Safety Concerns and ADHD

Children with ADHD generally sustain more accidents and injuries than the average child. Reduced awareness or inattention, impulsivity, and poor decision-making often leads to rushing into situations without thinking. For example, a young child may forget to check both ways when crossing the street or while riding a bike, even going so far as to dash in front of a car in a parking lot without thought for the consequences. Teenagers with ADHD who drive may have more traffic violations or accidents than those without ADHD.

One ramification of more frequent injuries is increased medical costs. The potential for an increased need for medical attention due to injures combined with the increased number of visits for diagnosis and medication management, as well as the regular costs of prescriptions, can lead to increased insurance costs.

Pay close attention to safety precautions to reduce the risk of injuries. Parents must establish safety rules such as avoiding cell phone use during driving, or wearing a helmet when riding a bike, and insist on adherence. Develop training programs for use with the specific needs of each ADHD child. Repeat the message a sufficient number of times so that the child can repeat the safety rules on his or her own. Also, remember that impulsive children will require more supervision than other kids. Do not be discouraged! Spending time supervising your child can be a positive experience, with the right attitude.

The following techniques can be used to reduce the likelihood of injury for children with ADHD:

• When riding a bike, skates or a skateboard, make sure to wear a safety helmet and other recommended gear (i.e., knee pads).
• Review safety rules each time before the child goes out or on a regular basis to help the child develop good safety habits. Consider enrolling the child in a bicycle safety class.
• Monitor the amount of time the child can engage in higher-risk behaviors, such as swimming, and check-in during those times to see that the rules are being followed.
• Keep dangerous household products, tools, and equipment out of reach of young children. As children get older, establish and discuss household safety rules and teach the appropriate use of tools.
• Limit the amount of music a driving teenager may listen to while driving; have them drive without passengers or limit how often they have them; and have them avoid using a cell phone.
• Adjust privileges according to maturity level rather than chronological age.
• Communicate clear expectations; use structure as a tool to ensure safety.
• Behavioral strategies such as rewards and consequences can help motivate children to comply with safety rules; wearing a helmet, for example.
• Ensure that a careful, detailed learning process, including practice sessions, takes place for any dangerous activities (driving, skiing, etc.)
• Substance use is a particularly important topic to discuss. Children need guidance in these areas. Research has demonstrated that kids will listen to their parents concerns and warnings about substance use.
• Whenever possible, talk through the consequences of actions with the child. Give them the opportunity to discover the answer by asking them to tell you what might happen if they "cross the street without looking," for example. This will help promote and develop their executive functioning skills. This technique can be helpful to most children, including all ages of individuals with ADHD.