Ask An Expert / Behavior Problems

My son, who has ADHD, is becoming aggressive when I ask him to do things. How should I handle this?

A parent worries about an increasingly angry child

Samantha P. Miller, PhD

My son is being more aggressive when I ask him to do things in the morning or at night. He has a lot of anger. Is this normal for an ADHD kid? He has started to hit when he is angry. What can I do to control him? Is it going to get worse? I am afraid I won't be able to control him. Lately, he doesn't want to take his Concerta pills. I am a single parent and he has visitation with his dad Tuesdays and Thursdays and every other weekend. His dad doesn't believe he needs the medication and this makes things worse for me.

Aggression in children with ADHD is usually a response to demands and challenges that frustrate them. It’s not uncommon, but the good news is that the kids themselves, and their parents, can learn to manage and minimize it with effective behavioral therapy. Treatment is aimed at helping your child learn new, healthier ways to deal with being angry, stressed, or sad.

You can help manage your son’s behavior by structuring his home environments so that he has a clear understanding of the expectations and rules of each house. It’s important for parents to be consistent with messages — positive feedback as well as discipline. Consistency is crucial for kids with ADHD, as is structure that helps them be productive and avoid conflict. They respond well to schedules and routines for things like homework and chores, with a reward system to reinforce positive behavior.

Stimulant medications have been used to treat ADHD for over 50 years, and significant research has been done on their effectiveness, safety and side effects. But your child should be monitored by his clinician, to find out how it’s working for him — including whether he’s experiencing bothersome side effects—and make any necessary changes in the treatment. In terms of assessing whether he needs it or not, it’s important to weigh the cons of taking medication against the cons ofnot taking medication, which may include decreased self-esteem related to problems in school, conflict at home, and difficulties getting along with other kids. Whatever is decided, you, your son’s father and his doctor need to work together as the key people on his treatment team.