All around the world parents are pulling their hair out every morning as they attempt to get their children dressed, fed and ready for school. These are some of the comments I hear:
"I send him to his room to get dressed. On the way he sees the cat, and then I've lost him." "She can stand in the middle of her room for 10 minutes and daydream - just daydream." "Just as we're getting into the car she remembers that she's dressed in the wrong uniform - It's Sports Day Mum !!!!" "I manage to wave goodbye with a big sigh of relief. As he heads to the bus stop I head to the kitchen - to find his lunch has been left behind"
I know you're nodding as you read this. We've all experienced ADHD morning mayhem. One of my gorgeous teenage clients recently introduced music into her morning, and significantly reduced the collective family angst. Before I tell you her secret, let's take a closer look at the situation.
What's really happening in your child's brain as you ask him or her to brush their teeth for the third time? In previous blogs I've spoken about the Executive Function deficits that occur for people with ADHD. According to Professor Thomas Brown the Executive Functions (EFs) of the brain include the ability to organise, prioritise & activate, to monitor & self-regulate actions, to control alertness, effort & processing speed, to focus, to use working memory, to shift & sustain attention, and to control emotions. Simply put, the brain is like an orchestra, with many sections doing many things. The Executive Functions are the conductor, ensuring that all the sections work together. In the ADHD brain, the conductor is asleep! So your child is unable to remember the sequence of tasks required in order to be ready for school / work. In addition, he or she has "Time Myopia" and is unable to judge how much time is needed for, or is spent on each task. And then, when time runs out and things become urgent, your child may struggle to control their emotions.
In order to complete a sequence of tasks, therefore, an external prompting system is required. This approach is highly recommended by Professor Russell Barkley, who constantly reminds us that ADHD requires intervention at the "point of performance". There is no point in giving your children a lecture on the importance of being ready for school on time. They know that. They also know how to get ready. What they don't know, is how to remember all the steps and complete them at the appropriate time. So what is an external prompting system and how does it work? Here are the steps:
1. Make a list (or a picture storyboard) of what needs to be done in order
2. Make the list highly visible to your child.
3. Keep your child focused on their list, as opposed to individual items.
4. Have an instant reward at the end of the list.
5. Make time audible for your child - that's where the music comes in.
To prevent the list being forgotten, there needs to be an external audio prompt. Many of the teenagers I work with have found the 30/30 app to be perfect for this purpose. However, others are less enthralled with this technology. It's all about finding the right stimulus for your child. And for my client last week is was The Playlist Prompt. She carefully chose and compiled her morning playlist, with a song connected to each task. Then she explained to her family that she would be using it as a prompt, and asked her mum to remind her to switch it on by a certain time. The Playlist Prompt is working very well for her, especially with the following rules:
1. Check the list each time a song ends
2. Singing along is permitted, but remember that the hairbrush is not a microphone
3. Dancing is fine, as long as it happens alongside a task - e.g. the toothbrush wiggle
4. Be sensitive to your family's eardrums - use headphones if necessary.
Perhaps the Playlist Prompt is something that could work for your child?
Whatever system you use, remember that this "simple" task of getting ready in the mornings is probably one of the hardest things for your child to learn. Celebrate the successful days, and encourage him or her to improve on dodgy days. Success will not occur overnight - but it will happen if you persist.