Ask the Developmental Doc Back to School Special: What’s the Deal with ADHD and Executive Functioning? Or Why can’t my kid ever get organized!!?

Dear Developmental Doc:

                  School is starting in just a couple of weeks and I cannot believe how frustrated I am with my son.  J is almost eleven and because he has ADHD (attention deficit hyperactive disorder), I just know that he will be struggling once again in class with basics like getting himself and his stuff organized enough to make sure that his homework goes from his desk into his back pack, from his back pack to his desk at home and then once completed, from his desk at home back into the backpack to be presented into the teacher’s in –box in the a.m. Year in and year out,  I still don’t understand what does this simple organizational task seems so impossible for him to do?! I am just imagining getting a call from his teacher letting me know that she has yet to receive one homework assignment from my son.  I getting worked up and the semester hasn’t even started yet!  We need some guidance NOW!

Much thanks, Maria in Tarzana, CA.

Dear Maria,

                  The beginning of the school year often reanimates behaviors that we, as parents, might have hoped would have disappeared over the summer.  Executive functioning which is located in the frontal lobe region of the brain is responsible for our ability to organize information and execute directions. ADHD is a neurological disorder and the general consensus is that the symptoms that you describe arise due to the inability of the brain to process appropriately chemicals called neurotransmitters that are responsible for supporting attention, reducing distractibility, irritability and impulsivity.  

                  My first question to you, is how aware is your son’s teacher and the administration regarding his condition? Is he on some type of medication (traditional western psychotropic, homeopathic, etc.)? Have you asked for an Individual Education Plan (IEP) where your son could be assessed and perhaps have some of his academic program modified to best support both his strengths as well as his challenges? When teachers are made aware of a student’s difficulties, typically there is compassion, as well as renewed direction, as the teacher begins to understand what is the best approach for reaching a student, who could be quite bright, but may need specific supports to best channel particular learning styles.

                  In regards to support, there are a variety of tips that can make a world of difference in assuring that a child knows what is going on in class and consequently feels good about himself and his abilities.

  1. Children and adolescents with ADHD need more parental supervision than their typically developing peers. Have the teacher e-mail you a copy of the homework assignment nightly. That way, you can monitor whether or not there is homework and help assure that the work, will, at the very least, make its way into the backpack for the trip back to school.
  2. Ask the teacher for a second set of text books that you can keep, so that if a text is left behind at school there are back up materials to make sure that your child is caught up with his class.
  3. Because ADHD is a neurological disorder there are often underlying sensory processing disturbances that are contributing to a child’s inability to attend and regulate. You may want to consider occupational therapy techniques that take into consideration how a body organizes when confronted with environmental stressors. These can include having your son chew gum (if school policy allows) and/or drinking from a water bottle with a sports top. The oral actions (the chewing and the sucking) can provide proprioceptive input for the body that helps support attention and calming.
  4. Many children with ADHD get visually overwhelmed and subsequently distracted. Suggest to your teacher that your child sit close to the board and have the staff create a visual schedule which clearly delineates what is going on in the class at any given moment.
  5. If these simple strategies are not providing your child with substantive results, you may want to consider a more coordinated program of support which can include occupational therapy, education support and vision therapy. Your pediatrician or local developmental specialist should be able to provide you with a listing of referrals.

                  As you gear up for the challenges of this upcoming school year, I ask you to keep in mind, that your son is not intentionally avoiding his responsibilities. By providing the right kind of support for your child, he not only will achieve success in the classroom, but also feel better about himself. Which in the end, is the real success… Yours, E. Hess, Ph.D. a.k.a. The Developmental Doc.