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Manage Stress, Self-Regulation & Provide Order

Margaret V. Austin, Ph.D., edited by C. E. Zupanick, Psy.D.

stressed figure5. Manage stress: Having a newly diagnosed child with ADHD can be an extremely stressful experience. Caregivers may become discouraged or overwhelmed themselves. Being the caregiver of a child with special needs calls up all sorts of feelings and emotions. Ask for help from professionals, particularly if you are feeling depressed, frustrated and exhausted. Use self-care to manage additional stress. When you're less stressed, your child is less stressed. Nonprofessional support groups are also helpful. Many communities have local support groups. Some are organized through Children and Adults with Attention Deficit Disorder (CHADD). You can find the nearest chapter to your home on http://www.chadd.org. Use the chapter locator.

6. Learn and teach the skill of self-regulation

A key skill for caregivers and children alike is self-regulation. Self-regulation is the ability to monitor internal states and to make adjustments as needed. For example, suppose an exhausted parent returns home after a long day at work. As soon as they walk through the door, they find their ADHD child in the midst of a tantrum. The child stomps their foot down for emphasis, and shouts, "I will not do my homework. Its' stupid. Besides, you can't make me." That taunting tone is enough to make any parent reactive. An initial reaction might be to jump into the fray without thoughtful consideration of the problem. This could easily occur because the parent is already tired and just doesn't have the mental energy to deal with the situation. However, a parent with good self-regulation would recognize they need a few moments to regain composure. This additional time alone allows the parent to readjust his or her internal mental state. The parent might lie down to rest briefly; do some yoga stretches; meditate; or simply take several deep breathes. The ability to self-regulate is a skill we all need at times. However, it is a skill that requires intention and practice. Once caregivers learn self-regulation, they can teach this skill to their child. Consultation with a psychologist to learn mindfulness techniques can be helpful.

7. Provide order and structure in the home

One of the most important ways to provide order and structure is to structure time. Time management is critical to success. Unfortunately, many kids with ADHD struggle with time management. They do not accurately judge the passage of time. They live in the moment and are happy to do so. They have difficulty estimating how long a project will take. Time seems to pass at an agonizingly slow rate when performing a "boring" task.

An impaired sense of time is often a lifelong problem. It doesn't tend to improve, even with medication. Helping children learn to compensate for these deficits is essential for their success. Punishing students for poor time management is not an effective technique. It does not help the child develop time management skills.

Caregivers can help children learn time management strategies. Time management involves four main steps:

1) Plan;
2) Prioritize;
3) Schedule; and,
4) Follow the plan.

Plan: A paper or electronic planner is a very useful tool to help children learn planning skills. Caregivers should practice using the planner with their child each day. Check to be sure that tasks were listed and recorded correctly. Check to make sure the planner is current and up-to-date, marking off completed items.

Prioritize: Caregivers can help children learn how to set priorities. You and your child might begin by dividing tasks into two groups: Important (do it now) and Unimportant (do it anytime). Students may need an additional category for semi-important items. Each task can be written on a post-it note so each task can be moved from one category to the next. Students can then pick the top three items and start there. Caregivers can discuss priority ranking criteria such as deadlines.

Schedule: Scheduling can be accomplished by transferring the "to-do" post-it notes, onto the daily planner. Children should be encouraged to accurately estimate the time it takes to complete a project. Encourage children to practice improving time estimation. One way to do this is by getting feedback on time estimate accuracy. First, estimate the amount of time for a task and record it. Then complete the task. Write down the actual time it took and compare the two. Although this can be a difficult task to learn, observing trends can facilitate learning.

Follow the plan: The last step in the sequence may seem obvious, but it is not obvious to ADHD students: follow the plan. Additional tools can be handy. For instance, it can be helpful to keep the "to do" list in sight by using 3x5 cards and organizing them on a cork board. Alternatively, post-it notes can be arranged, and rearranged, on a standup clipboard.

There are many apps for smartphones that provide planners, scheduling, timers, and reminders. Timers can be used to identify break times, and to guide movement from one task to the next.