adhd

We knew our now 4-year-old daughter was different very early on in her life. On her first birthday, she had another 1-year-old friend over to play in the backyard (it was COVID times, so there was no big party with all of her daycare friends). The boy, a neighbor of ours, sat and played in the baby pool for a solid hour without moving or making much of a peep. Our daughter, meanwhile, stripped off her swim diaper and spent the entire afternoon wandering around the yard, rolling in grass, swinging sticks around, and generally making mayhem. Making mayhem pretty much became her norm for the next few years. She slept poorly, had multiple meltdowns every day, and was so defiant my wife and I were left completely exasperated and in tears most days.

It wasn’t too long before we started to look into parenting coaching to get a grip on her behavior and regain some sense of normalcy in our lives. The stuff that had worked with our older daughter had been a colossal failure thus far. I loved our parenting coach and her ideas. Talking to her was almost like therapy for us. But her techniques didn’t work either. Then we tried Occupational Therapy. Our daughter loved going because she got to climb around on obstacle courses and play fun games that were meant to work on her vestibular system and help her feel more calm and grounded, but we never saw much of a difference in her.

We were exhausted.Giphy

Finally, we took the plunge and did a full-scale psychiatric evaluation, and the results showed that she had ADHD. It confirmed what we pretty much already knew. We thought we’d be going down the medication road sooner than later, but our doctor actually recommended a specific kind of therapy. It was called PCIT.

Parent Child Interaction Therapy promised to ‘train’ us on how to better interact with our daughter. Great, more parenting coaching, we thought. Another person to tell us that we need to be more consistent, apply more discipline, and yadda yadda yadda. But we didn’t have any other options, so we gave it a try.

In short, and to our complete surprise, PCIT has been a life-changer. When it was described to us as coaching or training, they really weren’t kidding. We spent several sessions in the office with our daughter while literally being observed with a camera and fed lines through a headset! As of this writing, we’ve been practicing the techniques for several months and we’ve seen a big difference. At so many points throughout the therapy, my wife and I agreed that all parents with stubborn kids should go through this program.

Here are just a few of the things we learned that helped us immediately in our daily life with a super defiant, too-smart-for-her-own-good, highly dysregulated kiddo.

1. The magic of 'Special Time'

Photo by Ryan Fields on Unsplash

Our first task in PCIT was to have more positive interactions with our daughter. We spent so much of our time telling her, "No," reprimanding her, arguing, bargaining, negotiating, and punishing that it was making it really hard to take any joy in being her parent.

So, our therapist introduced us to a concept called Special Time. For just five minutes every day, we were instructed to give our daughter our undivided attention and fill her with as much positive energy as possible. There were extremely specific ways that we did this, and, in fact, we even practiced and were measured in the therapy setting on how well we implemented all the techniques! But during Special Time, we play with our daughter one-on-one and let her lead the interaction. Our job is to play along. Meanwhile, we shower her with praise (“Wow, I love how nicely you’re sharing the toys with me!”), touch or speak to her affectionately (“I’m having so much fun playing with you”), imitate the way she played and even echo things she said back to her to let her know she was being heard and listened to. Doing Special Time made a huge difference, almost immediately, in reducing her negative attention seeking behaviors.

And we always feel good at the end of it, which helps offset the stress and frustration of our many conflicts. If you’ve got a kid that sometimes acts out for attention, pre-emptively giving them lots and lots of positive attention might help.

2. The Time Out flow chart

I think a lot of parents can relate when I say that, for years, we found implementing punishments with our daughter to be a disaster most of the time. With a stubborn and dysregulated kid, doing things like taking a toy away or doing 'No Dessert' would almost always cause an explosion, and/or end up hurting us more than it hurt her.

A lot of parenting experts have their own approach to Time Out, but not many of them are clinically validated like the one used in PCIT. When we learned how to do Time Out properly, Time Out became the primary 'punishment' we use. When she doesn't do what we clearly ask her to do, or she breaks a House Rule (like 'No Hitting'), she goes into Time Out. Once she's ready to do the thing we asked, she can come out of Time Out and the conflict is over. She can go right back to playing or having dessert. It’s so much simpler.

Although, when I first saw the flow chart for how Time Out worked, it looked like anything but simple.

It looks complicated at first, but it's actually simpler and more effective than we thought.Evan Porter/Upworthy

Seeing this flow chart at first was incredibly overwhelming! But with a little practice, it made sense. The first couple times using the Time Out sequence at home were a little rough, but after a little while of being consistent with it, just the threat of it is usually enough to get our daughter back on the right track.

Even if you don't follow the brain-dizzying flow chart above, I think all parents could benefit from learning a consistent Time Out sequence that ends with your child complying every single time without fail. It's tough! Sometimes it takes a while and you have to be a little stubborn yourself in order to see it all the way through to the end, but the investment is worth it.

3. Active Ignoring

This one is a little controversial in some circles but we found it to be an excellent tool to have in our toolbox. Our therapist even told us that if she could teach her patients just one thing, it would be how and when to use Active Ignoring or Selective Attention.

A handout from UC Davis describes this technique as: "We use Selective Attention to deal with behaviors that are minor, irritating, and inappropriate. Ignoring these behaviors is an active way to correct them! You will strategically use the technique to stop specific behaviors," like whining, sulking, screaming, being clingy, lying, and more. The idea is that these behaviors are attention-seeking so any kind of attention only fans the flames and rewards them.

Sometimes being unbothered works.Giphy

When our daughter is fussy, irritated, and whiny, we first try to help her regulate. One of the best ways we learned to do this (again, through PCIT!) is with leading by example. We used to bombard her with calming options. “Want to color? Want a snack? Oh, let’s walk outside! How about a drink of water? What if we put on some music?” And of course she would just say No, No, No!!!! And then we’d wonder why we could never get her to calm down by coloring. It turns out that sometimes what works way better, and is less overwhelming for her, is if we just calmly get out all the supplies and start coloring ourselves. She’ll almost always join in when she’s ready.

But if we just can't shake the grumpiness and whining and tantrums, we'll turn to Active Ignoring. This approach has two big benefits. Number one, it stops the conflict from escalating further. We used to get into these cycles where everything we would try to say or do would just make the tantrums worse to the point they became full-blown nuclear explosions. By just walking away, we were able to nip a lot of those in the bud. Number two, ignoring helps keep us calm. Yes, parents are human beings that get frustrated and angry and upset, too! And when those emotions start to pile up, it makes everything worse. Having the freedom to just turn away or walk away or stop talking has done wonders for our mental health.

Sometimes, some of the techniques we've learned in therapy feel "mean." We're not able to be as flexible and gentle sometimes as we'd like to do, but that's because flexible and gentle is not what our daughter needs most of the time. She needs us to be strong and consistent. That makes us reliable and safe, and it helps keep her regulated. The techniques taught in PCIT won't be right for every kid or every family, but it was right for us.

I was as skeptical going into all of this as anyone, but going through the therapy has allowed us to enjoy being her parents so much more. She's the sweetest kid and one of the funniest people on the planet. She brings so much fun and laughter to our lives, and it's been absolutely amazing to spend less time butting heads with her and more time soaking in her incredible energy.