Tuesday, May 26, 2015

The Best ADHD Advice Ever


guest blog by Katherine McGavern

If you’re reading this blog, odds are good that either you have ADHD or you live with someone else’s ADHD. Early on in your ADHD travels, you heard about or read the solid statistics showing that the most successful ADHD management comes from the use of both properly prescribed medication and behavioral training.

You are probably looking for another new strategy, one more idea, some fresh thinking about or unique approach to the management of this quirky brain. You may already have read many of the thousands of articles about ADHD management and medication and even attended workshops and classes. You should be doing these things, because when you live with ADHD, the more you—and your loved ones and colleagues—know about it the better.

But you are wasting your time if you think that any of these inventive approaches and new theories will work unless—before the meds and before any behavioral training—the three critically important foundational elements of ADHD management are in place. So, what are these fundamentals? Sleeping, eating, and exercising—or SEE.

I know what you’re thinking right now: “Seriously? Thank you, Captain Obvious.” And under normal circumstances, your indignation would be warranted. Who doesn’t benefit from sleep, food, and exercise?

But hold on. We’re not talking “normal circumstances” here. We’re talking about the fact that ADHD is a neurobiological condition, and the fact that ADHD brains are demonstrably, measurably different from non-ADHD brains, in ways modern neuroscience is finally allowing us to see and analyze for the first time ever. A brain that is physiologically unusual will naturally produce behaviors that are also unusual, and unfortunately, often problematic, such as:

  • impulsive, interruptive blurting out of inappropriate comments
  • a disinclination to make or follow any work plan
  • the habit of starting one project after another and leaving most unfinished
  • the chronic inability to be on time, or to judge correctly the amount of time required for a task, or to keep to a schedule
  • an inability to stop working on a project when good judgment or circumstances say it’s time to stop
  • a disinclination to perform any administrative tasks—even urgently required ones—because they “feel boring”
  • frequent forgetting, regardless of importance
  • a lack of awareness of the impact of all of the above.

So what’s so important about those three fundamentals, regular sleep, eating, and exercise? ADHD brains are (or can be) like wild animals. Unconcerned with the conventional limits of time, or rules, or oughts and shoulds, this brain is happiest going where it wants to go, when it wants to go, and staying there as long as it wants to stay! For all its amazing positive attributes—resilience, inventiveness, generosity, big-heartedness, originality, a great sense of humor, spontaneity, and kindness, to name just a few—it can also be, well, a brat. An ADHD brain really likes having its own way, and it has no qualms about hijacking your schedule or putting you in the doghouse yet again while it spins through space entertaining itself.

Imagine trying to control a powerful, unbridled horse that’s galloping full-tilt toward a cliff… or having to drop everything you’re working on to charge after a much-loved but unruly and untrained dog that’s racing out of sight. Remember the tiger in Life of Pi? How it took all the wits and skills and stamina Pi had to keep that tiger from eating him? Like that tiger—extremely dangerous, but manageable with skills and determination.

An ADHD brain can take you on an unbidden mental chase in a nanosecond, undoing all your best intentions and leaving a pile of unfinished business, missed appointments, hurt feelings, and deep regret (among other things).

If you have ADHD, you need to be in your best possible shape every day to manage this powerful, free-spirited brain, because if you don’t manage an ADHD brain, it will manage you.

For people who don’t have ADHD, eating, exercise, and sleep are almost discretionary in terms of impact on their effectiveness and output. But for people who have ADHD, proper eating, exercise, and sleep are mandatory. They provide the energy, strength, clarity, and staying power that’s needed hour by hour, day by day, every day, to stay in charge.

You simply cannot develop the tools you need to keep this brain under control all day, every day if you’re tired, or your blood sugar is low, or you’re out of shape and running on empty. So before you use one more new calendar, download a snappy new app, buy five more clocks, or adjust your meds, make sure these three fundamentals are in place every single day:

  • SLEEP enough. Every night. Whatever it takes. On a regular schedule if possible. No all-nighters. (Okay, maybe one a year when you’re on a roll, if you must; ADHD brains love all-nighters.)
  • EAT enough. Make sensible choices, at regular intervals. No skipping, even though some meds may make skipping easy. Don’t do it. Do not skip meals. Periodic healthy snacks which provide both protein and fruit sugar will keep you alert and productive all day. And always have water nearby; hydrate throughout the day.
  • EXERCISE enough. At a reasonable, not a killer level. At least three times a week, though daily is best. Thirty minutes is fine. Use it to kick off a work block, or to take a break from one. Just do it.

Post these three points where you can see them every day, and pay attention to them—if, instead of being run around by your ADHD brain, you want to be the one who’s in charge.



Katherine McGavern coaches adults with ADHD and is a certified Parent to Parent teacher. She presents talks on ADHD to teachers (K-12), community organizations, and parent groups; provides training on ADHD to student teachers at The College of New Jersey; and is a member of the editorial advisory board of Attention. McGavern is a co-founding member of CHADD Mercer County, and facilitates at their monthly meetings in Princeton, New Jersey.

Tuesday, May 19, 2015

Choosing Apps for Executive Function Challenges

 by Therese Willkomm, PhD, ATP, Stacy Driscoll, MEd, and Linda Beliveau

If you have issues with executive functioning, you probably have issues with organization. It seems cliché to say it, but there’s an app for that. As a matter of fact, there are many apps out there that keep you on task and scratching things off your to-do list.

Don’t just download the first organizational app with high ratings, however. When you have ADHD, you need to consider exactly which features will help you the most—and which ones might send you over the edge.

How do you enter information into the app, and how is it conveyed to you? If it takes five steps to enter a reminder about an appointment, it’s not the app for someone challenged with cognitive demands. Think about the steps in having to recognize the prompt, take action, find and open the device, tap on the app, put the device away, and then execute the task. It’s best to focus on apps that have few steps in the stimulus-response sequence.

It doesn’t have to be typing that gets information into an app, though. There are apps that use voice, video, pictures, icons or gestures, and more for the input piece. For the output, you might decide you want to get pictures as reminders, or videos, music, alarms—the list goes on. Wearable technology is becoming more popular, too. You can also set the level of engagement with an app. A banner prompt appears across the top of a device and disappears—but an alert shows up in the middle of the screen and is harder to ignore.

Wearable technology is becoming popular, too. The Pebbles Watch receives reminders from your cell phone, as long as it’s within fifty feet. When your watch vibrates, a quick glance at your wrist tells you to take action. As a bonus feature for those with executive function deficits, the watch can help you find your cell phone (ever misplaced that?). Just push the middle button and your phone plays the music you’ve chosen—even if it’s in silent mode.

Today nearly every device comes equipped with a camera app and an app to organize photos. These apps aren’t just for cute photos of kids and pets. You can document and organize anything with pictures or videos. Lose receipts often? Take photos of them and put them into a designated folder. Have trouble remembering the steps to complete a certain task? Take photos or short video clips, save them in a folder, and you’ll have the directions whenever you need them.

Of course, apps are a tool, not a treatment. They’re not all universally beneficial to everyone with ADHD. Still, with a little exploration and consideration of features, there’s no doubt that apps can help reduce the cognitive demand in completing tasks and organizing information. 


Here are some popular apps available on Apple's iOS platform that people affected by ADHD have found useful.

REMINDER APPS


Nudge-Reminders
- Simple Tailor Software
Alarmed ~ Reminders+Timers - Yoctoville
Any.Do - Task & To-Do List, Task Manager, Daily Reminders & Checklist Organizer - Any.Do
Calendar Alarm—CalAlarm 2 - DEVART
2Do - Guided Ways Technology Ltd

ORGANIZATIONAL APPS


Priority Matrix
- Appfluence LLC
30/30 - Binary Hammer
KanPlan - Houda Hamdane
Awesome Calendar - YunaSoft, Inc.
iSecretary - Ernest LS
Inspiration Maps - Inspiration Software
Popplet - Notion

CAMERA AND PHOTO APPS


Pictello
- AssistiveWare
Book Creator - Red Jumper Studio
Picture Scheduler - Peter Jankuj
Forgetful - IBEX
Choiceworks - Bee Visual

A longer version of this post appeared in the December 2014 issue of Attention magazine. Join CHADD and receive every issue!
Join conversations about managing adult ADHD on Attention connection, your social network for all things ADHD!


Therese Willkomm, PhD, ATP, an associate professor in the department of occupational therapy and director of ATinNH, the assistive technology program at the University of New Hampshire. Stacy Driscoll, MEd, an assistive technology assistant at ATinNH, is the founder of LifeLong Assistive Technology. Linda Beliveau is the technology integrator at ATECH Services.