Month: February 2023

Ask Dr. Saline: How Do I Build New Skills with Executive Functioning Difficulties?

New skill loading Dear Dr. Saline,  What is the main skill to work on with someone to help with their executive functioning difficulties? Assuming they are not on meds. Sign-up for my newsletter + Free Handout | Ask Dr. Saline  

From Dr. Saline 

Dear M: When I work with people to improve their executive functioning skills, we start with their primary areas of concern–the parts of daily life that are persistently tough for them. Since you didn’t mention your primary challenges, I recommend beginning with self-evaluation to find your main skill. Then, find a quiet time to reflect on these questions.

Questions to Consider:

  • What are the performance or productivity issues that challenge you the most?
  • How well can you manage your emotional reactivity or impulse control?
  • How easily are you distracted from the task at hand? 
  • What helps you maintain focus and stick with goals?
  • Do you find that you become overwhelmed and shut down more than you would like?

If I had a magic wand…

magic wandOnce you have considered these questions, ask yourself: If I had a magic wand and could change one thing about myself, what would it be? Then, consider all your responses and choose ONE main skill you would like to improve first.

How to start the process of change

Here are some tools you can use along the way to start the process of change: Inhibition and Emotional Control: Slow things down, pause before responding to anything, expect setbacks, and create a plan for recovering and making amends. Initiation:  Break things down into smaller components; use Apps to assist you; reduce perfectionism so you can begin and complete things without pressure; decrease avoidance by starting with something easy to get rolling. Organization: Lay out steps for completing tasks; create daily routines; make spaces for dealing with and storing materials. Prioritizing: Do a brain dump to help you distinguish between what’s urgent and important; break that list down into a smaller list of 3 tasks and then identify their components in terms of time and values. Sustained attention and Goal-directed persistence: Consider possible obstacles to maintaining focus; create a system of reminders to redirect your attention after you have drifted off; set realistic goals based on your actual capabilities and schedule breaks. Working memory: Write things down where you can find and remember them; use alarms, alerts, and notifications; take notes during important meetings, classes, or conversations; if note-taking is difficult for you, brainstorm solutions with your supervisor, professor or partner that may include recording things or let caring coworkers or friends assist you by taking notes (you may also ask for ADA accommodations).  Metacognition: Ask yourself questions that help you monitor and evaluate your productivity and emotional regulation and measure your progress toward your goals. Questions to start with: “How am I doing?” “What helped me before that I could apply to this situation?” Executive Functioning Skills by Sharon Saline

“Improving executive functioning skills takes practice, patience, and determination. While medication can be very helpful, pills don’t teach skills.” ~ Dr. Sharon Saline, Clinical Psychologist

Research

Recent research from the Florida International University Center by Dr. William Pelham found that, while medication-assisted children helped children complete more seatwork, improve their classroom behavior, and reduce rates of getting in trouble, children learned the same amount of subject material such as math, vocabulary, social studies, etc. as their peers. Another study by Dr. Pelham also emphasized the importance of behavioral therapy to learn tools and strategies to succeed at home, work, school, and social environments. Does this mean that people should stop taking medication? Absolutely not. But it underscores the importance of learning executive functioning skills for practical daily living. 

In Conclusion

Brain functionAll human beings have executive functioning skills managed by the prefrontal cortex of our brains. Executive functioning skills describe the directive capacities of the brain.  They work as a command center: connecting, prioritizing, and integrating cognitive functions moment by moment. They are responsible for self-regulation, linking memory to what we see and think about right now, self-awareness and judgment, and actions related to productivity and performance. People with ADHD have significant executive functioning challenges, with some areas of severity that can be quite impairing.  

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How to Practice Compassion & Understanding When Your Child Is Struggling In School

Father and Son Talking Students with ADHD want to do well in school, and most of them put a lot of effort into their work. But at the same time, they must contend with issues around focus, organization, distractibility, impulse control and time management, and their academic workload. So let’s take a step back and see how you can prepare your response to a disappointing report card and a disappointed child. Read More>>
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Why delegation is hard and how to ask for help with confidence

woman helping her friend climb mountain with clasped handsDo you hate asking for help because it makes you look weak, helpless, or incompetent? Many adults with ADHD feel this way, and you’re not alone. You may think there’s shame in getting help because you’re worried about disappointing others or possibly failing. But when you refuse to ask for help, reject it when offered, or pretend you’ve got things covered when you don’t, you make life much harder for yourself. When adults with ADHD are overwhelmed by a task, asking for assistance is often tougher because you are unsure where to focus or how to start. It can seem like you’re climbing up Mt. Everest with no trail map or markers along the path. You’re stuck but don’t want anybody to know or see your struggle. Shame rears its ugly head and shuts you down. Learning when, how, and where to delegate can change this pattern and offer personal and professional growth opportunities. But asking for assistance can make a world of difference. 

Asking for Help

Asking for assistance or delegating tasks doesn’t come easy for many of us, especially perfectionists. But living means leaning on others for support sometimes. There are times when you can’t do it alone. Becoming comfortable asking for help or offloading things to others relies on several things: 

  • Accepting that it’s okay not to know how to do something  
  • Accurately assessing personal strengths and limitations
  • Understanding that learning happens through trial-and-error experiences 
  • Acknowledging that perfection doesn’t exist

focus on progress not perfection graphicProgress counts more than perfection every time. Perfection is impossible to achieve; if that’s your goal, it’s easy to freeze out of fear of not achieving it. Instead, focus on shorter, reasonable goals that you can meet. Making progress on a task is always better than striving for perfection and getting nothing done.    

When You’re Overwhelmed by Big Feelings

Lack of clarity

Sometimes neurodivergent adults need clarification about what would be helpful. When you’re overwhelmed by big feelings, disorganization, and incomplete tasks, it’s tough to prioritize. Prioritizing relies on determining what is urgent (time-driven) and what is important (value-driven). When you are flooded emotionally or genuinely uncertain about what to do, you may reject any offers for assistance because you can’t process anything else at that moment.  TOOL: Break things down. Take a large piece of work and break it up into a few smaller tasks. Name each task, determine how to complete it, and identify when things are due. Ask for assistance from an ally like a friend, relative, or coworker. Brainstorm and separate identified items into categories by subject, deadline, or complexity. Break these items into smaller steps and mark who is responsible for completing each step. 

Focus on strength & authenticity

frustrated man in front of computer holding up help signAlthough most adults dislike being vulnerable, it’s especially tough for those with ADHD. You’ve already spent years hearing about how you’ve missed the mark–at school, extracurriculars, work, and home. You probably believe you will mess up again. You may not trust your abilities to respond appropriately, and consider asking for help further demonstrates weakness. By refusing any support, adults with complex ADHD falsely think that they can protect themselves from feeling exposed.  TOOL: Reframe vulnerability as strength. It takes courage to be accountable for your limitations and stay open to assistance. Instead of seeing help as a manifestation of weakness, focus on the strength in authenticity and knowing when you can’t do it alone. Remember that most people are kind and will be happy to aid you. They may even feel flattered that you sought them out for guidance!

Ask for assistance

Waiting for the next time they inadvertently do something ‘wrong’ and the criticism that will surely follow, many neurodiverse adults live with deep-seated and internalized shame about being ‘different’ from their peers. Whether this shame is visible or hidden, you may see any successes as short-lived and not believe that anything will make any difference. Moreover, shame prevents people from asking for support. For example, Ellie, age 27, tells me: “I’m embarrassed that I can’t do it alone, that I have a disability.”  TOOL: Asking for help is not a reflection of failure but rather an act of resilience. Recall a time in the past when you struggled, asked for assistance, and pulled through. How can you link the lessons from that experience to a current situation? 

Change your expectations

Nobody wants to let people down. The pressure to measure up can be intense, especially with social media driving the endless cycle of ‘compare and despair’ dynamics. Asking for help seems like opening the door to an avalanche of disappointment you would rather avoid. So, instead, you wrestle with doing things on your own, trying to get things ‘just right,’ giving up so you can’t fail, or praying for a miracle. Let’s face it; there is no perfect: everybody stumbles. The most important thing is to pick yourself back up, understand what happened, and make different choices as you learn from your experience.  young man with pencil speaking to smiling womanTOOL: Stop worrying about disappointment and pivot to what’s needed for optimum productivity and best performance. Are your expectations for yourself realistic? If not, what needs to change? Create goals that are within reach. Reduce your focus on the outcome and shift to emphasizing the process of doing something–efforting. You may not be able to do it alone. That’s okay. Who can help you, and what can they do?

Start small and build on each delegation’s success

hand holding wooden blocks stacked in growing columnsMotivate yourself to try delegation by starting small. Sometimes it’s hard to trust that other people will follow through, and you may feel insecure. Build your confidence in others slowly by first establishing low-risk experiments on simple tasks.  For example, if you’re stuck on a spreadsheet task, seek out a friend or coworker who is a spreadsheet rock star. Tell them how much you’d appreciate their expertise, and ask them to walk you through a couple of examples until you get the hang of it.    Your primary goals are to relieve stress, increase productivity, and get things done simultaneously. So please be sure to recognize when you need extra help, empower yourself to ask for it, and accept it.

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Become A Member

Please become a member of my newsletter community. You can find support and resources and connect with a group that understands your questions and needs. Click here  Follow me on social media: YouTube, Facebook, Twitter, and Instagram. Invite Me to Speak | Join A Group | Newsletter | Read my blog  

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