To help move from abstract concepts to skills, let’s look at impulsivity. Impulsivity can be looked at as a deficit in inhibition and impulse control, otherwise known as delayed gratification. Delayed gratification is waiting for a larger or higher quality reward in lieu of a lower quality, smaller reward. Identifying delayed gratification brings about behavior that can be targeted for intervention in context. Imagine what happens when a parent picks up a ringing telephone, and a child is playing with toys. Suddenly, the parent’s attention and their answers to previously unimportant questions become a child’s top priority. Children do lots of creative things to get a parent’s attention: take risks (i.e., climb the counters), pester (pull at a parent’s leg or clothing), and attempt to have parents answer questions through nonverbal means (just nod your head like this if I can have a special snack right now).
If we examine impulsivity as a behavior rather than an innate quality, we can pinpoint antecedents (what happens before behavior occurs) and consequences (what happens after behavior) that may contribute to impulsivity and identify environmental modifications that we can try. For instance, diverted parental attention from the phone call and consequent actions such as a parent saying “Go play with your toys,” “Can’t you see I’m on the phone right now?” or “If you don’t be quiet and stop, you’re going to your room!” may be unintendedly maintaining the behavioral issue.
Some strategies for handling impulsivity may be to work on the issue outside of when it occurs. For example, the parent, not under duress of attending to the phone call and the child, may question the child on what they can do when on the phone. Perhaps, the parent may even set aside preferred toys for the child that may only be used when the parent is on the phone. The parent may teach the child that only in an emergency can they be interrupted on the phone and explain types of emergency situations. Other antecedent strategies may include reviewing what happens if the child can wait or do something else that is appropriate when the parent is busy and the consequences the child may receive if no pestering occurs. Consequence-based strategies may include reinforcing alternative/other behavior than inappropriate behavior with a parent providing attention once the phone call ends by playing with the child with a preferred activity for a couple of minutes. Additionally, when on the phone, the parent ignores the child’s requests and perhaps walks away from the child to another location while on the phone. Obviously, practice for the above should take place frequently and in different situations. This may be done by role-playing situations and making it a game such as planning how this would look when in the car or at the store. Remember one cannot mistake that the behavior of waiting would transfer to other non-phone related situations. Preparation, providing opportunities for practice, having a plan of action, and consistency are keys to success when handling delayed gratification problems.
Next time, we’ll conclude our discussion of ADHD by revisiting the initial scenario and outline environmental strategies to promote success.
ADHD Series by Dr. Glenn Sloman
Continue reading using the links below:
- What Is ADHD? Part 1
- ADHD Symptoms Part 2
- Who is Diagnosed with ADHD? Part 3
- Executive Functioning Part 4
- Another Way of Looking at Impulsivity Part 5
- Promoting Success with ADHD Part 6
References
Attention-Deficit / Hyperactivity Disorder (ADHD). (2017, July 18). Retrieved October 02, 2017, from https://www.cdc.gov/ncbddd/adhd
Biederman, J. et al. (April 2010). Adult Psychiatric Outcomes of Girls with Attention Deficit Hyperactivity Disorder: 11-Year Follow-Up in a Longitudinal Case-Control Study. American Journal of Psychiatry 167(4):409-417.
Biederman, J. at al. (July 2012). Adult outcome of attention-deficit/hyperactivity disorder: a controlled 16-year follow-up study. Journal of Clinical Psychiatry 73(7):941-50.
CHADD – The National Resource on ADHD. (n.d.). General Prevalence of ADHD | CHADD. Retrieved October 02, 2017, from http://www.chadd.org/understanding-adhd/about-adhd
Diagnostic and statistical manual of mental disorders DSM-5. (2013). Arlington, VA: American Psychiatric Association.
Najdowski, A. C. (2017). Flexible and focused: Teaching executive functioning skills to individuals with autism and attention disorders. San Diego, CA: Academic Press.
Thapar A, Cooper M, Jefferies R, et al. What causes attention deficit hyperactivity disorder? Archives of Disease in Childhood 2012; 97:260-265.
The Understood Team. (n.d.). 3 Areas of Executive Function. Retrieved October 02, 2017, from https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/executive-functioning-issues/3-areas-of-executive-function
About The Author
Glenn M. Sloman, Ph.D., BCBA-D, NSCP is a Licensed Psychologist in New Jersey and Pennsylvania and a Board Certified Behavior Analyst at the Doctoral level. Dr. Sloman is also a Nationally Certified School Psychologist and a Certified School Psychologist in New Jersey. He earned his undergraduate degrees with honors in Psychology and Anthropology at the University of Florida. Dr. Sloman attained his Master’s in Education and Ph.D. in School Psychology at the University of Florida where he specialized in Behavior Analysis. He previously served as a program coordinator for Douglass Developmental Disabilities Center Outreach Program and supervisor of home staff in programming for individuals with an Autism Spectrum Disorder (ASD). Dr. Sloman has worked in New Jersey school districts as a case manager and school psychologist on a child study team developing and implementing individualized education programs (IEPs) and behavior improvement plans (BIPs), providing individual and group psychotherapy, social skills training, and staff and parent consultation.
Dr. Sloman is skilled in conducting psychological and psychoeducational evaluations, and functional behavior assessments (FBAs). He has experience providing outpatient psychotherapy to children, adolescents, and adults from ethnically and economically diverse backgrounds, and providing parent support and training.
Dr. Sloman has extensive experience in the treatment of children through adults who present with symptoms of anxiety, depression, ADHD, ASD, learning disabilities, oppositional defiant disorder, obsessive compulsive disorder, mood disorders, and social skills deficits. He also has expertise assisting individuals transitioning from high school to college life.
Dr. Sloman’s professional interests include Acceptance and Commitment Therapy (ACT) and applying Behavior Analysis in treatment and consultation. Dr. Sloman’s goals for his clients are to increase their psychological flexibility in pursuit of doing what matters to them and creating meaningful behavior change. He is a member of the American Psychological Association, the New Jersey Psychological Association, and the Association for Contextual Behavioral Science.
