Month: August 2021

Tone of Voice Awareness in Neurodiverse Families: How to practice self-regulation in family conflicts

teen getting angry at mom as mom takes away computer from herNeurodiverse families often struggle with emotional reactivity and verbal impulse control. Negative feelings and unpleasant words can intensify in the blink of an eye. Still, when the moments arise, it’s hard enough to calm down your own emotions — let alone the emotions of your child, teen or partner. Where do you even start? When that tone of voice (the one you’re all too familiar with) enters the picture, you can use the quick and direct steps of “T.O.V.” to help initiate a process of self-reflection and self-regulation for your family and yourself. Tone of voice awareness takes practice, but it’s a skill that will improve family communication and connections for years to come.

Family conflict: A familiar story

You are almost finished cooking dinner, a meal you’ve been planning since your last shopping trip a few days ago. You made sure to plan a meal that the whole family can enjoy, taking into account your son’s eating specifications. Everyone has had a rough week transitioning back into school mode. On top of that, work has been a bit overwhelming. You’ve been dealing with headaches on and off, and are ready for some quiet time. You have been looking forward to this meal all week, if not only to have some quality time with your family. You go to pull the roast out of the oven and call the kids in to help prepare the table. Your daughter comes in and begins to work with place settings. You call your son in – for the third time – and he stomps in, muttering about how he wasn’t able to finish the level in his video game. Mother sitting on the couch with her head on her hands while her kids run past out of focus.

You remind him he has plenty of time after dinner to wrap up his game and save it. In the middle of your sentence, you hear a commotion, high-pitched screech. You turn, and the kids are going at it. “She took my favorite cup!” he yells. They begin to chase each other around the kitchen.

You huff as you try to get the food from your prep station to the table without tripping over them. “If you had come in to help when I first called, you could have chosen your favorite cup.” “It’s not fair!” he screams, and hits his fist on the table, scattering silverware and causing a side dish to fall. Your heart rate spikes, your face flushes. You want to scream, but you know you have to set a good example. Your headache increases in intensity.

How did your easygoing family evening escalate into this?

Why can’t your son use another of your many drinking glasses? When will he learn to modulate how he expresses himself and be more cooperative? Why did you allow yourself to be upset by him in the first place? You’re aware that impulsivity and emotional dysregulation are challenges for your neurodiverse family. And yet, here you are again, ready to pull your hair out.

Enter: Tone Of Voice Awareness

Neurodiverse family conflict outside by a pond, a teen yelling angrily at parent in wheelchair while the other parent looks away upset So often, neurodivergent kids aren’t really aware of how they say things. They might have difficult understanding how what they say (and how they say it) can affect others. They might need guidance learning how to slow down and reflect on what they just expressed. But, since they are often sensitive to criticism, direct feedback can frequently backfire. Discussing the impact of their tone of voice allows your child – and your entire family – to reflect for themselves on how they can say something in a more impactful way. It also allows them to have more tone of voice awareness around their thoughts before they communicate them. Incorporating T.O.V. allows kids to practice several skills simultaneously: emotional regulation, verbal and behavioral impulse control, planning, shifting and personal insight (metacognition). So, where does this lesson start?

How to improve tone of voice (T.O.V.) awareness for more effective family communication

Step 1: Introduce the concept naturally.

Mother on the couch sitting with their teen who is talking in a calm tone of voice

Introducing T.O.V. won’t be very helpful unless it is introduced at a time when everyone is willing to listen and learn. In a calm moment, you explain to your neurodivergent child or teen that sometimes everyone needs help with improving tone of voice awareness and learning how their words and their tone of voice affect others.

If you have multiple children, it is important to include everyone in the conversation. This will make everyone feel like they are an equal part of the conversation, and will keep you from singling anyone out. Let them know that you will be saying “T.O.V.” out loud when you think they should reflect on how they are speaking to someone. Allow them a minute or two to practice their tone of voice awareness and pivot how they are speaking. Encourage them to try again.

Step 2: Be prepared that it might not always work immediately.

If your child or teen can’t manage their emotions enough to change their communication style, then encourage a timed break. Allow them – and yourself – personal space to breathe and regroup. Many times, a 10-15 minute break is all it takes. But be prepared for it to take a little longer, depending on everyone’s headspace.

Step 3: Be willing to forgive and move on.

When your child or teen is successful in practicing tone of voice awareness and adjusts how they are speaking to you, your job is to appreciate their efforts, accept their attitude adjustment, and move forward. Positive steps in the right direction include speaking slower or quieter and using more polite, less aggressive, language. Let them know how much their attitude adjustment means to you. Positive reinforcement is very important, especially in any child/adult relationship.

Remember, T.O.V. is a tool for everyone.

Neurodiverse teen boy and father making eye contact and having a conversation in the living room, view point from behind father. As much as you may be using “T.O.V.” to help improve your child’s communication efforts, you need to know your kids could call you out, too! How you respond to this is incredibly important. A good approach is to acknowledge your feelings, or laugh and admit that you are also capable of messing up. While you don’t want to create an environment where everyone is calling out “T.O.V.” constantly, you do want to lead by example in combative situations, and take the opportunity to practice tone of voice awareness for yourself! Be selective when you use it, and they will be encouraged to do so as well. More than anything, it’s important to realize that everyone is human. You can only react to things as your mood allows, and making sure you set everyone up with the proper tools to learn and grow through the aggressive moments can be very impactful.

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Personal Project Planners for ADHD Minds: Start managing tasks, time and ideas with this creative tool!

Person with ADHD sitting by a fireplace and holding a pencil to their face as they sit on a couch holding their personal project planner.Projects can be difficult. Whether you’re putting off a project, or just slugging through each part of it over the course of what seems like months, a new undertaking can really drain you. No matter how small a project, or how large a task, we have all experienced anxiety around completing something, especially if we or a loved one have ADHD. Fortunately, personal project planners can really help to diminish the overwhelm. The goal of using any planner is to provide structure for planning, prioritizing, and sequencing aspects of executive functioning skills. These are the processes that get you from the beginning to the end of a task. Different types of forms or personal project planners can make a task feel manageable. Here is why.

Beginning tasks can feel impossible, but creative planners can make them fun!

Starting a new task is challenging for everyone on some level. Whether it feels unpleasant or potentially problematic plays a huge role in the amount of energy a task requires. Simple tasks often feel impossible to people with ADHD. Creating steps to move it along, and then completing them can be challenging for people with executive functioning deficits. Having a formula for success can be important, and a personal project planner can do that. While spontaneity is important (and fun) from time to time, it is important to maintain a routine to set expectations and build good habits. This is important for tasks too. Routines offer organization and predictability to kids with ADHD. They comfort them, even if it sometimes seems counter-intuitive. Different designs might spark creativity in some minds, a simple design might feel less chaotic. 

Switching from one task to another can be less daunting with personal project planners.

Teen sitting in a skatepark next to his skateboard reading his personal project journal Kids and adults with ADHD often get overwhelmed when they’re asked to stop one activity and start another. Shifting from one task to another involves executive functioning skills – such as impulse control, cognitive flexibility and organization -that might not come naturally to them. Knowing how to wrap up where they are in a project, remembering where they’re leaving off so they know how to begin again when it’s time to return, and moving onto something new can be incredibly challenging. Having a planner handy to write down tasks, notes and times can help you keep track of where you are and what’s next.

Hyperfocus can make tasks more difficult, especially without a schedule.

Many people with ADHD experience hyperfocus, and it can be a very helpful trait for learning, creativity and productivity. It can, however, be detrimental in certain circumstances. While hyperfocusing on a project or activity can lead to great results, it can also make achieving tasks even tougher because of a lack of awareness of how time passes. Think about how time goes fast when you’re having fun, but at a higher level. No matter how many warnings your parent might give, having to stop a computer game or playing hoops with your neighbor to do chores can still come as a shock. Even stopping a task to start another one you think is fun can take time to process. Having a planner to work with can give the mind an easy outline of the tasks ahead. In addition, it offers space to journal out anything that might help you transition into a new thought pattern.

Personal project planners make tasks easier to understand.

Woman with ADHD using a personal project planner on her living room table next to a computer, a pair of glasses, a calendar and a vase of orange tulips. Many people with ADHD are visual learners, and learning quirks will happen. Even if the task has been explained thoroughly, and in a way that the person understands, there is often worry and other, perhaps more compulsive, thoughts that can overshadow understanding. Often, scenarios and projects are not explained clearly either. Sometimes all it takes is a quick YouTube tutorial searched online to help you clarify. However, personal project planners give you a space to write notes about the task or draw photos in a way that everyone can understand. No matter what, make sure to engage with the material in a way that suits your particular situation.

Create your own personal project planner

Whether you choose to devote yourself to a working spreadsheet on the computer, your tasking is available in an app, or you invest in paper planners, there is an option for everyone who’s interested. (Isn’t it great that they make to-do lists and project planners specific to tasks in addition to scheduling planners? And that they’re available at almost every retail shop around?) Here is how you can create your own forms that suit your and/or your child’s specific management skills. This will require some – perhaps difficult – effort in the beginning, but it will definitely yield results. My favorite method is a simple but effective form I have used over the years:

1. Gather a pen and a journal or a piece of paper.

2. Choose the topic or task and write that on the top of the paper.

3. Make a grid with 3 vertical columns and several horizontal rows. Label the three columns “Possibilities, Pros, Cons.”

It should look like this:

A personal project planner table that has three columns highlighted in yellow saying: "Possibilities," "Pros," and "Cons."

4. Put any ideas about the project in the possibilities column. Follow this with what you consider good and/or bad about that idea.

For example, if the task is organizing items in the basement, the possibilities list might range from “taking everything to the dump” to “getting rid of anything that I haven’t used in 5 years.”

5. Create the sequential steps needed to accomplish the task using another grid. This grid will have 5 vertical columns and several horizontal rows. Use the labels suggested below, OR create your own!

Make as many numbered rows as required to finish the project, and make the actions as specific as possible. Estimate the time it takes to do a step and then compare that guess with the time that passes. This will help to improve those all-important time management skills as well!

A table of 8 rows, the top row being titles of 5 columns, the bottom rows numbered 1 through 7. The titles of the columns are highlighted in yellow and say: "Action," "Materials needed," "Time estimate," "Actual time," "Finished!".

Keep in mind, some people might prefer to have a “Notes” column or journaling area, so that they can work through emotions. This can help them to perhaps explain what they loved or didn’t love about communication around the task and what they had to do. This can help everyone stay informed for the next time an opportunity like this comes up! Many kids and adults with ADHD struggle with maintaining structure and practice of task management. However, I have found that my clients ultimately embrace organization tools like personal project planners. Many find them extremely helpful! These “roadmaps” reduce anxiety, clarify goals and build confidence as activities are completed. Picture of a watch, notebook and pen next to a classic green typewriter

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Watch on Dr. Sharon Saline’s YouTube Channel:

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YourTango: Back To School With ADHD And COVID Uncertainty (Again) – Reprinted

“Just when we thought we’d turned a corner in the COVID war, the virus is rearing its ugly head for another wave. As kids go back to school, uncertainty looms once again. The Delta variant is making all of us more nervous than we might already be. School districts are debating mask mandates and some have returned to remote learning. It’s worrisome for parents and students, many of whom assumed that in-person learning would finally go forward.”

Click here to read Dr. Saline’s article on YourTango. Click here to read the original blog post by Dr. Saline.

College Opensource – Female Students with ADHD: How IECs Can Help

Article by Eric Endlich, PhD and Sharon Saline, Psy.D. “Nia had been so excited to go to college. She’d been diagnosed with inattentive ADHD in eighth grade and received accommodations such as extra time on tests, preferential classroom seating and getting copies of teachers’ notes. An executive functioning coach assisted her in using a calendar and organizing assignments. Nia worked hard, graduated with a 3.8 GPA and moved into her college dorm with high expectations. Sadly, six months later, she was back home. Depressed, anxious and on academic probation, she’d isolated herself, dropped one class and failed two…”

Click here to read the article.

Healthline – The 10 Best Books for ADHD in 2021

“Whether you’re the parent of a child recently diagnosed with ADHD or an adult seeking new methods for managing ADHD symptoms, there is a wide variety of books for ADHD available to offer you some guidance. Before you can pick up the best book for ADHD that fits your situation, it’s important to understand what you’re looking for. Below, we’ve rounded up the best books for ADHD according to the type of advice and topic you may be looking for, whether that’s a book for managing your own ADHD or solutions for connecting with your ADHD teen.”

Dr. Saline’s “What Your ADHD Child Wishes You Knew” was chosen Best for Parents.

Click here to read the article.

Learn Smarter Podcast: Improving Family Connections with Dr. Sharon Saline (Author Series)

“Dr. Sharon Saline, author of What Your ADHD Child Wishes You Knew: Working Together to Empower Kids for Success in School and Life, joins Rachel and Steph to discuss her goal of improving the connection between parents and learners with ADHD through improving conversation. She walks them through her 5C’s of parenting which are self-control, compassion, collaboration, consistency, and celebration. They also dive into a conversation about medication.”

Click here to listen to the episode.

Return to School with ADHD and COVID Uncertainty (again)

4 teens wearing masks and backpacks and holding school supplies and a basketball outside of their schoolJust when we thought we’d turned a corner in the COVID war, the virus is rearing its ugly head again. As kids go back to school, uncertainty looms once again. The Delta variant is making all of us more nervous than we might already be. School districts are debating mask mandates and some have returned to remote learning. It’s worrisome for parents and students–many of whom assumed that in-person learning would finally take place. When you consider the academic and social challenges for many kids with ADHD, it’s tough to know what to do to stay safe and create viable, rewarding learning experiences for your children and teens. 

Transitions back to school are typically challenging for kids with ADHD, LD, ASD and twice-exceptionality. When these changes are marked by continued concerns about the health of being in classrooms and engaging in social interactions, neurodiverse kids, who already struggle with anxiety and emotional regulation, become more stressed, worried and reactive. As parents, when you are confused about what to do or what to believe, it’s harder to put aside your feelings and be patient with your kids’ numerous questions or concerns. In this time of insecurity and frustration, the best thing you can do is name and work through the struggles.

Check-in with your child or teen about their school concerns

Father sitting and having a serious conversation about feelings around back to school with his ADHD son.

Rather than let this anxiety bleed into all aspects of daily living, pick one time per day for up to 20 minutes to discuss what’s happening. Discuss fears, acknowledge the unknowns and reflect on how you’ve all survived the challenges of the past 18 months.

          • What are some resources you relied on?
          • How did you come together as a family to support each other?
          • What types of decisions did you make previously that could be helpful now?

Let your kids ask questions and, if you don’t know the answer to their questions, tell them you will get back to them tomorrow with a response. When you assign a particular time to talk about a distressing subject, you contain it. This containment helps manage persistent anxiety. 

Here are 5 tips for making back to school with ADHD during COVID go as smoothly as possible:

1. Create predictable, doable routines–together.

Planning ahead reduces the frustration and overwhelm of making transitions for kids with ADHD. There’s no way around this. Some type of daily structure helps kids organize themselves and decreases family conflict. Use a whiteboard, chalkboard or large calendar to collaborate on what’s expected of your child in the morning, after school and before bed.

Keep these action items limited to 3 things so they are not overwhelmed. Kids can check the schedule instead of asking you what’s next so they can move themselves through the tasks. This builds confidence and competence, so they experience success as they start their year.

2. Stay compassionate and consistent.

Child laying in bed holding a hammer and holding it to a green alarm clock.Transitions are tough for many kids, especially those with ADHD, LD or other mental health challenges. Give them time to practice going to bed and waking up earlier. Brainstorm new ideas for lunch, and listen to their concerns about going back to the classroom and seeing other kids. Offer them choices about their schedule so they have more buy-in.

Your goal is to notice their efforting and aim for steadiness rather than focus on perfection. If they are trying to regulate themselves or do their chores–more times than not–let them know you see their efforts.

3. Address social anxiety without solving it.

As much as you would like to wave your magic wand and make their worries go away, kids need to learn how to deal with their fears and manage them. This is how they develop resilience, and it’s something we’ve all done to get where we are today.

Talk with them about their concern. Be sure to listen, and reflect back what you hear. Try a role play, or brainstorm possible strategies, phrases or responses. Recall past situations when they were nervous about or confronted a friendship issue and identify what helped them get through that tough moment.

The goal is to apply tools from previous challenges where they ultimately succeeded to what they are currently facing. Normalize–don’t minimize–their anxiety, and explore issues related to rejection sensitivity dysphoria.

Most kids and teens, with or without ADHD, feel uncertain at the beginning of school. Saying, “That’s not such a big deal or you’ll be fine” actually doesn’t give them the tools they need. Instead, try, “Of course you are nervous. That’s natural after not seeing people this summer or when you start a new school or have a new teacher.” This validates their experience and simultaneously reduces any shame about their feelings.

4. Make sure specific supports are in place for your alternative learner.

Notebook with a cover titled "Individualized Education Program" on a desk with other school supplies.

School is often the toughest area of functioning for neurodiverse kids. Make sure all accommodations–any 504’s or IEP plans–are in place.

Plan for an appointment to speak with classroom teachers or guidance counselors before school, and ask if your child can visit their new classroom or school to familiarize themselves with the environment. This will also reduce some anxiety.

Be sure to discuss any social concerns and discuss how you, your student and the school can work together to make this year run smoothly and successfully. Include your student in this part of the meeting so they will have buy-in.

5. Establish a back-up plan.

With so many things in flux, change is inevitable, and pushback and upsets will occur. Rather than being surprised when these occur, take some time to set up some guidelines of how you are going to manage those tense moments in advance of them occurring.

Set aside specific time for a family meeting–when people are calm, fed and awake–for no more than 30 minutes. Brainstorm possible scenarios when things go awry (I suggest using Stop, Think, Act). Agree on responses and talk about consequences for lying, disrespectful language or inappropriate behaviors.

Let your kids take the lead first on what meaningful interventions would look like. It’s useful to hear what they have to say and incorporate it into any plan you create. When you collaborate with them, they’re more likely to participate cooperatively. Write down whatever you decide and, just as you did with the daily plan, post it in a common space. 

Take care of your wellbeing as a parent, too.

Mother going on a morning run on a bike path with headphones in, practicing self-care for parent.

Regardless of the stress you feel, you’ve got this! Breathe, go outside for a walk, run or bike ride and practice self-care. Engage the support of your friends and family. This is a time to up-level your self-care.

Remember, when you travel on an airplane, the flight attendant instructs parents to put on their oxygen masks first before putting masks on their children. If you are feeling out-of-control or emotionally reactive with the stress of this COVID and school uncertainty, speak to your primary care provider or find a counselor.

Read more blog posts:

Watch on Dr. Saline’s YouTube Channel:

Deeper Dive: https://drsharonsaline.com/product/online-learning-tips-for-parents-bundle/ https://drsharonsaline.com/product/home-seminar/

Incredible Edibles: 33 Mental Health Experts & Wellness Professionals Share Their #1 Tips for Dealing with Anxiety

“Everyone experiences anxiety from time to time, but for some people, anxiety can be disruptive to their daily lives or even debilitating. If you suffer from anxiety occasionally or regularly, it’s always a good idea to talk to your healthcare provider about possible treatments and therapies that can help you better manage anxiety. However, there are some tools and techniques you can try at home.”

Click here to read the article.