Behavior Modification and ADHD

Toddler with a stick getting ready to hit somethingWhat Behaviors to Change

Children with ADHD will use many undesirable behaviors throughout the day. It’s best to start working on eliminating one behavior at a time, rather than all at once.

Unsafe behaviors should be addressed first, before other behaviors such as not following directions, whining, etc.

Safety-Breaks

A safety-break is essentially a “time-out.” The child is removed from the activity for a period of time because of using unsafe behaviors toward self or others.  Because of lack of impulse control, children with ADHD can become unsafe several times throughout the day. This could be for darting into the street to get a ball, aggressively taking a toy out of another child’s hand, or jumping on the windowsill.

Start giving safety breaks when the child begins doing things that are unsafe. This may be as early as twelve months old. The child will not grasp the concept of the safety break until they are probably closer to age two, but start the groundwork early on. It’s important to be consistent, otherwise the child learns that she can get away with these behaviors, and they will continue to escalate.

How to Administer a Safety Break

Avoid yelling. Avoid over-explaining. Avoid telling the child everything he needs to do to make improvements in his life. Let’s say a child angrily threw a toy at another child. In a firm voice, you might say, “No throwing. You chose unsafe behavior and earned a safety-break.” It’s important to use ten words or less. The child needs to know briefly the reason why they are going to the safety-break, and he also needs to know that he actually chose this consequence (to begin taking ownership of his behavior).

The safety-break needs to occur within ten seconds of the behavior occurring. If the child does not go to safety break area on his own, then you may escort him (carry him) and avoid eye contact. If he will not stay in an area, then you can put him in a safe room and close the door.

Do not give the child attention during the safety-break. Set the timer for the amount of minutes as the age they are. A two-year old will be in a safety-break for two minutes.

After the Safety Break

When the safety break is over, do not lecture the child about why she was in the break or try and prove your point. Instead, welcome the child back to the activity. “Hazel, if you are ready to use safe behaviors, we would like to play with you.”

A few minutes after the child is playing safely again, you might say something like, “Hazel, great recovery! I love that you are playing cooperatively with Amber.” It’s important the child realize that you didn’t like what she did but that you still like her. A toddler will automatically assume that the parent “doesn’t like me,” which actually promotes future negative behavior. If you use this type of approach instead, she will still feel worthy.

Skill Building with Empathy

Safety breaks do not teach skills; they only remove a child from a situation. If the child doesn’t learn skills, the child will continue to end up in safety breaks rather than making actual progress. Therefore, a few minutes after the safety break is over, use empathy with the child.

“Hazel, it must have been frustrating for you when you wanted to play with the toy Amber had. I know it’s hard to wait your turn when you are so excited about playing with something. Now that you are calm, can I see you ask with your words for a turn? (rather than throwing something at Amber).”

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Donna Mac

Donna is the author of Toddlers & ADHD: Relief for Parents, A Guide for Clinicians and Teachers . She has a background in early childhood developmental psychology and has worked professionally with ADHD as a teacher, as a nature-based summer camp director, and currently as a licensed clinical therapist.

Note: This Perspectives Blog post is written by a guest blogger of DrGreene.com. The opinions expressed on this post do not necessarily reflect the opinions of Dr. Greene or DrGreene.com, and as such we are not responsible for the accuracy of the information supplied. View the license for this post.

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