I saw Donny for an ADHD evaluation shortly after his eleventh birthday. Like many parents, his mother, Christine, reacted to diagnosis of her adolescent son with mixed feelings: sadness that he was not perfect and that the attention deficit disorder (ADD ADHD) wouldn't go away - and concern about the implications for Donny's future.

She hoped that the treatment plan we devised - a combination of academic accommodations, therapy, and ADHD medication - would improve their day-to-day lives. Mostly, she was determined to do whatever was necessary to help her son.

Christine became the boy's champion, protector, and advocate - getting him the ADHD teen help he needed.

She coordinated with Donny's teachers, school counselors, soccer coaches, piano teachers, and the parents of his friends to make sure that they understood his needs and treated him fairly. She attended IEP meetings and helped shape his academic plan. Morning, homework, and bedtime routines were established to structure life at home.

The bottom line? Donny thrived.

Changes for the worse

I saw the family again almost four years later. Sad to say, their life had taken a turn for the worse. Donny was and ADHD teen experiencing many of the same problems he had in the past: He was angry and defiant at home; he procrastinated about homework and became disorganized in the classroom. Finally, Donny began to rebel against taking his medication and going for after-school academic support sessions.

The old disciplinary standbys of grounding Donny and taking away his privileges had little effect on his behavior. Christine expressed worry about his choice of friends, and urged him to find more responsible buddies. Donny withdrew from family life and spent more time in his room or with his friends.

Christine was the same motivated mother, but the parenting approach that had worked so well before was now exacerbating Donny's behavior. What happened, she wondered? And where could she find ADHD teen help.

For one thing, Donny wasn't the same youngster at 15 that he had been at 11. His perceptions, expectations, and needs had, in some cases, changed drastically. To hear Donny describe things, his caring and dedicated mother had somehow become a controlling, demanding parent. She nagged him constantly, about "everything." Why couldn't she get a life and get off his back?

Trying too hard

I told Christine that she was trying too hard. The take-charge, proactive parenting that used to work was now smothering Donny. He didn't want to be taken care of; he wanted to be independent and mature. He was embarrassed when his mother checked with his teachers about his academic work. The routines set up at home now felt like a straitjacket to Donny. He perceived many of the family rules as attempts to limit his freedom. He hated taking medication. Donny was sick and tired of his AD/HD! He wanted to be like other kids his age.

Christine began to realize how Donny had outgrown many of the old strategies to manage his AD/HD, and her attitude started to change. She had run interference for her son for three years, but now he resented the interventions. She felt frustrated and guilty over Donny's struggles and concluded that she wasn't doing enough to help him.

In a nutshell, Donny wanted to grow up, but his loving mother - of all people - was standing in his way. It frustrated both of them. Christine needed a plan to find the right balance in mothering her AD/HD son. Here is the 10-step plan I devised to help her:

1. MAINTAIN REALISTIC GOALS.
AD/HD cannot be "cured" because there is nothing to cure; it's not an illness or a disease. A realistic goal is to help your child manage it well by providing strategies and interventions helpful to that particular child. Even with ideal interventions in place (a great IEP, therapeutic and tutoring help, the right medication at the right dosage), most children will continue to struggle at times. Expecting too much from your child, or from yourself as a parent, isn't fair to either of you.

Perspective: Everyone slips up occasionally - kids with AD/HD and those without it. Sometimes the school paper is put off until the night before it's due, and sometimes the garbage doesn't get taken out. Look at the implications of a given act. If there are none, ask yourself, "What am I getting so upset about?"

2. MINIMIZE THE GUILT AND FEAR.
AD/HD is a biological condition that, in most cases, is genetically transmitted. It's no one's fault. Parents aren't guilty of "giving" their child AD/HD any more than they are guilty of giving their child life. Feeling guilty or worrying excessively leads to trying to do too much. Take a breath, relax, and remind yourself that your child isn't doomed to a life of failure.

Perspective: Recall the baby and giant steps your child has taken since the original diagnosis. Ask yourself honestly: Hasn't your child made more progress than you thought he would after first being told he had AD/HD? Pat yourself and your child on the back for how far you've come and how far you will go.

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