ed.

Changing Learned Behavior – Ours It’s as easy as 1, 2, 3 Directions: Open in order: 1. Head 2. Heart 3. Mouth So… Child receives Helen Glass M. S. Ed.

Love and Logic® Jim & Charles Fay 2207 Jackson Street Suite 102 Golden, Colorado www. loveandlogic. com Provide training materials that teach a unique love and logic approach to raising children without the use of anger and frustration CHADD Parent to Parent © 2005 4 -45

Argument Stopper—One Liners If arguing begins, go “Brain Dead”— Use “One liners” n n n Probably so I know Nice try (big smile) I bet it feels that way I don’t know, what do you think? Bummer Thanks for sharing That’s an option I bet that’s true I’ll still (love, care, respect) you no matter whose class you’re in Ummmmm CHADD Parent to Parent © 2005 Love & Logic® 4 -46

Homework § CHADD Fact Sheet #2, “Parenting a Child with AD/HD” § Developing House Rules—Worksheet #7 § Behavior Management of AD/HD: Part Two CHADD Parent to Parent © 2005 4 -47