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Making a Visiting Nephew with ADHD Comfortable
Q: My nephew, whom I have never met in person, is coming for a two-week visit for Christmas. He is ADHD and also has an anger disorder. He is taking medication for both and is receiving some counseling. How do I make his visit comfortable and enjoyable for him and for our family? I have spoken with my children and they understand that Chris has a disorder. However, what do I need to be prepared for, and what can I do to ease the stress of the visit for him? Chris is 15 and in the eighth grade.
A: Your nephew is fortunate to have such a sensitive aunt. Family visits for kids with ADHD (especially when they get frustrated and angry easily) can be very difficult. I would suggest you take your cues from Chris's parents. Ask them what kinds of events are likely to be difficult for him, and which activities may be frustrating or lead to outbursts of anger. My general rule of thumb is to do everything that you would normally do, unless your sister or brother tells you that the activity is a set-up for trouble. Don't let Chris's behavior "rule" the visit. While problems may occur, the best thing for you and your children to do if he gets upset is to give him space. If he starts to get angry, and he can't or won't leave the room to quiet down, you can exit quietly, and let him "blow off steam." You might say, "Chris it seems like this is pretty upsetting; we're just going to give you some time to be alone" (or with your Mom, etc.). Make sure he has the opportunity to get outside. Playing ball or taking long walks or bike rides, if the weather allows, can be a good way to let off steam. Calm music in the house may help, too. If Chris is impulsive and does things without thinking, suggest to your kids that they say things like: "Chris, if you do it that way, it will [i.e., break the computer, fall off the table, etc.]."
Kids with ADHD can get wound up very easily. They get over stimulated and have a hard time getting settled back down. Try to keep things low key, and ask your kids not to get too "wild" around Chris. What's really important is to find out what your nephew likes to do, and make sure that there are opportunities for him to do some of these things. Let him make some of the choices. Also, find out what he does well, or find out what he knows a lot about and give him a chance to show his positive side in front of the family. Pay attention to him and compliment him, but don't overdo it. He'll sense that you are making too big a deal and it may upset him. Saying things like "I like it when you..." (and talk about positive behaviors) can go a long way.
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Jerome (Jerry) Schultz is the founding clinical director of the Learning Lab @ Lesley University, a program that provides assessment, tutoring, and case management services for children with learning challenges. Schultz holds a Ph.D. from Boston College, and has completed postdoctoral fellowships in both clinical psychology and pediatric neuropsychology.