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ADD: The Need for Structure, Consistency, and Predictability

Effective school programs for children with ADD provide a great deal of structure. Structure does not imply rigidity. Rather, a structured approach is one in which students know exactly what is expected of them, which behaviors are acceptable or unacceptable, what the consequences are for each behavior, and what the time frame is for each expected behavior. For example, a schedule is usually written on the board so that students will know exactly what will occur at what time. Routines are established early in the year, and followed on a daily basis. There are times when events occur that deviate from these schedules, and students may have a hard time. Over time, however, they become more able to deal with the changes. A structured approach allows teachers and students to be consistent, and it is this consistency that allows for predictability. Students with ADD benefit greatly from this concept, because they don't have to think about the extraneous things that go on in a school day. They can focus their energies on relevant aspects of instruction.

Despite a parent's best effort, it is difficult and probably not advisable to try to duplicate the school situation at home. It is important to recognize, however, that the transition from a structured approach at school to an unstructured one at home can lead to problems. What should parents do? Parents can bridge the gap by providing a modicum of structure in the home, especially on weekends and holidays. Many parents of children with ADD recognize the need to stick to daily routines during the week (for example, come home from school, have a snack, do homework, relax, eat, watch TV, go to bed), but abandon these routines on weekends and holidays. For many children with ADD, it is during these loose periods of time that they experience difficulty. Establish some kind of schedule on weekends. Initially, try not to deviate from the routines you establish. Begin with small blocks of time, such as:

8:30 Breakfast
9:00 Chores in room/house
10:30 Go to park
12:00 Lunch
1:00
Library
3:30 Free time
5:00 Help with dinner preparation
6:00 Dinner
7:00 Bath and free time
8:30 Bedtime

Obviously, the schedule will vary tremendously for each child or adolescent, depending on his age and grade, the severity of the disorder, and his interests. The idea is to create some structure by having and adhering to a schedule. Gradually you can expand the blocks of time to morning, afternoon, and evening, and you and your child can fill in activities that you will do during these times. When children are easily distracted by the environment around them, the structure you provide can bring about a sense of order in a chaotic world. Talk to your child's teacher to see if he can assist you in developing a meaningful schedule over long vacations, especially the summer.

Structure also implies a certain amount of organization. Clothes, objects, school items, and so forth should be stored in the same place. You can start by organizing your child's room so that she knows exactly where things are located. Try to involve her in this. Clothes should be selected for school by the child the night before, items necessary for school (lunch, books, papers) should be placed on the table near the door, and important items such as house keys should be kept in the same place every day, such as in a basket by the door. Keeping track of these things may seem minor, but all together they lessen the number of things your child has to think about.

Children and adolescents with ADD also benefit from consistency, not only in the manner in which you deal with them, but also, in the case of a two-parent household, in the manner in which parents deal with each other. This is where family rules will be helpful. It is important that specific consequences always occur for specific behaviors, that rules are uniformly adhered to, and that there is agreement on these issues by both parents. When parents disagree on child-rearing techniques, they are doomed to failure. Children are masters of "divide and conquer," and will readily recognize opportunities to benefit from such a division. If your son or daughter knows that homework comes before watching TV, and that both mother and father will enforce and reinforce such a rule, they will not attempt to negotiate. You may not agree on everything, but major child-rearing practices should be agreed on for the benefit of your child. At the very least, do not disagree in the presence of your child. If you have marked differences of opinion, seek professional assistance in order to work out the problems. It has been our experience that unless this is done, the lack of consistency will only serve to exacerbate hyperactive, distractible, and impulsive behaviors in both children and adolescents.

This also applies to families where parents share the custody of the child. As much as possible, both households should strive to provide consistent, predictable expectations and consequences for the child. We recognize that this may be difficult, but it is very important to your child. We know of parents who have sought the help of a professional to assist them in ironing out a reasonable approach to setting consistent limits in both households.

Finally, there is a need for predictability. For children and adolescents with ADD, much of the world appears to function in an unpredictable manner. By providing structure and consistency, you will become more predictable to your child. He will know exactly how you will respond to specific situations. We have asked many children with ADD the following questions:

  • When you act appropriately, what do your parents do?
  • When you act inappropriately, what do your parents do?
Although some children can tell you what occurs when they act inappropriately, the overwhelming number of these children are at a loss to describe the link between their behavior and the response of their parents. In their minds, their parents' responses occur by chance, depending on their moods. If children and adolescents fail to recognize a link between behavior and consequences - that is, between their behavior and their parents' response - they will have a very difficult if not impossible time engaging in appropriate behavior. Try this with your child. Role play a situation where you and your child reverse roles (you play her and she plays you). See how she responds; observe the way in which she acts like you act; look for consistency. If your child can mimic you to a certain extent, you are probably fairly predictable. If she appears to be lost, you need to establish a more consistent, predictable manner. The more predictable you become, the more your child will be able to respond appropriately to the world around her. You may know people who are unpredictable; you never know how they will respond to a situation. Many people find this disconcerting. Couple this with ADD and you have a situation that can only lead to failure.

A structured, consistent, predictable environment will provide children with ADD with a sense of confidence and security. They know that there is a great deal of disarray around them, but at the very least, their home is a haven. And remember, they won't always agree with your actions, but at least they will know what your actions will be.

More on: ADHD

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From Keys to Parenting a Child with Attention Deficit Disorders by Barry E. McNamara, Ed.D. & Francine J. McNamara, M.S.W., C.S.W. Copyright 2000 by Barron's Educational Series, Inc. All rights reserved. Used by arrangement with Barrons Educational Series, Inc.

Buy the book at Barron's.


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