Millions of people suffer from attention deficit hyperactivity disorder, or A.D.H.D., many of them teenagers who face problems in school. Here, Dr. Russell A. Barkley, clinical professor of psychiatry at the Medical University of South Carolina and author of “Your Defiant Teen” and other books, responds to concerns from parents of teenagers with A.D.H.D.

A High School Student With A.D.H.D.

My son has been impulsive and had difficulty following rules since kindergarten. He received above-average grades in a challenging school but did have behavioral organization issues. We worked closely with him at home and he was able to function just fine. He was diagnosed with A.D.H.D., but we continued our home intervention.

He is now a teenager in high school and it’s getting more difficult to help him stay focused and organized. His judgment is poor. He recently started taking Foculin and seeing a therapist. The results are mixed — he seems to lack motivation and rarely takes responsibility for his actions. Any other suggestions?

Dr. Barkley responds:

Even normal teenagers can go through motivational slumps during the school year, and this behavior is often exacerbated by A.D.H.D. Medication can help, but often a parent must institute some sort of incentive program to promote success in school.

One thing that can be very helpful is to put into place a point system, with a daily school behavior report card completed by each teacher to help track the teenager’s behavior across the school day. The ratings on the card can be converted to points, and these points can be spent on favorite privileges the teenager wants at home and out in the community.

A High School Senior With A.D.D.

I have an 18-year-old son who is a senior in high school and will attend college next year. He was diagnosed with A.D.D. (without the “H”) when he was in middle school. He used Ritalin for about a year, but quit before going to high school because of the side effects.

I know what he deals with because I recall the same symptoms through my school years. But, back then there was no name for the condition except labels like restless, fidgety, semi-retarded, etc. That all ended after we took our first round of I.Q. tests in the fifth grade, and the teachers were surprised that I had such a high score. I overheard one of the other teachers who taught one subject to our class ask our teacher which kid had the high I.Q. My teacher whispered that it was me. I had no idea what they were talking about, but got treated a lot better after that.

The reason I had never done well before that was that I only spent about a fourth of my time listening to what was being taught. When more attention was focused on me, I had to concentrate more and take shorter mental side trips. That was the start of my academic ascent from the cellar.

Over time, I managed to use this condition to my advantage and became a top student.

I would like to give some advice to my son on how to manage or use his A.D.D. to his advantage in college, but have trouble verbalizing it, probably because I adjusted incrementally over a long period of time. The best way I can sum it up is to say that I would work as fast as I could on a subject until I got tired of it, then switch to another and a third before circling back to the first. Working on one subject too long caused me to reach diminishing returns and start taking side trips.

I still operate this way when I start to get mentally restless.

Any other advice, Dr. Barkley?
John Zabrenski, Allentown, Pa.

Dr. Barkley responds:

On my Web site, www.russellbarkley.org, I have a free handout of“80-plus Classroom Accommodations for A.D.H.D. Children and Teens.” Many of these ideas can be adapted for someone in college, too. I share these ideas when I talk to educators, and
among the more than 80 suggestions are:

• Decrease the child or teenager’s total workload to what is essential to be learned rather than what is merely “busy” work assigned to fill class time.
• Give smaller quotas of work at a time with frequent breaks (i.e., five problems at a time, not 30, with short breaks between work episodes).
• Allow for frequent physical exercise breaks throughout the school day.
• Get color-coded binders and other commercial organizing systems to help keep student materials and assignments organized.
• Try color-coding of text using highlighters for marking key points in the text; better yet, write these highlighted key points down on paper after the reading is done.
• Assign a homework “study buddy” for peer tutoring done outside of school. Students from the same class can do their homework together, alternating whose home they meet at.