As National ADHD Awareness month concludes, knowing how to address problem behaviors associated with a diagnosis of ADHD is a tool many parents may find helpful. Children with a diagnosis of ADHD often exhibit inattentive behavior, impulsiveness and, in some cases, hyperactivity. Similarly, some problem behaviors associated with ADHD include non-compliance, off task behavior, arguing, tantrums, verbal aggression, and physical aggression. To determine the most appropriate intervention for any problem behavior, it is important to first identify the function of the problem behavior (i.e. why it is occurring). To determine the function, it is important to note what occurs directly before the problem behavior occurs (antecedents) and what occurs directly after the problem behavior (consequences). Once this information is noted, it is important to classify the problem behavior into 1 of 4 functions: gain access to attention, gain access to a tangible item or privilege, avoid or escape from an unpleasant situation, or access to automatic reinforcement (something that feels good to the child). Knowing the function of the problem behavior will better assist you in determining an appropriate intervention. Some examples of interventions for behaviors associated with ADHD can be categorized into proactive strategies (implemented prior to the problem behavior occurring) and reactive strategies (implemented once the problem behavior occurs). Some examples of these interventions are described below:
1) Proximity Control-stating demands within 3 feet of your child
2) Stating Specific Instructions-keeping demands short and sweet
3) Stating Expectations-tell the child what he/she gets from engaging in the appropriate behavior and what is lost if he/she does not engage in the appropriate behavior
4) Visual Schedules and Cues-use daily visual schedules, “first—then” charts, and yes (available)/no (not available) visual cues, when appropriate
5) Reward Board-a visual cue that clearly states daily expectations and the consequences (rewards) for complying with those expectations
6) Checklists-a list of all steps required to complete a task that the child can check off as each task is completed
7) Preparing the Environment-ensuring the environment is distraction free, when necessary, and that any environmental stimuli that may trigger problem behavior is removed. This can also include laying items out that the child may need that day
1) Provide Positive Consequences-providing praise, privileges, and tangible items to the child all throughout the day following appropriate behavior
2) Ignoring Junk Behavior-ignoring all behavior that is attention-seeking and inconsequential (i.e. doesn’t cause harm to the child, others, or property)
3) Physical Guidance-using hand over hand prompting to comply with demands, when appropriate
4) Punishment-should be used as a last resort but may include time-out, reprimands, additional demands, removing preferred items, etc.
By taking data on the problem behavior prior to providing interventions (baseline data) and continuing to collect data after an intervention is implemented, it will be easier to identify if the intervention is effective. Interventions based on the function of the problem behavior will be more effective over general interventions. Please note to remain calm when implementing interventions and to contact a Board Certified Behavior Analyst if assistance is required.