ORDER/DISORDER

ADHD & EXECUTIVE FUNCTIONING


ADHD as we know it is a condition making it difficult for children to stay on task (inattention), control their activity level (hyperactivity) and limit their behavior (impulsivity) in age appropriate ways. In response to these markers of ADHD many parents investigate putting their children on meds to counteract the hyperactivity and inattention. What many parents don’t realize is kids with ADHD also have deficits in the area of Executive Functioning and those deficits are much less responsive to pharmacological intervention and they need explicit instructional training.

Some of the skills associated with Executive Functioning involve planning, sequencing, prioritizing, and time management. Imagine trying to navigate successfully through life when these skills are impaired or non-existent. That is why as the parent of a child with ADHD it is your job to understand what executive functioning deficits your child might have and then work to find real opportunities to teach and reinforce these necessary skills.

If we look at the skill of organization as a part of Executive Functioning we don’t have to go far to see that the typical ADHD child has a difficult time managing his things whether it be in his backpack, his desk, his binder, his folders or his own bedroom. So, when helping the child with ADHD acquire skills in organization both “static” and “dynamic” organizational systems and skills must be taught. Static Organizational systems and skills are structured by doing the same thing, at the same time, at the same place, in the same way. We break down tasks and ask kids to complete defined components of that task at a certain time and place. Dynamic Organizational systems and skills are more complex in that they involve constant adjustment to priorities, workloads, time frames, tasks and places and the decision making is left up to the judgment of the individual.

When we ask a child to put his Lego blocks back in the bin we are fostering his Static Organizational systems and skills as a part of the task of “cleaning up.” But many times parents don’t understand the developmental leap it takes the child to carry out the directive of “clean your room.” This is a more Dynamic task in that the child must create an overall plan, know how to organize each sub category, be able to sequence properly, prioritize as well as manage his time.

Follow this step-by-step plan with your child to help him clean his room and strengthen his areas of weakness.
#1 Clearly define what needs to be done. Put all the elements of a clean room in checklist form. This helps your child learn how the skill of planning works. Then prioritize the list and sequence what is done first, second, third etc.

#2 Develop a system for motivation. A token in a jar can be given for each sub-task done, i.e. making bed, vacuuming carpet etc., and tokens can earn privileges like playing video games.

#3 Prepare the environment. Introduce your child to the tools he will be using, i.e. pledge furniture polish wipes, windex wipes, vacuum cleaner, clothes hamper/bin for whites and one for colored clothing etc.

#4 Break down the tasks into smaller chunks. The overall task might be make the bed, but the steps include: pulling up the top sheet, pulling up the blanket, tucking in sheet and blanket, placing the pillow down and pulling up the quilt, then placing stuffed animals on the bed. Assign a time estimate to finishing the task so that your child gets a concrete feeling of time management.

#5 Use visual aids to help with instruction. You will need to show by demonstrating how to do each one of the cleaning and organizing tasks. Talk through the process and allow your child to repeat the important information out loud to show that he is creating the inner dialogue to later help him with self-regulation. Finally, take a photo of what the finished task looks like. Laminate the photo of the clean and organized closet so that the child has something later to compare his work to.

#6 Praise a job well done! There is nothing like good home training to foster life skills, responsibility and self-confidence.

ADD/ADHD
Knowing The Why Behind The What

As a Learning Coach a number of my clients bring with them ADD/ADHD along with their highly visual, randomly non-sequential mental processing abilities. Some of my clients take meds while others don’t. With that being said, if taking a drug were “a magic bullet” to effective learning and performance, I wouldn’t have a practice.

ADD/ADHD has 3 primary symptoms: impulsivity, distractibility and bouts of excessive energy. ADD/ADHD as a syndrome is not one of attention deficit as much as it is one of attention inconsistency. While meds can improve a child’s compliance and help him finish things once started, it does not take care of all of the issues. As far back as 1990 we could see via PET scans that children with ADD/ADHD had reduced cerebral activity in the frontal areas of the brain. This area was responsible for not only concentration and attention span but language development and logical sequential reasoning. The PET scans also showed increased activity in the occipital or rear lobe, the primary visual area of the brain.

You might ask yourself the question, “How do the results of the PET scan translate into anecdotal evidence?” Looking to my clients I can tell you what they report as some of their personal strengths and weaknesses in learning.

· Struggles with phonemic awareness & phonics (they under perform due to difficulty with the fine-tuned hearing necessary to discriminate vowel sounds within words)
· Can learn a word more easily by sight when a word is connected with a picture and the child understands its meaning
· May have trouble decoding words without regular patterns i.e. thought, though, through, cough, rough, bough
· May have trouble with non-literal text and comprehending sarcasm, satire, allegory, metaphor and slang.
· Trouble with spelling (spells phonetically and inconsistently. Memorizes the words for the test but then does not apply them)
· Is a non-verbal processor and experiences delays in auditory processing as he struggles to turn spoken words into visual images
· Poor logical sequential reasoning leads to poor organizational skills and operations that require ordered steps.
· Struggles when writing with patterns of organization in works of compare/contrast, cause & effect, definition and even narration.
· Non-sequential thinking makes prioritizing needs and task difficult
· Views large projects as overwhelming rather than breaking down the whole into smaller steps
· Has trouble keeping one’s space (backpack, desk, room) tidy. Difficulties in establishing proper place, position and condition of one’s things, leads to misplaced items and homework assignments.

As a parent of an elementary school age child with ADD/ADHD, you need to endlessly educate yourself about the various learning challenges which accompany his attention struggles. By identifying your child’s individual learning style and looking for the right extra educational intervention, you can best support your child.