Difficulty in Transitioning featuring “Turning the Page on ADHD” a blog By: Mark Bertin, MD.

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JKM Brett: I had an opportunity to read this blog post by Dr. Mark Bertin who has written two books to aid parents and caregivers of children who have ADHD. ADHD makes it extremely difficult for a child to access the parts of their brain they use or rely on executive functioning (EF) skills. These skills include things like organization, time management, and being able to transition in and out of routines, both expected and unexpected. In my career many of my students suffered from EF deficits. EF Coaching from specialists teamed with parents can make a substantial difference. As Dr. Bertin notes in this post, children often take their EF cues from the prominent adults in their lives. When Parents take an active role in shaping routines, results tend to be more positive. If your child has ADHD or EF deficits, this is for you! Here, Dr. Bertin provides tips for each stage of the day.

Enter Dr. Mark Bertin:

Transitions create an opportunity for change. For parents, any shift in the family schedule is a great time to consider what you’d like to do differently. Around ADHD, kids rely even more than peers on parents for structure, whether around school, health, technology, or anywhere else. Naturally, change is hard for all kids, and can be harder for those with ADHD. A new school year is the perfect time to pause, reconsider, and set up new routines.

ADHD undermines executive function (EF), the skills required to anticipate, prioritize, manage time, and manage any new plan. Because of that, having ADHD itself gets in the way of planning around ADHD. That typically means parents, not kids, modify and implement new plans as kids grow up, right up until they figure out how to do it themselves.

Introducing these new routines during transitions often makes them less jarring. Adult guidance is how children with ADHD learn to manage their own ADHD: Now that you’re older, we’re going to do homework this way. Your bedtime routine is going to begin later. Or maybe, Now that school is in session we’ll need to manage your screen time differently. Finding a natural break makes shifting gears around ADHD and family routines a lot easier.

Here are a few common ADHD-impacted routines to reconsider as school approaches:

· Morning routines: One useful shorthand for problem solving is seeing ADHD as a developmental delay in executive function. Frustrating as it is, a child’s self-management skills are behind. If she can’t get ready on her own without distractions, a parent becoming more involved can be exhausting but leads to more success. It’s also through adult-supported consistency of this kind that independence eventually develops. Sometimes collaboration eases tension too – We both tend to run a little behind, so this year let’s see if we each can get dressed and have our teeth brushed by 7.

· Homework: Children with ADHD struggle with prioritization, procrastination, planning, and time management. Parents typically define the homework plan, right up until kids show themselves capable on their own. This year, you’ll take a short break after school and then get your homework done. Only then is it time to play. If you do it without arguing, you’ll earn a reward.

· Exercise: Being active helps improve sleep, mood, and ADHD itself. But ADHD makes team sports, sticking to exercise routines, and even sustained effort hard, so exercise is often avoided. Instead, make a concrete plan: Everyone is going to exercise. We’ll help you find something fun, but you need to pick something by the time school starts.

· Technology: Screens and ADHD are often a perfectly disruptive storm. Symptoms such as hyper-focus of attention, frequent boredom, persistent novelty seeking, and poor time management converge to make screen time a huge disruption. Clear, unambiguous boundaries around technology prevent children from becoming overly focused on it. This fall, you can watch one show while I make dinner, and that’s it for school days. On the weekend, you get one hour total a day. If you cooperate, you can earn extra time.

Start the new school year by putting in place whatever you feel would benefit your children. It’s an ideal time for parents to make ADHD more manageable and family life a lot less stressful. During these last weeks of summer, consider how you’d like to take advantage of the upcoming opportunity for change.

Dr. Bertin is a developmental pediatrician and author of Mindful Parenting for ADHD and The Family ADHD Solution, which integrate mindfulness into the rest of evidence-based ADHD care, and a contributing author for the book Teaching Mindfulness Skills to Kids and Teens. His next book, How Children Thrive, will be released spring of 2018. Dr. Bertin is a faculty member at New York Medical College and the Windward Teacher Training Institute, and on the advisory boards for the non-profits Common Sense Media and Reach Out and Read. His blog is available through Huffington Post, Mindful.org and Psychology Today. For more information, please visit his website at http://www.developmentaldoctor.com.

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