HELP FOR PARENTS WITH STRONG-WILLED, OUT-OF-CONTROL CHILDREN AND ADOLESCENTS

Education and Counseling for Individuals Affected by Oppositional Defiant Disorder and ADHD

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Pregnancy in Adolescence

Pregnancy in adolescence is often a crisis for a young lady and her family, as well as the child's dad and his family. Common reactions include anger, guilt and denial. Your adolescent might also experience anxiety, fear, shock and depression. Talk to your teenager about what she's feeling and the choices ahead. She needs your love, guidance and support now more than ever.

A pregnant adolescent (along with her mom and dad, the father of the child and his mom and dad) has a variety of options to consider:

• Terminate the pregnancy. Some pregnant adolescents choose to end their pregnancies. If your teenager is considering abortion, discuss the risks and the emotional consequences. Keep in mind that some states require parental notification for a legal abortion.

• Give the child up for adoption. Some pregnant adolescents choose to give their child up for adoption. If your teenager is considering adoption, help her explore the different types of adoption available. Also discuss the emotional impact of giving a child up for adoption.

• Keep the child. Many pregnant adolescents keep their child. Some marry the child's dad and raise the child together. Others rely on family support to raise the child. Finishing school and getting a good job can be difficult for an adolescent parent, however. If your teenager is thinking about keeping the child, make sure she understands the challenges and responsibilities involved. In addition to talking to you, encourage your teenager to talk about the options with her health care provider or a specialist in pregnancy counseling.

Pregnant adolescents and their children are at higher risk of health problems than are pregnant females who are older. The most common complications for pregnant adolescents (especially those younger than age 15 and those who don't receive prenatal care) include a low level of iron in the blood (i.e., anemia) and preterm labor. Some research suggests that pregnant adolescents might be more likely to develop high blood pressure as well. Children born to adolescent moms are more likely to be born prematurely and have a low birth weight. A pregnant adolescent can improve her chances of having a healthy boy or girl by taking good care of herself. 

If your teenager decides to continue the pregnancy, encourage her to do the following:

• Avoid dangerous chemicals. Alcohol, tobacco, marijuana and other illicit drugs are off-limits during pregnancy. Even moderate alcohol use during pregnancy can harm a developing child. Smoking increases the risk of premature birth, problems with the placenta and low birth weight — and drugs your adolescent takes can pass from her to her child, sometimes with devastating effects. Even prescription and over-the-counter medications deserve caution. Remind your teenager to clear any medications or supplements with her health care provider ahead of time.

• Maintain a healthy diet. During pregnancy, your teenager will need more folic acid, calcium, iron, protein and other essential nutrients. A daily prenatal vitamin can help fill any gaps. In addition, your teenager might need extra calcium and phosphorus because her own bones are still growing.

• Gain weight sensibly. Gaining the right amount of weight can support the child's health — and make it easier for your adolescent to lose the extra pounds after delivery. A weight gain of 25 to 35 pounds is often recommended for females who have a healthy weight before pregnancy. Pregnant adolescents may need to gain more weight. Encourage your teenager to work with her health care provider to determine what's right for her.

• Get tested for infections. Sexually transmitted infections (e.g., gonorrhea, Chlamydia, syphilis) can increase the risk of miscarriage, premature birth, low birth weight, birth defects and other pregnancy complications. If your adolescent has a sexually transmitted infection, treatment is critical.

• Get prenatal care. During pregnancy, regular prenatal visits can help your teenager's health care provider monitor her health and the child's health.

• Exercise. Regular physical activity can help ease or even prevent discomfort, boost your adolescent's energy level and improve her overall health. It also can help her prepare for labor and childbirth by increasing her stamina and muscle strength. Encourage your teenager to get her health care provider's permission before starting or continuing an exercise program, especially if she has an underlying medical condition.

• Take child birth classes. These classes can help prepare your teenager for pregnancy, child birth, breast-feeding and being a parent. If your teenager lacks the finances or transportation needed to obtain prenatal care — or needs help continuing her education — a counselor or social worker might be able to help.

Pregnancy in adolescence often has a negative impact on an adolescent's future. Adolescent moms are less likely to graduate from high school and to attend college, are more likely to live in poverty, and are at risk of domestic violence. Adolescent dads tend to finish fewer years of school than do older dads. They're also less likely to earn a livable wage and hold a steady job. In addition, kids of adolescent mothers and fathers are more likely to have health and cognitive conditions and are more likely to be neglected or abused. Females born to adolescent moms and dads are more likely to experience teen pregnancy themselves.

If your teenager decides to continue the pregnancy, address these challenges head-on. Discuss her goals for the future and how she might go about achieving them as a mother. Look for special programs available to help pregnant adolescents remain in school or complete course work from home. Encourage your teenager to take parenting classes, and help her prepare to financially support and raise a youngster. Whatever choice your teenager makes, be there for her as much as possible. Your love and support will help her deal with pregnancy and the challenges ahead.

Dealing with Difficult Teen Behavior: 40 Tips for Parents

Helping a teenager become a caring, independent and responsible grown-up is no small task. The teenage years can be a confusing “time of change” for adolescents and moms and dads alike. But while these years can be tough, there's plenty you can do to nurture your adolescent and encourage responsible behavior.

Use the following parenting skills to deal with the challenges of raising an adolescent:

1. As you allow your adolescent some degree of self-expression, remember that you can still maintain high expectations for your adolescent and the kind of person he or she will become.

2. As your adolescent demonstrates more responsibility, grant him or her more freedom. If your adolescent shows poor judgment, impose more restrictions.

3. Avoid disciplining your adolescent when you're angry.

4. Avoid reprimanding your adolescent in front of his or her friends.

5. Avoid setting rules your adolescent can't possibly follow. A chronically messy adolescent may not be able to maintain a spotless bedroom overnight.

6. Avoid ultimatums. Your adolescent may view an ultimatum as condescending and interpret it as a challenge.

7. Avoid using a sarcastic, demeaning or disrespectful tone.

8. Be consistent when you enforce limits. Whatever disciplinary technique you choose, relate the consequences to the broken rule and deliver them immediately.

9. Be prepared to explain your decisions. Your adolescent may be more likely to comply with a rule when he or she understands its purpose.

10. Be specific. Rather than telling your adolescent not to stay out late, set a specific curfew.

11. Before negotiating with your adolescent, consider how far you're willing to bend. Don't negotiate when it comes to restrictions imposed for your adolescent's safety (e.g., substance abuse, sexual activity, reckless driving, etc.).

12. Don't impose penalties you're not prepared to carry out.

13. Don't pressure your adolescent to be like you were or wish you had been at his or her age.

14. Encourage your adolescent to talk to other supportive adults (e.g., uncle, older cousin) for additional guidance.

15. Enforcing consequences can be tough — but your adolescent needs you to be his or her parent, not a pal. Being too lenient may send the message that you don't take your adolescent's behavior seriously, while being too harsh can cause resentment.

16. Focus on what you want your teenager to learn from a particular consequence - not whether or not he or she going to care.

17. Get to know the technology your adolescent is using and the websites he or she visits. If possible, keep the computer in a common area in your home. Remind your adolescent to practice basic safety rules (e.g., talk to a parent or trusted adult if an interaction or message makes you uncomfortable, don't text or chat on the phone while driving, don't share personal information online, don't share passwords, don't send anything in a message you wouldn't say face to face, don't plagiarize, don't get together with someone you meet online, and so on).

18. Give your adolescent some leeway when it comes to clothing and hairstyles. It's natural for adolescents to rebel and express themselves in ways that differ from their moms and dads.

19. Have plenty of time-outs (i.e., time away from your difficult teenager).

20. If your adolescent doesn't seem interested in bonding, keep trying.

21. If your adolescent shows an interest in body art (e.g., tattoos, piercings), make sure he or she understands the health risks (e.g., skin infections, allergic reactions, hepatitis B and C). Also, talk about potential permanence or scarring.

22. Keep in mind that only reprimanding your adolescent and never giving him or her any justified praise can prove demoralizing. For every time you discipline or correct your adolescent, try to compliment him or her twice.

23. Keep your rules short and to the point.

24. Limit consequences to a few hours or days to make them most effective.

25. Listen to your adolescent when he or she talks.

26. Make sure you reprimand your adolescent's behavior, not the adolescent.

27. Make sure your adolescent knows early on that you won't tolerate tobacco, alcohol or other drug use.

28. Not sure if you're setting reasonable limits? Talk to your adolescent, other moms and dads and your adolescent's doctor. Whenever possible, give your adolescent a say in establishing the rules he or she is expected to follow.

29. On days when you're having trouble connecting with your adolescent, consider each doing your own thing in the same space. Being near each other could lead to the start of a conversation.

30. One of the most important parenting skills needed for raising healthy adolescents involves positive attention.

31. Punish only the guilty party, not other family members.

32. Put house-rules in writing. Use this technique to counter a selective memory.

33. Regularly eating meals together may be a good way to stay connected to your adolescent. Better yet, invite your adolescent to prepare the meal with you.

34. Remember, adolescents learn how to behave by watching their moms and dads. Your actions generally speak louder than your words. Set a positive example and your adolescent will likely follow your lead.

35. Respect your adolescent's feelings.

36. Spend time with your adolescent to remind him or her that you care.

37. To encourage your adolescent to behave well, identify what constitutes acceptable and unacceptable behavior at home, at school and elsewhere. As you establish appropriate rules, be sure to explain to your adolescent the behavior you expect as well as the consequences for complying and disobeying.

38. Use “active ignoring.” Tell your adolescent that you'll talk to him or her when the whining, sulking or yelling stops. Ignore your adolescent in the meantime.

39. When a consequence needs to be issued for misbehavior, ask the adolescent to suggest one. Your adolescent may have an easier time accepting a consequence if he or she played a role in deciding it.

40. While it's important to consistently enforce your rules, you can occasionally make exceptions when it comes to matters such as homework habits, TV watching and bedtime. Prioritizing rules will give you and your adolescent a chance to practice negotiating and compromising.

My Out-of-Control Teen: Help for Parents

Creating An Effective Behavioral Agreement With Your Teen

Having problems getting through to your defiant adolescent about needed behavior changes? A behavioral agreement may be the way to go. Behavioral agreements are contracts between parent and youngster intended to produce desired outcomes. It may be higher grades, doing more chores, developing a better attitude, or making new friends. Regardless, the process to create a behavioral agreement is the same.

All moms and dads have a wish list for their kids. College preparation may be on the list. Doing more work around the house, or at least keep their bedroom clean makes most lists. Improved attitudes and more respect for moms and dads and other adult authority figures can be big. Pick the changes and plan an agreement that will lead to what you want.

Points to consider before drafting a behavioral agreement:

1. You are unlikely to turn an extremely poor student into the class academic leader with one quick agreement. Pick your battles and put them in writing. Avoid making the agreement sound like an ultimatum if possible. This is a contract reached by something resembling mutual consent. If both of you do not agree on it, it will not work very well.

2. Reducing unwanted behavior should have a reward attached. Likewise, when positive behavior is observed, it needs to be rewarded, too. The trick here is to find out how much change is enough to receive a reward. If you make it too little change, you will see very little progress. If you make it too much change, your adolescent may lose the incentive to try. This can be a little trial and error until you find what works best for your youngster. Your adolescent will probably tell you if it is too hard. It is not likely to be said if it is too easy. Find a system of rewards that excite your adolescent enough to keep her working for it. The reward may be something that you have on your list of dislikes which is really not terrible in the big scheme of things (e.g., a body piercing).

3. Failing to come home on time needs to be part of an agreement if it is a problem. Playing too many video games for too long and too often may need to be considered. For most adolescents, you need to include sexual activity as something to be eliminated. You will have your own list of behaviors to eliminate.

4. Lack of quality communication is what leads to most situations between adolescents and their moms and dads. Use the development of this agreement to establish some lines of communication. Make sure that the changes are not to just make you happy, but are intended to cause long-term benefits for the adolescent.

5. Be flexible when opening the negotiations. Listen to your adolescent as much as you talk. Make sure that it is not just you lecturing your adolescent. Be willing to delay some of your wants to get your adolescent on board with the agreement. Once it is working and your youngster sees the upside, making a new and more extensive agreement will be much easier. Keep this one simple. A mutual agreement that will work is your goal.

Creating the behavioral agreement:

1. First, arrange a time to meet with all the grown-ups who are responsible for enforcing rules and disciplining your adolescent (e.g., biological parent who lives outside the home, stepparent).

2. Discuss the problems that you are having with your adolescent. Allow everyone involved to offer input as different issues may arise with different caregivers. Behaviors that may be addressed include:
  • treatment of parents
  • school performance
  • dating
  • curfew
  • car use
  • cell phone use
  • alcohol and drug abuse

3.  Note ideas on paper as you brainstorm together. Finalize a list of pertinent matters and number the matters in order of importance (e.g., potentially dangerous issues like drug and alcohol use require more urgent attention than the amount of time your adolescent spends on her cell phone).

4. Narrow the list down to no more than 5 behaviors that you want the adolescent to focus on improving. Include these behaviors in the initial agreement and add others at a later date as he progresses.

5. Write a sentence for each behavior that states how your adolescent is expected to behave in a given situation. Format the sentence in first person perspective from your adolescent’s point of view. Utilize positive words and phrases.

6. Decide on a positive consequence that will result when your adolescent fulfills the expectation (e.g., a special privilege). You may also choose to simply list the natural consequences of good behavior (e.g., trust, respect, more freedom).

7. Determine what the consequence will be if your adolescent fails to behave in the desired manner. Consider consequences that are effective with your youngster and appropriate to the behavior, as well as your ability to enforce the chosen discipline.

8. List both the positive and negative consequences underneath each expectation. Establish the period of time for which the agreement will be valid and note the date at the bottom.

9. Create a chart with each expectation listed on the side and the days of the week across the top. Track your adolescent’s behavior throughout the length of the agreement by filling in the chart accordingly.

10. Meet with all the parties who are involved in the agreement. Review the terms of the agreement and clarify any questions that are presented. Allow your adolescent an opportunity to offer constructive feedback.

11. Include revisions as required to the agreement. Have everyone sign and date the final draft. Make a copy of it for each party.

12. Use the behavior chart to monitor your adolescent’s behavior on a daily basis. Enforce the terms of the agreement consistently to achieve positive results.

13. Revise the behavioral contract accordingly upon its expiration date. New expectations can be added as your adolescent displays a consistent ability to make positive choices in situations addressed within the original agreement.

Parent's Reverse Psychology: The Power of Choice

As moms and dads, we want to know that we’re in control. But our children tend to beg, plead, and whine about the options we make for them. So, give your children options (without really letting them choose). This is a great way to let children have an option without giving up all the parental control. But you don’t have to make it an option between something they want and something you want for them, like candy or an orange. Choose the orange for them, but they get to choose how they’re going to eat it… in slices or with cottage cheese.

Empowering your children with options gives them more independence. It teaches them the relationship between their decisions and outcomes. And with more practice, their decision making skills will grow into a valuable lifelong lesson. Giving children options encourages cooperation, which is what we are trying to get in the first place. Giving children options helps prevent power struggles. The ability to choose is a natural human need. Quench their thirst for control and watch the power struggles fade. The ability to create options is what gives your kids a sense of purpose. They are no longer helpless babies. They are functioning human beings that are fully capable of creating their own options.

Offering your kids options is an excellent strategy to have in your parenting "tool kit." If you make an effort to be genuine with the options you offer, you will communicate respect for your kids at the same time, which will result in greater collaboration and overall peace. 

Here are some strategies to apply when providing options for your kids:

1. Don’t forget to add the words ‘you choose’: “Would you like to play a video game, or color while I cook? You choose.” This will make it next to impossible for the power hungry child to pass up.

2. Give specific options that you are comfortable with. If you don’t feel like cooking lasagna for dinner, don’t offer the option.

3. If kids don’t like the option they made, acknowledge their disappointment and remind them that they can choose another option next time.

4. If your child tends to change his/her mind, confirm the option and your expectation that he/she sticks with it. For example say, "Okay, you chose corn flakes, right? Once I pour the milk on it, I expect you to eat it."

5. If you say, "Do you want juice or milk" and your youngster responds, "I want both," you can reply, "Which one first?"

6. If your youngster is reluctant to suggest some options, you can say, "You can decide or I’ll decide for you, but you might not like what I decide."

7. Limit options to two or three. Giving your child the option between 5 different shirts is going to do more harm than good.

8. Make sure the options are age appropriate. Four-year-olds are great at picking out their own pajamas, but don’t expect them to choose the color of your new car.

9. Make the options respectful to both you and your youngster. If you say, "Either quit throwing the ball in the house or I’ll take it away," you are making a threat and not offering a respectful, fair option. An effective, mutually respectful option would be, "You can either play with the ball outside or with another toy inside. You choose." Here, you can address safety concerns and respect the youngster’s need or desire to play.

10. Offer options that you can live with. For example, you might ask, "Do you want peas or carrots for dinner?" This narrows down the options and gives your youngster some say in the matter.

11. Offer options as often as possible. Much of your youngster's day includes following directions. As moms and dads, we tell our children when to be ready, where to go, and how to behave. At school, their entire day is scheduled around following "orders." So as often as is appropriate, give your youngster options. This might be something as simple as "Do you want to wear the long sleeve shirt or the short sleeve one?"

12. State your bottom line (the minimum standards that must occur or what is non-negotiable). Then you or your husband or wife can offer options within those limits. Your limits will usually relate to safety, health, rules, rights and things like that. Those are issues that the both of you can and need to control.

13. Don’t be overly rigid about forcing kids to pick one of your options. Any option that meets your bottom line is okay, because your goal is to reach a win/win solution.

14. Talk about options in advance. This gives your youngster a chance to think about the options and make an informed decision. For example, you might be planning a special family outing for your kids. If it really makes no difference to you which place you go (e.g., park, beach, museum, etc.), then give them the option to choose. This increases their sense of inclusion in the process and will likely help them participate more enthusiastically when the day comes.

15. Give your youngster time to make a positive decision. Learning how to make the right decision takes time, and sometimes your children just need a little space to come to the decision "on their own."

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