ADHD diagnosis

Self-Regulation and ADD/ADHD

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In many ways, ADD/ADHD can be seen as a problem with self-regulation.  Self-regulation is one of the executive skills that an ADD Coach or Executive Skills Coach attempts to remediate.  Self-regulation involves regulating not only attention and focus, but behavior and mood.  Initially, deficits with self-regulation are addressed by others providing cues, reminders, structure and reinforcement to keep an individual motivated, persistent and on-task towards a future goal.  The goal of the coach is to teach strategies and new habits so that the individual with ADD/ADHD or a self-regulation weakness is no longer dependent on others to keep them motivated and on task.

Some strategies an ADD Coach or Executive Skills Coach may utilize are listed below:

-clearly defining the goal behavior

-breaking the task into parts

-schedule and plan when the identified goal behavior will be executed

-setting up a reward system, and utilizing self reward for successful execution of goal behavior

-Utilize productive self-talk

-Utilize self-monitoring strategies

-Practice self evaluation

-Utilize external cues and reminders

-Create interest and excitement in the tasks involved or goal behaviors

-Positive Mental Attitude (PMT)

-Utilization of mood regulation techniques such as relaxation training or cognitive reframing.


The above mentioned strategies can take time to master.  But with the proper assistance and practice they can go far in helping an individual with ADD/ADHD achieve their personal goals.

ADHD Coaching is available online, by phone , and in-person

 

ADHD diagnosis

Why Smart People with ADHD Make Poor Decisions

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Parents, friends and spouses can become confused and frustrated when someone with ADHD can appear to be so smart in some situations, but still make such poor decisions in other situations.  The problem is that people with ADHD have an impairment with the executive functions.  Some of the executive functions include task persistence, sustained attention and emotional regulation.  Often, individuals with ADHD can reason adequately to solve a problem.

They know what to do. BUT, they just don’t do it when it is time to execute their solution or plan needed to reach their goal!

ADHD is not a knowledge or skill deficit.  It is an execution and self-regulation deficit.  This is why  explaining alone will not be helpful.  Neither will lecturing, nagging or yelling.

When it is time for  ADHD individuals to execute their plan so they can reach some future goal, their reasoning brain becomes hostage to their emotional brain.  The stimuli in the environment trigger thoughts and feelings that override their reasoning brain.  The promise of immediate gratification  which is calling to them right then and there, overrides the part of the brain that had a longer term goal in mind just moments earlier.

An ADHD coach can help  individuals with ADHD overcome their executive functioning weaknesses.  The first step is to have a good understanding of why the problem is occurring in the first place. It is important to take a disability perspective and to work to develop new habits and environmental accommodations that will help  ADHD individuals actually execute what they know they need to do. Review some of these strategies in more detail in future posts.

ADHD Coaching is available online, by phone , and in-person.

ADHD diagnosis

How to Help Someone with ADHD Make it all the Way to the Finish Line

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Goal directed persistence is a core weakness for individuals with ADHD.  Reaching long term goals can be problematic.  They have difficulty sustaining their attention and delaying gratification in order to reach a future goal.  The excitement and pleasure of some more immediate event present right here and now cannot be resisted.  The ADHD individual knows what they should do, but just doesn’t do it.  They become distracted, side tracked, lose motivation or change their plans.  These difficulties are frustrating for the ADHD individual and for their loved ones and can lead to underachievement, low self-esteem and depression.

Goal setting is an important first step needed to help an ADHD individual persist toward a future goal. Goals can include attaining a good grade on a test, completing a project, maintaining a neat room or work station, or completing a long term work project.  When an individual writes down, verbalizes and commits to a future goal, he or she is more likely to reach the goal.

The following are some strategies to help someone stay on track and maintain persistence and motivation in order to reach a future goal:

-Break tasks into parts and identify specific behaviors needed to reach each part.

-Commit to completing the specific behaviors intended.

-In advance, say out loud the exact behavior that you plan to do.  For example, “I will write my homework in my planner.” or “I will study for a half hour after work/school”.

-Reward yourself when you do follow through with the committed to behavior.  Parents, spouses and loved ones can reinforce the completion of a behavior by using praise.

-Externalize cues.  Write the goals down and post them at the point of performance.  This will create an environmental trigger to cue you to perform the behavior.

-Start with easier goals to create opportunities for success.

-Intersperse less boring or challenging activities with the intended behavior.

-Seek help, tutoring or education if there is a skill deficit and you lack the exact knowledge of how to perform a particular behavior.

-Limit distractions in the environment where the behavior is to take place as much as possible.

-Learn from successes and failures.  Review why you did or did not meet a goal to develop interventions for the future.


-An ADHD coach can help set up and fine tune strategies to help you reach your future goals.

ADHD Coaching is available online, by phone , and in-person.

ADHD diagnosis

What Can Parents with Daughters of ADHD do to Help Their Daughter Thrive Socially

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The first step to helping your daughter thrive socially is to carefully evaluate exactly why your child is having her social difficulty.  Is she breaking personally space, having tantrums, interrupting, not waiting her turn,  missing social cues due to inattention, annoying other children with off task or silly behavior?  Or is she socially shy or insecure?  The intervention will depend on your conceptualization of the problem.  So first investigate.  Talk to teachers.  Talk to your child.  Observe.  Once the source of your daughter’s difficulty is found a skills training model can be useful.  Provide opportunities to practice the behavior you want (ie waiting ones turn) and use a great deal of positive re-enforcement.  An ADHD child will require more structure, more cues, more immediate feedback and larger re-enforcement than a typical child.  Make sure your child has opportunities for success. Find her strength, encourage them and provide opportunities to express them.  Limit distractions as much as possible and attempt to place your daughter in an environment which will minimize or social difficulties (ie having only one child over at a time and playing a game or in a setting that minimizes your child’s difficulties).

How do we get people to take their daughters for diagnosis earlier?

If your daughter is struggling socially, behaviorally, emotionally or academically, familiarize yourself with the symptoms of ADHD.  If you have suspicions your child may have ADHD seek a professional ADHD evaluation.

ADHD Coaching is available online, by phone , and in-person.

ADHD diagnosis

What can Parents with Daughters of ADHD do to Help Their Daughter Thrive at School/Academically?

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Obtain a thorough evaluation by a professional with experience diagnosing and treating ADHD

Education:

Educate yourself as much as you can about ADHD and its
management. Read books, talk to professionals, and research on the internet.

Medication:

Stimulant medication (methylfenadate, amphetamines) and nonstimulant
medications (atomoxetine) have been shown to be effective. Seek a
qualified physician to evaluate use of medication.

Parent-Training/Coaching:

Parent-training or coaching is an affective treatment for ADHD.

Parenttraining/coaching helps decrease parent/child conflict, child defiance, and disruptive behaviors.

Parent-training/coachingalso helps reduce parent stress and household stress in general. Parenting strategies includecontingency management, effective use of commands, transition planning, positive attending, behavior
management plans, and various monitoring programs.

Psychotherapy:

Psychotherapy is helpful for children, adolescents and adults by helping them gain a better
understanding of the nature of ADHD, its management, and how it has influenced who they are today.
It is also useful to help with medication compliance.

Social-skills Training:

Accommodations and environmental changes.  Some strategies to help your daughter with ADHD achieve include:

-Organizing information and note taking: Students with ADHD
require extra assistance to organize and prioritize their homework.
At home, parents can help organize and prioritize assignments and
record important dates onto a home calendar.
-Providing a quiet environment: Make sure that the homework environment is quiet with
minimal distractions.
-Maintaining a routine: Routine brings order and order assists in the facilitation of focus.
Homework should be completed at the same time each day in the same quiet environment.
-Break into parts: The academic rule of thumb is that there should be 10 minutes
of homework added on for each grade level, i.e., 4th graders should be able to handle
40 minutes of homework each night. However, for a child with ADHD, 40 minutes may
be too long to sustain attention on one given subject area. Therefore, homework should
be ‘chunked’ into smaller segments.
-Manage time and set goals: After helping your child break their homework into smaller
segments or chunks, set time completion goals and accuracy goals. Use a timer to
externalize the time cue and provide the additional structure.
-Rewarding: Use positive reinforcement. Keep your attention focused on positive behavior. Set clear reward for homework completion and even for completion of each homework
‘chunk’ discussed above.
-Consequences: Adhere to the plan and set up realistic consequences for not completing the
homework.
-Communicating: Communication between the teacher, parent, and child is critical. Establish
a weekly or even daily report card which reports missing assignments, test grades, and up
coming projects and tests; and

Seek professional help: Know when it is time to ask for assistance from professionals

ADHD Coaching is available online, by phone , and in-person.

ADHD diagnosis

ADHD Symptoms in Girls

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What ADHD symptoms should parents look for in girls?

There are three main type of ADHD symtpoms, impaired response inhibition, off task behaviors, and poor persistence or sustained attention.
Impaired response inhibition includes:

-difficulty delaying gratification
-difficulty waiting ones turn
-interrupting others
-calling out, impassivity
-difficulty stopping a task
-being easily distracted
-difficulty stopping an ineffective strategy and changing to a more effective strategy

Off task behavior includes:

-hyperactivity
-being excessively fidgety
-frequently leaving ones seat
-appearing always “on the go”, constantly moving.
Poor persistence includes:
-difficulty sustaining attention with boring or tedious tasks
-difficulty sustaining motivation
-poor concentration
-difficulty returning to a task when distracted
-appearing not to listen

Other related problems include:

-poor time management
-forgetfulness
-frequently losing personal belongings
-disorganization
-poor regulation of emotions

 

ADHD Coaching is available online, by phone , and in-person.

ADHD diagnosis

Why is ADHD Underdiagnosed in Girls?

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Why is ADHD underdiagnosed in girls?
ADHD occurs in approximately 3-7% of the childhood population.  Boys are more likely to have the disorder than girls.  Boy are 3 times more likely to be diagnosed with ADHD than girls  and in mental health settings boys are 6-9 times more likely to be diagnosed.  This is primarily because of referral bias.  Teachers and doctors are more likely to refer children who are more disruptive and aggressive and boys with ADHD tend to be more aggressive than girls.

What happens if these girls’ symptoms get left untreated?
Left untreated, children with ADHD are at risk for a variety of emotional, academic and behavioral difficulties, including:
-Oppositional Defiant Disorder (50+%)
-conduct problems (25-45%),
-learning disability (25-40%)
-low self-esteem and depression (25%).
-Academic under-performance 90% of the time
-Retention in a grade from 25% to 50% of the time
-Requiring Special Education in 35% to 60% of the time
-Failure to graduate high school in 30% to 40% of the time
-Less likely to attend college 20% of the time
-Less likely to graduate college 5% of the time
-Peer-relation problems 50% of the time
-Substance-abuse/dependency 10% to 20%
-Early sexual activity and teen pregnancy in 38%+
-Increased risk for STDs in 16%

ADHD Coaching is available online, by phone , and in-person.