Teens

Managing ADHD: teenagers 12-18 years

Managing ADHD: teenagers 12-18 years

Worried your child has ADHD: first steps

If you think your child might have attention deficit hyperactivity disorder (ADHD), the first step is to visit your child's GP or paediatrician for an assessment. The assessment will look at a range of causes for your child's difficulties.

If your child is diagnosed with ADHD, you and your health professional will work together to develop a behaviour management plan.

ADHD is usually diagnosed in primary school, but sometimes children aren't diagnosed until the teenage years. This is when children have more schoolwork and go through social and emotional changes. Symptoms that you hadn't noticed before might become more obvious because of these challenges.

Behaviour management plans for teenagers with ADHD

Managing attention deficit hyperactivity disorder (ADHD) in teenagers is first about accepting that your child will behave in challenging ways at times and might have difficulties both at home and school.

Also, teenagers go through lots of social, emotional and physical changes, which can make things even more complicated. And teenagers with ADHD can develop mental health difficulties, including anxiety and/or depression.

A behaviour management plan can help both you and your child with managing his behaviour. It can also help with your child's social and educational development.

A management plan might include:

  • behaviour strategies, with a particular focus on helping your child become more independent and responsible
  • strategies for developing your child's social skills
  • strategies to help your child manage energy levels and tiredness
  • strategies to support your child at school
  • medication, if your child needs it.

The best plans take into account what suits your child and family. They consider all aspects of your child's life, including your child's needs and responsibilities at home, at school and in other social settings.

It's a good idea to discuss your plan with family, therapists and teachers. This helps everybody have realistic and common expectations and goals for your child's behaviour. And it also makes it easier and safer for anyone who has to supervise your child with her medication.

Behaviour strategies to help teenagers with ADHD

As your child moves into the teenage years, you and he might face new challenges in managing his behaviour.

Your child will want and need more independence as she gets older, and she's likely to push the boundaries. This is typical. But your child's ADHD symptoms - and any social and academic difficulties she has - might make the journey to independence a bit harder.

Here are some ideas that might be useful for encouraging your child to take responsibility for managing his own behaviour:

  • Involve your child in making family rules about behaviour. This can help your child understand and accept your expectations and take responsibility.
  • Use praise for positive behaviour. When you notice and comment on your child's responsible choices and positive behaviour, you encourage her to keep behaving this way.
  • Work with your child to set consequences for challenging behaviour and then apply them consistently. For example, you and your child might agree that he loses access to the PlayStation for a day or two if he gets aggressive.
  • Set up predictable daily routines for things like bedtime, chores and homework. This can make it easier for child to cooperate.

For more on managing teenage behaviour, you can check out our articles on encouraging good behaviour in teenagers, dealing with disrespectful behaviour in teenagers and discipline strategies for teenagers.

Social skills to help teenagers with ADHD

Teenagers with attention deficit hyperactivity disorder (ADHD) might need support to get along better with others. So your child's behaviour management plan could include some ideas to help your child work on social skills. For example:

  • Help your child practise what to do if there's a problem with another person. Walking away is often the best option. You and your child could even role-play challenging social situations.
  • Help your child practise strategies for understanding and managing her own behaviour. For example, in a challenging social situation, your child could take time to think through the consequences of her actions and consider solutions. A short prompt like 'Stop, think, do' can often work well.
  • Encourage your child to find an extracurricular social group or activity, like martial arts or drama classes. This might help him stay focused and build confidence. If he tries an activity that's out of his usual comfort zone, praise him for his bravery.
  • Be a role model for fair and consistent behaviour towards your child and others.

Good parent-teen relationships tend to lead to children having positive relationships with peers. So being warm and supportive, staying connected and actively listening to your child can help her with social and friendship skills.

Classroom strategies to help teenagers with ADHD

Teenagers with attention deficit hyperactivity disorder (ADHD) can have problems at school. They often struggle to be organised and prepared for classes. Many also have learning difficulties. So behaviour management plans should include classroom strategies to support your child's learning.

These strategies might include:

  • dividing tasks into smaller chunks
  • offering one-on-one help whenever possible
  • asking for your child to be seated near the front of classrooms and away from distractions
  • asking for your child to have extra time to finish tasks, especially tests
  • helping your child to make a checklist of assignments and other school tasks and what he needs to do to complete them.

Discuss these strategies with your child's homeroom teacher, year coordinator or learning support staff.

The school should work with you to set and review your child's learning goals and needs regularly. Your child's support plans should be set out in an individual learning plan.

Strategies to manage energy and tiredness in teenagers with ADHD

Hyperactivity and/or tiredness can affect your child's behaviour, emotions, attention, social relationships and school performance. So your child's behaviour plan will probably include strategies to manage energy and tiredness.

Here are some strategies to help your child manage energy levels and maintain focus:

  • Build rest breaks into activities.
  • Encourage your child to break up learning tasks like reading or homework with brief stretches of physical activity.

And these strategies can help your child avoid overtiredness:

  • Encourage your child to get at least 8-10 hours of sleep each night, and to go to sleep and get up at about the same time each day.
  • Provide healthy food options to help with energy and concentration.
  • Make sure your child's screen time is balanced with other activities during the day.
  • Make sure all electronic devices are switched off at least an hour before bed.

ADHD medications

If your child needs medication to help her manage her attention deficit hyperactivity disorder (ADHD), this will be included in her behaviour management plan.

Stimulant medications
Doctors will sometimes prescribe stimulant medications for children and teenagers diagnosed with ADHD if their symptoms are causing significant problems.

Stimulant medications improve the way the parts of the brain 'talk' to each other. This can help teenagers maintain focus and complete tasks. Stimulants can also help with self-control, which means they might help teenagers get along better with others.

Methylphenidate is the most commonly used medication of this type. It's sold under the brand names Ritalin 10, Ritalin LA and Concerta.

Other stimulant medications are dexamphetamine or lisdexamfetamine. Lisdexamfetamine is sold under the brand name Vyvanse.

Your child's paediatrician or psychiatrist will work out with you which drug and dose will be best for your child.

Here are a few questions you might want to ask your doctor:

  • What are the side effects of the medication?
  • Does my child need to take the medication every day, including weekends and holidays?
  • Can my child stop taking it suddenly?

Stimulant medications can cause some side effects. These might include:

  • loss of appetite, which can affect your child's weight gain
  • reduced final adult height - this might be reduced by 1-2 cm after long-term use
  • anxiety or agitation
  • headaches
  • worse tics, if your child has tics to start with.

If your child has been prescribed stimulant medication, your doctor should be monitoring him closely. If there are side effects that are causing problems, your doctor might change the type, dose or timing of medication to help with this.

Very occasionally teenagers with ADHD find stimulants don't suit them at all. Stimulants might make teenagers feel too quiet or just not themselves. If this happens, teenagers can usually stop the medication without any withdrawal symptoms. But you should contact your doctor so your child's management plan can be reviewed.

Taking stimulant medication doesn't increase your child's risk of developing alcohol and other drug abuse problems.

Other medications
Although stimulant medications are generally the best for treating ADHD, there are also some other medications available. These include Strattera (atomoxetine), Catapres (clonidine) and Intuniv (guanfacine). These are sometimes used for teenagers who get side effects from using stimulants.

If your child responds well to medication, she'll probably be on it for at least a year. As she matures, she might be able to function well without medication. If she's doing well, your child can talk with her doctor about having a trial period without medication.

Teenagers taking responsibility for ADHD medication

As children get older, they often want to take more responsibility for their medication, which is a good thing. Some children also go through a period where they don't like the idea of taking medications.

Either way, if your child can share his feelings about taking medication, you'll be better able to understand where he's coming from. Listening to your child will also help you understand how the medication affects his daily activities.

It's also good to encourage your child to discuss things with her GP or paediatrician. You might suggest she has part of her appointments alone with the doctor.

Support for yourself when your child has ADHD

Looking after yourself by asking for help and support is a big part of managing your child's attention deficit hyperactivity disorder (ADHD). Here are some options for you to think about:

  • Ask for help from family members and friends. If your child relates well to a particular family member, like an aunt, uncle or grandparent, that person might be able to spend some time with your child so you can have some time out.
  • Go to a support group or join an online forum for parents of older children and teenagers with ADHD.
  • Talk to your child's health professional about any difficulties you're having.
  • Learn about stress and how you can handle it.