Dr. Walt Larimore

Walt Larimore, M.D. has been called “one of America’s best known family physicians.” He is a nationally-known and nationally sought after speaker and health expert. read bio

Discipline and Structure for the ADHD Child

One of our constituents wrote to Focus on the Family saying, “We have a 5-year-old son who has been diagnosed with ADHD. He is difficult to handle, and I have no idea how to manage him. I know he has a neurological problem; I don’t feel right about making him obey like we do our other children. It is a big problem for us. What do you suggest?”

Dr. Dobson responded to this mother: “I understand your dilemma, but I urge you to discipline your son. Every youngster needs the security of defined limits, and the ADHD child is no exception. Such a child should be held responsible for his behavior, although the approach may be a little different.”

According to Dr. Dobson, “most children can be required to sit on a chair for disciplinary reasons. However, the ADHD child would probably not be able to remain there. In the same way, spanking may actually be ineffective with highly excitable children. As with every aspect of parenthood, disciplinary measures for the ADHD child must be suited to his or her unique characteristics and needs.”

Here are 18 suggestions from a book by Dr. Domeena Renshaw entitled The Hyperactive Child. Though her book is now out of print, Dr. Renshaw’s advice is still valid:

1. Be consistent in rules and discipline.

2. Keep your own voice quiet and slow. Anger is normal. Anger can be controlled. Anger does not mean you do not love your child.

3. Try to keep your emotions cool by bracing for expected turmoil. Recognize and respond to any positive behavior, however small. If you search for good things, you will find them.

4. Avoid a ceaselessly negative approach: “Stop.” “Don’t.” “No.”

5. Separate behavior, which you may not like, from the child’s person (e.g., “I like you. I don’t like your tracking mud through the house.”).

6. Establish a clear routine. Construct a timetable for waking, eating, play, television, study, chores and bedtime. Follow it flexibly when he disrupts it. Slowly your structure will reassure him until he develops his own.

7. Demonstrate new or difficult tasks, using action accompanied by short, clear, quiet explanations. Repeat the demonstration until learned, using audiovisual-sensory perceptions to reinforce the learning. The memory traces of a hyperactive child take longer to form. Be patient and repeat.

8. Designate a separate room or a part of a room that is his special area. Avoid brilliant colors or complex patterns in decor. Simplicity, solid colors, minimal clutter and a worktable facing a blank wall away from distractions help concentration. A hyperactive child cannot filter over stimulation.

9. Do one thing at a time: Give him one toy from a closed box; clear the table of everything else when coloring; turn off the radio/television when he is doing homework. Multiple stimuli prevent his concentration from focusing on his primary task.

10. Give him responsibility, which is essential for growth. The task should be within his capacity, although the assignment may need much supervision. Acceptance and recognition of his efforts (even when imperfect) should not be forgotten.

11. Read his pre-explosive warning signals. Quietly intervene to avoid explosions by distracting him or discussing the conflict calmly. Removal from the battle zone to the sanctuary of his room for a few minutes can help.

12. Restrict playmates to one or two at a time because he is so excitable. Your home is more suitable so you can provide structure and supervision. Explain your rules to the playmate and briefly tell the other parent your reasons.

13. Do not pity, tease, be frightened by or overindulge your child. He has a special condition of the nervous system that is manageable.

14. Know the name and dose of his medication. Give it regularly. Watch and remember the effects to report back to your physician.

15. Openly discuss with your physician any fears you have about the use of medications.

16. Lock up all medications to avoid accidental misuse.

17. Always supervise the taking of medication, even if it is routine over a long period of years. Responsibility remains with the parents! One day’s supply at a time can be put in a regular place and checked routinely as he becomes older and more self-reliant.

18. Share your successful tips with his teacher. The outlined ways to help your hyperactive child are as important to him as diet and insulin are to a diabetic child.

Used with permission and adapted from the book, Why ADHD Doesn’t Mean Disaster, by Dennis Swanberg, Diane Passno and Walter L. Larimore, M.D. A Focus on the Family book published by Tyndale House Publishers.

Medical information within this site is not intended for use in the diagnosis or treatment of any health condition. Please consult a licensed health care professional for the treatment or diagnosis of any medical condition.

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