In almost all cases, Attention Deficit Hyperactivity Disorder (ADHD) will have been identified long before the child reaches middle school or junior high school. The disorder occurs at younger ages and schools are much more aware of ADHD than they were 15 or 20 years ago. Up until 20 years ago, it was commonly thought that children with hyperactivity outgrew their condition by puberty, but it is now widely accepted that that isn't true. Although many become less restless and overactive, inattention and impulsivity often persist.

What is the Behavior of the Teen with ADHD?
A teen with ADHD:
Continues to have difficulty sustaining attention and focus.
Exhibits some form of motoric overactivity, restlessness, or fidgeting such as foot jiggling or pencil tapping.
Has difficulty with initiating, organizing, and completing homework, and structuring or planning for long-term assignments. (This is most specific to adolescents.)
Has conflicts with parents over rules and responsibilities.
Treatment: Medications are Frequently Recommended
Stimulant medications such as Ritalin, Dexedrine, Desoxyn, or Cylent tend to work for adolescents just as they do for younger children. These medications will decrease the hyperactivity or distractibility found in ADHD and thus increase attention span. There are some advantages for stimulant use with teens. As the teen has neared his or her adult height, there is little concern about growth stunting.

Medication is often more difficult to enforce with adolescents, however, as they may perceive it as a form of adult control. They may also balk because they don't want to be different. Don't force medication. Instead, help teens see the need for it. Explain to them that taking medication to increase their attention span is like wearing glasses to improve vision. Teens also need to be counseled as to the high risks of mixing medication with alcohol and other drugs.

What Can Parents Do?
The adolescent with ADHD has great impact upon the family. Normal adolescents are not easy to parent and adolescence is more "extreme" for the teen with ADHD. They typically experience wider mood swings and have more defiant behavior, creating greater family conflict. Their demand for independence is often greater, and as they behave more irresponsibly, they are less ready to handle independence. School-related problems may also increase. Chronic power struggles exist between parents, children, and teachers when a child is not completing his or her work.

The following "Top Teen Survival Tips of the 90s" are offered to parents by Arthur L. Robin, Ph.D., of Children's Hospital of Michigan.

Understand adolescent development and how it impacts upon a person with ADHD.
Give an adolescent with ADHD reasonable input into the decision making whenever possible.
Get your priorities straight. Distinguish between important versus unimportant conflicts, problems, and misbehaviors.
Learn steps of effective problem solving.
Continue to structure the environment. Set conditions and consequences for tasks to be done by the adolescent.
Learn positive communication skills.
Expect to utilize professional help for medication and therapy periodically throughout your child's adolescent years. Arrange to have a trusted professional do "family ADHD checkups" at least every six months to see how you are doing.
Parents and adolescents need vacations from each other several times per year.
Parenting programs (such as STEP or Active Parenting) which teach the avoidance of power struggles and the concepts of positive communication and encouragement are helpful.

In addition, parents should assist their children in developing organizational skills and should provide a "distraction-free" environment for study at home. The teen's need for frequent breaks should be considered and daily exercise encouraged. Remember, we cannot make children study, or do their homework. We can provide the time for study, the place for study, continued encouragement, and occasional help.

Sibling Reactions
Siblings develop their own ways of dealing with the presence of a child with ADHD. They may feel sorry for him or her; they may feel anger or resentment or they may feel neglected. A younger sibling may develop fear for the older, impulsive, or aggressive child. Older siblings may become overprotective. Greater emphasis may also be placed on the need for the sibling to behave well. Some siblings may become overachievers to prove they are different or to meet the parents' needs. Allow your other children to be "imperfect." When they start to rebel or misbehave on occasion, don't be too concerned. Siblings will need special, alone times with you. Provide them also with their own outlets, like sports and school activities. Encourage them to express their feelings.

Each child in the family should not be parented the same way. Each has special needs. Siblings can cope with the different expectations parents have of the child with ADHD as long as there is fairness and some balancing when it comes to their needs. Educate them as to what ADHD is all about.

Encourage, Encourage, Encourage
Coming to terms with a chronic condition can be difficult, particularly at a time in life when being one of the crowd is so important. It's up to parents to make sure the adolescent's self-esteem doesn't suffer. Keep him or her educated and encourage his or her efforts. Many experts have observed a correlation between creativity and ADHD. Discuss with adolescents career and educational possibilities which are flexible and need "idea" people. Help in increasing self-awareness and work on coping and organizational skills to ease their process of growing up.

Reprinted from Ohio State University Extension Service