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New Year, New Habits, Same ADHD: How to plan for and maintain new habits together, as a family

Happy New Year! As we welcome 2022, it’s natural for most people to consider what worked last year and what you’d like to do differently in the months to come. You might be considering how can you reduce work or family stress and improve the ease in daily living. However, many of us have realized that New Year’s Resolutions often fail–because people aim for too much change, set unrealistic expectations about happiness, and/or struggle with how to follow through on their goals. For folks living with ADHD, it’s especially tough to break down goals into achievable chunks and identify necessary steps for meeting them. Fortunately, working together as a family can make a big impact for everyone. Here’s how you can help your family work together to identify, create and maintain meaningful new habits in the year–with collaboration, accountability and encouragement.

New Year, New Habits – But Why?

A New Year’s Resolution isn’t about altering a person’s character; it’s about taking action in a measured way to promote more ease and satisfaction in daily living. Take the time to emphasize this with your family, and focus on changing behaviors rather than criticizing personal flaws. You are working together and modeling that everyone has aspects of their life that can benefit from some tinkering.

ADHD and New Year’s Resolutions

When you add in typical ADHD challenges with time management, organization and planning, well-intentioned hopes for 2022 may dissolve quickly and fade away. New Year’s Resolutions can become another way that people with ADHD feel they ‘don’t measure up.’ This year, do something different: Pick just ONE habit to focus on, and practice self-compassion as you work on it. Allow yourself and your children to stumble and regroup along the way. This is where the strengths that come with being there for each other as a family can really shine through.

Choosing Your Goal: One New Habit

1. Choose a practical time frame

You don’t have to set your goal for the entire year: that may be too long. What about a goal for three months, with a specific date to assess progress? Or would weekly goals foster a better sense of progress?

2. Tap into a ‘growth mindset’

Then, look at your mentality. The process of change relies on having a growth mindset. A growth mindset establishes that being human means living and learning: you will make mistakes, and, instead of berating yourself or your kids for their fumbles, you pause, regroup and tweak what you are doing. It’s this capacity to pivot that encourages us to keep going and keep growing. Habits take time and practice, especially if we are trying to undo something that’s familiar–even if it’s not working.

3. Choose ONE habit to focus on

Now, look around your life–your house, your job, your relationships, your routines–and select the ONE thing that really triggers you. Ultimately, family goals work best when they are collaborative. Try to choose a goal that matters to your kids or your partner, and make sure it includes something that matters to you for the best result. Choose something about your life that you’d like to see run more smoothly (e.g. family meals or bedtime rituals), result in less conflict (e.g. homework or chores) or help you be your better self (e.g. positive attitude, punctuality or patience). Write this habit down.

4. Collaborate with your family

Next, in a calm moment (maybe after dinner or on a Sunday morning), ask your kids and/or your partner to do the same. Write all of these down, add your own to the list, and then explore any overlap. Perhaps you share a family goal of smoother starts to the day, you want to have more patience, and your teen son wants less nagging. See how various goals could fit together.

5. Fine tune your goals: Be specific

As you examine your joint list, rule out items that seem like fantasy or appear too vague. Make things as specific as possible. For example, being more organized is a great goal, but it isn’t precise enough to lead you or your child to do anything differently. Whereas being more organized with your homework, about your bills, or with your clothes are all more exact and will likely result in more success.

Creating a Game Plan

Having a goal for less yelling is great, but that alone is not linked to action, and is therefore harder to do. What you need to do is identify the situations where yelling occurs, and then break down the contributing factors. For instance: If there’s a lot of arguing about ending a video game when screen time is finished, then the issue is stopping something fun and how to shift to something else. – What can you do to give more effective warnings or reminders about the upcoming transition? – What would a logical consequence be for having a meltdown? – How can your child cope with their frustration in a different way? When you identify steps to support these goals, you create concrete actions towards accomplishing them.

Making New Habits Stick: Follow Through & Maintenance

Accountability Create a plan of accountability based on pre-planned, reoccurring family meetings to evaluate progress and make any needed changes. Put these on your calendar in your phone, and on the family schedule too. Steadiness The key to being successful with your ONE new year’s resolution is steadiness. Of course, persistence can be tough for folks with ADHD, so do the best you can. Avoid expectations of perfection, and lean into being ‘good enough’ instead. Rather, practice mindful self-compassion towards yourself, your children or your partner in the midst of ‘efforting’ to change. Encouragement Words of encouragement offer crucial support and stave off defeatist, negative self-talk. Use technology for helpful reminders and prepare to repeat cues for your kids. Don’t give up when it becomes hard or you forget to do it. Instead, recalibrate and start again.

Here’s to a healthier and happier new year for all!

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Family, Forgiveness and ADHD: Loving and letting go, during and beyond the holiday season

In the midst of the hustle and bustle of the holiday season, many of us have shorter fuses. Tempers flare, angry words are said, and the joy of family gatherings suddenly sours. Sadly, the stress of special events can lead to negative interactions, behaviors or outbursts. Whatever you celebrate, you have the opportunity to pivot from feeling shutdown to being connected. The holidays bring joy, lightness and good cheer. Practicing forgiveness with your family (and yourself) will assist you in having a happier, fulfilling experience.

Recognizing the impact of ADHD on behavior

Living with ADHD can be challenging for kids and adults and the people who love them. Children and teens test limits, argue about routines and struggle to manage intense feelings. It’s tougher for them to remember their chores, to brush their teeth daily or to stop playing Fortnight or using Instagram.

Like adults, kids and teens may know what they should do, and sincerely want to do that. However, due to challenges with impulse or emotional control, they cannot make better choices with consistency. Sometimes, it’s unclear to folks with ADHD and their circle of friends, relatives and caring adults what behaviors are purposeful and what reflect having ADHD. This confusion leads to blame, shame and frustration.

What it means to forgive (and what it doesn’t)

Forgiveness is a purposeful decision to let go of feelings of resentment, blame or revenge towards someone who has hurt or harmed you–whether or not you think they deserve it. It does not condone what they did, but rather frees you from the pain of holding onto your anger and criticism.

Forgiveness is about mercy and compassion. It is something you offer because you realize that it is the most effective response to a situation. Forgiveness encompasses an awareness that a number of social-emotional and environmental factors influence reactions, emotions and behaviors of people with ADHD. It’s also about being cognizant of your self-righteousness.

Whether your young adult son refuses to take his ADHD medication and can’t seem to hold down a job, your ten year old explodes when you won’t let him watch R-rated movies, or your teen repeatedly leaves their dirty socks on the couch–what you can control is your response.

Yes, you’re agitated and disappointed. Yes, you know the medication will help, PG-13 movies are more appropriate and the socks belong in the hamper. But, what’s needed here is understanding about their struggles, scaffolding to teach executive functioning skills, following natural and logical consequences and, frankly, letting some things go.

Forgiveness in the holiday season

Forgiveness is part of the holiday spirit, because it offers somebody the gifts of kindness and generosity of spirit. Empathy is a key component of forgiveness, particularly when we are talking about neurodivergent kids and adults. Compassion teaches us that, just like us, they are doing the best they can in a given situation with the tools they have available to them in that moment. This is especially true for their Now/Not now brains. When flooded with strong emotions, rational thinking goes on a quick vacation, and the amygdala takes over with survival responses instead of thoughtful, cognitive ones.

At times, compassion can be difficult

When you are in pain–anger, sadness, guilt or shame–it’s much harder to practice empathy or compassion. It’s common for people (parents, partners, children or teens) to export this pain onto others. Then, those folks take it on and try to fix it. However, this is usually an impossible task, because you are not a miracle worker, and your capability to make things ‘okay’ is limited. Rather, acknowledge what is going on, brainstorm potential solutions together, and see what happens. Focus on doing your own work, why you feel triggered, and how the present situations might replicate something from your own history. Set up a family policy of using a Take-Back of the Day to demonstrate forgiveness in real time.

Offer yourself forgiveness and compassion, too

Rather than berating yourself for not being good enough at home, at work or in your relationships, practice accepting yourself, as you are, instead. Decrease your expectations about your professional, academic or parenting skills so you don’t walk around feeling like a failure.

A mother recently told me: “I’m pretty good at forgiving my 3 children with ADHD, but I struggle with not forgiving myself and blaming myself. I feel like I can never do enough to provide the structure they need.”

Pay more attention to what you are doing with the resources you have available. Everybody stumbles: two steps forward and one step backward is still forward motion. If you make a mistake, be accountable for your actions without going into a shame spiral of self-loathing. This is really tough to do, especially for perfectionists. But it doesn’t serve you, and it certainly doesn’t model for your kids how they can accept themselves. Start by forgiving yourself for something small, such as yelling about bedtime, rather than tackling all of motherhood.

Forgiveness is an ongoing practice

Forgiveness is an ongoing practice: it’s a gift that grows and changes over time. Releasing your resentment increases your potential for happiness and contentment. This is the best gift you can give yourself and your loved ones!

Read more blog posts:

Watch on Dr. Saline’s YouTube Channel: Deeper Dive: https://drsharonsaline.com/product/apologies/ https://drsharonsaline.com/product/home-seminar/

ADHD, Emotional Regulation and Managing Family Conflict: Replacing Time-outs with Time-in or Time-apart

Many parents of ADHD children and teens come into my office and report that nothing really works in terms of discipline and consequences. “My son just doesn’t care what we take away,” or “my daughter laughs when we ground her.” While all kids balk at rules sometimes, those with ADHD tend to squawk more often and louder. Commonly associated with ADHD are emotional regulation and executive functioning challenges, so instances where your child or teen needs to manage anger, inhibition or flexibility, for instance, can be difficult. How you decide to handle any family conflicts that might arise is important. To rein in and redirect undesirable behaviors, parents have to respond instead of react and rely on pre-arranged interventions. The Family Emotional Regulation Method (FERM) can help your family make well-considered decisions about how to manage emotional meltdowns and behavioral infractions–with options that foster connections instead of conflict.

Rethinking Time-outs for ADHD emotional regulation

Many parents rely on using Time-outs when emotions start to escalate in the family. But Time-outs focus on the “wrong-ness” of the action, rather than on the child or teen’s accountability. Most kids experience them as punishment, which makes them feel worse about themselves. They frequently feel like they are ‘bad’ people who are engaging in ‘bad’ behaviors that, because of their ADHD, they often can’t control.

In addition, Time-outs usually don’t teach emotional regulation because learning this key executive functioning skill requires modeling and support–not isolation. Of course, a child in Time-out will eventually calm down, but they usually don’t come away from the experience with the necessary tools for self-awareness to use the next time they become triggered and dysregulated.

What’s behind big emotions

Let’s look at the biology of a quick, intense rise in emotions–the amygdala takeover. It takes around six seconds for the adrenaline released during an amygdala takeover to dissipate in the brain, but up to 10-20 minutes for the effects on the body to wear off. During this time, the ‘thinking brain’ has gone offline, and emotions are ruling the day.

This is why you can’t negotiate anything in these moments. Creating a plan of appropriate options for settling down and self-soothing is what’s called for instead.

Using a Time-in or Time-apart to support ADHD emotional regulation

Isolating your upset child or teen to cool down when emotions intensify can be helpful for some people but provocative for others. While using a Time-out, such as sending your 10 year-old son to his room, when he is in a meltdown might offer you some relief, it may not be the most effective solution for him.

Instead, he may need a quiet few moments with you on the couch, rubbing his head and reading a book. This is an example of using a Time-in to manage ADHD emotional dysregulation.

Though it might be the opposite of what you feel like doing when you are activated, give it a try. Exercise self-Control (one of my 5 C’s of ADHD Parenting) by taking a deep breath, going to the bathroom to get centered, and then showing up for a hug and that quiet activity.

On the other hand, after you and your 16 year-old daughter argue about her curfew, you may need 20 minutes alone with a cup of tea, and she may want 20 minutes to listen to some music on her bed. Both of these can happen with a Time-apart. It’s not punitive; it’s recuperative.

Learning the Family Emotional Regulation Method (FERM)

The FERM relies on a pre-negotiated intervention that gives you options in the moment. As a family, talk about the pattern of emotional eruptions and lay out some strategies in advance. This way, you can better cope with what is going on when the ‘thinking brain’ goes offline. In addition, you avoid power struggles that result in banishing your ornery teen or crying child to their room out of anger and frustration. You’re also not stuck needing to invent interventions off the cuff. Instead, you integrate self-soothing strategies that work for everyone.

The Family Emotional Regulation Method is based on creating an environment for families living with ADHD that teaches self-regulation through collaboration when family members can think clearly and aren’t feeling upset. This strategy relies on the positive aspects of your parent-child connection–the bond that incentivizes cooperation in the first place.

Here’s how to create your FERM:

1. Identify the patterns

Set aside a time for one or two family meetings (15 minutes maximum) to discuss and name the triggers and characteristics of family meltdowns. Identify signs that emotions are heating up. What contributes to their escalation? What would help everybody slow down, recover and pivot? How long is an ideal recovery time for you, your child or teen? Write these down.

2. Think about your own responses:

How are you responding to your child or teen’s intense emotions? How would you like to respond? How can you help your child or teen with ADHD learn emotional regulation strategies? What tools could help you stay settled? Write these down for yourself and keep this list on your phone so you can look at it when you start to feel overwhelmed.

3. Improve cooperation:

Use everybody’s desire for fewer arguments and more peace in the house as motivation for implementing your family plan. This lies at the heart of kids’ buy-in. When you ask for their opinions and include them in your strategies, kids with ADHD feel more interested because they are working with you: you are allies on the same team to reduce conflict and nurture closeness.

4. Create your FERM chart:

Download your free FERM Chart Template handout here!

Example:

– Trigger: Setting a time limit on playing Roadblocks or Minecraft

– Kid’s Typical Reaction: Yelling and protesting

– Your Typical Response: Taking away screen privileges for the rest of the day

– Your New Planned Response: Calling a break in the action for agreed upon amount of time before escalation

– Time-Apart or Time-In Option: Ask whether your child wants a Time-in (activity together from list) or a Time-Apart (choice of self-soother)

– Recovery: Quick conversation that explores accountability and next steps

5. Practice makes progress:

Create realistic goals, aim for steadiness instead of perfection and remember that everybody is doing the best they can in a given moment with the tools available to them. It takes time and practice to change family habits of negative interactions. Try out an intervention, expect to make adjustments and then try it again.

Read more blog posts:

Watch on Dr. Saline’s YouTube Channel:

How Do I Manage ADHD and Emotional Explosions? (ADDitude Q&A with Dr. Saline)
Anger Management with ADHD (ADDitude Q&A with Dr. Saline)
How to Get Your Teens to Open Up (WWLP 22 News interview with Dr. Saline)

Deeper dive:

Sources: Cuncic, A. (2021, June 22). Amygdala Hijack and the Fight or Flight Response. Verywell Mind. Retrieved November 17, 2021, from https://www.verywellmind.com/what-happens-during-an-amygdala-hijack-4165944.

Sissons, C. (2018, July 17). What happens when you get an adrenaline rush? Medical News Today. Retrieved November 17, 2021, from https://www.medicalnewstoday.com/articles/322490.

Productive Procrastination and ADHD: How to stop running in place and start tackling your goals

Many people with ADHD think that procrastination is a natural part of having ADHD and, all too often, see themselves as being incapable of getting things done that they would like to. However, most procrastinators rarely spend their time doing nothing. Instead, they are great at doing other things–sharpening pencils, picking the right music to listen to, tidying up the kitchen, etc.: anything but the main task. It seems that people with ADHD who procrastinate can be productive, as long as they’re focusing on a task that interests them and isn’t too challenging. When people engage in more interesting and approachable tasks, while putting off a more important task that might seem overwhelming, it’s known as productive procrastination.

Procrastination, ADHD and anxiety

Procrastination can be debilitating. Your child with ADHD puts off her science project until the day before it’s due; you wait to clean your house until an hour before your in-laws arrive when your panic about having a messy living room kicks in. Adrenaline jumpstarts your activity level by fueling your dopamine pathways to fire. Often, procrastination is a form of anxiety; you’re not sure that you can do the task, project or assignment the way you want to, or at all. You’re worried and uncertain about the outcome, so you avoid it and set it aside until the due date is right in front of you. The term productive procrastination was first used by Piers Steel in his book, The Procrastination Equation. Productive procrastination is also known as ‘procrastivity‘ (Russell Ramsey, Ph.D.), positive procrastination or structural procrastination. Often, people put the big ticket items at the top of their to-do list–if they make one–followed by other easier items. Then, they aim for the low hanging fruit, even if it means they are wasting their time.

The short term relief of productive procrastination

Productive procrastination is a delay tactic that feels good because you are getting other things done while avoiding the onerous or unpleasant ones. You keep yourself busy with something else and stay away from the big thing that’s really looming over your head. You still do things that need to be accomplished, but what you work on is less urgent and important than the items you push aside. This makes you feel temporarily better because you feel like you are making progress and you are. But this short term relief increases your long-term stress.

Productive procrastination and the ADHD brain

Reducing productive procrastination relies on self-regulation and the ability to prioritize. You have to do a brain dump: identify what’s critical to do right now (emergencies and crises), and then sort out everything else. This is where folks with ADHD stumble; it’s tough to determine what is most important if urgency isn’t attached to it. It’s harder to write a history paper or finish that work report than it is to do the laundry. Both need to be accomplished, but doing the laundry is less cognitively demanding than writing, so it gets pushed to the front. It’s a task that’s more on autopilot than the creative, organizing, sorting and persistence needed for research and writing. That’s why ADHD brains wander off to do those tasks first. Tasks that lend themselves to productive procrastination often have a time frame, with clear starting and endpoints. Doing the laundry or taking out the chicken to defrost for dinner is a finite task. Written work, especially if you throw in perfectionism, does not. The ADHD brain, driven towards the satisfaction and engagement from tangible, higher dopamine activities (those that seem more easily achievable), will focus on those activities first.

4 tips to combat productive procrastination:

1. Break down big tasks into smaller chunks

When you complete a piece of work, the work not only then seems smaller, but it also helps reduce your anxiety about completing it. Create a fixed time period to work on it so it doesn’t takeover your life. If you are parenting a child or teen with ADHD, prepare to assist them in chunking assignments and chores. Take stock of what you’ve accomplished when you take your pause. You’ve done something, keep going!

2. Pay attention to and address mood issues

Your son may not want to walk the dog because he’s not in the mood. Your daughter may pick an argument with you to avoid doing her math homework. You may struggle yourself to summon up the effort to sit down and balance your checking account. Overcoming your negativity using emotional control, and starting anyway, is what’s called for. With a smaller chunk of work as your goal, and a set start and stop time, you may find that you can summon the motivation to begin. Consider playing soothing or inspirational music, making a cup of your favorite tea or setting your timer. Ask your kids what would help them get into the frame of mind. The mood may never arrive, and that’s okay. Do it anyway. If you can’t, make a plan with a friend, family member or work buddy to help you talk about what’s bothering and sit down at your desk. If there is nobody you can reach, talk it out in your voice memo, or write it out for a short timed period. Think about how you will feel (positively) on the other side of doing some work.

3. Avoid negative self-talk, exaggeration and trickery

Negative self-talk will tell you that you can’t do things that you actually can do and probably have accomplished in the past. Anxiety often erases memories of courage and competence, and our negative memory bias doesn’t help. Anxiety also distorts things and can exaggerate the discomfort or impossibility of doing a task. Many people with ADHD also deceive themselves into thinking they cannot do something because it didn’t work before, without giving themselves a chance to try it again differently. This is true for kids, too. Challenge these parts by recalling previous successes. Think about a time when you dreaded doing something and left it until the last minute.

- How did that work out for you?
- What was the price you paid to complete it?
- Do you want to do that again?

Create some phrases to talk back to this part of you:

- Say, “Yes, I can do this, and I have succeeded in the past.”
- Or, “I’ve set my timers, I’ve planned my reward when I stop, so let’s get started.”

4. Build a strategy to reduce productive procrastination

Use your logic and ask for help when needed. These tools will continue to improve prioritization skills. Over and over, ask yourself (or your child) about the time and value factors related to the tasks on your to-do list:

- Is this urgent?
- What is the importance of this task?

Identify helpful supports–whether digital apps or human advise. Create a map of how to approach the hard stuff, how to set up meaningful incentives, and what tools you might need for self-regulation to get there. If you are really struggling, consider finding a buddy who can assist you or keep you company in this process.

Read more blog posts:

Watch on Dr. Saline’s YouTube Channel:

ADHD & Productive Procrastination (ADDitude ADHD Q&A with Dr. Sharon Saline)
Planning and Prioritizing with ADHD (ADDitude ADHD Q&A with Dr. Sharon Saline)
4 Tips to Boost Motivation in Kids and Teens (WWLP 22 News Mass Appeal Interview with Dr. Sharon Saline)

Deeper dive: https://drsharonsaline.com/product/harness-grit/ https://drsharonsaline.com/product/home-seminar/

Sources: Ramsay, R. (2020, July 16). Procrastivity (a.k.a. sneaky avoidance) and adult ADHD coping. Psychology Today. Retrieved November 3, 2021, from https://www.psychologytoday.com/us/blog/rethinking-adult-adhd/202007/procrastivity-aka-sneaky-avoidance-and-adult-adhd-coping. Steel, P. (2012). The procrastination equation: How to stop putting things off and start getting stuff done. Harper.

Celebrate ADHD Awareness Month by Accepting the Wonderful Uniqueness of Living with ADHD

October marks ADHD Awareness Month! Let’s kick this off by focusing on how you can live with more acceptance of ADHD — as an individual, as a family or with your child. As a person moves through life with ADHD, criticism, from others and yourself, not only adds up over the years but also becomes internalized negative beliefs. This inner critic puts you down and makes it seem like you never measure up when compared to neurotypical peers, who seem as if they don’t make as many mistakes or struggle to the same extent. The secret to reducing negative thought patterns and harsh self-judgments lies turning down the volume of this negative self-critic and accepting the brain you have. Maybe it’s forgiving those moments where you forgot an appointment or learning how to laugh when your daughter left her lunch on the counter again. Acceptance begins by normalizing your experiences and recognizing that you’re not alone. It begins with self-compassion.

Embrace your ADHD with self-compassion

Dr. Kristin Neff says that self-compassion is treating yourself with care and understanding instead of harsh judgment. This compassion reduces the isolation that your inner critic thrives on and places you within a common humanity. Instead of feeling alone, unworthy or damaged, you are part of a larger whole — who also experiences disappointment, frustration and low self-esteem at times. All suffering is not the same, of course, but all humans experience pain and suffering in some way that’s worthy of empathy. Dr. Neff explains that compassion depends on mindfulness: the ability to sit with things as they are and not deny or minimize them. This is especially important for kids with ADHD, who need to accept themselves — warts and all — in order to learn how to advocate for themselves effectively and see themselves positively as they develop. Self-compassion means asking yourself, “What would help me now? What do I really need at this moment?” instead of, “What’s wrong with me? Why can’t I get things right?” It allows someone to stop fighting with themselves and start embracing a growth mindset instead.

Explore who you are, and address feelings of shame

Accepting yourself depends on identifying your strengths, talents and interests while acknowledging and addressing shame. I have been working with kids, teens and adults with ADHD for nearly 30 years, and there is one sad constant that I have seen: every single person has a deep seated sense of shame about having ADHD and/or being ‘different’ from their peers. Whether this shame is obvious or buried, many youngsters and adults living with ADHD just don’t feel good about how they manage school, work, life tasks or social relationships next to their peers. Just like your kids, you may compare yourself to others and come up short. Engaging in “compare and despair” not only hurts you but also makes it much harder to foster the resilience and self-compassion that you and your child really need. When shame, doubt and judgement rise to the surface, shift your focus, and talk back to this inner critic: “I don’t have to listen to you. I can pay attention to my inner coach instead.”

Amplify the voice of your inner coach

While you need to know where you struggle to create plans and programs for improvement, it’s equally very important to remember and understand where you succeed, where you are engaged and what makes you feel good about yourself. This inner coach is your other voice — another part of ourselves that’s stronger and louder than shame. It comes from the parts of ourselves that we really like. Ask yourself:

- What about myself am I proud of, and what do I do well?
- What do I like about my ADHD?
- Which activities do I really enjoy and wish I could engage in more?

Brainstorm answers to these questions with your kids, too! Maybe you’re a loyal friend or a talented artist; maybe they are a skilled soccer player, delicious baker or enthusiastic pianist. Write down several of these positive aspects, and leave this list in a bedroom, in the kitchen or on your phone.

**Identify what your ADHD means to you.**

One of my 10 year-old clients transformed the term ADHD into a colorful list of words he liked about himself: “I have ‘Active, Determined, Heavenly, Dreamer Brain,’ or I have ‘Amazing, Desirable, Heartwarming, Delightful Brain.'” What a great positive reframe from having a “disorder,” which is a term that many people in the ADHD community don’t actually agree is an accurate way to describe their ADHD neurotype. According to Dr. Barbara Fredrickson, the ideal positivity ratio is 3 positives for every 1 negative. So, by having his list around, it cued him to notice the positive every day. He increased the volume of the voice of his inner coach while turning down the noise from his inner critic.

Celebrate YOU this ADHD Awareness Month

ADHD Awareness Month is about celebrating who you are. Celebrate by noticing what is working, what goes well and what you like about yourself. Help your kids do the same! There are so many wonderful aspects of being a creative, outside-the-box thinker. Can your family name these or make a fun poster to hang in the kitchen during October? People who live with ADHD make our world a much richer place. Take pride in the things you or your kids do that are unique, funny, artistic, athletic and brilliant. Accepting yourself with self-compassion allows you to be good enough just as you are: a wonderful, perfectly imperfect human being, and unique — just like everybody else! Enjoy this ADHD Awareness Month — dedicated to you!!

ADHD Awareness Month Events with Dr. Sharon Saline:

ADHD Awareness Expo (10/1 – 10/31) Hosted by Tara McGillicuddy

TADD Talks for ADHD Awareness (10/1 – 10/31) Hosted by ADDA

3rd Annual ADHD EdCamp Home (10/9) Hosted by Brooke Schnittman, Dr. Christina Seamster, Lynn Miner-Rosen and Melissa Knight

On The Right ADHD Trail Telesummit (10/15 – 10/17) Hosted by Cathy Goett

Join me at the 2021 Virtual International Conference on ADHD in November! It’s a fantastic place to learn, socialize and have fun with hundreds of people living with ADHD — just like you! Register here!

View all upcoming events with Dr. Sharon Saline.

Read more blog posts:

Watch on Dr. Saline’s YouTube Channel:

How Do I Explain ADHD Without Shame? (ADDitude ADHD Parenting Q&A with Dr. Saline)
Tips for Helping ADHD Kids and Families Share Feelings (ADDitude ADHD Parenting Q&A with Dr. Saline)
How to Deal with & Educate ADHD Doubters (ADDitude ADHD Parenting Q&A with Dr. Saline)

Deeper dive: https://drsharonsaline.com/product/shame/ https://drsharonsaline.com/product/home-seminar/

Planning and Prioritizing Practices for ADHD Brains: What’s the plan, and when do you start?!

Does it ever seem like you have way too much to do, and every task looks equally important and daunting? Many kids and adults with ADHD struggle to figure out what the order of doing things should look like and how to get started. This contributes to the common experience of feeling overwhelmed. There often needs to be a crisis or something unpleasant will occur if you don’t do the task right now. Planning and prioritizing are executive functions that are closely related to organization, time management and initiation. However, these skills can be improved individually, and here are some practices to help get you started.

The Core Principles of Prioritizing

Before learning techniques to help you (and your kids) decide what to do, in which order and when to begin, let’s look at the fundamental principles of prioritizing: urgency and importance. Urgent tasks cause us to react immediately and stop whatever else we are doing to attend to them. Urgency reflects a time pressure or a deadline. Important tasks represent the significance we attribute to something. They also reflect our life values and guide us towards our purpose and goals.

How we prioritize things, and understand their relevance, depends on two connected factors:

1. 1. The first revolves around when something needs to be accomplished and why it needs to be accomplished, based on what we know about it.
  2. The second factor involves emotion: our brain calls up any conscious or unconscious memories about this task (or something like it) from our lived experience. The feelings that go with these memories contribute to how we rate the significance of the task, its interest to us and its inherent rewards.

When we are faced with prioritizing activities, these two factors work together to engage or bore us.

Urgent and Important: Learning the Eisenhower Matrix

The Eisenhower Matrix was developed my President Dwight D. Eisenhower to assist him in choosing which of the many tasks to focus on each day and make difficult decisions. This matrix can be very useful to folks living with ADHD as a tool to help them think about the ways that they prioritize certain items while putting others off.

Here is my adaptation of The Eisenhower Matrix:

- Quadrant 1: Spending time in Q1 means living in crisis mode. Many kids and adults with ADHD live here or put things off until they wind up with emergencies. The intensity of urgency and importance helps motivate them to get things done, but they wind up with lots of stress.
- Quadrant 2: Time in Q2 feels like being in the flow; you are setting goals for yourself, making plans and following through.
- Quadrant 3: When you struggle with managing interruptions and setting boundaries, you probably spend time in Q3.
- Quadrant 4: Q4 is the home of distractions–everything you do to avoid the task at hand.

Spend time reflecting on the following questions:

– Where do you spend your time? – In which quadrant does your child or teen hang out? – How can you spend more time in Q2 and less time in Q1 and Q4?

To improve the ability to prioritize, we have to strengthen our capacity to determine time pressures (deadlines); schedule plans, work, homework, personal projects, chores and errands, and then reasonably estimate how long something will take and rely on a system of organization. Then, you’ll have to break tasks down into small enough, bite-sized chunks to get started on them. This typically means using the exact executive functioning skills that are naturally challenging for ADHD brains.

4 Steps To Approach Planning and Prioritizing with ADHD:

1. Do a brain dump:

Many folks with ADHD attempt to hold all of their to-do items in their head or write them on several pieces of paper which they then cannot find. Centralize this process. Pick one location for your lists: your phone, your computer or iPad or a notebook. Sit down and take two deep breaths: breathe in for 4, hold for 4 and breathe out for 6. Now, write down everything you can recall that you need to do. You probably won’t get everything in one sitting–that’s fine. You can come back and add things as necessary.

2. Assign time and importance values to your tasks:

Pick a time value (when is this due?) and an importance value (how critical or significant is this?) for each of these items in order to prioritize them. This is where most kids and adults with ADHD get stuck. Everything seems equally critical, unless there’s a real emergency that’s pressing. I’ve created this chart with some examples to help you create your own. You can also use Post-it notes to help you move things around and schedule them.

TASK	DUE DATE	SIGNIFICANCE	PRIORITY NUMBER
Laundry	None	I have no clean socks	2
Work Report/History Project	Friday – in 2 days	Performance/50% grade	1
Making dentist appointment	Haven’t had a teeth cleaning in 2 years	Cavities, gum disease or other concerns	3

To decide the priority number, ask yourself these questions:

– What will happen if I don’t do this? – What will happen if I do this? – Which task am I leaning towards avoiding?

The more you don’t want to do something, the more likely that it’s important to start. These answers are usually very personal. Some people might rank making the dental appointment over the socks and will wear a used pair again. For me, I prefer clean socks and I can make the dental appointment when I’ve started the laundry.

3. Make an accountability buddy, or be a body double:

It’s usually easier to determine your priorities when you have support. Having someone to discuss ideas with or talk through urgent and important issues can be extremely helpful to kids and adults with ADHD. Planning and prioritizing are executive functioning skills that really benefit from direct instruction, so having another person there to assist you is essential.

As adults, think about a friend or family member who can support you as you do the laundry, clean up the kitchen or break down the steps to approach your work report. With kids, you are that buddy.

Become a body double: sit with them while they pick up their clothes from the floor and fold the clean stuff. Or, review their brain dump and talk through how to choose where to start.

4. Be patient and persistent:

Planning and prioritizing on a regular basis takes practice and time. Expect to stumble and feel frustrated. This is a tough skill to learn and practice makes progress! Most people, with and without ADHD, struggle with this skill so be kind to yourself and compassionate with your kids as you embark on improving it.

Read more blog posts:

Watch on Dr. Sharon Saline’s YouTube Channel:

Initiating and Completing Tasks with ADHD (ADDitude Mag ADHD Q&A with Psychologist Dr. Sharon Saline)
Planning and Prioritizing with ADHD (ADDitude Mag ADHD Q&A with Dr. Sharon Saline)
4 Tips to Boost Motivation in Kids and Teens (WWLP 22 News Mass Appeal Interview with Dr. Sharon Saline)

Deeper dive: https://drsharonsaline.com/product/harness-grit/ https://drsharonsaline.com/product/home-seminar/

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

Neurodiverse 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.

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

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.**

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.

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.

Read more blog posts:

Watch on YouTube:

ADHD and Oppositional Defiance (ADDitude Mag Q&A with Dr. Saline)
Anger Management with ADHD (ADDitude Mag Q&A with Dr. Saline)
How to Get Your Teens to Open Up (WWLP 22 News interview with Dr. Saline)

https://drsharonsaline.com/product/managing-technology-families-video/ https://drsharonsaline.com/product/home-seminar/

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

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.

Kids and adults with ADHD often get overwhelmed when they’re asked to stop one activity and start another. Shifting from o ne 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.

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:

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!

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.

Read more blog posts:

Watch on Dr. Sharon Saline’s YouTube Channel:

Initiating and Completing Tasks with ADHD (ADDitude Mag ADHD Q&A with Psychologist Dr. Sharon Saline)
Planning and Prioritizing with ADHD (ADDitude Mag ADHD Q&A with Dr. Sharon Saline)
4 Tips to Boost Motivation in Kids and Teens (WWLP 22 News Mass Appeal Interview with Dr. Sharon Saline)

Deeper Dive: https://drsharonsaline.com/product/motivation/ https://drsharonsaline.com/product/home-seminar/

Return to School with ADHD and COVID Uncertainty (again)

Just 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

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.

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.

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.

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:

How to Help Your Children Transition Back to School Smoothly (WWLP 22 News Mass Appeal interviews Dr. Saline)
ADHD Students: Tips for Transitioning Back to In-person Learning (ADDitude ADHD Parenting Q&A with Dr. Saline)
Help Your Kid Overcome School Anxiety (Operation Parent Webinar with Dr. Saline)

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

Responding to ADHD Doubters: Learn history and science that debunks 5 common ADHD myths

It’s a sad but true fact. Many people still, even after the surge of ADHD research over the past 30 years, don’t believe it’s real. Whether they are misinformed about – or deny – the existence of neurodiversity, their denial likely affects you in some way at work, school, religious groups or social functions. Dealing with doubters means educating them instead of responding to them with anger, frustration or avoidance. Whatever blame, shame and criticism you receive from the doubters in your life tarnishes your relationships. When they deny your reality, they minimize your experience. Support yourself and your neurodiverse kids by challenging myths with these facts.

5 myths commonly believed by ADHD doubters, and why they’re not accurate:

Myth #1: ADHD is not real.

Actually…

ADHD traits have been recognized and studied for centuries.

The first time a disorder resembling ADHD appears in history is with findings by Scottish physician and author Sir Alexander Crichton in 1798. Since then, reports of ADHD-like traits have been discovered throughout history with neurodivergent explanations and types of treatment. The American Psychiatric Association did not recognize ADHD (as hyperkinetic impulse disorder) until 1968, in its second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM).

In fact, it took until 1937 for medication to be formulated for ADHD, and it was discovered completely by accident. Dr. Charles Bradley was originally tasked with creating something that would alleviate headaches in children under the care of staff at Emma Pendleton Bradley Home (now Bradley Hospital in Road Island). It was the first children’s psychiatric hospital in the nation.

ADHD has had many names.

Previous names used to identify ADHD before its current definition was set forth include:

- - - brain-injured child syndrome,
    - hyperkinesis (1968 DSMII),
    - hyperactive child syndrome,
    - and minimal brain dysfunction.

Researchers in the 1970s observed that hyperactive children are likely to experience chronic inattention issues. Both symptoms improved with stimulant medications. Thus, the third edition of the DSM outlined the meaning of ADD in 1980.

More research and awareness has led to more diagnoses.

Because there was a more thorough and accurate diagnostic description, and the terms have become more common in households around the world, official diagnoses started climbing in the 1990s. More parents were able to recognize symptoms in their children. There was also increasing awareness in the medical and expanding mental health fields.

The most recent definition of ADHD was outlined in DSM 5 in 2013. This current description of ADHD in the DSM 5 outlines hyperactivity/impulsivity, inattention and other factors that are specific to people with ADHD. The Centers for Disease Control and Prevention (CDC) gives more details on diagnosis factors, allowing the general public to be better informed when it comes to caring for and interacting with people with ADHD.

Myth #2: ADHD is caused by poor parenting.

Actually…

ADHD is not at all caused by a lack of discipline for children and teens.

ADHD is a biologically based condition. According to the CDC, it is the most common neurodevelopmental disorder of childhood. Additionally, it is the most highly inherited mental health issue reported, as over 50% of adults with ADHD will have a child with ADHD. If one child in a family is diagnosed with ADHD, there is a 33% chance that another child has – or will have – it.

ADHD is not just hereditary. Often, difficulties during pregnancy or premature delivery can cause your child, and other children down the line, to experience symptoms. Prenatal exposure to ethyl alcohol, drugs and tobacco are all exposure risks that could impact the neurodiversity of children. Teach your children about these risks as part of supporting a healthy lifestyle.

Myth #3: ADHD is over-diagnosed and medication is over-prescribed.

Actually…

More research and awareness has led to more diagnoses.

As we discussed earlier, it was just a few decades ago that the medical community really got a grasp on this condition. A lot of research is recent and ongoing. So, of course, there were fewer diagnoses until more recently. At the time of this article, around 10% of children in the United States are diagnosed, with a reported 5% worldwide. The rate of adult ADHD diagnoses is 6.76% and steadily rising.

Getting an ADHD diagnosis isn’t easy.

The ADHD diagnosis process, and what it takes to get there, is complicated and thorough. It’s more than filling out a form. Rather, it involves a complete history and assessment of cognitive abilities, learning capabilities and attention.

Medication for ADHD management is closely regulated.

Medication is more stringently prescribed than in the past. Studies have found that when kids and adults with ADHD are given appropriate medications that work for them, medications reduce the need for substance abuse, or self-medication.

It is important to remember that medications do not help everyone who has ADHD. Some people can’t tolerate the side effects or don’t see noticeable positive changes. Of course, pills don’t teach skills. The most effective treatment has been found to be a combination of medication and cognitive behavior therapy, family dynamic and personal education that includes (sometimes extensive) parent training.

Myth #4: Most kids with ADHD outgrow it.

Actually…

While children diagnosed with ADHD do have the ability to outgrow it, that is not always the case.

In fact, only around 20% of early diagnoses tend to outgrow their symptoms. In addition, adult ADHD can be more complicated to diagnose, especially in women. Just as the tools to identify ADHD in kids have become more robust over the years, the measures to assess ADHD are better understood and more reliable. However, because of the recency of these developments, some adults who were told they had ADHD as kids may have been misdiagnosed or their symptoms were (due to a lack of information) completely overlooked in their childhood.

Another very likely factor is that adults have developed personal strengths and habits over the years to help them live more effectively. They simply have more choices and autonomy than children and teens. They can change their environments – home, work and otherwise – and encourage themselves in different, more sophisticated ways. For these reasons, ADHD symptoms may be less likely to interfere with their everyday life.

Myth #5: ADHD is actually a lack of self-discipline.

Actually…

ADHD is a biologically-based disorder related to the neurotransmitters dopamine and norepinephrine.

ADHD is a chronic condition marked by many notable symptoms, including persistent inattention, hyperactivity or impulsivity. While these traits can exist in neurotypical children, teens and adults, they are often observed more frequently and at a much higher intensity in those with ADHD compared to others in similar age and cultural groups.

ADHD is often associated with the belief that there is a lack of self-discipline and inability to participate, focus, or achieve. There is an overall misconception that people with ADHD are lazy and unmotivated. It just isn’t true. It’s not about laziness or purposeful distractedness. In fact, I don’t like the word “lazy” at all!

It is common that people with ADHD focus more easily on things they like or excel at. This is a trait we can all access to some degree, an indescribable satisfaction with a project or outcome. The focus on this idea or that result is derived from an interest in the activity itself, and the satisfaction of the journey. More engaging activities do find more appeal.

People with ADHD often find lengthier pursuits, things that require concentration or more time on the finite, overwhelming and daunting.

These types of activities include work meetings, classroom lectures, loud events or shows, homework and an array of athletic endeavors. Even with the benefit of of hyperfocus, folks show adverse feelings toward completing projects, homework sheets and forms. Often, people of all ages with ADHD find the ability to focus on more interactive pursuits like video games and television for more extended periods of time. These activities are inherently captivating – the rewards are built right into them!

While defending the existence of ADHD can be a bit complicated sometimes, it is definitely worth knowing the facts. Have a few go-to facts to rely on when you need help the most. Create a few phrases based on this information that you can use when you encounter a doubter. To keep up your morale, make sure you keep people who acknowledge the truth of ADHD and know about it near and dear. The more support the better!!

Read more blog posts:

Watch on Dr. Saline’s YouTube Channel:

How to Deal with & Educate ADHD Doubters (ADDitude ADHD Q&A with Dr. Saline)
What the world gets wrong about ADHD – ADHD Awareness Month (ADDitude ADHD Q&A with Dr. Saline)
How to Get Your Teens to Open Up (WWLP 22 News Mass Appeal interview with Dr. Saline)

Deeper dive: https://drsharonsaline.com/product/home-seminar/