The House We Build for ADHD

Mark Bertin, M.D., provides a blueprint for long-term, successful ADHD care.

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You’re building a home and a family—one with ADHD in the mix. The sheer volume of information and misinformation about ADHD can compromise your designs and make your house seem built of straw more than bricks. But it needn’t be this way. Reinforce the foundation of evidence-based care, build upwards to address the rest of ADHD, and your home can be as solid as every other one on the block.

ADHD Care from the Ground Up

ADHD is a common disorder of child development that influences self-regulation and self-management, not just attention and activity level. Seen from this perspective, it’s understandable why ADHD potentially affects all of life. It has been linked to everything from behavioral and academic concerns, to difficulty with sleep, eating, and as children grow older, substance abuse and even auto accidents. Yet while those perils are real, when ADHD is addressed fully, everything changes.

A successful blueprint for managing ADHD has two levels. As with construction, ADHD care starts from a strong base on which to build. This solid foundation integrates everything research suggests works for ADHD management into practical, real-life decision making. From there, move beyond crisis management into proactive “well care” for ADHD, more fully fashioning the home you imagined for your child.

Setting a Strong Foundation

You can consider ADHD management, therefore, in two parts: A foundation, and the house you build on it. The foundational parts are most proven to have large effects on ADHD symptoms. When they are under-emphasized, stress related to ADHD often continues. Three care components (listed below) are the bedrock to consider whenever acute difficulties arise, typically around behavior or academics.

There’s no one pre-fabricated plan (or home) to fit all families, and a child’s needs may change over time. But when crises flair or progress slows, reconsidering this solid base helps organize your thoughts and leads to concrete actions to take (and what better way to build a foundation than with something concrete?). Consider these three core options whenever you feel unsettled about ADHD, reinforcing the foundation on which everything else stands:

Educational interventions that fully consider all aspects of executive function and ADHD. Consider expanding support services, or addressing associated learning disabilities. When children feel more confident and successful at school, it often impacts their life outside of school too.

Family-based supports outside of school, such as parent training, ADHD coaching, or cognitive behavioral therapy, that help with the stress and strain ADHD creates, along with providing specific tools to manage ADHD and make daily routines easier.

Medical interventions have been shown beneficial for many children and are safe when used appropriately, in spite of often specious suggestion otherwise. Recent research even suggests ADHD medication may help children outgrow ADHD by adulthood.

Finishing the House

But a foundation is not a home. After addressing acute concerns, you can build upwards, an oft overlooked perspective on ADHD care. Less intense ADHD effects frequently persist and affect how a child and family live. Details (some quite large) related to healthy sleep, eating, efficient time management, technology, safe driving, and even communication can be managed proactively to avoid pitfalls. So can the impact of ADHD on parents and their marriages.

The rest of crafting a customized, comfortable ADHD home therefore addresses its broader everyday impact. ADHD gets in the way of daily routines, often leading to a kind of paradox. Research suggests that these same routines may decrease ADHD symptoms when they happen consistently. But forming and sustaining new habits are harder when living with ADHD, often continuing a cycle of difficulty. Some patterns to consider are:

• ADHD tends to cause sleep problems, but better sleep improves ADHD

• ADHD affects eating and weight, while healthier nutrition may influence ADHD symptoms.

Exercise benefits children with ADHD, but sustaining these routines may be challenging for reasons related to scheduling, time management, distractibility, and all the rest of executive function.

• Media and technology can be both entertaining and useful in assisting with organization and planning, but with ADHD, children are at risk for disruptive, intrusive relationships with this part of our modern world.

Holding it all Together with Mindfulness

And then there is mindfulness, cognitive fitness training aimed at building real-time, objective, and compassionate awareness of our lives…instead of remaining lost in distraction, on autopilot. Mindfulness does not replace any single aspect of ADHD care, but supports all of them. One way to look at mindfulness, to push the metaphor, is as the mortar that holds together the rest of ADHD care:

• ADHD increases stress; mindfulness helps with stress management.

• ADHD management often requires changing habitual behaviors and thoughts; mindfulness supports flexible thinking and the changing of habits.

• ADHD often leads to emotional reactivity, and mindfulness helps cultivate emotional awareness and responsiveness.

• ADHD often affects self-esteem and feelings of self-worth, and mindfulness builds compassion for yourself and others.

• And of course, mindfulness is a form of attention training, which has been shown to benefit individuals with ADHD (although there is no proof as of yet that suggests mindfulness can actually replace any other aspect of care).

To build a solid and joyful home around ADHD typically requires seeing the full picture of what it is and what it does. When ADHD-related problems become acute, reexamine the foundation of care. Are there changes to consider within the big three of school, home, or medical choices? If some specific detail requires attention first, like an intense sleep problem, start there, but over time emphasize the foundation whenever questions arise.

After that, a patient, methodical approach to home-building proactively guides a child wherever ADHD touches his life. When the ground seems solid, move onto wherever else ADHD influences your child’s experience. If all this planning begins to feel overwhelming, focus on each step individually. Start from the foundation, build upwards, and create the home you want for your child with ADHD.

Of course, each of these details can be a challenge to implement. Some resources to consider are linked within this blog, or try valuable sites such as orAdditude Magazine.

Adapted from Psychology Today