I recently had the pleasure of spending over an hour answer questions and giving insight to the parent of a child with ADHD and Executive Function difficulties that were not only affecting the child at school, but also at home. Executive Function is the process within each of us that helps us to stay organized, remember what we just read, multitask effectively, wait our turn, make connections between our past and the present, initiate and complete tasks, adjust to changes to routines or schedules, control impulses, manage our emotions, make plans, set priorities, and monitor our use of time. Wow! That’s a lot of behaviors all controlled by the executive function area of our brain, also known as the pre-frontal cortex. (I have been reading a lot about brain research and the effect of the brain on mental health. It’s fascinating, but I digress.)
Some suggestions that I was able to provide this parent included:
Posting lists in her child’s room, bathroom, kitchen, and front door to help her remember the things that she needs to do in each of these areas. There are times that it takes this student 10 prompts to finally brush her teeth. So, I advised Mom to make a self-care list to keep in the child’s bathroom. This would include things like brushing her teeth, using the restroom before bed, bathing, and any other self care the child may need to perform during the day. This can be divided up into morning and afternoon routines. Depending on the level of difficulty the child has with following it, include a reward system for completing those tasks as needed in the beginning. I will talk more about reward systems shortly. Post a list in her room of things she needs to remember to do before bed or before she leaves her room for school in the morning with the same expectations and possible rewards as the self-care list. Additionally, a chore chart in the kitchen could list things like finishing homework, feeding the dog, unloading the dishwasher. Finally, a sign by the front door could list things she needs to remember to take to school such as jacket, water bottle, homework or other assignments, fundraising or other materials due. At school I suggested a list in her locker of things to take from her locker into class each morning and a list of things to remember to take home at the end of the day such as jacket, lunchbox, water bottle, agenda.
Another concern mom had was how she unpacked her school bag at home, including sorting through its contents effectively rather than removing it’s contents and handing most of it to mom. I advised her to initially plan to sit with her at the table each day and talk about the contents while sorting them into piles such as, mom needs to sign, correct and return to teacher, and completed assignments that need to go in the trash or collection location determined in advance by the family. By teaching her that everything has a place she will learn how to empty the contents of her book bag on her own without the support of a parent. This will also be effective at teaching her how to manage her things as she generalizes this skill to other areas of her life such as school and in her own personal space or bedroom. I told her that at my house I have mail boxes on the kitchen wall for key family members so they know where to find their mail or other items without having to leave them on the counter until they choose to come get them.
One other thing that mom asked me about was responding to her daughters frequent complaints about things not going according to her plan. This included things from wanting only her favorite cereal that mom would have to go out of her way to buy, getting her preferred seat in the car, and arguing with siblings when they are in her way or making too much noise. I assured her this is common for most children and not just an ADHD thing. I suggested that she set ground rules for these things. For example, the first kid to the car gets to choose their seat. If the kids are arguing in the back seat they are not earning points on their reward system as discussed below. I advised mom to stay out of their arguments as much as possible so they can learn to work out issues on their own. One of the greatest skills elementary students are lacking is problem solving, not only academically, but also socially. Additionally, I told her not to go out of her way for a certain grocery item unless it is being used as an infrequent reward. It should not be an everyday expectation. Children should have some choice in what they eat, but they should also be happy for what the parents provide even if they prefer something slightly different. I advised mom to teach the children to walk away from minor annoyances like Johnny tapping his fingers on the table or Sally crunching her ice too loudly. These are things they are going to experience everyday for the rest of their lives. They need to learn tolerance for these experiences or how to leave the location of the annoyance rather than picking a fight with a sibling who may have no idea they are irritating. Picking a fight only leads to more drama. It does not solve the problem.
Keeping a record of completed chores and homework is kind of like keeping a record of the hours you worked so that you can get paid. We go to work not only because we love what we do, but also because it pay for other things we love, like eating, having a roof over our head, and a car to drive. Children appreciate being paid for the things they do as well. This is where a family economy or reward system is effective. Reward systems do not have to be things that cost money. They just need to be things that are important to the child that they cannot obtain any other way. For example, staying up late on the weekend, getting to choose the family entertainment for the evening, an extra weekend at a favorite Aunt or grandparents house, or maybe a box of that favorite cereal only available at a store across town. Now, there are also ways to use money as an incentive that will not make you feel like you are paying them to do what they should be doing anyway. If your children earn an allowance for completing these and other chores around the house, that money can then pay for little things you might typically buy for them. These things might include school spirit items, dollar store trinkets, candy or gum at the grocery store check out. This can be used to teach children the value of money. You can require that they give a percent to charity, save another percent and spend only whats left. The options are limitless, but could be an amazing learning experience.
I have covered just a few Executive Function areas and how a parent can support their child’s need to be taught how to cope with these deficits. For more information on Executive Functioning check out one of these resources:
Understood.org Executive Function 101 E-book
What is the Executive Center of the Brain?
Executive Function: Implications for Education