Navigating ADHD: Empowering Executive Functioning Skills
As a child and teen psychotherapist, I have seen an influx of parents telling me that their child has attention deficit hyperactivity disorder (ADHD). In this post, I would like to delve into ADHD, how it presents, and how it develops, and empower parents and children to focus on skill building.
ADHD is the most common childhood behavioral disorder and presents clinically in three types: inattentive, hyperactive, and a combined type (Felt et al., 2014). Some examples of how hyperactivity presents in children/teens include descriptions of them acting like they are “driven by a motor,” “always on the go,” constantly fidgeting, blurting out answers, and having difficulty sitting still or doing calming activities (Felt et al., 2014). Children who have the inattentive type are often described as having difficulty paying attention, lacking organizational skills, and getting distracted easily (Felt et al., 2014). Symptoms are most noticeable from ages 6 to 12, and symptoms must be present in two different settings (like home and school) and persist for six months or more (Felt et al., 2014).
As a therapist, I recognize ADHD as a genuine neurodevelopmental disorder and see firsthand its rising prevalence in diagnoses. This increase could be due to heightened awareness, refined diagnostic methods, or even the increased use of social media, which is affecting attention spans.
Many parents tell me that their child or teen does not want to do their homework or forgets to turn it in and point to ADHD. It's essential for parents to focus on empowering their children by helping them work with their ADHD, fostering the development of coping mechanisms and executive functioning skills. Instead of using ADHD as an excuse for not being able to do homework or pay attention in class (while not undervaluing the impact it has), ADHD should be seen as an opportunity to understand and support each child’s unique strengths and needs. Through collaboration and education among parents, educators, and therapists, we can help children overcome challenges and realize their full potential.
Children and teens with ADHD lack executive functioning skills. Executive functioning skills are cognitive processes that help us plan ahead, focus, remember instructions, and manage time (Langberg et al., 2014). The prefrontal cortex, which does not fully develop until the mid-20s, is the brain's home base for executive functioning. In children with ADHD, an impairment in the development of the prefrontal cortex has been found that affects the development of executive functioning skills (Langberg et al., 2014). This can lead to difficulties with maintaining attention, working memory, controlling impulses, and organizing tasks.
I always feel so bad when clients I work with who have ADHD label themselves as “dumb” or “stupid” because they have problems paying attention or understanding homework. I know that our traditional school system is not always the best equipped to attend to students who have ADHD. Sitting in a chair for many hours a day, and paying attention to subjects that kids generally don’t like is extremely hard for someone with ADHD. Kids may feel shame or internalize negative messaging they hear from teachers or other students when they have issues paying attention, and this can lead to low self-esteem. On the other hand, I have also seen an increase in kids saying they “don't want to do their homework,” and from what I understand, they blame it on their ADHD. This is where I feel there needs to be a change and shift in the mindset. Instead of just letting students point to ADHD for their inability to focus in every class or have the motivation to do their homework, I want to see a change in the way we collectively speak and empower kids to take ownership of their ADHD and strive to thrive.
So what can we do? There are a few behavioral strategies that help kids with ADHD learn to improve their executive functioning skills. Just because kids with ADHD may be slower to develop these skills does not mean they can't achieve them. Developing these skills is like any sort of muscle training; you need to do a lot of reps to build muscle. The brain itself is a muscle, and executive functioning skills can be built and strengthened. It just takes time, focus, and a commitment to practice. Here are a few helpful suggestions.
Create a Routine: Kids with ADHD have been shown to thrive when there is structure and predictability in routine. I recommend that parents maintain structured routines, which can even be shown through images, drawings, and catchy alterations. A structured routine creates consistency, which can reduce anxiety and help children know what to expect. This predictability can make it easier for them to focus on tasks. Structured environments also include clear rules and expectations. This clarity can help children with ADHD understand what is required of them, reducing confusion and frustration. Having a structured schedule can help kids with ADHD learn to manage their time better (Miranda et al., 2006).
Offer Rewards: Kids with ADHD thrive when there is a reward system in place. Because it is harder for them to focus on tasks, rewards help reinforce behavior. My recommendation would be to create a sticker chart in your home to reinforce positive behaviors. For example, if your child comes home from school, does their homework, and completes a chore, they get a sticker. If they get five or so stickers, they get some sort of reward. You can also “gamify” the rewards, creating some sort of game or competition (Miranda et al., 2006).
Chunk Tasks: Breaking tasks into small manageable steps, or “chunking,” is really helpful for kids with ADHD. Instead of just saying, “Do your homework,” help them break it down into small steps. This reduces overwhelm and feelings of frustration. Teaching them this skill will ultimately help them feel more capable because they can complete small steps and not get scared or intimidated by a big task (Miranda et al., 2006).
Foster Organization: Teach them the skills of organization, such as how to write in a planner, create to-do lists, and prioritize tasks. This may sound easy or mindless, but these are skills that kids with ADHD lack, and they can be taught and reinforced with persistence and patience. As a parent, you may be frustrated, but I want you to focus on being patient even if you are annoyed. These skills may have come easy to you, but every brain and every person is wired differently, and some kids need more help than others.
\I want to emphasize that ADHD does impact many children, teens, and adults. But getting stuck in the label and diagnosis won’t create any change or belief in self. I want the kids I work with to know that they can improve and practice these skills, even if it takes more time. While navigating the challenges of ADHD in kids and teens can be daunting, it's essential to recognize that with perseverance, support, and the right strategies, we can help kids develop valuable skills that enhance their lives. Each step they take, no matter how small, builds resilience and fosters growth.
We should also acknowledge that the unique perspectives and creativity often found in those with ADHD are strengths. By embracing their differences and focusing on skill development, we empower these children and teens to thrive, reminding them—and ourselves—that their journey, though it can be challenging, is also filled with potential, and they can thrive!