A Behavioral Approach to ADHD and Attention Span

A Behavioral Approach to ADHD and Attention Span

School administrators and parents often call on Joe Newman for help with so-called difficult children. But what Newman wants to make clear is that no child is ever too difficult—that’s because he was also deemed a problem child growing up. Then he was diagnosed with ADHD and put on medication, but he found that it only marginally helped him. What eventually helped Newman as an adult was flipping the negative narrative into a more positive script. And he wanted to work with kids who were just like him, kids who had been written off and perhaps overmedicated—kids who were not living up to their fullest potential.

In his book, Raising Lions, Newman lays out his compassionate, systems-based approach that builds on strengths, not weaknesses, and encourages children to be what he calls “lions”—strong-willed, confident, self-assured. But to raise lions, says Newman, adults need to parent like lions. Without firm boundaries, those willful children can develop behaviors that become diagnosed as attention disorders. As he explains, his method for developing children’s attention span is relatively straightforward. Much of the work begins by setting clear expectations that help children build and strengthen these mental muscles on their own—because every kid, he says, has the capacity to do so with the right set of tools.

A Q&A with Joe Newman

There seems to be a continual rise in the number of children diagnosed with ADHD. What do you think is causing this?

A broad cultural shift is taking place. There are increasingly more activities that hold our attention and direct and organize us, and fewer activities that require us to do these things on our own. Children are required to self-regulate, hold, and direct their own attention less and less. Some overarching reasons include:

Children do fewer chores and less work around the house.

Children have less free time to create, manage, and organize their own play.

Interactions between children are increasingly organized and managed by adults.

Children are more willful, and parents and teachers are less successful in getting them to do activities that would strengthen their ability to focus and defer gratification.

We’re allowing technology to direct and organize more of our children’s activities.

If there’s one primary explanation for the rise in disorders associated with attention, impulse control, and self-regulation, it’s that children exercise these mental muscles less and less. While there is a genetic component to ADHD, that genetic predisposition is exacerbated or mitigated by experience. Imagine a child who is genetically an eight on a scale of one to ten (ten being extremely ADHD). Picture them raised in a home where the parents don’t enforce any boundaries. This child doesn’t practice attending to anything that’s not highly stimulating and is not exercising deferred gratification, self-regulation, or impulse control. When this kid goes to school, they’re going to look like a ten, and everyone will think they’re disordered and want to medicate them.

Now, take the same child and imagine they’re raised in a home where the parents have the tools to hold boundaries, motivate attention, defer gratification, and teach the child to exercise self-regulation and impulse control. This child will go to school and look like a six, and people will think they’re precocious but just fine.

Your work focuses on understanding children’s behavior as shaped by adult interaction and less on brain neurology. What’s the relationship between behavior and attention span?

They’re inseparable. If you can’t enforce behavior boundaries, then you can’t get children to do things that build attention and delay gratification. Having your child stop and sit quietly for a minute exercises attention span and the muscles of self-regulation. If you can’t get your child to stop and sit quietly for a minute, that’s a behavior problem. You have to solve the behavior problem before you can get your child to do the activities that build attention.

Asking your child to put away their toys before they can move on to another activity requires that they exercise deferred gratification, attention, and self-regulation. If your child gets upset and insists you help them and you relent and end up doing 75 percent of the work, they’ve just avoided strengthening 75 percent of these important neural pathways. Doing chores develops executive function. But when you ask parents why they don’t make their children do chores, they’ll often tell you, “It’s easier to do it myself than to get them to do it.” These are behavior problems, and when repeated day after day, they slow the development of executive function.

Our brains are neuroplastic, meaning they are highly changeable. Each time we do an activity, we strengthen the neural pathway that was used during that activity. If a child has a tantrum every time you give them a regular cup instead of their sippy cup, and you give up and wait a year until they decide they want the regular cup, they’ve just missed a year’s worth of development of those neural pathways of balance, attention, and focus that are required to master that skill.

While it’s difficult to watch your child experience discomfort, boredom, or frustration, keep in mind that solving problems will always require them to endure unpleasantness in order to accomplish goals, to work well with others, and even to love and be loved. As your child looks up at you, learning that they must finish this to get to that, remind yourself that they are building a muscle that they will need to live in the world they’ll inherit.

You write in your book, “Our children are fine. It’s us who have to change.” So how and when should a parent address attention issues? How do we decide between problematic and acceptable behaviors?

Our expectations for attention deficit children are entirely too low, and I say that as someone who has struggled with attention all my life. The problem with high expectations comes only when we pair them with judgment, anger, and disrespect. When we use a compassionate, nonjudgmental tone to communicate what we need, we can act as a coach to help our kids be their best. Wondering whether our kids are capable of more and reworking the motivators so they challenge their difficulties will help us determine what requires understanding and what requires boundaries.

My approach is rooted in an experimental rather than diagnostic outlook on children. It’s optimistic, not pessimistic. Say there’s a girl who is never able to focus during homework time unless her mother is at the table helping. Mom is frustrated because it’s like pulling teeth, and she ends up doing half the work. We don’t know what this girl is capable of until we test whether or not she can adjust her behavior when she has the motivation to do so.

This mom could set up the following motivator: If she thinks the work could be done in about twenty minutes, she might ask her to sit quietly with her work at the kitchen table for forty minutes before she can go do something fun. The earlier she finishes, the quicker she gets to the thing she wants. I would encourage the mother to step out of the dynamic and see what her daughter is capable of on her own. Experiment with your kids, be a scientist about behavior, and see what behaviors you thought were set in stone end up changing when they are met with consistent, nonjudgmental consequences.

A note on flexibility: I’ve always been a person who likes to move while I work, so I tend to be pretty flexible when I see this in children. Children have different learning styles: Some need stillness and quiet to focus; others need to move and make some noise. Standing behind your chair and dancing to a song in your head while you lean on your desk and do your math might not look normal, but if the math is getting done, I’m good with it. In addition to being flexible with our kids, we also want to raise kids who have flexibility with others. We do this by having and expressing our needs. There’s no such thing as one-size-fits-all fair needs and unfair needs. One parent may need their children to learn how to help prepare dinner, while another parent might want their children to spend time having family conversations or doing other family activities.

The idea that rules and schedules need to be perfectly consistent from person to person and from day to day should be abandoned—this is not how the world works, and we’re preparing our children for the world. One day your friend’s mother has died, and you need to comfort her instead of going on the planned trip to the park after school. Your husband likes it when your son tackles him the moment he walks in the door, but you need a minute to take a breath and put your things down. Everyone is different, and things don’t always go according to plan. These are life lessons that naturally happen when children learn to adjust to the needs of those closest to them, their family. Attending to the needs of others is an opportunity to practice attention.

What’s your personal experience with ADHD? How did you cope with your attention problems?

During my grade school years, no one had much success getting me to focus on anything I wasn’t interested in. I was always in trouble of one kind or another, and I felt misunderstood from a very early age. This was the reason I began working with children with behavior problems. In my late twenties, after years of struggle, I realized I was not broken, and I wanted to go back to help children who were like me.

It was only after I started working with children that I got serious about developing my ability to concentrate and complete tasks. I moved into a studio apartment without a TV or a computer. I wanted to learn to read nonfiction books, but I knew that as long as technology was around, I’d be distracted by it. I created a space where there was nothing else to do, and I started reading. I’d read three pages of linguistics, get distracted, put it down, and read two pages of mathematics, then four pages of educational theory, then a few pages of psychology, etc. I’d do this for three or four hours every evening: pick up a book, read as long as I could, then pick up another. I would read twenty or twenty-five books at a time. Gradually, I noticed I was reading eight or ten pages at a time, and by the end of two years, I was reading entire chapters before getting distracted.

When it came time to finish college, I chose Antioch University because I wanted to develop my writing ability. Between 1981 and 1997, I dropped out of college six times, so this was my seventh attempt. At Antioch there were no tests; instead they required you to write about what you were reading and learning. Short papers needed to be written and turned in several times a week.

In both of these examples, I put myself in situations where I was motivated and more likely to succeed. Then I did the kinds of work and practiced the kinds of attention I needed to develop. And both experiences show the neuroplasticity of the brain: By reading and writing over and over again, I was strengthening the neural pathways that gradually improved my attention and strengthened the areas that were holding me back.

What are some practical steps that parents can take to help develop their children’s attention span?

It all starts with setting boundaries and getting reciprocity. Start by using simple behavior tools, like breaks and this-before-that, to make sure your needs are taken seriously.

Breaks. Children should learn how to stop, sit quietly for a minute, and calm themselves when they’ve ignored or chosen not to recognize your needs.

This-before-that. Create some rules about the nonpreferred things that must be finished before preferred things are allowed. Room is cleaned before going outside. Homework time is finished before iPad time. Dishes are put in the dishwasher before the TV goes on.

Create time when children must entertain themselves without technology. This can include outside activities, sports, playing with friends, learning a new card game, helping prepare meals, art, crafts, and building. Your children should know how to play by themselves and tolerate, maybe even enjoy, boredom and daydreaming.

Homework. Have a set amount of time each day when children sit and do homework. This should be in a public place in the home with nothing but their homework—no TV, iPad, laptop, or phone. Require them to complete this time before they are free to do preferred activities. This creates a holding environment that is free of distraction, has a natural motivator, and encourages self-organization.

Chores and work. While it can be difficult to get children to do chores, becoming proficient at chores and helping around the house can be a great source of pride and confidence for them. You can teach children to help with shopping, cooking, cleaning, and putting away groceries. (“When you’ve finished putting the groceries away, you can play with your Legos.”)

Help them find healthy interests. I loved the camping and crafts of Cub Scouts and Boy Scouts, and my daughter was enthusiastic about her high school theater department. When your child shows an interest in something, try to create a space where they can explore that interest autonomously.

Set clear time limits on your child’s use of technology. Have a set amount of time on technology for weekdays and weekends. This time should begin only when other nonpreferred activities are finished.

Don’t moralize about behavior. Give it consequences, frustrate it, but never judge or moralize. When you moralize with your children, they will fight against you even if it’s against their self-interest.

What is your position on medication for attention problems?

I was medicated for ADHD from age seven to fourteen, and I don’t have any resentment toward my parents about that. Medication allowed me to survive school in a way I likely wouldn’t have otherwise. Having said that, my goal is to give parents tools that my parents didn’t have, tools to increase their children’s attention span and ability to self-regulate in order to reduce the need to medicate.

If you’re concerned your child might be ADD or ADHD, use a behavior strategy first to see how things change. If your child is already on medication for attention problems, use a behavior strategy to improve their ability to pay attention, defer gratification, and self-regulate. If things improve, talk to your doctor about the medication. And talk to your children about the medication. Help them become aware of the difference in their thinking on and off of the meds.

I have a problem prescribing attention medication before seeing what happens when parents are given effective tools to enforce boundaries and activities that might change, or solve, the problem. Diagnosing and medicating a child for attention problems before addressing behavior is like painting a portrait of someone wearing a mask—you’re not getting the full picture.

We live in a culture that teaches us to pathologize our children, ourselves, and others. In the past, we’d say a child with a behavior problem was bad; now we think it’s kinder to call them disordered. I don’t think it is. A disorder is permanent; if I’m bad, at least I have the ability to change. But whether you call a child bad or disordered, you’re still looking at the child in complete isolation, as if our interactions with them and their relationships with the world had nothing to do with their behavior.

Joe Newman, MAOM, developed the Raising Lions Method to engage children deemed too difficult to control. Today he trains and consults parents, teachers, and school administrators to raise and teach healthy, respectful children. He lives in Santa Monica, California.

This article is for informational purposes only, even if and to the extent that it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this article are the views of the expert and do not necessarily represent the views of goop.