5 Strategies for Parents to Promote Independence and Emotional Growth for Children with ADHD
By Kelly Budnick, MOT, OTR/L
What is ADHD?
Attention-deficit hyperactivity disorder (ADHD) stems from a deficit in the brain’s executive functioning abilities. “Today, most clinical professionals—physicians, psychologists, psychiatrists, and others—believe that ADHD consists of three primary problems in a person’s ability to control behavior: difficulties with sustained attention and increased distractibility, problems with impulse control or inhibition, and trouble self-regulating one’s activity level” (Barkley, 2020).
In the U.S., it is the most diagnosed neuro-developmental disorder of school-age children (Benson Adams, 2024). “Conservatively estimated, 5–8%, or between 3.7 million and 5.9 million school-age children, have ADHD. This means that there are at least one or even two children with ADHD in every classroom throughout the United States” (Barkley, 2020).
ADHD is 3-5 times more frequently diagnosed in boys than girls due to many complex factors (Benson Adams, 2024). Between 35-65% of adults self-report symptoms continuing to impact their function.
ADHD is a lifespan condition due to its fundamental difference in the brain (Benson Adams, 2024). However, as children get older, effective strategies, treatments, medications, and compensatory strategies can improve functional participation and independence in occupations of daily living.
Here are some top strategies for parents to help support a child with ADHD.
1. Use Effective Communication
Lori Benson Adams, a special education intervention specialist, notes that parents use prompt-dependent or directive language when they want their child to accomplish a task. Parents usually tell their child what to do, such as “Go pack your soccer bag.”
Children with ADHD benefit from internal language to guide their behaviors.
For parents, incorporate verbal communication to support the step-by-step thinking process. When kids are engaging with you verbally, this builds a pause or an inhibitor to impulsivity. Rather than telling the child to pack the soccer bag, ask, “What do you think you need first in your soccer bag?”
The goal is for kids to actively think of the steps needed to accomplish a task. “This can provide improved attention and reduce impulsivity during task completion” (Benson Adams, 2024).
In his book Taking Charge of ADHD: The Complete, Authoritative Guide for Parents, Barkley recommends that parents “give the child immediate feedback for how well she is doing. Don’t just walk away; stay and pay attention and comment positively on your child’s compliance.”
Provide your child with specific praise throughout the learning process.
While this may take additional time upfront, it ultimately creates independence. Research indicates that children with ADHD have deficits in the “motivational or reward centers of the brain.” It exists to a great enough degree that some scientists call children with ADHD “stimulation seekers” (Barkley, 2020).
Providing this positive feedback will activate the brain’s reward center and help motivate the child to complete everyday tasks.
Speech-language pathologists (SLPs) or occupational therapists (OTs) can educate parents and children on communication strategies to anchor the child in language and provide training in specific cueing strategies.
2. Create a Consistent Sleep and Activity Routine
According to the Sleep Foundation, people with ADHD are more likely to experience sleep-related problems.
Research shows that 50% of individuals with ADHD experience sleep disturbances (Zeigler Dendy, 2011). What does this mean? When sleep is impacted, memory, attention, and emotional regulation can be negatively affected during the day.
To address this issue, create a consistent bedtime routine with a sensory diet or activity schedule that regulates the child’s nervous system. A sensory diet or schedule is a personalized, consistent compilation of activities.
Parents can also modify the sensory environment to create a calming atmosphere for the child during bedtime. This may include:
Turning on light dimmers or nightlights
Reducing visual distractions on bedroom walls
Using white or brown noise
Plugging in essential oil diffusers
Listening to audiobooks
OTs can help create sensory schedules and recommend home modifications for improved sleep routines.
Children with ADHD benefit from consistent movement in their daily schedules. Physical exercise can help alleviate the symptoms of ADHD in children by improving attention, executive function, and motor skills (Sun, Yi & Zhou, 2022.)
Exercise can be as powerful as some medication for some individuals (Benson Adams, 2024). Creating a routine with movement activities, sports, and outdoor time promotes focus during seated tasks.
Incorporating movement breaks supports focus when children return to learning activities. Modifying the seated environment with movement activities is another tool to promote focus. This can include:
Adding fidget objects
Sitting on wobble seats
Placing TheraBands around chair legs
Balancing on yoga balls
OTs can educate parents and children on sensory schedules, movement breaks, seating modifications, and other strategies to promote improved sleep and activity routines.
3. Create Strategies to Manage Time
Most kids (with or without ADHD) struggle with time management.
A 2019 research study found that children with ADHD struggle to manage their time, leading to reduced productivity and higher stress. Children with ADHD have difficulty making connections across time and processing timespans (Benson Adams, 2024).
Visualization of time is key for individuals with ADHD.
Create visual models to represent time, including:
Visual schedules
Calendars
Checklists
Visual or auditory timers (Benson Adams, 2024).
Visuals need to match the child’s language and cognitive levels.
OTs can skillfully educate parents and children on environmental modifications and visual compensatory strategies to effectively create a schedule and build connections across time.
4. Outsource Memory
Adams also states that working memory is one of the foundational challenges of children with ADHD, as it’s based on the ability to focus attention.
However, information may not be stored if a child's focused attention is impaired. She recommends outsourcing memory strategies. This may mean accessing a notes app on a phone, using visual timers, or utilizing a visual day planner to store information (Benson Adams, 2024).
Children with ADHD can also have difficulty retaining facts outside their areas of interest. Incorporating these preferred areas into learning can improve executive functioning, including working memory skills.
OTs and SLPs can assist parents and children in creating personalized strategies for outsourcing memory.
5. Promote Emotional Wellness and Self-Regulation
ADHD can interfere with the development of social-emotional learning (Maguire, 2021).
“Children with ADHD experience the same emotions as do other children, but their feelings are more frequent, intense, and longer-lasting. Because the underlying brain mechanisms that help manage emotions are affected by ADHD, emotional regulation development is delayed” (Buzanko, 2023).
One component of executive functioning skills is emotional control. Since children with ADHD have deficits in executive functioning, this consequently leads to the expression of intense emotions.
There are multiple ways parents can foster emotional awareness and regulation.
Children with ADHD need to learn regulation by approaches that are proactive and positive.
Sharon Saline, a licensed clinical psychologist and ADHD expert, states it is helpful to teach kids to practice the steps “Stop, Think, Act.” Typically, when feeling intense emotions, people act first, then stop and think last.
Saline states the goal is “instructing your children to manage their big emotions by engaging the thinking brain.” More information on this method can be found in the book What Your ADHD Child Wishes You Knew: Working Together to Empower Kids for Success in School and Life.
Fostering “future-oriented prosocial emotions are particularly important for children with ADHD because they live moment-to-moment, unable to think ahead about the consequences of their emotions or behaviors” (Buzanko, 2023).
Down-regulating big emotions can be cognitively challenging, so helping children learn to up-regulate positive emotions can be an easier, helpful strategy for emotional well-being.
One way to do this is by building pro-social emotions like gratitude, pride, and compassion (Buzanko, 2023).
Parents can cultivate gratitude through a round table gratitude discussion at the dinner table each night.
Parents can promote pride by letting their child be the expert in something they enjoy and encouraging the child to teach them about this topic.
Harnessing compassion can include “talking about neurodiversity and everyone’s strengths and challenges” (Matheus, 2023).
Children with ADHD often receive much corrective feedback on a day-to-day basis, and promoting self-compassion and understanding of their brains is essential for self-confidence. “While eliminating negative thinking is unrealistic for anyone, given the high frequency of criticism that kids with ADHD receive, reducing it is crucial for fostering self-esteem and resiliency.” (Saline, 2018).
Parents of children with ADHD can support children by teaching them how big emotions impact the brain, strategies, and tools to combat negative thinking, coping skills to manage feelings, and reminders of the positive traits they already possess.
Ready to learn more?
Contact Columbia Pediatric Therapy to schedule an appointment with one of our professional OTs today.
References
Barkley, R. A. (2020). Taking charge of ADHD: The complete, authoritative guide for parents. The Guilford Press.
Benson Adams, L. (2024, April). ADHD: Intervention Strategies for School-based Therapists. Sensational Brain. Retrieved April 30, 2024, from https://sensationalbrain.com/shop/instructors/lori/adhd-school-based-intervention-strategies/.
Buzanko, C. (2023). The Key to ADHD Emotional Regulation? Cultivating Gratitude, Pride & Compassion. ADDitude. https://www.additudemag.com/emotional-regulation-adhd-kids-strategies/#:~:text=Children%20with%20ADHD%20experience%20the,emotional%20regulation%20development%20is%20delayed.
Kreider, C. M., Medina, S., & Slamka, M. R. (2019). Strategies for Coping with Time-Related and Productivity Challenges of Young People with Learning Disabilities and Attention-Deficit/Hyperactivity Disorder. Children (Basel, Switzerland), 6(2), 28. https://doi.org/10.3390/children6020028
Maguire, C. (2021). 6 Ways to Develop Emotional Control. School House Blocks: Building Foundational Executive Function. https://www.additudemag.com/wp-content/uploads/2021/07/Success@School.pdf
Matheis, L. (2023, November 7). ADHD and emotional regulation: A parent’s guide. ADHD and Emotional Regulation: A Parent’s Guide. https://www.additudemag.com/adhd-emotions-positive-parenting-impulsivity/
Pacheco, Danielle., & Dimitriu, Alex. (2023). ADHD and sleep. Sleep Foundation. (2023, November 16).https://www.sleepfoundation.org/mental-health/adhd-and-sleep#:~:text=ADHD%2Drelated%20sleep%20problems%20may,later%20onset%20of%20melatonin%20production%20.
Saline, S. (2018). What your ADHD child wishes you knew: Working together to Empower Kids for success in school and life. PENGUIN Books.
Sun, W., Yu, M., & Zhou, X. (2022). Effects of physical exercise on attention deficit and other major symptoms in children with ADHD: A meta-analysis. Psychiatry Research, 311, 114509. https://doi.org/10.1016/j.psychres.2022.114509
Visser, S. N., Danielson, M. L., Bitsko, R. H., Holbrook, J. R., Kogan, M. D., Ghandour, R. M., Perou, R., & Blumberg, S. J. (2014). Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003-2011. Journal of the American Academy of Child and Adolescent Psychiatry, 53(1), 34–46.e2. https://doi.org/10.1016/j.jaac.2013.09.001
Ziegler Dendy, C. A. (2006). Teenagers With ADD and ADHD. In Teaching Teens with ADD, ADHD, and Executive Function Deficits. essay, Woodbine House.