Disciplining Inattentive ADHD versus Disciplining Combined Type ADHD

Disciplining Inattentive ADHD versus Disciplining Combined Type ADHD
This is the last in a series of posts that I have been writing about how the inattentive subtype of ADHD differs from the Combined type. In the first post I wrote about Inattentive ADD differences in response to ADHD medications. In the next two posts I described Inattentive ADD classroom strategy differences and in last week’s post I began a discussion on how disciplining kids with inattentive ADHD can differ from the disciplining approaches used for combined type kids.

I have written before about how ADHD expert Russell Barkley has described a function of our brain that speak to us about what behavior is appropriate. Barkley has examined this trait in people with attention deficit issues and has found that, in people with ADHD, this internal brain voice is faulty. The internalized speech that Barkley is describing is a key part of the executive function known as ‘Self regulation’. It is Barkley’s belief that this particular executive function is a key problem of the combined type of ADHD. Barkley, however, also believes that this internal voice is partially intact in kids with inattentive ADHD and this is the reason why they are often less impulsive, less positional and more self reflective.

Inattentive kids have trouble regulating their attention and motivation but the “internal voice” that speaks to them about appropriate speech and behaviors is loud and clear. I mention these executive function differences because the number one approach to disciplining my inattentive son involves using his intact internal voice and just reasoning with him.

My combined type son tends to be pretty oppositional and argumentative. Reasoning with him, or just talking out our differences, is not an option. I can go to my inattentive son, however, and ask him about his transgressions, discuss with him how best to improve the problematic behavior, and ask him to come up with an appropriate punishment. Believe it or not, he often is more hard on himself than I would be.

When the above strategy does not work, there are other disciplining tools that we have used at our house that have also worked pretty well. Plain, old fashion punishment sometimes are pretty effective. The negative incentives that have motivated him to behave appropriately include:

  1. · Removing or decreasing his allowance
  2. · Removing or decreasing his allotted screen time
  3. · Increased household chores
  4. · Removing dessert (he absolutely loves dessert)

Positive incentives have worked less well but on occasion we have used them with success. Examples of positive incentives include:

  1. · Increased Screen Time
  2. · Increased Allowance
  3. · Buying him a gift.
  4. · Taking him out to his favorite restaurant

The disciplining of kids with inattentive ADHD can be difficult. Strategies such as the removal of social opportunities or the removal from participation in sports activities, as I discussed in my last post, are often not effective. Punishments such as restriction, detention or “Time Outs” are also sometimes worthless because these kids are especially happiest when they are just left alone. Inattentive kids are generally a bit more cooperative than combined type kids however, so reasoning with them often works as do both negative and positive disciplining strategies.

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