Strategies for parenting an ADHD (inattentive) child?

June 15, 2015 8:55 AM

My 11-y.-o. son seems to check all the boxes for ADHD (inattentive, not hyper). I am in the process of having him formally evaluated. In the meantime, I need help figuring out how best to support him in daily activities without losing my mind.

Bottom line: Please tell me what specific strategies you have successfully used to help your inattentive child form habits, keep his immediate environment organized, and come down off the cliff of his hyperfocus. (Anonymous because of potential medical issues.)

My kid is great, and bright. But. As we're moving into more complex school stuff, and as he is asked to take on (discrete, physically manageable, age-appropriate) additional chores, he forgets what he needs to do, wanders away from the task at hand, and cannot concentrate on or do the task at hand. He's starting to become sullen about this and says more and more often things like "It must be because I'm so stupid." He's not. He's far from it. But getting him to do anything is like asking Bartleby -- he just prefers not to.

Things we have tried: Chore chart. Chore-based allowance. No [fun activity] until all toys on the bedroom floor are put away. Please help because you live here. Because this is a good habit. Because there's no room for your friend to pitch his sleeping bag. Nothing has stuck. Verbal reminders are met with "I KNOW" and written reminders get ignored (or he puts the paper down somewhere and forgets it).

Some of this is voluntary on his part (he admits to working slowly because he knows it annoys me), and some is not, hence the seeking out of professional help. I have read a number of questions on the green describing the experience of being ADHD-inattentive, and wow, I saw my son in them: uncomfortable in his own skin, lots of abstract thoughts, lack of attention to the thing he's supposed to be doing coupled with a hyperfocus on his Lego (oh God, the DREAD when he comes in crying because there is a piece missing), the way the physical world challenges him (karate was... not a success, and team play eludes him, and he tends to drop objects, and forgets to do his fly/straighten his collar kind of thing), left to himself to complete something will disappear if I am not right there coaching him. I missed a lot of this, chalking it up to quirkiness, and every time I got worried, he seemed to self-correct. But he has a little sister, the dandelion to his orchid, and as she has mastered these activities of daily living/routines/rules-learning/getting tasks done, the deficits in his abilities have become more evident.

A side-note: I am kicking myself for not catching this earlier. I feel incompetent as a parent, even though what I am doing for my other kid seems to let her thrive. I need help. Perspective. Strategies. Because feeling incompetent + being busy + being a "GET EVERYTHING DONE NOW" type + living with the equivalent of "I would prefer not to" is making me angry and defeated. That's no way to parent. He's angry and overwhelmed, and sometimes I dread dealing with the emotional storm that happens when I ask him to do something. Schoolwork this last year has been awful in terms of his willingness to work (this was a helpful previously).

The house is pretty orderly, we have a loose schedule of things that happen on a daily/weekly basis, there are daily chores. We are losing the battle of limiting screentime. There's lots of opportunity for outdoor play, with or without the dog. There's not much junk food, and lots of fresh options. I take every opportunity to remind about habit-building (why is brushing hair such a thing?), and he makes his bed every day. I help him clean his room, and calmly ask him to shut the refrigerator door when he has left it standing open. Again and again and again.

And inside, I am losing my shit because nothing seems to stick. And there's the sneaking suspicion that his life is easier because I do so much support work, and sometimes he takes advantage of this. The slowness! The attitude! The amazement that I am annoyed by the tenth time I have asked him to do something! The daily affirmation that what I am doing for him is not working (balanced by the fact that it's working for his sibling). He is exhausting to parent.

Maté's "Scattered" and Kolberg's "Attention-deficit disorder friendly ways to organize your life" are on the way, and we're lining up appointments (meds are an option if indicated). I am trying. I need more help. Suggested readings, activities, schedule formats all appreciated. What's working for your family? How do you keep calm and carry on?

posted by anonymous to Human Relations (12 answers total)

Biggest helps for us as a family were getting the diagnosis and getting a therapist who specializes in ADHD and strategies to help him be successful. My 11 year old does take medication, which helps immensely also. For me, the biggest help was having his therapist talk to us about how his brain works differently, and how he's not actually TRYING to be mean and rude. Also, we've worked a lot on helping him to not panic whenever anything goes wrong, which has been life altering. My initial inclination, like yours, was to not help so much, but it turns out, when we made the help about him asking for help, it was much less stressful for everyone involved.
posted by Nimmie Amee at 9:28 AM on June 15, 2015 [1 favorite]

I could have written this question 6 months ago. 11-year old boy, bright (gifted in math, according to the school), lego hyperfocus, losing the battle to limit screen time, why is brushing hair such a thing, increasing attitude, etc. The parallels continue with the little sister who is a study in contrasts and seems much easier to parent.

The pediatrician diagnosed ADHD (after interviews, questionnaires that we filled out and his teachers filled out). Once he started on ADHD meds, it was *night and day different*. Suddenly life was so much easier for him and for us. We're working now on behavioral therapy that the meds open a window to, and have a long term goal of tapering off the meds in a year or two, as long as he has good coping strategies in place.

Good luck!
posted by Doc_Sock at 9:36 AM on June 15, 2015 [2 favorites]

How much opportunity do you yourself have for physical activity? I ask because my own patience for frustrating things is much improved when I have regular vigorous activity (or even regular yoga, too.) Self care is important for parents, too!

So that would be my step 1 - make sure the caretakers are getting taken care of!

I have a family member who, at almost 30 years old, still needs to keep busy otherwise he just struggles. If he keeps busy, he really shines and excels! His parents made sure to keep him physically active with regular practice and activities as he was a pre-teen and teenager. This didn't make him an honor roll student, but it kept him (and them) stay more sane and get things done in time. He did team sports (it sounds like you've tried that with your kiddo already) to help keep him active, which helped him focus better in school. You say you have a dog and plenty of opportunities to be active, but how many of those opportunities are taken? Can you and the kiddo have a twice daily dog run together? Morning and evening? It doesn't require team work and it'll help you both get your ya-yas out. Or, if running is out of the picture, biking or swimming or some other kind of endurance activity? Would kiddo be more apt to join in if you or your spouse were along with it? (And leave the sister at home so kiddo won't have to compete.)
posted by jillithd at 9:39 AM on June 15, 2015 [2 favorites]

I take every opportunity to remind about habit-building

I would stop doing this. As an adult who works with children, I understand the reasoning behind it. As a former child with ADHD, I can tell you that being nagged endlessly about "habits" by my well-intentioned and frustrated mom came across as "you're deficient, let me remind you how deficient you are because you're not doing what I want you to do." Habits seem pointless to 11-year-olds because time does not work the same way for them, and because for some of us with ADHD, we are not going to acquire a habit until we have a solid and concrete reason for that habit. It being a "good habit" is not reason enough for some of us.

(Example: I am not a tidy person by nature. At all. At all, in spite of years of hectoring and judgement from people around me. The one thing that I learned to be super fussy about was coiling audio cables correctly and putting them away every time because when they're not put away correctly, they tend to break. Since I was an audio tech and therefore, the person who had to fix them, I learned to spare myself the effort of dealing with busted cables. Concrete reason=habit.)

Your son is frustrated all the time. He can tell that you are frustrated with him and will tune you out/work slowly in order to drive you crazy because he has so little control over his world. The crazier you are driven, the greater the motivation he has to keep doing it. So I would pick your battles, especially right now as he is being evaluated. Don't worry about the habits right now. Just worry about getting through the day or the hour. The habits will come with time and whatever interventions the professionals recommend.

Make sure you take care of yourself and give yourself due credit for having your son evaluated. You are not an incompetent parent by any means! On the contrary, you are trying to figure out what will help your kiddo. This will be a huge asset to him in both the long and short term. Hang in there.
posted by corey flood at 9:54 AM on June 15, 2015 [16 favorites]

As a tutor who works with a lot of ADHD kids and as a person who has ADHD herself, I'd suggest thinking about getting him an IEP if he doesn't already have one. School requires a tremendous amount of organizing fiddly details, which I remember as maddening and impossibly exhausting. I had no willpower left to handle chores or interruptions or people at home after school; I just wanted to curl up into a ball and collapse from overstimulation. So! Reducing his academic workload might very well be useful, and lead to a kid with more brain left to spare at home.
posted by Alex Haist at 10:34 AM on June 15, 2015 [2 favorites]

I think one practical thing to evaluate is to what degree certain aspects of "order" or "routine" are pragmatic to expect him to contribute to sans medication or behavior therapy for his condition. Remembering to shut the fridge? Yeah, makes sense! Something like making his bed, though--it's probably not the end of the world if that slides a little bit. If he finds focusing just superbly taxing, and if 3/4ths of the year if he is tuckered out by trying to hold it together in any way at all at school, the idea of focusing on boring tasks for reasons that aren't concrete might be bewildering and too much to expect. (I have never made my bed in my life with the exception of being a good guest, and I'm a relatively functional adult! :) )

One thing to tell yourself to make it a little bit easier (and you're already going down this route, obviously) is: a lot of his aggravating forgetfulness probably isn't him, it really is his ADHD. As a clinician who has assessed adults with ADHD, it is really amazing to me as someone who does not have clinical attention issues just how distractable people with ADHD can be. You can see it really strongly on neuropsychological tests of attention--individuals with more debilitating ADHD and no treatment really can't hold it together to focus, and look so, so different from a "healthy" person, even when they are highly motivated to do really well. Even with constant reminders, it might be very hard for him to do something like remember to close the fridge, and he might be frustrated with both himself for being unable to do it time and time again, and resentful to others who point out his inability to meet expectations. ADHD is especially hard for young people who do not have fully developed cognitive systems, and simply doesn't have the resources yet to compensate for ADHD problems with other qualities. Another thing to remember is that attention is a huge, huge, huge part of memory--if you're not paying attention to something, you're not encoding that memory well, and it just isn't going to stick. Individuals with ADHD sometimes show "memory" deficits that in fact have nothing to do with their memory system per se and in fact are ameliorated with proper treatment.

It's so good that you've identified this as being a potential problem, and I hope you guys have a lot of success in getting him evaluated and appropriately treated!
posted by Keter at 11:25 AM on June 15, 2015 [4 favorites]

Whatever you're doing for home organization and upkeep, consider following flylady.net's method. Even if you keep a clean house already, her method is especially kind and successful with engaging children, especially in ADHD households. But it's for parents to engage in. Kids get drawn in to the fun, from sideways, which is perfect for kids with ADHD.

(Incidentally, it's also a helpful process for people who focus too much on household cleanliness and people with OCD. It tells adults when to stop.)
posted by vitabellosi at 11:27 AM on June 15, 2015

I just finished reading through The Explosive Child by Ross Greene. It's a book about reducing disagreements and yelling matches between parents and their children. I don't think his approach is particularly new, but he does emphasize that this approach often works better with students with ADD and ADHD than sticker charts and reward systems.

In a nutshell, he says there are 3 options when approaching a disagreement with your child:
Let's say the child refuses to clean their room.

1) Tell the child what to do. (often this means saying No to a request)
Clean your room or you'll have x consequence.

2) Ask the child what their concern/worry is. Express your concern/worry. Invite child to help you think of a solution that you can both live with.
Parent: You don't feel like cleaning your room? How come? or Why not? or What's up?
Child: I don't have enough time or Cleaning my room is annoying or I always forget
Parent: When the room stays messy I worry that x will happen. You don't want to clean your room for y reason. What can we do to make us both happy?
Child: How about we make time on Saturday mornings to do it together or Let's get bins to make sorting simpler/ a special vacuum/broom just for my room or Let's set up an alarm or post it to remind me
Parent: That sounds great. I'm going to make a little sign to help us remember what we decided. We'll try it out and talk about it in a couple of weeks to see if it's working.

3) Let the child do what they want (this often means saying YES to a request).
Alright, don't clean your room. When you decide to do it, let me know and I can help you.

So, there are times when method 1 is ideal (usually when the child's safety is in question) and times when method 3 is ideal (if it really doesn't matter that the child do the thing/have the thing). But, Greene says you should try to strive for more use of method 2, and, that this should be used before you're knee deep in the middle of the fight. The child will likely not be able to think of good solutions initially, but with practice they'll get better and this should save a lot of time later. If you go through this process and find it's not working then have the same conversation again. I noticed that you're having troubles remembering what we talked about. What's making it hard for you? How can we make it easier for you to remember? etc.
posted by eisforcool at 12:23 PM on June 15, 2015 [3 favorites]

Reading through the excerpt, I can see that some of it may resonate with you.

"You can't imagine the embarrassment of having Jennifer ‘lose it' around people who don't know her," her mother continued. "I feel like telling them, ‘I have two kids at home who don't act like this -- I really am a good parent!'"

"I know people are thinking, ‘What wimpy parents she must have...what that kid really needs is a good thrashing.' Believe me, we've tried everything with her. But nobody's been able to tell us how to help her...no one's really been able to tell us what's the matter with her!"

"I hate what I've become. I used to think of myself as a kind, patient, sympathetic person. But Jennifer has caused me to act in ways I never thought I was capable of. I'm emotionally spent. I can't keep living like this."
posted by eisforcool at 12:27 PM on June 15, 2015 [1 favorite]

Depends on the chore. For school things, there is nothing as good (for my kid) as getting everything together the night before. (He likes this because it postpones bedtime.) It's a great habit to get into.
Also get him to take notes on things, like school reading. If he doesn't like to handwrite, have him text the notes to himself.

For doing chores around the house, I have to say, I find Flylady.net's suggestions really helpful. Ignore the religiosity and concentrate on the time-limits, like choose one part of a room and clean it for 15 minutes and then STOP and do something else. 15 minutes a day can really get a lot done, if you do it every day. You can be working on one side of the room and him on the other. He can concentrate for 15 minutes, and if he dallies (as he will), say it'll go another 15 minutes. ADD kids have to learn to do things intensely and quickly, while their attention lasts. The other option they suggest a lot is 27-pick up, that he has a box or trashcan and has to pickup and/or put away 27 things in 5 minutes. Set a timer. Point is to keep the time limit very short, but do it every day or twice a day. You can adapt this to different tasks. (Some won't work that way, like mowing the lawn-- you sort of have to do that all at once, but just once a week. So choose chores that are daily but time-limited. It's important to make a big deal about how short the time limit is.
I have this problem myself, and I play music. 15 minutes is 5 pop songs. Make a CD or playlist (or have him do it) which is that long, and he just has to work while singing along. Then when the 15 minutes is over, he can stop (if he's been working all along), and this might mean leaving half the books unshelved, but he can deal with that tomorrow.

ADD-types have to learn, I think, to ride the wave while they can, and get stuff done quickly. Maybe he should get the chores that fit that target time limit. You could gradually add on other 15-minute sessions if this works, so he might have one in the morning before school, and then one in the evening.
posted by pippin at 7:50 PM on June 15, 2015 [1 favorite]

Just saw this article today and related to it: constant movement in ADHD may help children think, perform in school. I know it helps me enormously to be either dividing my attention and/or fidgeting.
posted by jenfullmoon at 11:13 PM on June 15, 2015

Does he know EXACTLY where to put each toy? Each decision point is a point where he may freeze up and procrastinate out of the situation. I really wish my mother had found me some large baskets, or sufficient containers for my things. I had no idea where to put things, and stuffing too many things in the few containers I did have, just made things more 'lost' to my perspective. Out of sight, out of mind. Lots of bookshelves, and clear containers on shelves for things helps.
If he isn't tidying, and you have a stand alone house, tell him to do three laps of the house, or run to wherever makes sense, and then when back inside, put on some loud, active music, and tell him he has to tidy as much as he can for 10mins/3 songs, etc.
My sister was hyper, and sent to run quite often, I was inattentive, and I only realised as an adult that actually, the same trick would have worked on me, too, despite grumbling. Better concentration and a mental clean sweep.

Provide more time limits, and alternate between tasks. Timed chores, then TV etc on for a certain amount of time, then timed activity. Working at any speed other than "as quickly as possible" often doesn't work. This is why I still need to only give myself 30 minutes to get ready in the morning, any longer, and I dawdle.

Have required activities happen in someone's presence. Homework at the kitchen table, while dinner is cooked, etc.

Books I know of are for adults, like 'Add friendly ways to organize your life' by Judith Kolberg
posted by Elysum at 8:01 AM on June 16, 2015