Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Experiencing and surviving the teen years is challenging for both parents and adolescents. All parents can conjure up personal recollections of the experience -- and are absolutely sure that they "had it much harder" than their child. Similarly, we mature adults are now clever enough to realize all the inappropriate, risky, and "just plain stupid" things we did (and thus put our parents through). As parents, we want to shield our children from all the frustrations and disappointments we experienced -- and as bonus -- free ourselves from the fate our own parents were forced to endure.
Unfortunately, try as we might, history often repeats itself. Our goal as parents is to hopefully reduce the impact of the crash landings our adolescent children will invariably experience. Try as we might, we must ultimately take off the training wheels and watch as they weave all over the road and accept that occasionally knees will get scraped. (Our main responsibility is to make sure that a helmet is always worn.) In other words, we must do our best to protect them from the most severe consequences of their inexperience.
You face unique challenges parenting a teen who has ADHD. Here are some tips and strategies to help you with the task.
Live in the here and now. Deal with the current situation or issue. Rehashing prior problems aggravates everyone and accomplishes nothing. Skip the lectures and "I told you so."
Be compassionate about your teen's condition. Teens (like everyone) dislike being blamed or criticized for their behavior. Disorganization and forgetfulness are not purposeful behaviors for teens with ADHD. Better to collaborate with your child and his teachers to lessen such experiences. There are no excusing behaviors that do have a voluntary component. Impulsivity is a basic feature of ADHD; shoplifting or purposefully damaging an item is not.
Keep calm. Shouting matches rarely accomplish the desired goal. While parenting styles may differ, is better to adhere to a rational reminder of expected behavior and enforcement of a reasonable (and already agreed upon) penalty. When in doubt, behave like Judge Judy; make your point and move on.
Anticipate pitfalls. A good general never enters a battle they know they are going to lose. Parents should be one step ahead of their ADHD teen -- anticipate problems and either proactively attempt to resolve the issue or realize that "screw-ups" will happen and work out as a couple how you will handle such events in a constructive and calm manner.
Set boundaries and stick to them. Whatever you do as a frustrated parent, don't decree an unenforceable penalty. If this strategy didn't work when he was 2 years old and he couldn't leave the table until he ate his carrots, it won't work 15 years later when you announce he's grounded for the rest of the year. To quote your child, "Yeah, right!"
Focus on the positive! Don't just focus on the negative aspects of your teen's behavior; remember to praise him or her when they do well.
Ditch power struggles. Adolescents do better with concrete information that has a limited option for misinterpretation. Write down basic rules and the consequences for failure to follow through. These "contracts" should be bidirectional -- from parent to teen (for example, car privileges) as well as teen to parents (for example, payment for supervising younger siblings).
Help your teen develop social skills. Teens who have ADHD may have difficulty interacting with others. Help your teen develop social skills such as listening, not interrupting when other are speaking, and maintaining a conversation. These skills may be especially important for individuals who have associated behavioral conditions (for example, autism) with their ADHD.
Listen to your teen. Teach your ADHD teen how to explain their feelings. Instead of hurling insults back and forth, let your child rant and rave without any interruptions. The only rule: no profanity, name-calling, or insults. When your teen is done, announce that you are glad you listened to their ideas and need to think about them for one to two days and would like to talk again about the issue. The only "must" -- you have to have the follow-up conversation you promised.
Stand your ground on important topics. Your teen will understand the concept that big offenses should warrant a big penalty. Fairness and justice require this tradeoff. Since teens with ADHD are more likely to engage in high-risk behaviors (especially if they are not taking ADHD-directed medication), there should be a zero tolerance for illegal or dangerous behaviors. These high-risk behaviors (for example, driving, use of alcohol/drugs, truancy, etc.) should be addressed in a contract between parent and teen. Demonstrated infraction = non-negotiable penalty. Case closed.
Encourage good nutrition. Eliminate junk food, sugar, and excessively fatty foods from your household. Stick to regular meal times to help maintain your child's energy levels.
Set appropriate boundaries. Much to your teen's frustration, your home is not a democracy. A benevolent dictatorship is a better analogy. A family meeting to discuss acceptable options and the consequences for failure to meet these expectations is reasonable. Enforcement of such consequences should be non-negotiable (for example, "All B's or no car keys").
Give your teen choices. Allowing your child to choose between options promotes confidence and autonomy while helping your teen to feel more like an adult.
Several of the behaviors displayed in childhood ADHD carry through to the teen and even adult years. The manifestations may be more subtle and/or "hidden" due to the more mature coping mechanisms as well as the need to adapt to the expected behavior society demands with more advanced age.
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