Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

26 Tishrei 5761 - October 25, 2000 | Mordecai Plaut, director Published Weekly








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Home and Family
Behavior Modification Without Drugs
by A. Ross, M.A. in Speech, Education

When Reward Doesn't Work - and When It Does

For a behavior program to be effective, a child first needs to listen, to remember, plan ahead, think before he acts, and be motivated by rewards. That is the weakness of ADD children. These children don't listen, and if they do, they hear half the instructions and forget the rest. They don't see the consequences of their actions and often `leap before they look'. We have spoken of the weakness of frontal lobe function in ADD which causes poor control of unwise behavior. For a child with ADHD, an idea hits the front of the brain and he acts, without thinking of the consequences.

Lack of impulse control destroys discipline in these children, and the situation is made worse by their poor response to reward and punishment. The average child will tidy the toys, be rewarded with a piece of chocolate, and will do it again the next time. The ADD child will get the chocolate, complain that it isn't the kind he prefers, and then ask for another piece, as this wasn't big enough. He may ask again and again... These problems of being unable to `let go' and of responding poorly to reward partly explain why these children are so difficult to discipline.

The best results come with clear communication, simple instructions, a small number of important rules and regular and repeated rewards. Once a parent realizes that with this particular child they have to `back off' and not take notice of every trivial irritation, they are on the way to winning the battle. Someone once said, "In boxing, the victor is the one who uses the most force. In parenting, the winner is the one whose children still love them at the age of eighteen." Naturally, for us, the statement should read: "The winner is the one whose children go in the true derech haTorah and also still love them at the age of eighteen."

Structure and Instructions

Human beings are happier when life is predictable, when they have a routine, when they know where they stand. This need for structure is even more important for children with ADD. To get them to start their structured day happily, obtain their attention, and then give one instruction at a time. Use the child's name, look him in the eye, and tell him to wash his hands, get dressed, put his pyjamas under the pillow. But do not make the mistake of putting this into one blanket instruction of "Hurry up and get ready." Mumbling, nagging, shouting will get you nowhere. The child won't even hear you (but the others will). The secret of successful communication is eye contact, simple words, enthusiasm and step-by-step instruction. And if you can bear it at that time of day, a small reward. We realize that it is much easier to give advice than to follow it, especially if there are numerous other children waiting to be seen to, and Mother has been up most of the night with a teething baby. But if you want peace with an ADHD child, keep to routine.

If he spills his cereal and then steps on it, does it really matter? Of course, it matters to you, but you will have to clean it up anyway once he has gone to school. Avoid confrontation if you possibly can. Keep that for major battles. Take a step back and ignore `minor' infringements if you possibly can. Keep that for major battles. The siblings may complain, you will have to explain, perhaps when he is not around! Any change in the child's routine, late nights, visitors or long journeys amongst other things, may trigger off an explosion. The changes cannot always be avoided, but anticipating trouble often makes it easier to handle.

There are parents who are uncompromising and tough (especially if it is their first child). They may have oppositional defiant children. There are other parents who are easy going, permissive and peace loving, who, although they usually remain close to their children, may have little monsters. There is no clear cut answer. Unfortunately, if one of the parents is easy going and the other is a stickler for discipline, it is a no-win situation. All children are quick to pick up differences in the parents' attitudes and will play one parent against the other. The child with ADD might modify his behavior in the presence of the parent who insists on it, but the other parent will carry the full rebound. It is a truism to say that parents would do well to agree to disagree, but then not to argue about it. As I rough guide, I would suggest 85% nurture, 15% firmness.

Avoid a No-Win Situation

Avoid arguments with a child with ADD. Don't start a debate; it is pointless. He has many words and no logic. State the rules and stand your ground but don't argue, as you will never win. Children need rules. These need to be stated at a time of calm, and not in the heat of battle. They need to be simple, fair and clearly understood. When a rule is challenged, it must be clearly restated and then enforced. We should not be inflexible but no amount of nagging or protest can change these few simple rules. The child is reminded and action follows. Try to stay calm, and repeat the rule in a flat voice like a broken record.

The Countdown

What action? My mother used the following tactics on me and I have used them many times successfully on many generations of children. When confronted, most ADD children refuse on principle. We tell them, "Do it NOW" and they just gaze at us. My mother asked politely and then began to count till three. This old well tried technique gives a little bit of space needed to avoid reflex refusal. You state the rule: e.g. "Everyone has to have a drink before leaving the house," and say "One". Wait five seconds: "Two". Wait five seconds: "Three." Then act. In this case, he will almost invariably take his drink. Thomas Phelan describes the technique in his book, "One Two Three Magic."

There are rules and counting techniques but there comes a point when things seem to be quite out of control. Once behavior gets past a certain point, there is no place for reason. The child needs time out. Time out allows a deteriorating situation to be salvaged by removing the child from an audience, and from all attention. For this to work, the child has to be put in place without debate or anger. This works from a very young age and one can reckon about one minute for every year of life. In our family, we had a chair. If the child gets up before time, the period of time out starts again. Do not respond to calling out, in fact, do not respond at all. Ignore the child. He may not be repentant after time out, but you will have defused the situation. This only works well up to age ten or so. Some parents put themselves in time out, if the child is too big to be physically removed. If a mother locks herself in her bedroom for ten minutes and it works, fine.

But what if a child refuses point blank? The first cardinal rule is not to argue, and to stay calm. Use a monotonous voice and say, "I want you to go to your room. If you go to your room now, you can ride your bike later. But if you choose not to go, you will go to bed after supper." A choice lessens the risk of reflex refusal and allows some room for maneuver.

We are talking about ADHD behaviors. Remember that even the worst behaved child is good some of the time. Catch him being good and reward him. Reinforce his positive side.


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