Ask Dr. Saline: Helping kids with ADHD find alternatives to screens

Dear Dr. Saline, Dear Dr. Sharon: Our 14 year old son can rarely think of alternatives to screen time that he actually seems to enjoy. He does not do video games or sports–doesn’t react quickly–but does love movies/Youtube videos and would watch them constantly if we did not set limits. When his screen time ends he frequently asks, “What are we going to do?” but has no response to, “what do you want to do?” When he “is in the mood,” he likes to read, draw or write stories. He also plays the trumpet in the school band. How can we help him discover alternatives to the screen and try new things?  – Eve

From Dr. Saline

Dear Eve, Thank you for this great question. It’s tough for so many kids with ADHD to stop engaging with screens and choose alternative activities. While it sounds like it’s easy for him to log onto his devices to watch movies or television, there’s not a lot of natural rewards or satisfaction in logging off. Nothing else seems as interesting which is why managing screens is such a huge, common problem in families. He is resistant to shifting to a different activity and is unclear about making a decision because he really has no idea what would be as much fun. He needs a visual cue. Luckily, he has other interests and hobbies so you are halfway there. 

Set Expectations Around Screen Time

While logging onto devices is easy for kids, especially those with ADHD, getting off can be an ordeal for everybody. This phenomenon is related to the lower amounts of the neurotransmitter dopamine in ADHD brains. With their Now/Not now thinking and need for visual stimulation, kids like your son struggle to make transitions to anything after screen time. Helping your son understand that technology is a privilege, not something he’s entitled to, is an important first step. Most kids think they should have their screens 24/7- no matter what. So, establishing sensible technology guidelines for your child is critical. Instead, we want to use screen time as an earned privilege that is part of an established routine with clear limits. Plus, it’s critical to separate out different types of screens or programming: watching movies does not equal watching YouTube videos or television shows. My guess is that your son dislikes your arguments as much as you do.  Reducing them and “stopping your nagging” is his incentive to cooperate. Set a time to sit down and talk about managing screen time in the family. Be clear about how much time you want him to have as a baseline and what he can earn through cooperation. Ask him about his desired amount and see if you can create a compromise that is lower than what he initially wants but offers him opportunities to earn more time. This Easy On/Easy Off plan is based on collaboration. By linking his desired screen time to activities you would like to see him pursue, you are putting the have-to’s before the ‘want-to’s. He has to do a non-screen activity before using the screens OR he can have his baseline screen time but the bonus time is earned after doing something different. Either way, he’s broadening his horizons.

Brainstorm Alternative Activities Together

Given that there is a delay in the maturation of the ADHD of up to three years, I think it’s unlikely that your son will willingly exit his technology time or choose a follow-up activity. His brain is on stimulation overload and wants more of something high-paced. Instead, I recommend that you create a list of possible activities that he can choose from. During a quiet moment, brainstorm “The Big List.” This list will become your handy tool to offer him options when he is bleary-eyed and help him improve his abilities to organize, prioritize and sequence as well. Together, rank order the stuff that seems most fun to him and move those items to a new list so that he’s not overwhelmed. (Later, when he’s tired of this shorter list, make a new one from other, unused activities on the first one.) When it’s time to turn off the screen, give him a choice of three activities from this list. I call this process Guided Free Choice. The list stimulates his brain so he can see his options instead of recalling them or arguing with you. He will feel less pressure and so will you.  Here are some suggestions:  Go outside–run, walk, swim, bike, skateboard or scooter Baking/Cooking Art–drawing, painting, chalk designs, coloring books Photography Play a board game or a sport Do Soduku or other puzzles Read a book or illustrated novel Listen to or play music Learn card tricks, yoyo skills or juggling Go to bowling or to a rock climbing gym or escape room Do something with a grandparent or friend–mini golf, ice cream, surprise adventure, etc Do chores to earn a desired privilege or activity Volunteer Build a fort Take a class  Stage a play Using the Easy On/Easy Off plan and Guided Free Choice will take practice and patience. You may need to tweak these strategies to fit your family’s needs. Stick with these tools and you will find alternatives to screens which work for you. I am confident things will improve for the better soon.