Q My 11 year-old son was recently diagnosed with ADHD, the inattentive type. He has excellent behavior at school, but has a difficult time keeping up, staying organized and each year is getting more and more difficult. We recently enrolled him in a private school with much smaller class sizes and a more individualized approach to educating their students. It is more academically challenging, but we feel that this will be a better environment for him overall.His behavior at home is another issue. He is very difficult and it is affecting the entire family. The constant teasing and picking on his siblings and family dog is sometimes unbearable. He constantly tries to become physical with everyone...always trying to have his hands on someone. It often takes repeated requests to stop the behavior, and sometimes that doesn't even work. I have to also get physically involved, either through yelling and pulling kids apart. I sometimes feel our household is out of control.Is it common for an ADHD child to have great behavior at school and very difficult behavior at home? I picture someone with ADHD being out of control, but with my son, I recognize that he is in control of his behavior, but possibly loses control at home or selectively loses control? I am so confused. I am not sure if I am afraid to label my son with ADHD or if I am buying into hype diagnosing him. Any advice for me?
It’s very common for kids with ADHD to behave better in one setting or another, whether that is behaving well at home and terrible at school or vice versa. Oftentimes, this is because of a difference in the home and school environments.
It’s great that your son is in a smaller and more challenging school setting. Very structured schools are great at helping keep kids with ADHD organized and focused throughout the school day, but when that structure isn’t available at home, disruptive behavior can be a consequence. Plus, when kids are working really hard to keep it together at school, they might be worn out at the end of the day, and have a hard time holding things in at home.
Now that he’s eleven, your son also probably has more demands at home, such as more homework, more chores, and more responsibility. These demands can be difficult for kids with ADHD, so it’s common for parents to get pushback and defiance. Tolerating boring and unstructured situations at home can also be hard for kids with ADHD, and might lead to the kind of disruptive attention-seeking behaviors you’re describing.
Although your son may suffer from the inattentive type of ADHD, some of the home behaviors you are describing seem consistent with the hyperactive/impulsive type of ADHD. Given that he was recently evaluated, it might be worth asking the professional who made the diagnosis about the extent of your son’s hyperactivity and impulsivity.
I am also curious about what treatment you are seeking for your son. Having a smaller, more specialized school setting will be helpful for him academically. But what interventions do you have in place for home behavior since that has been problematic for you? The most effective interventions for children with ADHD are a combination of stimulant medication, parent training to create more consistent structure, rewards, and consequences, and cognitive behavioral therapy to provide better problem-solving strategies in different situation. If your son is not already receiving medication for ADHD, I would encourage you to consult with a psychiatrist to determine if medication would be indicated. I would also encourage you to seek parent training in order to create more structure to his daily activities as well as rewards for appropriate behavior and consequences for his disruptiveness.