Podcast Transcript

Guidance for Uncertain Times: Tips for Creating an ADHD Friendly Home Environment

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Podcast date: March 26, 2020

Learning Objectives:

  1. Learn strategies for helping students with ADHD at home
  2. Learn ways to help children with motivation
  3. Learn about medication management at home and with professionals
  4. Discover strategies for finding at home activities
  5. Learn how to manage fear and anxiety at home


Announcer:  You are listening to a special podcast of All Things ADHD in response to the coronavirus pandemic.

Sarah Brown:  Hi, I'm Sarah Brown, and I'm the director of The National Resource Center, a program of CHADD. I'm here today with Dr. Margaret Sibley, who we call Maggie. And we're here to talk about how to help our ADHD kids now that they're out of school. Dr. Sibley, would you like to introduce yourself?

Margaret Sibley:  Hi, thanks for having me, Sarah. My name is Maggie Sibley. I am Associate Professor of Psychiatry and Behavioral Sciences at the University of Washington. And I'm also a psychologist at Seattle Children's Hospital.

Sarah Brown:  Schools are closed now. Two weeks, four weeks, maybe even for the rest of the semester. How can we help our kids that have ADHD get through this semester?

Margaret Sibley:  So, we're going to rely on some of the strategies and tips that we would normally implement, even if it were a typical schedule or typical setting that our kids are in. And we can make these things adjusted a little bit for the current circumstances.

So, some of the strategies we want to be thinking about are getting a really consistent routine in place. So that includes having bedtime, wake up time and being up at the same time every day. We want to be coming up with a daily schedule that becomes a routine that kids are used to. So, it could be that certain amounts of time are scheduled for homework or scheduled for classroom activities. And then having other times of the day that are scheduled for more enjoyable activities, like getting exercise, and doing creative work like music or art, making those enjoyable activities go around the schoolwork so that kids know that there's something fun to look forward to if they get their work done. And there's other strategies parents can use, like providing rewards for getting certain amounts of work done. Rewards can be enjoyable activities. It doesn't have to be something that you buy.

Also sitting down and asking yourself, what's the best location for my child to be doing work? Can I create a distraction-free environment somewhere where it's easier to focus, somewhere that maybe you only go when you're doing schoolwork to kind of create those boundaries between school time and playtime at home? And as a parent, I think it's also important that even though we're trying to set up these routines, it's okay to break them sometimes. We have to be watching out for our kids' mental health and how they're doing in this stressful time. So you shouldn't feel pressure yourselves to be perfect with these schedules, but allowing the kids to know what's expected of them and having kind of clear, positive, and maybe more challenging times of the day is something that is a good balance for kids to help them get through each day one at a time.

Sarah Brown:  Yeah. And I think it's really stressful on everybody now. How can parents help keep the kids motivated and then also on task?

Margaret Sibley:  Yeah, that's a great question. So if you have a younger kid, something like a point system can be a really good strategy to help your kids feel excited about getting work done, something like using a menu of rewards at the end of the day, that if you've got all the schoolwork done that was planned, there's a number of fun activities that you can go do, and you can choose which one you want to do each day. You can also extend that to having good behavior at home or participating appropriately in activities. Also just noticing them when they're doing things right. And when they're meeting your expectations and giving them verbal positive feedback on that can go a long way. And in addition, when kids are doing minor negative things, trying to cut them a break, not overreacting and creating stress at home, and just letting some of those little things go right now, because there's already a lot of reasons to be stressed and the little mild negative behaviors aren't necessarily worth getting into battles over.

For older kids, you want to involve them a little bit more in the motivational piece. So, helping them set goals for what they want to get done each day. And then you can even contract with teens, where they can tell you things that they'd like to be allowed to do, whether it's just having alone time, unrestricted in the room, without anyone bugging them or making them do chores, or being able to watch a show that they like to watch, that maybe you don't usually let them watch in exchange for them getting the work done and doing the chores around the house that you might be engaging them to do. That's sort of an age appropriate strategy that you might use with the older kids.

Sarah Brown:  Does taking their medications regularly and on time help with keeping kids motivated and on task?

Margaret Sibley:  If your child is already taking medication during the school day, and we're trying to create that normalcy and that consistency with what school is usually like, then it probably means that continuing that same medication schedule, even when you've moved learning to home is the way to keep that consistency.

But if you have any specific questions about your child's medication dose, and whether to take it at home, then luckily, most providers are still providing services to patients, either through telehealth where they can get on the phone with you, or they can get on video chat with you, and even if you can't leave home they can still help you with what you need to be able to manage medication.

Sarah Brown:  How about kids getting bored? You know, this is a long period of time that they're sitting at home. What do we do about bored kids?

Margaret Sibley:  Yeah. Well, and that's particularly a concern with ADHD, right? Because kids with ADHD just have more of a propensity to get bored quicker and more easily. So, I know this is probably intimidating for parents who suddenly find themselves tasked with managing their kids' learning. And how do I keep that fun and engaging? The good news is that the Internet right now is full of ideas for parents about things they can do to create fun learning activities at home. And really some places have stepped up, like the National Parks are doing online tours of the park, where you can get online with your kids and look around. And they're doing virtual museum tours right now. There's a lot of people who are posting art projects on video, so the Internet's your resource right now for coming up with interesting activities.

And if you've got older kids who can kind of manage their own activities, there's a lot of cool ideas going around right now. You can challenge your kids to think of something they've always wanted to know how to do, but have never picked up, like a new instrument or learning to build something with them with tools. We've heard of kids who've started writing their own comic book about what it's like to be going through the coronavirus. Teach your kids how to bike, teach them how to bake. Go out gardening with them. I mean, you can come up with lots of cool things that aren't just fun but become life skills that can pay off long-term for your kids. So, we're encouraging parents to sort of think outside the box and make this a special opportunity to do something different than you usually might do with your kids.

And then of course we can still socialize virtually, right? So creating virtual playdates for your younger kids, where they can get on the video chat with other kids at school, you can do things like virtual show and tell where you show them something you made at home today, or show them something cool in your house and talk about it. So luckily, I can tell you a few things in five minutes, but the Internet's going to have tons of resources for people if they just start Googling.

Sarah Brown:  Yeah. I think I've seen a lot of good things to do on the internet. How about the parents are having a difficult time managing their kids' behavior? I've seen on CHADD's Health Unlocked, there's been a number of people that have said how hard it is for them to work from home and still have to help your child with school. And then if they have ADHD and have issues with behavior, or issues with their siblings, how do you work with that?

Margaret Sibley:  Great question. So, I think there are some things that everyone can try at home, that are the basics. That if you try those things, it's going to take care of a number of these behavior problems. But what I also will say is that if you find yourself really struggling, know that psychologists, and mental health providers, and behavioral health providers are still out there providing services to homes. And in the hospital where I work, and in many of the private practices where I have colleagues, everyone's just switched their services to online. So, this may be a particular time where you need that extra support. And most insurance companies are either already accepting reimbursement for telehealth or are working to figure out how they can do that.

So, but I can share some tips for folks of some of the basics. And some of the things we want to consider are making sure that you have clear boundaries around screen time and limiting that. A lot of times the source of arguments has to do with screen time, so being clear about things that might trigger arguments and thinking about how you can prevent those things ahead of time. Keeping your kids' wellbeing up by making sure they're having regular physical activity every day, and making sure they're eating healthy foods, and on a good routine.

And then we're going to go back to our classical behavioral principles for strategies that parents can use to manage misbehavior. So, like we said before, let a lot of stuff go that's minor right now. It's not worth the arguments when everyone's already stressed. Be clear in your own head about what you consider a behavior problem that you want to address and what you think are minor things you can let go. Make sure you catch them when they're being good and provide them a lot of positive reinforcement for that, so that they realize that their good behavior pays off and that you appreciate that.

And just make sure that the expectations are very clear for them. If you have a work meeting and you need them to be quiet for an hour, so you can go into your office and have that phone call, ahead of time, make sure you let them know what's going on, let them know what you expect them to do, and what they may get it in return, as in the form of playing outside or something like that, if they're able to maintain that quiet during that time. And again, if you have clear rules in your house, and those rules are posted and kids are aware of them, and kids know what the consequences are for breaking those rules, if the consequences are fair, if you're implementing them consistently. So not making exceptions, but every time you see the kids breaking the rules, you're consistent about those consequences, that goes a long way.

And then you also have opportunities to reward kids with bonuses for consistent good behavior. So, if they go a whole day or a whole week without breaking a lot of rules, how can you go out of the way to acknowledge that? And really acknowledge that they're stressed right now, and so their behavior may be a little bit worse than it normally is. And if they're making efforts to follow the rules and do a good job, we really want to honor that as well.

Sarah Brown:  Right now, kids are hearing all about this pandemic and are stressed and have a lot of fears. How do parents help them calm themselves or work together to calm each other?

Margaret Sibley:  Well, I think one of the most important things here is that parents need to model good coping skills for their kids. So, if kids see their parents freaking out and being really anxious, and not showing good ways of coping with stressful situations, that's going to really trickle down to the kids' reactions. So, parents should also be taking care of their own mental health and thinking about what they need to do to set a good example.

It's really important to make sure that we're not over-exposing kids to scary media right now. With just being able to freely go on the internet and look at whatever you want, there's a lot of bad information out there. There's a lot of sensationalized information out there, and if we don't know what kids are reading, we don't know how to help them sort through that and know what's true and what's not true. So, you do want to be monitoring what they are looking at, maybe looking at things with them. There's no reason why people need to be spending more than maybe 30 minutes a day getting updates on the situation. Reading about the coronavirus for hours on end is that mentally healthy for anyone. And making sure that information that you're looking at together is from a reputable source, like the CDC or like information being shared by local officials.

And then giving you the space to talk about it. There's a lot of resources online right now. I know CHADD has some posts about how to talk to your kids about this. And also being aware that if you send clear messages to your kids about your family's going to be safe, we're staying inside to help other people who might not be as lucky as we are, then that's going to go a long way for making kids feel like there's not a panic going around.

And then once again, like I mentioned, if you feel like your family is suffering with anxiety about this, or you notice that your kids are showing signs of secondary issues like feeling depressed, or panicky, or even symptoms of things like obsessive compulsive disorder about being scared of the coronavirus. These are all things that kids with ADHD have a higher risk of developing. You've got teenagers who maybe have a higher risk of things like smoking marijuana in this situation. You should just be aware that you can still get services and help her those things. And that there are still ways families can reach out to professionals.

Sarah Brown:  Well, Maggie, this has been a great help. I've learned a lot, and I hope our audience will learn some things that can help them in this time. Thank you so much.

Margaret Sibley:  Thank you.

Announcer:  You are listening to a special podcast of All Things ADHD in response to the coronavirus pandemic. In this time of crisis, we know everyone in our community is facing tremendous pressures, and CHADD and its National Resource Center on ADHD are here to help. We are committed to continuing to be the resource on which you can rely. For more information, visit our website at CHADD.org and follow us on Facebook, Instagram, Twitter, LinkedIn, and Pinterest.


This podcast is supported by Cooperative Agreement Number NU38DD000002-01-00 from the Centers for Disease Control and Prevention (CDC). The contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.