11 doctors weighed in:

My boyfriends son (6) has adhd, he hits and pushes my daughter (5). Does he know what's hes doing or not cos of adhd? We talk to him about hitting and we tried to punish him and nothing is working, i really think one day he is going to hurt my daughter. W

11 doctors weighed in
Dr. Johanna Fricke
Pediatrics - Developmental & Behavioral
5 doctors agree

In brief: Effective treatment

Of adhd = medication management, behavioral therapy, parent behavior management training & environmental supports (" section 504" at school, quiet homework space & consistent routines at home).
Spanking/yelling teaches him that physical/ verbal aggression is okay. A child psychologist can help y'all set up & use effective rewards & consequences & talk to your son about his feelings. See chadd.Org.

In brief: Effective treatment

Of adhd = medication management, behavioral therapy, parent behavior management training & environmental supports (" section 504" at school, quiet homework space & consistent routines at home).
Spanking/yelling teaches him that physical/ verbal aggression is okay. A child psychologist can help y'all set up & use effective rewards & consequences & talk to your son about his feelings. See chadd.Org.
Dr. Johanna Fricke
Dr. Johanna Fricke
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1 comment
Dr. Deepak Patel
Children with ADHD can act like they are bad kids. Most of them are not. They just cannot control it. Most of us think twice about consequences of our behaviors. ADHD patients may not. They are that impulsive. However, it depends on the severity and no two ADHD kids are alike. Having said that, I do not attribute your situation to ADHD alone. At 6 he knows better not to hit others. I do not want ADHD to be used as a license to hurt others. So, what else is going on that he is targeting her. Is this a new relationship where he had dad's full attention and now you are taking that up and he acts out on your daughter? Is she an easy target to express himself when he is having a bad day? Is he bullied in school? If he is not hitting others outside of home and only does this to your daughter, then there is something specific about how the family works, and how he is expressing his feelings - and that needs to be explored further. Finally, make sure his meds are OK. Best wishes.
Dr. Marney Gundlach
Pediatrics
3 doctors agree

In brief: Children

Children with adhd can often act impulsively - they don't always stop to think things through before they act.
So, like your boyfriend's son, he may get mad and not take a moment before he just reacts by hitting your daughter. Most 6 year olds have a clear concept of right and wrong, and can be held accountable for their actions. In general, i recommend using time-out in this age group as follows: 1) give a warning (i omit this for physical violence - that immediately goes to step 2) 2) tell the child what he did that was wrong - be specific! for example, "no scott, we don't hit. We keep our hands to ourselves." 3) place the child in a quiet area away from the family activities, but still close enough for you to monitor his or her behavior. This spot has to be boring (i.e. Stairs, corner, wall) - don't send him to his room with all the cool toys to play with, or let him be able to watch tv from time out! 4) have the child stay in this spot for one minute per year (in your case, 6 minutes). I recommend the use of a timer - like an oven timer - to reinforce when time out is done 5) return to your child and either tell them again what they did that was not acceptable (toddlers) or you can ask them why they were in time-out (school age) 6) have the child say "sorry" - sincerely - for the behavior, and let the child know that he/she is forgiven ("hugs and kisses time"). In the case of physical violence, i make the child apologize to the one he or she hurt. 7) let the child return back to the regular activities. Don't keep referring to this all day long - the punishment is done, and move on! in your case, if your relationship is newer, his son may not be as willing to accept you as the disciplinarian - so talk with your boyfriend because consistency between all parents is very important! in my opinion, most children with adhd or add do best clinically on a combination of medications to control the impulsivity, hyperactivity, and inattention and counseling to help the family and the child learn how to manage his or her behavior best. Another thing to consider is that since all children are different, they may react differently to certain medications. Some children may have headaches, stomachaches, loss of appetite, tics (involuntary movements), problems with sleep, or become tearful, withdrawn, or aggressive. If you are concerned about this, talk to your doctor about the medication that your boyfriend's son is on - maybe a different medication would work better. Finally, we have a doctor at utmb pediatrics at bay colony who specializes in these issues - dr. William mize is a board certified behavioral and developmental pediatrician who has a special clinic designed to help general pediatricians (like myself) manage children with adhd where the treatment is not optimal. Your doctor can make a referral to dr. Mize, if desired, and you can call 1-888-utmb-kid for more information. I hope this is helpful! sincerely - dr. Marney gundlach.

In brief: Children

Children with adhd can often act impulsively - they don't always stop to think things through before they act.
So, like your boyfriend's son, he may get mad and not take a moment before he just reacts by hitting your daughter. Most 6 year olds have a clear concept of right and wrong, and can be held accountable for their actions. In general, i recommend using time-out in this age group as follows: 1) give a warning (i omit this for physical violence - that immediately goes to step 2) 2) tell the child what he did that was wrong - be specific! for example, "no scott, we don't hit. We keep our hands to ourselves." 3) place the child in a quiet area away from the family activities, but still close enough for you to monitor his or her behavior. This spot has to be boring (i.e. Stairs, corner, wall) - don't send him to his room with all the cool toys to play with, or let him be able to watch tv from time out! 4) have the child stay in this spot for one minute per year (in your case, 6 minutes). I recommend the use of a timer - like an oven timer - to reinforce when time out is done 5) return to your child and either tell them again what they did that was not acceptable (toddlers) or you can ask them why they were in time-out (school age) 6) have the child say "sorry" - sincerely - for the behavior, and let the child know that he/she is forgiven ("hugs and kisses time"). In the case of physical violence, i make the child apologize to the one he or she hurt. 7) let the child return back to the regular activities. Don't keep referring to this all day long - the punishment is done, and move on! in your case, if your relationship is newer, his son may not be as willing to accept you as the disciplinarian - so talk with your boyfriend because consistency between all parents is very important! in my opinion, most children with adhd or add do best clinically on a combination of medications to control the impulsivity, hyperactivity, and inattention and counseling to help the family and the child learn how to manage his or her behavior best. Another thing to consider is that since all children are different, they may react differently to certain medications. Some children may have headaches, stomachaches, loss of appetite, tics (involuntary movements), problems with sleep, or become tearful, withdrawn, or aggressive. If you are concerned about this, talk to your doctor about the medication that your boyfriend's son is on - maybe a different medication would work better. Finally, we have a doctor at utmb pediatrics at bay colony who specializes in these issues - dr. William mize is a board certified behavioral and developmental pediatrician who has a special clinic designed to help general pediatricians (like myself) manage children with adhd where the treatment is not optimal. Your doctor can make a referral to dr. Mize, if desired, and you can call 1-888-utmb-kid for more information. I hope this is helpful! sincerely - dr. Marney gundlach.
Dr. Marney Gundlach
Dr. Marney Gundlach
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Dr. Eric Wexler
Psychiatry

In brief: Yes, he knows

Behavioral therapy is the best approach.

In brief: Yes, he knows

Behavioral therapy is the best approach.
Dr. Eric Wexler
Dr. Eric Wexler
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2 comments
Dr. Kathryn Seifert
He should have a complete psychological evaluation to see if anything else is going on. He should definitely be in treatment, perhaps family treatment which includes behavioral treatment. Try reinforcing positive behaviors.
Dr. Johanna Fricke
DB Pede or Child Psych needs to know genetic set-up, pre-& postnatal exposure to alcohol, tobacco & drugs & early environmental adversity.
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