How Can I Manage ADHD in My Teen?

You’ve been giving your son Adderall since he was age eight. But how can you help him with his attention deficit/hyperactivity disorder (ADHD) now that he’s entering adolescence?

The answer, say experts, is to understand that ADHD—a mental-health condition that causes restlessness, mood swings and difficulty completing tasks—changes as patients grow older. “During the teenage years, ADHD becomes less outwardly visible and more internalized,” says James Perrin, M.D., a professor of pediatrics at Harvard University and a spokesman for the American Academy of Pediatrics. “Treatments need to reflect the fact that while a six-year-old with ADHD may squirm or blurt out in class, a 16-year-old will sit in silence but have trouble focusing on what the teacher is saying.”

Teens are just as likely as younger children to have ADHD, with 5 percent of girls and 11 percent of boys affected.  But with adolescent patients, treatments have two new aims: helping teens take on more adult responsibilities, and helping them avoid drug abuse, car accidents, and other types of trouble. “Teens with ADHD are more likely than their peers to make impulsive decisions,” says Ari Tuckman, vice president of the Attention Deficit Disorder Association (www.add.org). “And at this age, that that can put them in risky situations.”

How can you help your teen stay on track? Here are three strategies for success.

The Right Meds
When they enter their teens, children with ADHD usually continue taking the same stimulants they used in the past to balance the neurotransmitter levels in their brains (these medications can include Adderall, Concerta, Daytrana, Dexedrine, and Ritalin). Kids may also continue taking other prescription drugs such as Strattera (an anti-anxiety treatment) and anti-depressants (such as Wellbutrin or Efflexor). But as they age, teens may need to adjust their meds. An elementary-school student might take a 12-hour stimulant in the morning and remain relatively focused all day. But a teenager might need to take a 12-hour drug in the morning—plus a shorter-acting, four-hour drug in the evening to help her focus during nighttime study.

Loving Support
Now that your child is old enough to understand that ADHD is caused by an imbalance in brain chemistry, he’s also old enough to take more responsibility for addressing that imbalance. You can help him become more self-sufficient by asking him to administer his own medications and by encouraging him to brainstorm about what he can do to help himself when he feels skittish or unable to focus. “Reward him with positive feedback and loving encouragement when he remembers to do his homework and his chores, and withdraw privileges if he fails to take these steps or acts irresponsibly,” recommends Perrin.

Other Treatments
Other effective treatments for adolescents with ADHD include support groups (for families and other teens with ADHD) one-on-one counseling (which can improve a teen’s self-esteem plus her management and organizational skills); reorganization of the study environment (so it’s TV- and iPod-free and not distracting); neurofeedback (which will measure a teen’s brainwave patterns while she focuses on different tasks); and CogMed Working Memory Training (computer-based attention training, which you can read about at www.cogmed.com).