Dr. Bob: I am so embarrassed when I take my 4-year-old son out in public, like to the grocery store, and he has a temper tantrum. He screams and makes quite a scene. Do you think he has attention deficit disorder?
Answer: I can appreciate your question. So many parents in my career have dealt with behavior issues in public. It is stressful just to go grocery shopping and then add trying to corral an uncooperative youngster. Let me address some immediate concerns then discuss the possibility of ADHD (attention deficit hyperactivity disorder).
- When embarking on a shopping trip, always set the expectations for your children – that you are going to do this and then we will do that. I think it is appropriate to always discuss this and offer some special time, effort or purchase as a reward for good behavior. I do not consider this a bribe. I consider it an exchange. You are asking the children to do something that is, more likely than not, less than desirable so you can let them know them know that you will devote some special attention to him in exchange.
- Do not have unrealistic expectations. If your child is routinely unruly in certain situations like in restaurants, I would avoid those situations until they have matured enough. Some will argue that the children will need to learn how to deal with those situations. Of course they will, but why purposely set up a situation where everyone will get frustrated? A frustrated or angry parent cannot adequately regulate a difficult situation.
- If a tantrum starts, I would encourage you to ignore it as much as possible. Tantrums are intended to change your behavior. But ignore it in a calm loving way. Expressing anger, striking your child or raising your voice only escalates the situation. Something like “I am sorry that you are upset but we will be done shortly. I would appreciate it if you could lower your voice. I used to get upset sometimes when your grandmother took me shopping. We can talk about this in the car” might be helpful. You will more than likely need to ignore the stares from the other shoppers.
- Avoid threatening privileges because most of the time it is an idle threat (in my experience). Plus, the execution of that action is far removed from this immediate situation and children do not understand the disconnect. Make sure any steps you take are measured, fair and calmly discussed.
Parents have often questioned if their children have ADHD based on behavior and activity in public situations. I think it a fair question, but one best addressed with your pediatrician. Children with ADHD often have a difficult time with the multiple stimuli out in public. Parents of children with ADHD have frequently asked me what to do in certain situations. The best piece of advice is to avoid situations that you know will be difficult. That can be hard to do but sometimes some advance planning will help avoid situations where everyone will be frustrated and upset.
Conscious parenting, as outlined in my most recent book, can be the key to managing behavioral issues. Parents need to understand their own situation while understanding their child’s developmental progress. Every situation can be different, so parents need to be understanding of the child. It’s never all about the parent or all about the child. It’s about the dynamic interchange between them.
Dr. Saul is Professor of Pediatrics (Emeritus) at Prisma Health and his website is www.mychildrenschildren.com. Contact Dr. Bob at askdrbobsaul@gmail.com with more questions.