Tuesday, April 21, 2015

Six Steps to Managing ADHD Overload

guest blog by Mark Bertin, MD

When the logistical details of life and school accumulate, they become overwhelming for students with ADHD. If they have weak executive function skills, they will require ongoing support from an adult.

What steps can you take to help children and teens with ADHD learn to manage the academic demands that increase as they grow older? And if your child falls behind and must somehow weather an academic storm, what strategies can change the situation and teach him or her to better manage ADHD challenges?

1. Clear the decks. When needed, hit the reset button. Forge a one-time amnesty, forgive the backlog, and begin from scratch. If someone is not yet able to do what is being asked every day, there is not much chance they are going to keep up plus catch up. If amnesty is not entirely possible, at minimum we distribute the backlog over time so that the total work required every day is sustainable. The goal is maintaining a reasonable amount of work each day, within what is possible for any individual.

Kids should not expect this type of amnesty to be constantly available. However, “responsibility” and “motivation” only follow from success, and success stems from asking kids to work within their actual ability level. Homework isn’t meant to bring to mind Sisyphus pushing his boulder up the hill, never to quite reach the top before it rolls down again. If a child can get five things done each day and we keep asking for six, eventually the child will fall behind.

2. Establish a daily plan. Create a detailed and easy-to-follow daily checklist. Setting and sustaining a plan to manage homework is not intuitive to most children with ADHD. Knowing when to get started, predicting time, keeping track of books and assignments, and many related skills are all related to executive functions. Parents should set a homework time and create a distraction-free place to get things done. If the after-school schedule varies, instead of a specific time the rule might be “work starts fifteen minutes after getting home.”

Most students benefit from a step-by-step, written checklist for how to complete work appropriately. To make certain things get back to school, include a clear ending such as “put your homework away in your homework folder.” While working, children also often find it easier to focus with scheduled stretches on task interspersed with timed breaks (such as twenty minutes on, five minutes off). In-school supports involve breaking down assignments into daily parts, checking out with a teacher at the end of the day, reminders to hand in work to the teacher, and countless other possibilities (see the CHADD Educator Manual for more).

Monitor the child's development. A ten year old might have the skills of a six year old when it comes to organization. Unfortunately, there is no one perfect measure of executive function in real life, so observe, make informed choices, and readjust based on how a child progresses.

Maybe the child is not ready to manage his or her own to-do list at school. Maybe he cannot yet see how to break a longer project into its component parts. Maybe initiating her work after school is hard, or prioritizing time, or estimating how long various assignments will take each night. All these difficulties require direct support and instruction. By sustaining a daily routine over months or years of school, it becomes a habit all the way through adulthood.

3. Externalize the system. Maintain adult support and involvement. Getting off task from a long-term plan is a routine part of ADHD, and does not typically stem from poor effort or laziness. Identify a parent, teacher, therapist, ADHD coach, or anyone else who can make sure the details are being followed. While written checklists and physical alarms also can act as external reminders, children need someone supervising with higher-level organizational skills.

A solid solution often involves parents and teachers almost taking over organization in the short run. Temporary relief from responsibilities allows more energy for learning and keeping up with the more methodical plan you’ve created. A long-term plan hands back responsibility at whatever pace a student proves capable.

4. Consider modified homework. Avoid the counterproductive punishment of adding more to an already daunting load. In Understand Your Brain, Get More Done: The ADHD Executive Function Workbook (Specialty Press, 2012), psychologist Ari Tuckman writes, “It is vital to keep up with work as it comes—because it becomes impossible to do it all at the end. Homework can sometimes be (or feel like) a losing battle where it is impossible to keep up at all. At those times it may be helpful to speak about homework reductions, especially when a student is spending a lot of time but not getting enough done.”

ADHD isn't an excuse for slacking off. Children with ADHD should show good effort and do what is needed to learn. But they also should not spend their whole lives treading water, up to their necks in schoolwork. The goal is to find a groove where a child works hard but does not get consumed. Homework is meant to augment classroom academics. While the research is vague, the recommendation is around ten minutes per grade.

5. Offer stress management tools. A first step to managing stress may simply be managing ADHD itself. ADHD compounds stress by making it hard to get anything done all day long. With ADHD, every detail may be taking ten times the effort with five times the uncertainty. Assertive management supports long-term success by balancing behavioral, educational, medical, and even complementary options when appropriate.

Stress itself makes managing ADHD difficult. Under stress, most of us fall back on old habits, become more reactive, and lose our resilience. For an individual or family living with ADHD, these patterns make it harder to keep up with any plan. Working with a behavioral therapist or ADHD coach may help both in addressing executive function deficits and in developing stress management tools. The practice of mindfulness is also an evidence-backed, accessible way to manage stress.

6. Create an early warning system. Schools should contact families as soon as assignments are missed. Finding out about seven missed homework assignments over two months is hard to address, but finding out about two over a week is manageable. Don’t allow the back-up to happen in the first place.

If work starts accumulating, step back and look at the bigger picture: Can the child do the work asked of him? Has he had an appropriate educational evaluation? At least half of children with ADHD also have a learning disability and others have language delays. Assigned homework should consider present academic abilities and avoid material above a student’s ability level.

When the student continues to miss assignments, consider whether he or she is able to handle the workload right now. Does the child need more directed organizational supports? Modifications that cut back on the amount required each night? Does medication need adjusting? Is homework even being done during the window of time medication covers?

THROUGH THE COMBINATION of an external system, adult monitoring, and modification of work, school and homework should become more manageable. As the system become more ingrained, most students with ADHD can handle a workload similar to that of their peers.


A slow drip of missed details can affect anything your child must keep up with in life, but the same technique applies. Emails pile up; the solution balances getting the in-box back to zero and creating a plan to keep up every day. If the child has an astoundingly messy room, start with a one-time effort to put everything in place while in tandem establishing a new system of some kind — maybe ten minutes of cleaning before bedtime. Balancing short-term exertion with a realistic and empathetic long-term plan creates an entirely new way of living with ADHD.


A longer version of this post appeared in the June 2013 issue of Attention magazine. Join CHADD and receive every issue!
Join conversations about parenting kids with ADHD on Attention connection, your social network for all things ADHD!


Mark Bertin, MD, is a pioneering developmental pediatrician in private practice in Pleasantville, New York, and assistant professor of pediatrics at New York Medical College. He trains physicians, teachers, and psychologists in ADHD care and leads stress-reduction classes for parents. From 2003 to 2010, he was director of developmental pediatrics at the Westchester Institute for Human Development. He is the author of The Family ADHD Solution (Macmillan, 2011).

Tuesday, April 14, 2015

ADHD and Organizational Overload

by Mark Bertin, MD

Imagine that you are in ninth grade and you are given six assignments a day to complete. That’s a gross simplification over real life, which requires you to figure out when to do the work, how to do it, to coordinate various long-term projects, and to manage your busy life in general. But for now, imagine you need do nothing more than get those six things done... except you have ADHD and because of that you’re only capable of completing five.

Far from a disorder of only attention or hyperactivity, ADHD represents a neurologically programmed deficit in the exact managerial skills that allow you to handle everyday logistics effectively. So you continue to work diligently, even though people implore you to try even harder. By day two you have six more assignments plus one to make up from day one. By the end of the week, you’re potentially five assignments behind. By the end of the first month, you may be dozens of items behind—and now demands have risen to seven assignments a day. Whatever can you do?

An unexpected academic squall

There’s only so much any of us can accomplish in any one day. For someone with ADHD, that amount often shrinks compared to other people, since ADHD undermines cognitive abilities called “executive functions” that are required for planning, organizing, managing time, and prioritizing. So, where one person may be able to juggle a pressured high school academic schedule, two sports, and a social life, someone with ADHD may have used up their cognitive resources by noon.

Sometimes what had been a reasonable organizational plan no longer holds together as demands rise over time. Maybe before high school, not having a consistent to-do list or some type of logical plan to manage long-term projects was okay; not ideal, but manageable, and the procrastination did not impact life too much yet. By high school, there’s too much to mentally track and better time management becomes essential.

Each little bit not quite accomplished throughout the day rolls over to the grand life to-do list. It accumulates into an overwhelming and insurmountable pile, until eventually the whole system shuts down. A child with barely the bandwidth to keep up now is asked to make up an additional pile of missed assignments. Their cognitive gears lock when the combination of both doing their everyday work and their overdue list becomes literally too much to handle.

Stress is often defined as the perception that something in life is not manageable. The sense that the load has become impossible creates stress, which further undermines efficiency. Things fall apart—perhaps they stop working entirely. For some, it can even become “learned helplessness,” the assumption after repeated failure that there is no point to trying again. School anxiety grows and children may lie about their work, make excuses, or become oppositional in avoiding it. The solution lies in creating realistic daily demands that account for ADHD and implementing a structured organizational system that allows someone to maintain day-to-day control.

Take the rudder and hold on tight

Problem solving can be challenging even for a motivated child with ADHD. The executive function skills needed to identify the root of an issue, create a strategy, and stick to the organization system over time are all impaired. So instead of being able to pause, gather himself, and refocus as we might hope, the wheels come off entirely. He creates a plan that isn’t sustainable (I’ll stay up three hours later every night until I’m all caught up) or is inefficient to the point of increasing overall effort and stress.

To create a solution, we instead aim to “externalize the system”—when executive function is impaired, we build an external structure that supports it. Mental managerial skills are replicated through routines and reminders until they become more habitual. Thankfully, many tools support organization, ranging from day planners to sophisticated, smart-phone applications. This approach seems intuitive if you have strong executive function skills, but can be inherently difficult when you have ADHD.

Critical to implementing a new framework is recognizing the need for ongoing support from an adult. It does not quite make sense to expect someone to monitor a plan on their own if their core impairment is an inability to organize their life. Maintaining a compassionate perspective means recognizing that however it looks from the outside, the underlying issue is not effort or motivation but a developmental delay in executive function. In many ways, having ADHD undermines the exact skill set needed to start addressing ADHD in the first place.

Next week we'll look at strategies for managing ADHD overload.



A longer version of this post appeared in the June 2013 issue of
Attention magazine. Join CHADD and receive every issue!
Join conversations about parenting kids with ADHD on Attention connection, your social network for all things ADHD!


Mark Bertin, MD, is a pioneering developmental pediatrician in private practice in Pleasantville, New York, and assistant professor of pediatrics at New York Medical College. He trains physicians, teachers, and psychologists in ADHD care and leads stress-reduction classes for parents. From 2003 to 2010, he was director of developmental pediatrics at the Westchester Institute for Human Development. He is the author of The Family ADHD Solution (Macmillan, 2011).



Tuesday, April 7, 2015

More Magic of Pet Ownership, Part Two

by Elaine Taylor-Klaus, CPCC, PCC

Part one of this post described two good reasons to include a pet in your family. Here are three more reasons pet ownership can be a helpful support strategy for ADHD.

Structure and accountability

Not only can kids cultivate relationships with pets, but they can learn to put systems and structures in place to care for them. Since kids with ADHD often have a difficult time finding the motivation to accomplish “boring” tasks, a pet offers the chance to make a household chore more “interesting.” Let’s be serious — feeding the dog is at least more compelling than washing the dishes!

In our home, our youngest child is expected to feed the dog before he feeds himself, twice a day. While our son is not yet completely independent in this task, it has provided a platform to teach him to set up systems, tweak them, and re-establish them as needed.

For example, recently we noticed our son had become a bit slack on remembering to feed the dog before himself. (This is common in ADHD world when systems become “boring” and difficult to continue). Keeping a note at his place at the table was no longer working, so we brainstormed about how he could make sure he handled this task. (As if on cue, the dog looked up at him with soft brown eyes and tilted her head as if to say, “What about me?” It was perfect!)

Our son decided to draw a picture of a dog to keep at his place at the table as a reminder, along with a really funny Valentine’s Day card he'd gotten from her. It’s too soon to say if it will work, but having to address this every so often is actually a great opportunity. It teaches him that his ADHD requires constant vigilance.

By learning to care for his dog—with a parental safety net so the dog doesn’t go hungry—our son is learning critical lessons about how his ADHD shows up, and what he’s going to need to do to manage it in his life.

Managing impulsivity

As pet owners, we can’t afford to forget, for a moment, that our animals are just that—domesticated, maybe, but animals nonetheless. A girl and her dog can have the most wondrous relationship imaginable, but it is inherently dangerous. Success comes when you create a conscious environment and keep a safety mindset.

At one point, I had my doubts. There was a particular episode in Sasha’s youth when I was afraid we had made a big mistake. She had discovered a Brillo pad under the house and appeared with it in her mouth. I remember the face-off (nineteen years ago) as if it were yesterday: Rottweiler jaws clamped tight, dribbles of pink bubbles sliding down the chin and dripping to the ground. A stalemate. It is hysterically funny in retrospect, but at the time I was just hysterically terrified.

I knew Sasha loved me, but would she bite me instinctively, protecting her precious Brillo pad? It was certainly within the realm of possibility.

As we raised our three kids – and several of our friends’ kids, too – into a household of dogs, we taught them to have a healthy respect for all animals, no matter how domesticated. My kids (and my husband) never met a dog that was a stranger, so we taught them to control their impulsivity quite directly:

•    approach new dogs cautiously,
•    ask permission of their owners, and
•    hold out the backs of their hands to be sniffed

If I could be afraid of my dear Sasha, then anything was possible. My kids learned to proceed with caution before playfulness - not an easy task for a passel of kids with ADHD! It’s worth noting here that my friendly, playful spouse had learned that lesson the hard way. In fact, you might say a big black chow had to bite him in the butt to teach him how to teach his kids to manage their impulsivity.

Comfort and companionship (and energy release)

True confession: Sometimes I get jealous of my dog. My kids talk to her and feed her. My husband plays with her on the floor. She gets the attention from those I love that I wish I got more often. And I wouldn’t have it any other way.

There is a pure and healing energy that a well-loved animal brings into a home, sometimes coupled with a release for unbridled hyperactivity. Talk about a perfect recipe for ADHD success!

Pets invite us to take some time each day to relax and play. They offer friendship and companionship. They ask very little in return, except that we make the time to be with them, to be kind and playful, and to take care of their basic needs.

Pets teach us to:
•    slow down
•    pay attention to the fundamentals
•    be kind
•    enjoy life
Are there any more important lessons than those?

As an added benefit, some pets offer a physical outlet for excess energy. A great dog is willing to run, wrestle, and roll around on the ground with the kids, and becomes a walking buddy and accountability partner for parents. In an ideal world, that dog is also willing to sit quietly at your feet as you do your homework. That kind of friendship can be hard to find.

A special treat

Recently I had a discussion with my son about a structure for making sure the dog is fed. Since he was starting to feel a little “wrong,” I stopped the conversation to assure him that he’s doing a great job. I explained that it’s important to find structures that work for him, because we’re not always going to be around. To be successful, he’s going to have to learn to use systems to get done what he wants to get done. It was a great teachable moment.

And then I had an aha! moment: Feeding the dog is one of the hardest tasks I could give to a child with ADHD. I’m always talking about improvement instead of perfection, but feeding an animal is one situation where perfection is actually important. A 90% isn’t good enough. When I told my son that, he responded,“Yeah, mom, but I can get points for extra credit. I can give her treats!”

Animals change the playing field when you have kids in your home. Having a pet invites children to learn to communicate on another plane. It’s one of those little gifts of life that is difficult to express. You can't overestimate the peace and joy it can bring.

A longer version of this post appeared in the April 2013 issue of Attention magazine. Join CHADD and receive every issue!
Join conversations about parenting kids with ADHD on Attention connection, your social network for all things ADHD!



A member of CHADD's board of directors, Elaine Taylor-Klaus is a certified coach, parent coach, writer, educator, speaker, entrepreneur, and mother. She is the co-founder of ImpactADHD.com.

Tuesday, March 31, 2015

The Magic of Pet Ownership - Part One

by Elaine Taylor-Klaus, CPCC, PCC

It’s a huge responsibility to care for a domesticated animal. With a family of five with ADHD, sometimes I wonder what we were thinking. After all, who needs another mouth to feed, much less one that can’t communicate effectively when she’s hungry?

Frankly, it’s a mixed bag. On the one hand, I hate the feeling of not knowing if the dog was fed. The bowl is empty, but is she finished, or did someone forget? On the other hand, I can’t imagine life without a four-legged dependent cruising around my house (though I might have to limit the bones lying around as my age advances—they’re dangerous!).

In the end, the gifts of having a pet far exceed the challenges—even when the family has a heavy dose of ADHD.

When you have ADHD, your greatest challenge is to learn to live with it effectively. If managed with awareness, raising a pet can actually be a helpful support strategy for ADHD. It can provide:

•    adults with practice before having a child
•    kids with training in responsible relationships
•    accountability for using systems and structures
•    practice managing impulsivity
•    comfort and companionship (and energy release)

These are five really good reasons to include a pet in your family. Let's talk about the first two this week. Next week we'll cover the last three.

Pets are good practice

Raising a dog is a lot like raising a child, really. You are responsible for another living being, and for everyone and everything she or he touches. It requires emotional investment and significant resources (both time and money).

Shortly after we began our married life, my husband and I tested our parenting chops with an adorable puppy named Hobbie. We arranged our weekends around walks to the park and laughed endlessly about the antics of a puppy. We went to owner training school (let’s be serious, we know who’s really being trained!), and installed a doggie door to foster independence.

When Hobbie was six months old, we created Irish twins with the addition of a new puppy, Sasha. Those two lovely animals raised each other well, despite our nervous, hyperattentive new-parent overinvolvement. By the time our daughter was born, Sasha and Hobbie had trained us well to give ourselves over to the love of a child.

In a strange but genuine way, we felt at least somewhat ready to take on the awesome responsibility of raising a child. Do any new parents ever feel completely ready?)

Training ground for responsible relationships

To have a pet is to be in relationship with another being—and that requires skills all children can benefit from cultivating. A pet offers the chance for kids (and sometimes grownups) to care for another being who is completely dependent. It’s an awesome obligation, if you think about it, like a tail-wagging, panting, magical training ground for responsible relationship building.

Now, I know there are some adults who just can’t imagine having a pet—and that’s fine. It’s not for everyone. Like children, pets make noise, and messes, and need occasional emergency care. (Okay, I’m not so sure that turtles have ER visits, but my nephew’s gecko did!) Caring for another being is not to be taken lightly, and I have immense respect for people who choose not to have a pet rather than manage the responsibility less than honorably.

But I will say that if there is a part of you that is so inclined, or wonders if it’s right for your family, it’s worth exploring. There is something magical about exposing your children to an authentic relationship with another being who cannot speak to them, but is wholly dependent on your family for survival. Most pets require attention, interaction, and a sense of obligation to another. Any way you slice it, that’s a healthy life skill for people with ADHD to learn.

A longer version of this post appeared in the April 2013 issue of Attention magazine. Join CHADD and receive every issue!
Join conversations about parenting kids with ADHD on Attention connection, your social network for all things ADHD!




A member of CHADD's board of directors, Elaine Taylor-Klaus is a certified coach, parent coach, writer, educator, speaker, entrepreneur, and mother. She is the co-founder of ImpactADHD.com.

Wednesday, March 18, 2015

ADHD and Your Extended Family

by Janette Patterson, MSW, LCMFT, and Larry Maltin, MA

As awareness grows, we are better able to address the challenges people with ADHD face at school, at home, and in the workplace. Self-help strategies abound, but the focus is usually on help for the immediate family—the child, mom, dad, and siblings. The impact of ADHD symptoms does not stop with the immediate family, however. What about the concerns and reactions of grandparents or uncles and aunts? Research is lacking on the role and dynamics of the extended family when one or more members have ADHD.

In Taking Charge of ADHD, Russell A. Barkley, PhD, writes: “Parents of children with ADHD also may be deprived of the encouragement, warmth, and assistance of a supportive family. They tell us that they have fewer contacts with their extended family members than in families without children with ADHD, and that these contacts are less helpful to them as parents and more aversive or unpleasant.”

As parents, we want to help our children to become well-functioning and socially successful people, and our own anxieties are sometimes triggered when our children with ADHD act out and misbehave. We desperately want our child to behave appropriately and to be accepted. We often feel embarrassed and defensive for our child when he gets reprimanded or described as “spoiled” by a relative. And we feel guilty for being unable to prevent these stressful occurrences.

How do we respond to when our child becomes symptomatic at family functions? How can we advocate for our child, but also validate our extended family members’ experience while respecting their opinions and decisions?

Strategies for coping and healing

Much of the research and literature on dealing with ADHD can be helpful for educating our extended family. What strategies make the most sense in managing a family gathering so that our child (and everyone else) can participate and feel comfortable?

1. Educate the extended family about ADHD. The more we can speak openly with them about how ADHD affects our child (and us) in a way that is understandable, the more we can have meaningful conversations and explore problem solving skills.

2. Develop self-awareness. Find a way to slow down so that you can take a moment to check in with yourself. Practicing mindfulness, for example helps us become aware of how we feel in the moment, and is a key element for emotional healing and building of coping strategies and skills. For some, this means finding a word or phrase to help them remember to check in with themselves. For others, it might be deep breathing exercises to facilitate the process of self-awareness.

3. Practice self-advocacy. While advocating for our child, we are also aware of our own struggles and experiences and we also need to address our own struggles. To be effective in advocating for our child, we must check in with our family member and make sure that he or she is able to listen. How many times have you experienced rejection from an angry family member?

4. Explore alternative or new ways of communication. We need to explain to our family members that our child’s behavior is not about them, but is directly related to our child’s inability to regulate his or her emotions in the moment. It takes practice, patience and flexibility to work with these highly charged, emotional situations.
  • Be proactive. Prepare for the next event by having conversations with your relatives before the family gathering.
  • Brainstorm with your relatives. Include them in the process of exploring how potential stressors can be avoided or addressed before an incident happens.
  • Be aware of your relatives’ concerns and feelings.
  • Stay positive!
5. Utilize the best ways to defuse behavioral disruptions at family gatherings. Even the best intentions are not always enough; your child with ADHD can get triggered and disaster unfolds.
  • Do “prep work.” For some kids and for some occasions, it might make sense to negotiate a “deal.”
  • Find allies. Find some benevolent family member(s) who could jump in to support you in a time of need.
  • Be prepared. Keep an eye on your child to check when the behavior is beginning to escalate so that you can step in before it gets out of control.
  • Advocate for your child and yourself. Speak up and explain to your family members what is happening and how they can help when your child is in crisis.

As parents of children affected by ADHD, it is our responsibility to develop understanding and mutually acceptable support within the extended family. It is up to you to initiate the conversation. You know your child and yourself. When you reach out to your family members and invite them to explore how you can have a more satisfying family experience, you are creating an opportunity for change.

Advocating for and supporting our family member with ADHD is an ongoing process. With practice, patience, understanding, and consistency, we can better help our child with ADHD, our immediate family, and ourselves. We can also strengthen the ties to the loved ones in our extended circles of family and friends.

 

A longer version of this post appeared in the June 2014 issue of Attention magazine, available through our free app, which you can download on the App store. Current CHADD members can access it through the app at no extra cost.


You can also join the conversations about parenting kids with ADHD on Attention connection, your social network for all things ADHD!



Janette Patterson, MSW, LCMFT, is the co-coordinator of the Montgomery County, Maryland, chapter of CHADD, and a family therapist. Larry Maltin, MA, is program coordinator for Elkins Park Pennsylvania CHADD.

Tuesday, March 3, 2015

Help for Hypervigilant Parents



guest blog by Sheila Grant, MS, RN

As a recovering, card-carrying hypervigilant mom, I have vast experience with the associated behaviors. I was constantly on the lookout for any potential danger and jumped in to ensure that my children were spared from any discomfort. (They weren’t spared anyway.) With a longstanding compulsion to protect my children at all costs, I was on guard, on edge, and exhausted.

To be fair, I had good cause to be concerned and protective. When my two young children were diagnosed with ADHD, they were constantly getting into one scrape or another. Arguments with neighborhood kids, upsets at school, difficulty doing the smallest tasks, and verbal impulsivity were frequent occurrences. I cringed every time the phone rang, hoping it wasn’t a neighbor or a teacher calling to tell me my child was in some sort of trouble.

All parents want to protect their children, but the urge to protect children can become even more intense when the child is diagnosed with ADHD, because we know the child will have unique challenges. It is appropriate and prudent to offer the type of support and care he or she needs.

Effective and critical strategies to support your child include getting comprehensive evaluations and following up with appropriate therapies, including medication, academic supports, IEPs, coaches, and therapists. Being available emotionally and physically to guide a child is important for all parents, but it is critical for those parents who have a child with ADHD. These behaviors are indicative of concerned and caring parents who want to support their children and help them to cope with the challenge of having ADHD.

So, then, what is hypervigilance and what does it look like? Psychologist Lynn Margolies describes hypervigilance as being hyperalert to danger and hypersensitive to one’s environment. There is a constant scanning of the environment to protect or guard against a real or imagined threat. Severe, acute anxiety accompanies hypervigilance and may lead to mental and physical exhaustion.

One way to tell if you are hypervigilant is to recognize how you are feeling. Are you constantly tense and on guard? Are you in a state of panic, is your heart racing, and is your stomach upset? Do you feel an urgency to act? Do you listen in on your child’s phone conversations to ensure she is being socially appropriate? Have you followed your child as he drives through the neighborhood to ensure he is going the appropriate speed? Are you lying awake at night obsessively reviewing what you could have done better that day in regards to your child? Do you believe you are the only one who can help your child? Are you consumed by your child’s difficulties, to the point that you do not have a moment to enjoy life? Are you feeling anxious and depressed?

Hypervigilance doesn’t protect you or your children from danger and may even cause you to make mistakes. Being in a constant state of fear may impact your ability to focus and concentrate as well as your physical and mental well-being. Hypervigilance renders you ineffective in solving problems and navigating your way through the challenges of raising a child with ADHD.

Paradoxically, the effort to protect your child at all costs has the opposite effect of what you hoped for. Jumping in to fix all of your children’s problems ensures that when they become adults, they will have difficulty solving their own problems. As parents, our job is to help our children, teens, and young adults learn how to solve problems—not to jump in and fix them. Obviously, it is a fine balance and the problem-solving must be age-appropriate.

When you are on hyperalert at all times, you send your children a strong message: “You are not capable of caring for yourself or managing your life, so I will.” You may not be saying this out loud, but your children get the message loud and clear.

Here are five tips to help you get on the road to less hypervigilant parenting:
•    Find a supportive community; create a circle of care.
•    Get help for yourself.
•    Get the help you need for your child; ensure appropriate supports are in place.
•    Consider a spiritual perspective.
•    Remember this is a marathon, not a sprint. Pace yourself.

The dance we parents of children with ADHD are required to learn is tricky; the steps are complex and there are always missteps on the journey. We must balance our role as parents to be concerned and available without harming ourselves with excessive vigilance and anxiety over the lives of our children who have ADHD. When we manage our own anxiety and become more centered and calm, our children will surely benefit.


A longer version of this post appeared in the February 2015 issue of Attention magazine, available through our free app, which you can download on the App store. Current CHADD members can access it through the app at no extra cost.

You can also join the conversations about parenting kids with ADHD on Attention connection, your social network for all things ADHD!



Sheila Grant MS, RN, is co-coordinator of Chester County/MainLine CHADD where she facilitates the parent support groups. She is a psychiatric nurse on the adjunct faculty at Immaculata University.


Tuesday, December 30, 2014

New Year, New Calendar

guest blog by Karen Sampson Hoffman, MA

Along with shopping for holiday gifts (five children call me aunt and one toy store awaits my mad dash), I hunt for two calendars every year. One will become my sister’s family notebook, where she keeps track of everyone’s schedules and events, and one will be a pocket calendar for me. Without them we wouldn’t be able to keep track of the routines, events, and holidays in our very busy lives. It just wouldn’t be New Year’s without the New Calendar.

In homes affected by ADHD, planning takes conscious effort. More so for long-range planning, which is what most of us do as we approach the new year. Getting our calendars ready is important. Finding a calendar early is vital, since they disappear from stores sometime in early January.

Planning for the year

There are rhythms in routines. The rhythm of the year goes into the calendar first. If you find a calendar with holidays already marked, you’re ahead of the game. Mark the dates of public and religious holidays, along with family holidays and neighborhood or school events. Next make sure to add birthdays, followed by anniversaries. If you know vacation schedules, put them in now. This is the time to make reservations for family trips or to schedule time in the coming months to do so.

For those who have children affected by ADHD, now is the time to make plans for your child to attend specialized summer camps or programs:
•    Start early in finding and applying to camps. Programs fill up quickly and scholarships may be limited.
•    Review your options. There are many styles of camps, from day camps to overnight adventures camps, to one s that focus on academic, arts and social skills.
•    Evaluate your child’s strengths, weakness and desires.
•    Talk with your child about possible programs. You may want to select three programs you are comfortable with and allow your child to choose from among those.
An article on savvy tips for selecting camps for children with ADHD appeared in Attention, and the National Resource Center on ADHD, a program of CHADD, also has a resource on camps

Planning by the month

For each month, consider which events will require additional pre-planning. The goal is always to take large projects and break them into smaller “bites.” Perhaps your family celebrates Easter; one weekend could be Chocolate Bunny Day for making candies and a separate weekend will be Spring Cleaning. The same can be done for other holidays.

Most organizations keep members informed through e-mail newsletters. When the monthly or weekly announcements arrive, jot them on your calendar right away. Get information in the calendar as soon as it comes your way and you’ll be better able to plan.

Planning by the week

Some calendars allow you to view one week at a time; or, you can draw up weekly calendars to keep on your desk or the refrigerator. Decide which day is your Day One or the start of your week. On Day One, check your calendar for all events, holidays and projects. Prepare a to-do list and keep it with your calendar for easy reference. Many people find it helpful to cross off accomplished tasks or to draw through a day once it’s ended.

Smart planning

•    December or January—Mark all holidays, birthdays, anniversaries, and vacations. Find summer camps, programs, or holiday destinations.
•    February—Make reservations. Begin family and friend talks about holiday locations for the year.
•    March and April—Make sure revisions are in your calendar.
•    May and June—Prepare for summer; make arrangements at work for vacation or at home for children during the summer.
•    July—Mid-year review of the calendar; holiday discussions with friends and family.
•    August—School shopping, late summer sales for business clothes and start planning for the holidays.
•    September and October—Start budgeting for holiday gifts and home repairs before winter.
•    November—The holiday season has begun. Break holiday projects into “bites.”
•    December—Finish holiday shopping. Make the holidays work for you by delegating and keeping projects manageable.

And December’s most important task: Find a new calendar for the coming year!



Karen Sampson Hoffman, MA, is the coordinator of the NRC's Ask the Expert webinar series and a contributing editor to
Attention magazine. An earlier version of this article appeared in Attention magazine.