ADHD Kids and Consequences – What the Research Says

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ADHD Parenting Podcast Introduction

0:30Welcome to another episode of the ADHD Parenting Podcast. We have a really good topic today. This topic is one that a lot of parents ask about, and there's a lot of debate about we see in parenting spaces. And the topic is, do kids with ADHD need consequences? Welcome to the ADHD Parenting Podcast with Mike McLeod of Grow Now ADHD and Ryan Wechselblatt of ADHD Dude. Learn about parenting kids with ADHD from a licensed clinical social worker and speech-language pathologist who specializes in ADHD.

1:02No fluffy parenting advice, only practical information that will equip you to help your child with ADHD effectively. Well, rather than sharing our opinion, we're going to share what the evidence shows. So I am here with Mr. Mike McLeod, author of the Executive Function Playbook. Welcome, Mike. Welcome. How are you? I'm good. I'm good. So, Mike, where do we want to start with this? So, overall, there's a style of parenting content that is really over-consuming right now and very hard for parents not to find themselves seeing within their algorithm of social media that's very, very popular right now.

1:38And what parents are always hearing is that punishments don't work. Kids need connection and co-regulation. They need to process their feelings. And we totally understand why that resonates. Instilling consequences and punishments have been a difficult part of parenting since the beginning of time. And only more difficult since now we're in information overload with all of these parenting influencers taking over your algorithms.

Research on Consequences for ADHD Kids

2:08The goal of this episode is to walk through what the research actually shows for kids with ADHD and executive functioning challenges. Because a lot of what's being shared right now is not aligned with real evidence and data. So, Mike, let's just start with the statement, kids with ADHD don't need consequences. I think, Mike, I would have mentioned that the way I actually got the idea for this episode was I recently saw a post from an ADHD parenting influencer. And the post was about this.

2:40And as you might imagine, Mike, it got tons of likes and shares, you know, like, no, our kids just need connection, right? They don't need punishments or consequences. Okay. So, as Mike said, this is one of the most common messages right now. And what the research shows is actually the opposite. Kids with ADHD are more dependent on external consequences, not less. So, Dr. Barkley has a video on YouTube where he speaks about this. And he has explained in his work, including his 2013 and 2020 publications, that ADHD is a disorder of performance, not knowledge.

3:15That means behavior is governed much more by immediate consequences than by what a child understands. So, Mike, why don't we elaborate on that a little more? Yeah, and one of my favorite quotes in all of, you know, Dr. Russell Barkley's work is if you want to see an ADHD child or teen fail, put them in an environment with no consequences. And very sadly, when we look at today's world big picture, we've really created that world for so many kids. You know, we look at our schools now.

3:46Where are the consequences? I can't tell you how many schools I go into for professional development or observations or collaborations. And they have these infraction systems or whatever it may be that are completely meaningless. And the kids know they're meaningless. You get a certain number of infractions and it just triggers a quick little meeting. And they're never really held accountable to their behaviors. And a lot of schools now have really done away with things like detentions and in-school suspensions and, you know, whatever it may be to really hold kids accountable.

4:19And we see kids emotionally checking out and having more behaviors because they know that it's really a free-for-all and there's little to no consequences within the school environment. And just like we've touched on already in this episode, that's what we're seeing in the home because parents are being fed such pseudoscience and misinformation about connection-seeking and the dangers of consequences. When Dr. Russell Barkley in all of the science tells us it's not the danger of consequences, it's the danger of not having any.

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Connection vs Consequences

5:59Anybody listening to this are well-connected to their kids. So the issue with your kids is not a lack of connection at all. So we just want to make that really clear because I think, Mike, one of the things that we've heard is, you know, when parents get these messages, you just need to connect more or your child's disconnected. That's why they're acting this way. It makes a lot of parents feel like you're doing something wrong. And this has nothing to do with connection. So some other research we want to point out, such as a study from Doffer and colleagues in 2023, found that structured behavioral parent training, which includes consistent consequences and reinforcement, leads to sustained improvement in child behavior.

6:38So I just want to give an example of that. So part of my parent training is a course called Creating Daily Expectations. And in that course, what happens is parents learn how to put in expectations for helping around the house, cooperation and behavior, and in order for the child to earn what I call their currency or the privileges that the parents provide for them. And this, you know, this statement right here is really a reflection of that because the consequence, if you don't do what you need to do or treat your family member with respect, is that you're not earning your currency.

7:09You know, and the other thing that I teach and, you know, both Mike and I feel strongly about is what I call purposeful recognition and praise, that we have to give kids a lot of specific, clear praise for things like effort, resiliency, flexibility, and thinking about the needs of others. So another study from 2023 was a meta-analysis of randomized controlled trials. Let me do that over. Another study from 2023 found that consistent improvements in child behavior and parenting outcomes when consequence-based and reinforcement-based strategies were used.

7:46So our point is to say, you know, we're not just making this up. There is many years of research data supporting this. This is nothing new at all. It's just something that we felt we really want to be clear about. The other thing we want to mention is that if you would like to see the research citations that we bring up in this episode, you can find it in the show notes. Exactly, and if there's two things we need to highlight from those two sources of references that Ryan just mentioned, it's number one. The first one says leads to sustained improvements, and the second one was found consistent improvements, and that right there should be music to every single parent's ear of sustained improvements, improvements that transferred into the natural environment and were seen over time.

8:28None of this nonsense with time management organizations, folders, and messy backpacks kind of stuff, things that work for two weeks and fall apart, or measuring progress in the controlled environment of the session with the therapist that doesn't transfer into the home. This is exactly what every single ADHD parent is looking for, sustained improvement and consistent improvements when consequences were being used. Things that actually showed true internal skill building, which is what all this work is all about and what my book describes.

9:01And what Ryan mentioned earlier, all this nonsense about connection-seeking and guilt-tripping parents, you know, we have to be honest. If anything, the parents of today are connecting too much. They're doing too much work. They're getting too involved in the morning routine, homework, evening routine, their social life, all of those different things. Parents aren't living their own life anymore. They're living their kids' lives. So who are these parenting influencers on social media telling you that you need to connect more, when in reality, you're doing too much? So what parents are constantly hearing is that kids just need connection and co-regulation, and that's what's going to teach them skills and stop the behavior and stop what's creating all of this parenting burnout.

9:44Because parents are continually told, if your child feels safe and connected, these behaviors are going to improve. And many parents already have these close, affectionate relationships, but they still see defiance, argumentative behaviors, verbal aggression, and all of those different things. We understand as parents, all of us, connection certainly helps, but it's not teaching skills, and it is definitely not preventing those behaviors from continually happening.

10:17We've said this in many other episodes, but we're going to say it again. What decades of research has shown is that an authoritative parenting approach, not authoritarian and not permissive, is the most effective parenting approach for positive mental health outcomes in all kids. So, for instance, a study in 2017 from Pinkwart found that the most effective parenting combines warmth with structure. That is authoritative parenting. And one of the things we should mention is that warmth alone was not associated with the same improvements in behavior.

10:50So that line is really important right there. Just being loving and empathetic and compassionate, you know, that's not going to help behavior improve. And I know there's so much messaging, Mike, going out there right now about that, you know, that, right, your child doesn't need discipline. They don't need, you know, correction. They just need you to, like, you know, be compassionate and empathetic. And then magically their behavior will improve. And that's just not what the research supports. One other study, a 2014 treatment review, and then some research in 2021 by Dr. Maggie Sibley,

11:22showed that improvements in behavior come from structured interventions that include reinforcement and consistent responses, not from relationship factors alone. Exactly. A child can feel very connected to you and still struggle significantly with how they respond when they don't get their way. And that is so especially true to ADHD kids and teens, who we know and we've discussed many times on this podcast, they get lots of dopamine and stimulation from negative attention-seeking and negative behaviors.

11:56That's another thing that has really been shunned on social media is replacing all negative attention-seeking behaviors with connection-seeking behaviors. But as we know with ADHD kids, with the way their brain works, it is, it truly is negative attention-seeking. You know, just like with screens, they're going to get dopamine and stimulation from arguing, negotiating, complaining, all these different things that create these levels of conflict. So there truly is negative attention-seeking when it comes to ADHD.

12:30ADHD, and parents will see it when kids don't get their way, and it's not a question of your connection to them. So another thing that we're seeing a lot is this idea that kids don't need consequences. They just need emotional validation and to process their feelings. One of the things, like I always say, is, you know, sometime in the, I think, probably the mid-90s, the child psychology field started teaching parents to play armchair therapist, meaning they put parents, they taught parents, yeah, you want to be in this role of constantly talking about feelings

13:00and processing your child's feelings and coming up with these hypothetical narratives about why your child behaves the way they do. And, you know, a common experience is that, you know, a kid can explain what happened, they can describe their feelings, they can articulate them, but the behavior continues. So another thing, like, you know, I, a lot of times when, you know, parents tell me that, you know, their child is in therapy and I say, well, what are, what are they working on in therapy before I hit them with the fact, right, that therapy is not an evidence-based treatment for kids with ADHD. And often what I get is, you know, they're working on, you know, identifying feelings.

13:33I say, okay, so how is that supposed to help modify their behavior if the therapist is doing this in an office with them, you know, because there's no evidence to support that. So to that point, you know, Dr. Barkley has described, as we said, ADHD as a performance problem, not a knowledge problem, including in his 2015 book on executive functioning, meaning kids often know what to do but struggle to do it in the moment. And by the way, that's part of the reason why therapy is not effective for kids, because they can be taught something, but the application of it in the moment does not happen,

14:07which is why he says we have to teach kids at the point of performance, meaning in school, you know, in the home. Another study, a treatment study summarized by Evans and colleagues in 2014, show that behavior change comes from practice, reinforcement, and feedback, not from insight alone. So kids' behavior doesn't change from just developing insight, right? It comes from having that practice, that reinforcement that we provide them through scaffolding, and direct feedback that is, you know, done in a way that is, you know, both respectful and empathetic,

14:41but honest with them. And Mike, that is one of my biggest things I teach parents is, you know, to not use what I call fluffy language with kids, you know, so, you know, don't use language saying things like, you know, use safe hands, right? Say, tell them what to do and what not to do. And I have to credit the nurtured heart approach for teaching me this, because kids with ADHD, Mike, as you know very well, need very clear and very specific language. They don't do well with things in the abstract. They don't do well with things that are vague. And we'll actually talk about that in the next episode. But the one takeaway I want you to have, you know, from this is being able to talk about feelings

15:15is not the same as being able to self-regulate and manage behavior in the moment. That's exactly it. And that takes us back to what Ryan was saying about therapy is, you know, so many parents need to ask themselves, you know, do I have my child in therapy for them to gain skills or for me as the parent to be able to sort of check that box and allow me to feel better? It makes me as the parent feel good knowing they're in therapy. But how are we really teaching them how to manage their behavior in the moment? And that is done, as Dr. Russell Barkley describes,

15:47through direct consequences. He actually talks about how ADHD kids need more consequences than neurotypical kids, more consistent, more apparent, and more in the moment. Because, you know, just like Ryan said earlier, oh, they're learning how to identify their emotions. Many kids with ADHD are very good at identifying their emotions. You know, this is not a question of intelligence. Many of these kids do very, very well with their IQ and their intelligence. It's a matter of performance. So they can identify all they want. But when it comes in the moment, it's a self-regulation deficit disorder.

16:24The identity is only just semantics. Now it's a matter of in the moment, am I able to actually regulate this so that my emotions don't negatively impact others, most notably my parents? Another common reason why we're hearing why kids and teens don't need consequences or shouldn't receive consequences is because of the rise of all these different labels and narratives, such as masking, rejection-sensitive dysphoria, pathological demand avoidance, or all this very vague nervous system

16:56disorder. We hear a lot about the nervous system because it's very catchy and vague and very easy to get a lot of likes and shares when it's something that's not very specific or measurable kind of thing. So parents are opening social media and they're hearing about this concept of masking, about how the child goes to school all day and they literally have to be so self-aware and be able to hold in all of their ADHD behaviors all day long at school. And by the time they get home,

17:26they're just so exhausted from masking all day long. When they get home, it doesn't make sense for you to give them consequences for the behaviors they show at home in the unstructured environment towards those unconditional love relationships of parents because they're just so exhausted from masking. So no consequences at home because of how well they did at school, but really they only did well at school because they were masking. So you're going to have to let the behaviors at home slide. That's a common thing we see all the time. The next is rejection-sensitive dysphoria,

17:59which in many ways has been labeled on social media as this separate diagnosis. And I've had many parents reach out to me and say, my child has ADHD, but he really just has rejection-sensitive dysphoria. That's his true, that's his true label. That's his true diagnosis. All rejection-sensitive dysphoria really is, is highlighting that self-regulation of emotions is really the primary aspect of ADHD. ADHD is an emotion management self-regulation disorder. And that involves,

18:31you know, the feeling of rejection and having some, some issues with that. It's not a separate diagnosis. It's an emotion disorder. Uh, so this concept of rejection-sensitive dysphoria is not an excuse to not receive, uh, consequences at home because at the end of the day, ADHD is the primary diagnosis. And as Dr. Russell Barkley, the research, the data tells us when it comes to ADHD, we need more consistent consequences. Then we talk all the time about PDA, how it is not in the DSM, how there's

19:04so much, uh, pseudoscience out there about having to, uh, not placing demands on students because they have PDA, uh, and having to treat them in a very low demand parenting style because of the pathological demand avoidance. There's a lot of very harmful information about that online that Ryan and I speak about a lot, uh, that a lot of parents are kind of falling into that rabbit hole because of how, uh, relatable that information can be, especially to the burnt out, exhausted parent. But parents need to be very, very careful. And that goes right along with this nervous system

19:38disorder where all the influencers are doing is just using this very vague language of the nervous system, the nervous system, the nervous system, because it's, it's something that can't really be seen or identified. And it allows the parents to say, I can't give consequences because it's really an internal nervous system disorder. And, and these become explanations for the behaviors. And we totally understand why parents want clarity. They want an explanation, explanation. They want their feelings to be

20:12validated. They want to feel heard, but it's not leading to solutions. Mike, one of the things I want to mention is when I do, um, office hours for membership site members, you know, one of the things parents will, you know, write is they'll say, you know, well, you know, my child was masking all day at school. So that's why she comes home and like hits me. And I have to say to them, no, that's not why she's hitting you. She's hitting you because you haven't established a boundary yet, that it is not an okay behavior. And because there are no expectations for, you know, how we should treat family members. So her hitting you has nothing to do with masking at all. Correct. No, the other thing I'll hear is, you know, you know,

20:45my, right. My son is emotionally reactive because he has RSD. And I explained, you know, that is a label to describe a behavior as Mike just so beautifully articulated that has to do with self-regulation. If you're emotionally reactive to something because you feel rejected or feel embarrassed, that has to do with, with self-regulation. That is not a standalone diagnosis, you know, in any way. And, and again, right. We understand why these labels are so emotionally compelling because they may help people make sense of things. They tell a narrative that makes things clear and it makes people feel like, Oh, it's not me doing something wrong. You know, it's my child's,

21:19you know, label here, but what that's really doing at the end of the day, it's pathologizing kids. It's saying, here's something else that's wrong with my child. And there's just no evidence to support that. So to that point, wanted to mention, uh, the same study I mentioned before by Evans and colleagues in 2014, which was a large treatment review, consistently focus on observable behavior, reinforcement and skill development, not on explanatory labels like these. And some more recent work, um, from 2020 that Dr. Barkley was involved in, uh, continues to emphasize executive

21:52functioning and measurable behavior as the targets of intervention, not using labels to construct narratives. Yeah. So, so, so for all the parents out there, there's, there's an old saying of, you know, do you want help or do you want a hug? And that's really, you know, what's happening here in terms of social media and this feel good information, giving parents an explanation, but it does not give you a strategy that changes what's happening day to day. And when we talk about consequences, you know, we're not talking about consequences as a punishment saying, right, you did something bad. Now you're going to like pay your time. We're talking about

22:26consequences that are used constructively. Okay. And having an explanation such as this narrative or one of these labels, you know, it doesn't give you that strategy and it doesn't help your child learn anything. And that's the most important point here. Yeah. So, so overall, what we have to look at here is what actually helps versus what keeps parents stuck. The pattern that we continually see is parents constantly explaining the behavior, explaining to the child, but lots of words, which really goes against another huge aspect of Dr. Russell Barkley's teachings of use less

23:00language, act, don't yak, lectures don't work. So all the constant of trying to explain to your child how his brain works is not going to change their behavior. Focusing on emotional experiences with the child and trying to reduce pressure from them. You know, this is what we're seeing at schools by really over accommodating kids and decreasing consequences, not leading to them enjoying school more, caring more about their grades, caring more about homework, because the more the

23:32consequences are, the more the accountability is there. That's what helps. But we have gone in the

Effective Parenting Approaches for ADHD

23:37opposite direction. So we're focused so much on the short term of feeling better, but long term, the behavior is persistent. So when we look at the research about what actually helps versus what keeps parents stuck, we can look at some research by Lumen and colleagues in 2010, and then some more recent work by Tripp and Wickens in 2020, that showed that kids with ADHD are especially responsive to immediate and predictable feedback, which is exactly what we're talking about. That could be purposeful recognition and praise, or it can be a consequence for their behavior. And that can come in

24:10the form of, you know, not meeting expectations like what I teach, you know, or sometimes the consequence has to be because, you know, they did something hurtful to somebody else. The other thing we want to mention is that, you know, some more recent reviews from Dr. Sibley in 2021 showed that structured, consistent behavioral approaches produce the strongest improvements over time. So again, everything we're saying here is not new. It's well supported by research going back a long time. And we just wanted to put it in a format to help everyone understand why consequences are not a bad

24:42thing, right? Consequences are a necessity, not something that maybe you should do. They are a necessity for kids with ADHD to learn. Absolutely. So really what we're looking at here is reducing expectations may help in the moment, but over time, the skills are not developing and avoidance increases. And as Ryan and I have seen over all the years, the ADHD problems and the parenting burnout is going to continue to snowball into a much bigger problem. So at the end of the day, what we want you to take

25:12away from this is kids with ADHD don't need fewer consequences. They need clearer and more consistent consequences. And along with that, they need a lot of purposeful recognition and praise as well. Exactly. So what we're really hoping here is that parents are able to listen to this episode and have some more confidence stepping into their parental authority and instilling consequences because they know they're doing the right thing based on science and research. There are far too many ADHD kids that are blatantly saying no to their parents or ignoring prompts, not doing the right

25:46thing, sometimes being very verbally abusive or, you know, really having some significant behaviors in the home. And then a minute after having that behavior, they're right back on their phone. They're right back on Fortnite, Roblox, Minecraft, or doing these privileges because we still continue to convince ourselves that those are social things that are rights instead of privileges. And if your child's able to have big behaviors in the home or at school without consequences, and they're able to go right

26:18back on the internet, right back onto screens after having these behaviors, that is very clearly classical conditioning teaching the brain that it's okay to do those things. And I can do those things with no consequences and escape immediately back into the virtual world. Mike, one last point I wanted to make is, you know, I have a saying I teach parents that kids need to be held accountable by other people besides their parents. So for instance, a question I get a lot is, you know, my child is constantly late for school. What can I do about that? And I always ask them, what is school doing about it? And mostly at times today, what I get is nothing. And I tell them,

26:52I say, ask the school to hold them accountable. Tell the principal or assistant principal, if my child is late, please pull them into your office and confront them about it. Because if they don't do that, they're not learning anything from it because there's no natural consequence. It is uncomfortable to have to speak to your principal, your assistant principal about why you're late, right? That is a natural consequence right there that is so important. And you know what? Often when parents do this, things improve because the kid doesn't want to have to go talk to the principal again because that's uncomfortable. And it's so hard for parents to hold their ADHD child or teen accountable for a school-based issue.

27:27You know, if they're not doing their homework, if they're not studying, if they're late to school, all of those different things, how are you as the parent? Your ADHD child is very black and white and rigid. They're never going to see mom as a school employee or school staff. How are you going to hold your child accountable for being late? Being late to school is not a home-based problem. It's a school-based problem. So it's not about accommodating them. It's about increasing consequences. Maybe if they're late to school in the morning, they have to stay after for detention

27:58after school. Maybe they have to stay in for lunch detention. You know, maybe they have to go into the main office, sign in, and explain why they were late. Maybe they need to have the feeling of walking into class late after class has already started. Those negative experiences is what's going to build the motivation and the regulation the next morning to actually get things done on time. All right, everyone. So thank you so much for listening to this episode. We hope you found it helpful. If you would like to see the research that we cited in this episode, please go to the show notes and you'll find it there. And we will talk to you soon. Take care.

28:30Take care. Thanks for listening. To learn more about Mike's practice, Grow Now ADHD, please visit his website, grownowadhd.com. To learn about the services Ryan provides, please visit adhddude.com. You can find Mike on Instagram at grownowadhd and Ryan on the ADHD Dude YouTube channel. We'd love to hear your feedback or questions. So feel free to contact us at the ADHD Parenting Podcast at gmail.com. The ADHD Parenting Podcast and content posted by Grow Now ADHD or ADHD Dude are presented solely for

29:07general information and educational purposes. Our goal is to provide valuable insights and knowledge, not to replace professional services. Mike and Ryan cannot provide clinical consultation or free advice through social media or other forms of communication. The information on this podcast is not a substitute for professional advice. If you or your child have any medical or mental health concerns, please consult your healthcare professionals.