How to Develop an “Inner Coach” in teens with ADHD and Executive Dysfunction

Dr. Tali Shenfield | October 16, 2014

We love our children and when we see them struggling with school or in their social lives we want to do everything we can to help them. This is especially true if they have any one of a number of developmental challenges such as ADHD/ADD, executive dysfunction, a learning disability or a disorder on the autism spectrum. Many of these children have great intentions, which they fail to translate into real-life achievements due to their weak executive function. Executive function encompasses a number of skills, including purposeful planning; organizing one’s time, belongings, and activities; executing the preplanned actions and monitoring progress; evaluating the result and adjusting the next steps accordingly and many more. We want to do everything we can to help our children avoid the pain and disappointment that we anticipate will follow them through their entire life.But is our love and caring enough? And indeed, can it actually be getting in the way of our teen’s own development ? Are we indeed through our loving care quite unintentionally developing learned helplessness in our children? Most parents of course would respond with “But what choice do I have? He’s already lost three cell phones this year.”

This is the dilemma that parents of teens with developmental challenges face. We want to protect them and take care of them in the present while figuring out how to prepare them for a self-reliant and independent life in the very near future. It can feel as if we are pushing a bird that can’t fly out of the nest. It can also be confusing for a teen who is trying to establish his or her emotional and physical independence from the family while at the same time needing more support than his or her chronological peers.

As someone who has worked with children and teens with developmental challenges for many years I believe that one of the best preparations that we can provide for our teens is to assist them in the transition from the present to the future by helping them to develop heightened self-awareness. This is critical not only for children who have been identified through psycho-educational assessment or ADHD assessment, but for any typically developing teen.  Self-awareness quite simply is all about learning to live, even for brief flashes at a time, in the present moment. This is of course what we seldom if ever do. Typically the minds of the most average of individuals are somewhere else other than ‘here’. And for the typically distracted minds of our teens this can be even more of a challenge.

The problem with not being ‘here’ is that while our minds are off doing other things, our lives are operating on autopilot. We continue to do what we have always done in the same absent minded way that we brush our teeth in the morning. For the teen who is distractible and disorganized, operating on autopilot results in a steady stream of lost phones, forgotten homework assignments and awkward friendships (which are, of course, the most typical ADHD symptoms). The self-regulation which develops for the average teen and helps him or her to remember lost cell phones and homework assignments is still waiting to kick in. And this is where self-awareness comes in. Changing behavior quite simply requires being aware of behavior as it is happening and choosing to behave differently.

This is of course what you have been doing in a surrogate role for years and years. You have been that voice in your child’s ear reminding them to put their homework in their back pack and remember their lunch. You, your child’s teachers, and perhaps even their therapists have been that voice coaching them from the sidelines, that voice otherwise labeled as ‘nagging’. You have been that HERE in their lives while their minds were elsewhere. But now your teen is quickly growing up and either off to a job or to college – and all without your direct supervision. Yet they still need help.

Your voice won’t always be there. And even if it were, when was the last time your teen actually paid attention to what you were saying? After all of these years they’ve become positively tone deaf to your messages. It is time to help your teen to internalize that voice of self-regulation that tells them that they are laughing at something that is totally inappropriate or that car keys should always go in their pocket. So how do you do this? First, think SMALL. Think very small. Developing self-awareness, or mindfulness as it is often called, is not something to be tackled in hours of meditation every day. That typically doesn’t work for the average person let alone your distracted and hyperactive teen. You will want to encourage your teen to do some small practices every day that will help them to learn to pay attention to what is going on around them.

By small, we are talking about increments of thirty seconds and at most two minutes. This is of course contrary to what most people say about developing mindfulness. But whether it is you teaching your teen to take mindfulness breaks, or having someone else teaching them, it should always start in these small increments. To begin with, ideally two or three times a day, someone should either remind your child with a text message or perhaps a school timeout to pause and simply breathe slowly and deeply as they watch their breath for a total of thirty seconds. That’s 3-5 breaths. The simple instruction is to breathe a little more slowly and deeply than normal through the nose and just be aware of the breathing. Nothing else. If the mind wanders just bring it gently back to the breathing. That’s it.

After you teen has been doing this for a week or two something interesting will begin to happen. First, your teen will become calmer. These small mindfulness breaks interrupt the speediness of mind that is so typical of people with ADHD. Second, your teen will start becoming more aware of what is going on around him or her. He will actually start noticing his own behavior.

You may also want to find an ADHD counselor or coach who can help your teen make the transition to self-sufficient adulthood. A counselor or coach can really be supportive in ways that may be difficult for you and they can provide you with specific recommendations tailored for your child. The reason you may want to consider external help is that these people have been trained to work with ADHD population and understand inner workings of ADHD brain. They can provide encouragement and motivation and help your teen with structured goal setting, time planning and task management, as well as building self-respect and self-confidence. And when things go wrong they don't get frustrated or angry, so your teen may actually listen to what they say and follow their advice.

Either you or someone who is helping you can look through numerous books that are available on mindfulness and find more recommendations for small additional practices for your teen. Remember, think small. One that I really like is Reflective Planning. This means doing a little rehearsing every evening for the activities of the next day. Ask your teen to just relax somewhere, do a couple calming breaths and just think through the activities of the next day step by step. They should do this the way that they would rehearse a part in a play. A word of caution … Don’t be surprised if you see your teen from time to time bolting by you and running downstairs to throw their underwear in the washer. As they rehearse the next day’s activities they may well discover that there isn’t a stich of clean clothing anywhere. That’s okay! This type of gentle rehearsing will help them to be far better prepared for each day - including wearing clean clothes. This is all part of developing self-regulation. Reflective planning is actually something that should be considered a life-long practice.

The bottom line is that as your teen develops self-awareness they will automatically see themselves in their environment more clearly.  They will be able to pause in their impulsive actions enough for their inner voice to tell them how they should be responding. As they continue this work they will begin to internalize the messages from the weekly sessions and apply them to daily life. Their inner coach will eventually replace your voice and all the external voices that supported them.

 

If you want to read more on this topic we suggest an excellent article by Lisa Aro "Mother of Five ADHD Children Shares Her Parenting Tips", which is a must-read for parents of ADHD children.

 

Image Credit: Clayton Cottingham @ www.flickr.com/photos/cottinghamphotography/6780326085

 

About Tali Shenfield

Dr. Tali Shenfield holds a PhD in Psychology from the University of Toronto and is a licensed school and clinical psychologist. She has taught at the University of Toronto and has worked at institutions including the Hospital for Sick Children, Hincks-Dellcrest Centre, TDSB, and YCDSB. Dr. Shenfield is the Founder and Clinical Director of Advanced Psychology Services.

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