Attention Magazine October 2018

ADHD affects the ability to manage life–particularly when situations require sustained effort, consistency, and planning. ADHD can undermine health, social relations, self-esteem, efficiency, and far more. Because of that broad impact, grades are not the bottom line for evaluating ADHD, even in school. Educational law states that impairments related to ADHD, not specific grades, are the bottom line.

When academics come easily, high marks may not reflect a child’s ADHD. ADHD may undermine the potential of a student who should be excelling but only does passably well. It may exhaust and overwhelm a teen who gets her As through ten times the effort and five times the stress as her peers. Other students get labeled disrespectful or apathetic because they barely attend to their teacher but still know all the answers. For gifted students with ADHD to meet their potential, school plans require an accurate and wide-ranging approach to care.

Focus on short-term ADHD symptoms

We want our children with ADHD to live up to their full capabilities. When they get strong grades without working on it, many learn to coast, setting themselves up for later hardship. It’s not the grades themselves that matter most, it’s allowing someone with ADHD to perform at their best. Here are some suggestions:

● Require use of planners and to-do lists. For longer-term success, the overriding message with ADHD should become “don’t keep track of anything in your head.” Children with ADHD who are strong students get by without much of an organizational plan. They may resist organizational systems entirely and seem to rely on adult reminders indefinitely. Until a student manages his work well, patents and teachers must supervise routines, coordinate homework posted daily online, and communicate together as soon as issues crop up–all the way through high school. Through this adult reinforcement, stronger habits eventually take hold.

● Set a homework schedule. A solid homework routine imparts study and time-management skills. Without adult intervention, ADHD symptoms like procrastination, avoiding effort, and “time blindness” define schoolwork. Instead, set a time and a place for homework. Then, implement a homework checklist to make sure it gets done well. “Check each class for assignments, complete them, check your work, and put everything in your backpack” is a good start. While this approach is always valid with ADHD, lax routines often are left alone and become lifelong habits when academics come easily.

● Support routines that compensate for ADHD symptoms. ADHD causes distractibility and forgetfulness and a host of other academic challenges–traits that are not a choice or a sign someone does not care. There is little value to marking someone down repeatedly for failing to hand in assignments on time or anything else directly caused by ADHD. Give students a chance to figure out a solution, but step in when ADHD-related issues persist. ADHD is a disorder of planning, so students initially require guidance instead of being left on their own to figure things out. A student can be years ahead in reading or science and still benefit from adult support around ADHD-related strategies.

Focus on long-term skills

ADHD is best seen as an executive function disorder. These self-management abilities include attention and behavior, but also time management, task management, and more. Academic skills like studying and writing rely on executive function–but if academics are easy, students get by without much work at all. Ineffective work habits eventually catch up if we don’t find opportunities to teach them broader life skills.

● Make a daily plan out of longer projects. Until children learn for themselves, take long-term assignments and plan them out backwards. Starting from the due date, mark each step on the calendar working toward today. For example, a paper due on the 21st should be edited on the 20th, which means written by the 19th, which means outlined by the 17th. For someone with poor executive function, projects don’t naturally break into smaller parts, and procrastination is the norm until this direct instruction takes hold.

● Teach test taking skills. When your grades remain reasonable, is easy to shrug off chronically lost points here and there for carelessness and missed details. Poor self-monitoring, rushing, and carelessness are all ADHD symptoms, and ADHD gets in the way once again of planning and problem-solving. Expecting someone to overcome this situation through motivation alone underestimates ADHD. Students learn when provided specific techniques for slowing down and checking their answers, writing with appropriate level of detail, and even how to adequately show their work. Otherwise, they learn that their small chronic errors are an inevitable part of life, instead of something to be worked on.

● Build study habits. Teach children to complete a quick review for any test, even when they have been doing well. If they know the topic, it won’t take much time at all– but more often, they’ll discover small details they would otherwise miss. Collaborate on studying as you would on projects, teaching children and teens how to use flash-cards, take practice tests, outline, and use other subject-specific study skills, as well as how to parse studying out over days or weeks.

Executive function, self-advocacy, and life management

ADHD affects a child’s ability to advocate for herself and effectively manage her life. Set up collaboration with a parent or teacher on school plans instead of leaving students to navigate academics. Most often, having supports available to seek out when needed, without scheduling them, isn’t enough–because executive functioning includes how kids identify their own problems, make plans, stick to them, and make good choices in the moment. Until a student is ready to take charge, we must recognize the reality of immature EF even in an otherwise bright and hardworking child.

Executive function lags delay full independence for even the most adept student–so we build skills by staying involved as an adult. The frustrating disconnect between a clearly advanced student and inconsistent performance comes down to immature executive function. We best promote long-term success through sustained and compassionate supports as they progress towards adulthood.

MARK BERTIN, MD, is a pediatrician, author, professor, and mindfulness teacher specializing in neurodevelopmental behavioral pediatrics. He’s a regular contributor to Mindful.org, HuffPost, and Psychology Today. He is the author of How Children Thrive: The Practical Science of Raising Independent, Resilient, and Happy Kids (Sounds True, 2018). Dr. Bertin resides in Pleasantville, New York. For more information, visit developmentaldoctor.com.