Teens, ADHD, and Risky Behavior
By Katherine Kam
Reviewed by Kimball Johnson, MD
When teens with ADHD take reckless risks, their parents are understandably upset. But grounding the teen or yanking his driver’s license can backfire.
“The challenge is not to prevent a kid with ADD from doing anything else that any other adolescent would do,” says UCLA pyschiatry professor Mark DeAntonio, MD.
Instead, the parents’ task is to keep their teen safe, without nipping their development in the bud.
“You don’t want to make the person a child,” says Harold Robert Meyer, founder and executive director of the ADD Resource Center in New York.
The Allure of Risk
It’s no secret that some teens don’t always show good judgment when it comes risk. But risk may be particularly attractive to teens with ADHD.
Why? “In general, they’re more impulsive. They do things without thinking,” DeAntonio says. “Another thing is that they often have complaints of being easily bored. Often, what gets their attention are things that are more risky or excitingâ€¦ and they often don’t fully consider the consequences of their acts.”
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Almost all of his teen patients with ADHD struggle with impulsivity. But only about one-third engage in truly dangerous behaviors, he says. “Some of these behaviors are things that other teens [without ADHD] do, but they’re willing to push it to the limits.”
For example, teens with ADHD will skateboard, surf, or rock-climb, he says, but “they tend to have more broken bones or they blow their knees out when they’re playing sports.”
Some also “do things like reckless driving, drug behaviors, sexual behaviors,” he says.
Meyer has seen some teens who steal, taunt people, or provoke fights “to produce an adrenaline rush,” he says.
Their risky behavior may also happen online. “Many of the kids, especially the girls with ADD, seem to be more trusting of people on the Internet,” he says.
For those with low self-esteem, doing risky things can give them a warped form of bragging rights. “They’re able to do something that other people can’t or won’t do,” Meyer says.
DeAntonio helps his teen patients to identify the activities that put them in harm’s way and to “to help them appreciate the risks that they’re taking.”
Peer pressure, in good relationships, can help. Since teens value their friends’ opinions, DeAntonio tells teens with ADHD: “Listen when your peers say, â€˜You really scare me. You do things that you shouldn’t be doing.'”
As teens grow into their 20s, a serious relationship can have a calming effect, Meyer says. For example, if a young woman tells her boyfriend who has ADHD that she doesn’t like his high-risk activities, Meyers says, “It can quiet them down… They want to behave a little bit better, and to hear it from a girlfriend has more of an impact.”
Some sports can cause serious injuries, so DeAntonio emphasizes safety gear, such as helmets, for biking and skateboarding. Parents should also insist on protective gear, he says, or tell their child, “Otherwise, you can’t do it.”
He also warns teens against taking part in risky sports alone. Parents should be alert to such hazardous situations, for example, if your teen says, “I’m going out rock-climbing by myself,” DeAntonio says. Rock-climbing — maybe. On your own, where there’s no one to help you if things go wrong? No.
You might not have to ban an activity. You might just need to redirect your teen — for example, to a team sport where there’s supervision, he says.
Teens with ADHD are two to four times more likely to have traffic accidents and three times more likely to get injured than teens without the disorder, according to the organization Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD).
Teens with ADHD can still learn to drive, but again, parents should approach it with greater caution and make sure their teen is taking ADHD medication as directed whenever they’re behind the wheel.
“Usually, most [teens] can drive fine,” DeAntonio says. “But again, you’re more concerned about issues of texting or using cell phones, about other people in the car distracting them, about drug and alcohol use while driving that will affect their impulsivity even more. I think the rules for driving are no different than for any other kid, but I think you have to be more thoughtful and be more specific with a kid with ADD to make sure they’re following the rules.”
As a parent, you can’t control your teen’s every move. So you must allow him or her take responsibility for the consequences.
For example, let your teen know that if he breaks the driving rules, he can’t borrow the car, Meyer says. “Bring it to the consequence: If you do that, you’re telling me that you’re not ready to drive the car.” Follow through if your teen tests you.
You can also stress that your teen may drive as long as they don’t get traffic tickets, Meyer says. If they get a speeding ticket, they should pay for it themselves and not expect you to come to the rescue. “One of the problems that many of the parents have is that they feel guilty for their child’s risky behavior, so they don’t enforce it,” Meyer says.
Put consequences in writing ahead of time. That cuts down on arguing in the heat of the moment, Meyer says.
Cutting the Risk
When your child has ADHD, DeAntonio says, “check in with them more… go over their plans in more detail than you may do with other kids.”
For example, rather than banning your teen from going to parties, make sure that responsible adults will be there, he says. “It doesn’t mean, â€˜You can’t do it at all,’ but you just have to be more concerned about supervision at activities.”
If your teen does something truly risky, rather than blowing up at him or her, Meyer encourages parents to impose consequences and talk about what they could do differently next time. “Make it more [about] problem-solving,” he says.
View Article Sources
Harold Robert Meyer, founder and executive director, ADD Resource Center, New York.
Mark DeAntonio, MD, clinical professor of psychiatry; director, Inpatient Child and Adolescent Service, Semel Institute of Neuroscience and Human Behavior, UCLA.
CHADD: “Driving and ADHD.”
Reviewed on November 22, 2012
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