ADHD and Siblings

Remember the bird mobile above the baby's crib? When there's more than one child in the family, children with ADHD will affect the behaviors of siblings. The behaviors that annoy teachers and classmates – interrupting, blurting out, losing items, and others – also will annoy brothers and sisters, but to a much greater degree because they have to live with them every day.

I recently had a parent tell me, "Where the child (with ADHD) goes, so goes the family." What he was saying was that the emotions and behaviors of that child dictated the emotions and direction of the entire family. When siblings react to the child with ADHD with resistance or anger, parents have to deal with the fighting that results.

A family came into my office because of sibling fighting. Mom was tired of the older brother constantly yelling at and pushing around his younger brother. After a few questions, it became clear why this was happening. The two boys shared a room and the younger brother had been diagnosed with ADHD. Little brother often took big brother's things and didn't put them back; sometimes those things got broken or lost. Big brother was fed up and was using force to stop it. It also didn't help that the older brother was tidy; he liked his things put away neatly and wanted a well-kept room – an impossible standard for the younger brother. The result was resentment, frustration, and a constant battle between the two brothers.

I told Mom I thought each boy needed his own space, and that one of the goals of therapy would be to help younger brother learn boundaries and respect for others' property.

Although it wasn't possible for each brother to have his own room, the family reorganized their room to give each one his personal space. We then worked with younger brother on maintaining respectful boundaries and worked with older brother on how to handle frustration and get help when needed.

The biggest problem when siblings become frustrated with their brother's or sister's behavior is that they don't have the emotional tools or maturity to respond in a helpful way.

That is why they resort to name-calling, put-downs, or even physical aggression to express their emotions. How can you restore peace in your house? Here are a few suggestions:

• Although the "squeaky wheel gets the grease," it is important that you give all of your children attention, not just the child with ADHD. This means watching for opportunities with all your children to give praise when they behave appropriately. I sat in a school classroom one day to observe a child who had been diagnosed with ADHD. The parents were complaining about the child's behavior at home, but the teacher said she didn't have much trouble with him. What I saw was a masterful teacher using subtle skills to influence this child's behaviors. When the child would begin acting out, the teacher would walk close by without looking at or talking to him. She would then praise another nearby child for his appropriate behavior. When the disruptive child became quiet and returned to his task, the teacher then gave him her attention and praised him for his appropriate behaviors. I left there thinking parents can easily do this at home: Praise the child who is behaving appropriately and ignore the child who isn't. When the negative behavior stops or the child makes an attempt to stop the misbehavior, make sure you give him or her praise for appropriate behavior. The child will soon learn that positive behaviors earn positive attention and praise and negative behaviors don't.
• Don't make your child with ADHD a scapegoat. You may be able to understand the frustrations of siblings, but always siding with them only alienates the child with ADHD. Help the siblings develop skills they can use anytime they are frustrated, not just when they are reacting to their brother or sister.
• At the same time, make sure all children know they are responsible only for their own behavior, not that of others. The child with ADHD is responsible for his behavior. The other children are responsible for their behavior. Respond to each one individually, based on his or her behavior. A sibling should not be allowed to respond to his brother's behavior with physical aggression just because the brother has ADHD!
• Look for opportunities to build self-esteem in the child with ADHD. When he's playing or otherwise getting along with his siblings, make sure you provide a lot of praise.