THERE IS NO SHORTAGE OF TECHNIQUES, cues, and strategies for each family to try with a child or teenager with ADHD. But when all is said and done, parents are often left frustrated and confused as to why their child carries around the ring attached to their bookbag with the series of laminated strategy cards that never see the light of day. Those cards that were so creatively done and took endless hours to make just collect dust and are never used.

There are many useful tools that are there for the child to use–the hard part is done right? If that’s the case, then why is it so challenging to get kids to actually use them?

The hard reality is that, at the end of the day, you can have all the toolkits and strategies in the world to help children, teenagers, or young adults with ADHD learn how to self-regulate, but none of them will work if they are not implemented the right way. Putting a plan into action is difficult! For a child to use any strategy or tool, the child is required to be able to pause and think, and that particular function is a large part of self-regulation. The solution is simulation. Any strategy or skill a parent wants a child with ADHD to learn can be enhanced with simulation.

Simulate the experience

Simulation is designed to replace and intensify real life experiences with guided ones that evoke or replicate significant aspects of a child’s real-world executive function challenges in a completely interactive situation. This goes beyond role-play and talking about what it will look like when the child uses his strategies.

Simulation means allowing the child to experience and practice a scenario until the child feels more comfortable and can master the specific skill. By simulating a real life interaction–like becoming too angry, shouting, and stomping off during a play date–the child can experience the heat of the moment and then, subsequently, what it feels like to actually use strategies to down-regulate.

This practice is critical, so that when the child is no longer in the presence of the parent or caregiver, the child is still able to call up that past simulation and implement the strategy in the real world. With consistent practice, the child is learning how to improve self-regulation.

The key is to learn to implement the strategies in the moment. By practicing the simulated experiences, any child will succeed. The beautifully created ring of strategies in the backpack will get used!

How should you incorporate simulation?

There are four important steps to follow when introducing simulation to a child with ADHD.

Step 1: Bring the experience to life.

To bring the skill into the real world, the parent must shadow the child, and then prompt him to use the strategies in the moment. It will require active listening and collaboration. Share with the child that you are going to work together because you understand that he wants to improve his situation and to use his strategies, but that he just forgets when things get a bit overwhelming.

For example:

When a child or teenager with ADHD becomes too silly, laughing at a joke, flopping around giggling long after his peers have stopped, he has lost control and needs to learn to self-regulate. The child with ADHD is at a disadvantage–he doesn’t understand why over-giggling is a problem. He can’t see that his goofiness has turned from funny to weird and is causing his classmates to shy away from him. The challenge is that the child needs to be able to feel the “awkwardness” he’s created and many times the parents are not there to prompt him to use his strategies to regain control. Too often, a parent tells the child, “When you get too silly, stop and go calm down.” Frustratingly, it does not work. To properly simulate the experience, the parent needs to allow the child to lose control–to become silly and goofy, and then, while he is in that state, implement the strategies and regain control.

Step 2: Teach everyday situations.

Executive function skills like self-regulation must be taught in everyday situations where the learning is transferable to the child’s daily life experiences. Simulating the event and allowing the child to practice what dysregulation feels like will allow the child to experience a parallel situation to what he is going to experience in the real world when the parents or caregivers are no longer with him. He will also learn that strategies do work. Simulation turns learning new executive function skills into an active experience. The child must experience the dysregulation and know how and when he is feeling it in his body. He must understand what getting out of control looks like. Then and only then can he learn what the identified strategy does for him.

For example:

Two siblings, Chris and Jack, often fight and wrestle, it escalates, and things get out of control. The ADHD sibling, Chris, loses his self-control and the whole thing turns violent. The parents tear their hair out and wonder what to do, but the answer is always found by simulating the experience. Executive function skills can only be improved by helping the child pay attention and gain the situational awareness they need. The parents in this case need to repeat the scenario that just played out. They should discuss with Chris and Jack that a more harmonious interaction is wanted and then allow the boys to wrestle again. This time, when they begin to lose control, the parents should step in and guide Chris and Jack through each choice they made along the way. Only when a child can feel it, and understand how his actions bring certain reactions, can he make the needed changes.

Step 3: Ask questions in the moment.

Parents can prepare the child by discussing what they have noticed during the times of dysregulation.

For example:

Sometimes Chris and Jack have trouble remaining safe and in control when they wrestle. Prepare the children– help them understand that you know how hard it is for them to remember strategies and that you are going to help them by stepping in at certain times to guide them toward being able to use their strategies without future intervention. It is important to work with the child while in the moment. Remember, only when he is losing self-control can he experience his body signals, emotions and how he feels. In short, parents must allow the child with ADHD to get worked up and dysregulated, then step in and ask:

● How do you feel?

● What’s going on in your body right now?

● Describe what is happening?

● What will happen if you keep going on with the “insert any activity”?

● What do you think can be done differently?

● How would the outcome change?

The goal is to make the child who has ADHD aware of what he experiences when he is dysregulated and have the ability–in the moment–to be able to use his strategies to down-regulate. Help him understand what that means to him. After each simulation, be sure to talk about what went well and if there were situations where he felt things weren’t working. Talk about how it felt to be able down regulate.

Step 4: Keep it fun.

Practicing simulation doesn’t have to be boring or related to something that causes stress for the child. Try working on getting the child completely silly.

For example:

The parents of Chris and Jack can have them bounce on a trampoline, allowing time to wrestle until both are out of control. Then say, “Use the strategy.” Now that Chris is in the dysregulated state, he knows how it feels and how to correct it in a typical day-to-day scenario. By simulating the experience of losing control, the child can experience the physical manifestations of dysregulation and conversely what it feels like to use a strategy, pause, and calm himself down.

Caroline Maguire, ACCG, PCC, MEd, is a personal coach who works with children with ADHD and the families who support them. Maguire earned her ACCG from the ADD Coach Academy and her PCC from the International Coach Federation. She also received a master’s degree in education from Lesley University.

FURTHER READING

Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121(1), 65–94.

Kopp, C. B. (1982). Antecedents of Self-Regulation: A Developmental Perspective. Developmental Psychology, 18(2), 199–214.

Liebermann, D., Giesbrecht, G. F., & Muller, U. (2007). Cognitive and emotional aspects of self-regulation in preschoolers. Cognitive Development, 22(4), 511–529.