Photo by Ute Grabowsky/Getty
As they go through the most challenging period of their life, there are ways you can help them not just cope but thrive
by Margaret Sibley + BIO
Photo by Ute Grabowsky/Getty
‘The only thing that helps me focus is if I’m genuinely interested in what I’m doing.’ Sitting across my desk was Celia, a first-year undergraduate diagnosed with attention deficit hyperactivity disorder (ADHD), who had attended my university’s ADHD summer camp when she was in middle school. As we caught up on the past five years of her life, she described how she’d felt unmotivated throughout her high-school years. Celia recalled her parents’ attempts to coax her interest in conventional subjects, such as mathematics and literature, without success. Looking down at her shoes, she described feeling left out and demoralised during her final year of high school when each of her friends had celebrated acceptances to rigorous universities.
There’s no doubt that adolescence can be incredibly challenging for girls and boys like Celia who have ADHD but, with sufficient support, they can thrive – as you’ll see when I return to Celia’s story later in this Guide.
ADHD is a neurodevelopmental disorder
ADHD runs in families and is estimated to affect about one in 15 adolescents. It is a mental health disorder characterised by differences in the structure and function of parts of the brain that are involved in attention, executive functions (such as thinking ahead and planning) and motivation.
Usually, ADHD is first diagnosed in childhood because a parent or teacher notices overactive behaviour or trouble keeping up with obligations at home or in school. For most people, ADHD is a chronic, lifelong disorder. However, the symptoms of ADHD change as a person develops from a child to an adolescent and finally an adult.
ADHD interacts with the upheavals of adolescence
The human brain changes dramatically during adolescence. This is challenging for everyone, but especially for teens with ADHD given their neurodevelopmental differences. The result of this interaction between adolescence and ADHD is a human experience that is often filled with adversity. Many people with ADHD tell me that adolescence was the most challenging period of their lives.
Brain development during adolescence happens gradually, across several years, and some regions develop earlier than others. In particular, the limbic system, which is involved in emotions and reward-seeking, gains its adult strength early in adolescence, but the prefrontal cortex, which is involved in self-control and decision-making, does not fully mature until the mid-20s. This imbalance in brain maturity can make adolescents vulnerable to the limbic system’s preference for immediate rewards (ie, what is interesting or enjoyable) without sufficiently strong checks and balances from the prefrontal cortex’s long-term and strategic thinking abilities. ADHD also affects these same neural circuits and therefore, in a sense, ADHD compounds the challenges of adolescence.
One consequence of this is that teenagers with ADHD have particular trouble learning from experience. Reward signals in our brain govern what we pay attention to, what we choose to do, how well we store information, and how we overcome temptations to act inappropriately. These processes are all affected in ADHD, and teens with ADHD can need stronger or more urgent consequences to motivate them sufficiently to take appropriate actions.
Parenting a teenager with ADHD poses distinct challenges
Parents today are expected to gradually reduce supports at home to allow for teen autonomy by the end of adolescence. Teachers do the same at school. These newfound freedoms lead most teenagers to stumble a little. When this happens to typically developing adolescents, they usually experience a negative consequence and modify their behaviour accordingly to avoid this consequence in the future. In contrast, teens with ADHD might make the same mistake two, three or 20 times. For example, some adolescents with ADHD might repeatedly get into trouble or consistently fail to turn in schoolwork. The negative experience of receiving punishment or failing grades is not properly encoded by their brains and does not appropriately influence their future behaviour.
As a panicking parent, you might have responded reflexively in these situations by removing freedoms or returning to higher support levels that are appropriate for younger children. But that would have left your teen with fewer opportunities to develop autonomy, creating a vicious cycle that can result in poor preparedness for adult life. Alternatively, perhaps you have felt helpless and unable to influence your teenager’s behaviours. Enforcing rules might seem ineffective, only leading to arguments, and so you take a step back from parenting. Now your teen has greater freedom but, with that freedom, often unchecked behaviour can lead to a troublesome path. These are tough dilemmas when you are parenting a teenager with ADHD.
Parenting such teenagers is hard. But you’ll find there are little things you can do to support them that will pay off slowly over time. In the clinic where I’m based in Seattle, we work with parents to help them strike the difficult balance between supporting teens with ADHD, but also requiring them to be independent and accountable for their actions. In this Guide, I will outline eight key actions that you can take to raise healthy and self-motivated teenagers with ADHD. These tips are aimed principally at parents and guardians, but if you’re a teacher or relative of a teen with ADHD and wish to be more supportive, you might also find the information helpful.
It is the small things that parents do every day that can have a long-term impact on the learning and behaviour of adolescents with ADHD. The response to your actions will not be immediate. The going will be slow. However, over time, if you focus on the eight strategies I’ve outlined below, you will increase the odds that your teenager will become responsibly autonomous, and can successfully transition to adulthood.
Help your teenager find activities and topics they find highly rewarding
Because the limbic system rules the behaviour of adolescents with ADHD, they will engage best in tasks that are of natural interest and enjoyment to them. Even after they become adults with fully developed prefrontal cortices, people with ADHD will continue to do best in high-interest domains.
Returning to the story of Celia, whom we met earlier, she began to excel at university after discovering computer science was the thing in which she was genuinely interested. Celia told me about participating in programming competitions and realising that she could spend hours fixed to her screen, fascinated by the problem-solving aspects of the challenging tasks. Unfortunately, Celia had attended a high school that did not offer computer science coursework. But at university she excelled in her computer science courses and programming competitions, and was immediately hired by a major tech company after graduation (they didn’t care that she failed her Literature course twice and took six years to graduate).
Thus, parenting action #1 is to leverage the upsides of limbic system-driven motivation. Your teenager will be very good at focusing on tasks they love. The trick is to help them find healthy and productive educational, extracurricular and career areas that promote natural engagement. This quest may require detective work and extra efforts. Your teen may not be motivated to try new things or research new activities. As a parent, guardian or teacher of an adolescent with ADHD, you might need to be on the lookout for productive high-interest areas because teens will often not notice or find them naturally. So, sit down together and research part-time jobs, summer programmes, or extracurricular groups that your teen can try out. Give them multiple choices and require them to pick one if they seem uninterested in joining. Sometimes, your teen will need to develop skills before they can be successful in a high-interest area. Invest in this skills development. Conversely, pushing an adolescent with ADHD to engage in low-interest areas can result in conflict and is not usually sustainable long-term.
It can be hard to accept that our rosy vision of the child’s future might not be realistic. However, success is possible for all individuals with ADHD if, like Celia, they can find their niche. Building a life around high-interest areas is a critical part of this niche-finding. As an added bonus, your teen is most likely to be socially engaged and successful with peers who share their interests. It is a lot easier to bond and relate when talking about shared interests and experiences than to navigate awkward small talk or situations that are of low interest to the teen.
Help your teen spend more time in supportive environments
Each classroom, extracurricular activity, interpersonal relationship, after-school job and home comes with unique challenges and opportunities for teenagers with ADHD. They will thrive more in those environments that value their unique strengths and abilities. By contrast, a poor-fitting environment places a high value on qualities that might be hard for a teen with ADHD. ADHD is a diverse disorder, which means that not everyone with ADHD experiences the same symptoms or has the same strengths. Good-fitting environments will increase their self-esteem, lead to skills development and personal growth, and increase opportunities for success and personal advancement. In contrast, poor-fitting environments can lead to demoralisation, reduced effort and task avoidance.
Most adolescents with ADHD have not yet developed the critical thinking skills to evaluate how well they cope with different daily environments. They likely do not understand the ways that different situations could be affecting their development. Therefore, parenting action #2 is to actively gather information about the range of environments available to your teen and to help them spend more time in supportive, beneficial situations. These environments could be educational settings, part-time jobs, organised extracurricular or social activities, and everyday relationships with adults and peers. Weigh any benefits of the status quo against the long-term consequences of demoralisation, and consider the opportunities for personal growth and positive feedback they’d get in a better fitting environment, which would otherwise be missed. For example, if your teenager has difficulty sitting still and sustaining attention, help them find a part-time job where it is an asset that they are always on their feet. If your teen needs the threat of immediate consequences to stay motivated in school, find an academic programme with a high level of structure and accountability.
Set reasonable expectations using the baby steps rule
When working with a teenager with ADHD, parenting action #3 is to ask for improvements in baby steps, such as a 10 per cent improvement or similar. Progress is often slow for teenagers with ADHD, and they’ll find small changes easier to make than big ones. This approach means that sometimes you will permit suboptimal behaviours that bother you. The focus is on better behaviour, rather than good behaviour. This means asking a teen who is doing no homework after school to start by just putting in 10 minutes a night. As soon as 10 minutes feels easy, you can bump your expectation to 20 minutes, and then 30 and so on. By contrast, all-or-nothing rules, such as demanding full completion of homework or a permanent positive attitude, can be too challenging to achieve and could lead teens to stop trying entirely.
Of course, there are some serious negative behaviours that will require an all-or-nothing approach, such as drug use, violence or unsafe behaviours. However, when you’re trying to increase positive behaviours, the baby steps rule can lead to small gradual improvements that pay off over time. It is essential to clearly communicate your expectations to the teen. Write them down, when possible, to avoid differently remembered rules. When you and your teen disagree about expectations, acknowledge the disagreement and calmly explain your point of view.
Establish fair and consistent consequences for irresponsible behaviour
Many parents feel that teenagers with ADHD do not respond to consequences. They are partially correct – teenagers with ADHD do not respond to consequences in the same way as their peers. Research suggests that people with ADHD take longer to learn cause-and-effect relationships but, eventually, they do learn them, especially when things are predictable. They are in the best position to make accurate judgments about the consequences of their actions when there are simple cause-and-effect relationships between their choices and the outcome. They also often respond best to urgency or strong consequences.
Parenting action #4 is therefore to set appropriate consequences for when your teen fails to meet the fair expectations you set for them. Consequences should be: 1) made clear ahead of time; and 2) consistently issued. Because of the neurophysiology of ADHD, you might need to use immediate and salient consequences to adequately motivate your teen. Failing to discuss consequences in advance will cheat adolescents of an opportunity to practise weighing the pros and cons of a given decision. Similarly, inconsistent issuing of consequences can teach adolescents with ADHD that they can take a gamble. They might consider that it’s worth being irresponsible because there is a good chance you won’t follow through with any consequences. Because consistency is so important, you should announce only those consequences on which you are positioned and ready to follow through. Empty threats or surprise consequences will undermine your teen’s ability to regulate their own behaviour because the rules of the game are constantly changing. Finally, the punishment should fit the crime. Over time, moderate but consistent consequences will be more effective than big, unpredictable punishments.
For example, a consequence for missing a class assignment might be to miss one day of after-school sports to complete the missed work. A consequence for an incident of disrespectful speech might be missing 15 minutes of time on digital devices to write an apology letter to the grandparent who was treated rudely. On the other hand, a serious misbehaviour (such as sneaking out to attend a party) might earn the consequence of two weeks of grounding. Whatever consequences you settle on, remember to always communicate them in advance and apply them consistently.
Be strategic with home routines
Individuals with ADHD struggle with self-regulation in unstructured environments that lack natural incentives. In contrast, they often thrive when there is structure and built-in encouragements to stay on task. Parenting action #5 is to build a home routine that is as consistent as possible. This routine can also build in incentives strategically. Higher-interest tasks, such as screen time, friend time or pet time, should be placed immediately after the completion of lower-interest tasks, such as homework or chores. This consistent ordering of daily activities establishes natural cause-effect relationships in the daily structure, which are completely within the adolescent’s control. ‘Want to jump on your video games?’ you might say. ‘No problem, just show me you’ve finished your homework first.’ This reliable structure to home routines will help prevent you from needing to issue consequences.
Manufacture opportunities for autonomy
Responsible parenting of a teenager with ADHD can frequently result in loss of teen freedoms. In demanding follow-through for your rules and expectations, you might find yourself issuing consequences that reduce free time, enforce a strict curfew, or lead to higher levels of adult assistance during schoolwork. This means you might need to offset necessary reductions in autonomy by manufacturing additional opportunities for your teenager to develop independence. To achieve the goals of adolescent development, teens need opportunities to practise independent decision-making, planning skills and self-sufficiency. Consider extracurricular activities that are a fit for your teen’s strengths and interests, and that will provide them these opportunities for independence. You might need to go out of your way to research unique options in your community or beyond that promote personal development and link to your teen’s areas of interest (recreational, scholastic, artistic, vocational or social). At home, you might also give the teen special responsibilities that interest them, such as cooking dinner, redecorating their bedroom, sending them off with a shopping list, or planning a family outing.
Parenting action #6 is therefore to practise granting responsibilities in situations where the consequences for failure are low. To reinforce your teenager’s self-confidence, acknowledge instances when they display even the slightest autonomy. When autonomy failures occur, avoid shaming the teen and instead respond neutrally by helping them process cause-and-effect relationships in their decision-making. In everyday situations, you can help your teen perceive themselves as capable of independence by using supportive language, such as ‘it’s your decision’, ‘you are in charge of yourself’ and ‘you know yourself best’.
Build their self-confidence
Adolescents with ADHD usually have lower self-esteem than their peers. Years of mistake-making, frustration from parents, social struggles and underachievement in school and activities can create in them beliefs such as ‘There is something wrong with me’ and ‘I’m not as good as the other kids.’ If you believe your teen lacks confidence, it’s important to help address it – in adolescence, serious and chronic struggles with self-esteem can lead to depression, social isolation, irritability and substance abuse.
Parenting action #7 is to actively build your adolescent’s self-confidence. First, self-esteem grows when we feel good at things. So, invest in your teen’s competency development in areas where they show interest or natural abilities. Help your teen connect with in-person friends who are accepting. This might require parenting efforts to maintain healthy friendships, such as offering to take a friend on a fun outing or signing up the teen for new social activities. Finally, notice when your teen is doing things well or better than usual. Always draw attention to these successes in a way that affirms the teen’s worth and strengths. Try to create a life in which the teen hears at least as many positive messages about themselves as negative messages.
Establish a regular parent-teen meeting
An effective way to lay the foundation for all the previous steps is to schedule a weekly parent-teen meeting (parenting action #8). If executed consistently, this simple practice can pay off slowly over time. It’s also a chance for you and your teen to practise communicating respectfully (see the Learn More section). Schedule the weekly meeting between you and your teen without siblings present. Pair the meeting with an enjoyable experience, such as visiting a coffee shop or restaurant, sitting in a park or favourite viewpoint, or while listening to favourite music. Treat the meeting like a date, but make sure your activity is simple enough to keep the conversation focused and allow for notetaking. Another strategy is to start with a more active parent-teen activity that you enjoy together (such as playing a sport, taking a hike or going to a movie) and then sitting down afterwards for your weekly chat. Depending on your teen’s attention span, the meeting might be relatively brief (eg, 15 minutes) or a bit longer (eg, 45 minutes).
I recommend coming to the parent-teen meeting with planned topics each week and inviting your teen to do the same. There may be some topics that repeat each week and others that are specific to the week. Here are some example weekly topics:
Examples of special, one-off topics:
It’s best to schedule your parent-teen meeting strategically, at a time that will maximise adolescent engagement. For instance, avoid holding the meeting at a time that conflicts with their favourite social or recreational opportunities. Instead, consider holding it at a time that allows the teen to be sprung from a less desirable obligation (such as getting the school’s permission to collect them 30 minutes early one day, or taking them to get coffee while other family members are doing chores). No matter how engaging you try to make the meeting, you’ll find its appeal to your teen is completely relative to the alternative activities they could be doing instead.
Making a parent-teen meeting a consistent, weekly practice throughout the adolescent years, using it as a space to discuss important topics for autonomy development, and for practising and slowly mastering communication skills, is foundational for adolescents with ADHD.
Practise respectful communication
During parent-teen meetings and in many other settings, it’s possible that the discussion might trigger negative emotions in your teenager, such as frustration, anger, hurt feelings and contempt. Everyone in the family can practise advanced communication skills to prevent conflict and ensure calm and productive get-togethers and meetings. You can teach these skills to your teen directly or you can lead by example. To give you an idea of what this might involve, the first important skill is active listening. This approach can involve saying back what you heard your teen say, before sharing your own point of view or offering an immediate counterpoint. For example:
Teen: You are the only parent I know who takes away the phone at night. You treat me like a baby and it’s embarrassing.
Parent: It makes you feel self-conscious with your friends that you don’t have your phone at night, and you feel like you might be missing out.
When parents use active listening approaches (and teach teens to do the same), both sides feel validated and understood. Highly emotional responding is often reduced.
A second important communication skill is to use ‘I’ statements to explain your point of view instead of ‘you’ statements. For example:
‘You’ statement (avoid these if possible): You don’t act responsibly when you have your phone. It’s your own fault that you can’t have it.
‘I’ statement: I feel disappointed that you think I’m taking your phone away just to make you miserable. I want you to have your phone in the evening but need you to prove you can manage it responsibly. Do you see where I’m coming from?
Finally, whenever you come to an impasse, be prepared to compromise. Parents of teenagers have less control over their charges than parents of younger children. Sometimes, teens refuse to follow a rule or want to follow a rule but have trouble following through. In these cases, consider making a deal with the adolescent. Offer something they want in exchange for something you want. For example: ‘I’m willing to let you stay out an hour later on Fridays and Saturdays if you will let me give you a list of weekend chores to complete each week.’
ADDitude is an educational magazine for parents and patients with ADHD. Their weekly podcasts are freely available and feature a range of experts discussing the ADHD experience.
Attention Magazine is a bi-monthly parent- and patient-focused magazine offering evidence-based information on ADHD. Its archives contain many free articles, while digital subscription grants full access to the online magazine. (Note: I am on the editorial advisory board of this magazine but have no financial relationship.)
The award-winning YouTube channel How to ADHD provides advice to individuals living with ADHD. The information is relatable, balanced and grounded in the latest science of ADHD.
The patient advocacy organisation Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) is the world’s largest, and holds an annual conference (using a hybrid format that allows for worldwide participation) designed for parents, patients and professionals who specialise in ADHD. Their local chapters and parent-to-parent networks allow parents to find and connect with others experiencing similar challenges.
The book The Self-Driven Child: The Science and Sense of Giving Your Kids More Control Over Their Lives (2018) by William Stixrud and Ned Johnson is a guide for parents to help their children and adolescents cultivate self-motivation. Although it’s about parenting in general rather than specific to ADHD, it hits on many themes that will be relevant to you.