Abigail Levrini, PhD Betsey Noboa, PsyD Indu Singh

“Succeeding with Adult ADHD: Daily Strategies to Help you Achieve Your Goals and Manage Your Life” Levrini & Prevatt (APA, 2012) Amazon.com PEC Planner (in collaboration with Tools4Wisdom) Amazon.com APA Video Therapy Series - Treating ADHD Levrini & Prevatt (2013) “ADHD Coaching: A Guide for Mental Health Professionals” Prevatt & Levrini (APA, 2015)

Practically speaking, problems with the "brain's CEO" contribute to several problems: disorganization, difficulty getting started and finishing work, remembering homework, plus difficulty memorizing facts, writing essays or reports, working complex math problems, remembering what is read, completing long-term projects, being on time, controlling emotions, and planning for the future.

Working memory and recall (holding facts in mind while manipulating information; accessing facts stored in long-term memory.) Activation, arousal, and effort (getting started; paying attention; finishing work) Controlling emotions (ability to tolerate frustration; thinking before acting or speaking) Internalizing language (using "self-talk" to control one's behavior and direct future actions) Taking an issue apart, analyzing the pieces, reconstituting and organizing it into new ideas (complex problem solving). Shifting, inhibiting (changing activities, stopping existing activity, stopping and thinking before acting or speaking) Organizing/planning ahead (organizing time, projects, materials, and possessions) Monitoring (self-monitoring and prompting)

In school, at home, or in the workplace, we're called on all day, every day, to self-regulate behavior. Executive function allows us to: Make plans Keep track of time and finish work on time Keep track of more than one thing at once Meaningfully include past knowledge in discussions Evaluate ideas and reflect on our work Change our minds and make mid-course corrections while thinking, reading, and writing Ask for help or seek more information when we need it Engage in group dynamics Wait to speak until we're called on

 Goal directed behavior occurs when a person is able to hold a Goal in their awareness and use the abstract image of that goal to guide and direct their actions.  Being S.M.A.R.T-P makes for an effective goal! ◦ Specific ◦ Measurable ◦ Action Driven ◦ Realistic ◦ Time Sensitive ◦ Process Based (rather than Outcome based)

 Some kids naturally self-regulate more easily than others.  For those that don’t, this skill can be taught by using external motivators.  Talk through goals and objectives, and consider attaching an external motivator (in advance) to those that kids struggle with naturally.  Don’t forget to allow your child to take the lead!

 Be complimentary - The most effective rewards and consequences are those with relevance to a particular objective or goal. For example, pair a budgeting goal with a consequence of “giving twenty dollars to charity,” both of which involved spending money responsibly.  The sooner the better - The immediacy with which rewards or consequences are delivered will impact how well they work.  Get creative – As you begin to think of ideas for rewards and consequences, take a week and see what you are doing or gravitating towards instead of what you should be doing or are avoiding. If you take a good look you can come up with some creative and fun ideas to work with.  Try both and then use what works (or, try neither and revisit later)– Despite evidence that external incentives are helpful to adults with ADHD, you may find that that either the rewards or consequences aren’t motivating. This can happen for a variety of reasons Therefore, you should begin by using both rewards and consequences but then decide if both are motivating, one works better than the other, or both cause added stress, and adjust accordingly.  This isn’t a bribe –The point of rewards and consequences are not to bribe you or reward you for doing something you should be doing to begin with. This is not an excuse for personal accountability. Instead, the idea is that by putting emphasis on particular objectives and creating a structure with immediate feedback, you can begin to internalize a sense of self-regulation not previously experienced.

 Specialty Timers  Life Wheel  Metaphors  Inspiration Toolbox  Decision Making Table  Juggling Exercise  Processing Exercise  Eisenhower Grid  Learning Style  PEC Planner  Graphic Organizers  Apps and Web Products

 According to the National Sleep Foundation, children aged six to 13 need 9-11 hours of sleep.  If you have to wake your child up for school, he/she is not getting the sleep he/she needs. ◦ Additional signs of a sleep deficit include:  Difficulty paying attention  Unable to concentrate  Hyperactivity  Defiant behavior

 As children enter elementary school, there are increasing demands on children’s time due to:  Longer school hours  Increasing amounts of homework  Extracurricular Activities  Sports  In addition, kids are becoming more interested in watching TV, using computers, the internet, and videogames. These have been linked to:  Increased difficulty falling asleep  nightmares  sleep disruptions (wake-ups.)

 Important to remember that getting enough sleep is a biological necessity. It is as important to good health as good nutrition and exercise.  Children who don’t get enough sleep are: ◦ Less mentally alert ◦ More inattentive ◦ Easily distracted ◦ Can be more physically impulsive ◦ Have more mood swings ◦ Less likely to share ◦ Show a decrease in appropriate social skills

 During sleep, our brains create and strengthen different types of memory. ◦ Just before your child wakes in the morning, his brain uses the last stages of REM sleep to sort and store memories and information from the previous day and get ready for the day ahead.  Children's brains transform subconsciously learned material into active knowledge while they sleep.  Sleeping after learning supports the long-term storage of the material learned.  During sleep, children take what they have learned and turn into a form of memory that makes future learning easier.

 Talk to your children about healthy sleep habits. Educate them on why sleep is so important.  Keep TV’s, computers, iPhones and Ipads out of the bedroom.  Help your child establish a regular and consistent sleep schedule. They should go to bed and wake up every day at the same time (even on weekends!)  Create a relaxing routine before bedtime.  Create a bedroom environment conducive to sleep. Keep it dark, cool, and quiet.  In the mornings, open up the shades and blinds right away. Exposure to morning sunlight can help keep the body’s circadian rhythms in sync and make falling asleep easier.

 If your child continues to have difficulty falling asleep, a psychologist can help teach your child relaxation strategies including progressive muscle relaxation, deep breathing and the use of imagery.  Children sometimes have difficulty sleeping because of fears related to bedtime. A psychologist can suggest strategies to help work through these fears including:  Helping parents understands their child’s fears and how to best manage them.  Teaching children to manage their own anxiety.  Help parents set up a reward system to encourage and reinforce appropriate sleep behaviors (being “brave” and staying in bed, not calling out)  We can also help with an all too common problem – your child sleeping in your bed!