adhd problem solving

How to Help Children With ADHD Develop Problem-Solving Skills

What’s inside this article: Background information as to why kids with both ADHD and autism struggle with developing problem-solving skills. Strategies you can use to help them develop better problem-solving skills, and board games that help them practice these skills.

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We don’t always see it as adults, but kids actually run into a lot of problems. Between arguing with siblings, disagreeing with parents’ rules, school work, balancing fun and responsibility, it’s tougher to be a kid than you think.

It seems there’s always some problem plaguing children. It might seem minor to your, but it isn’t to them. This is why we need to help them develop problem-solving skills .

It’s important for kids to learn how to problem-solve on their own because this is one of those critical life skills that they need.

Problem-Solving Skills & ADHD

Problem-solving skills are an executive function. Executive functions are the more complex functions of the brain.

This matters for children with ADHD because executive dysfunction is a hallmark ADHD symptom. In fact, kids with ADHD are, on average, 30% behind their peers when it comes to executive functioning.

To put that into perspective, if you have an 8-year-old, they probably only have the problem-solving skills of a typical 5-year-old. This becomes an issue because they may already struggle with social skills and now handling conflict with their peers is another challenge.

Spending extra time practicing problem-solving skills and other executive functions can help children with ADHD to develop these important life skills.

Set Realistic Expectations

Adjusting your current expectations, or knowingly setting realistic expectations for your child can help you see that your  child is doing the best that they can.  

As a parent, you can acknowledge this and help your child develop better problem-solving skills.

In the meantime, if your 8-year-old only shows the skill of a 5-year-old when they encounter a problem, you should assume they only currently have the ability of a 5-year-old. Set your expectations to match their current ability.

When your expectations are realistic, your children have more opportunities to be successful. This builds their confidence and helps them thrive.

How to Help Kids Develop Problem-Solving Skills

There are a number of ways you can help children “practice” their problem-solving skills, which over time helps them become more competent.

This involves both games that use their skills and also push them out of their comfort zone a little.

Start with games and situations in which your child will be highly successful. You want to begin by building their confidence so they will be more willing to try solving more challenging problems on their own later.

These strategies are helpful for all children but children with executive dysfunction may need extra time and practice to work on their skills.

Thinking of Possible Solutions

I took a training class on behavior intervention strategies and problem-solving skills were part of the discussion. The instructor said to us:

In order to problem-solve, you need to be able to come up with at least two possible solutions

This statement stuck with me. Kids with ADHD and autism often struggle with cognitive rigidity.

When it comes to problem-solving, cognitive rigidity could look like a child getting “stuck” on the first solution that comes to their head and seeing no other possible way to make a situation work.

For children, that first solution is often impulsive and probably not the best way to handle the situation.

So first of all, find out if your child can think of multiple solutions to issues, either independently or working collaboratively with you.

Start with a brainstorming game. Write a “problem” in a bubble and then ask your child for different ways to handle it and write them down.

After you have a list, see if they can figure out what the “best” way would be to deal with their problem.

Start simple, or even begin with hypothetical problems about their favorite fictional characters.

For example:

In the example above, the most practical solution is to eat something else instead. But if your child gets “stuck” on things they may see no resolution because hotdogs are all that they will eat and will say they won’t eat until you go to the store and buy more.

If they aren’t able to see other possible solutions this may lead to an outburst or meltdown.

Regular practice with this brainstorming activity, especially hypothetical situations where their emotions aren’t involved, will help children to think about multiple solutions to their problems.

Ask Open Ended Questions

When your child is struggling with something, open-ended questions can help them think about things in a different way without you directly intervening and handling their problem for them.

• Can you identify the problem?
• What do you want to do?
• What do you think would happen if you did that?
• How would that make other people feel?
• What other ways might work?

Be that listening ear that your child needs while they work through these big feelings.

Games That Involve Problem-Solving

Strategy and board games often require a higher level of thinking that helps activate the problem-solving region of the brain, known as the prefrontal cortex.

For example, kids may strategically plan a couple of moves ahead in a board game but then need to problem-solve and adjust their strategy after their opponents’ turn.

There are board games for all skill sets and abilities so there’s definitely something out there that is developmentally appropriate for your child and you can work up to more challenging games over time.

Some games you can try include

• Tic Tac Toe
• Think a Link
• Daily Dilemmas Jar

Even though these games don’t include specific problems that your child is facing or may encounter, they still help.

The brain is moldable, so the more you practice using any type of problem-solving, the more connections form in the brain. With practice, this actually improves real-life problem solving too.

The Problem Solving Wheel

The problem-solving wheel is simply a wheel of generic solutions that may help your child solve their problems. This may be helpful if your child struggles to come up with possible solutions because it will prompt them to think about the situation in other ways.

You can use the problem-solving wheel for hypothetical situations, or through role-playing and pretend play scenarios, or as a way to prompt your child to work through their current problems independently .

Do Not Resolve Sibling Conflicts for Them

When siblings start to fight, perhaps over a toy, or which movie to watch, it feels natural as a parent to step in and handle it.

You decide who is right and who is wrong, or you dictate what the fair “compromise” will be. But, every time you intervene and solve this sibling conflict for them you are stealing away an opportunity for them to p ractice their problem-solving skills.

Instead, shift to the role of a mediator and guide them to solve their own problems.

For example, your kids are playing with Play-Doh together and you hear arguing. You look over and see them fighting over the same tool. There are a few ways this scenario plays out.

• You could intervene and say that since no one is getting along then nobody can use the play-doh
• Perhaps you could intervene and dictate which child gets the first turn and which goes next.
• You could reason with them, telling them about all the other cool play-doh tools and hope one of them is enticed to try something different.

Or you can be their mediator.

Just say “I see that you both want to use that play-doh cutter right now and it’s pretty upsetting for both of you… What do you guys think would be a good idea so that everyone is happy playing with the play-doh?”

You would be surprised how often children will willingly suggest fair compromises when prompted instead of being told how to resolve their problems.

The child who would have thrown a fit and stormed away when you dictated they get the second turn will now be offering their brother the item happily.

Make sure you positively reinforce their problem-solving each time they are able to peacefully handle an issue on their own (or with your guidance).

Push Them To Make Choices on Their Own

Children who struggle to make choices also struggle to problem solve. Push your child to make their own choices as often as possible. From the small mundane ones to the somewhat larger choices. They need to be able to do this on their own.

If your child gets overwhelmed making broad decisions then offer options at first. For example, have them pick from two or three choices.

Your child needs to be confident in making their own choices in order to become confident at problem-solving

Let Them Experience The Natural Consequences

The next part of this equation is letting your child experience the natural consequences of their choices. Natural consequences are the inevitable result of your own actions.

If you shield your child from the natural consequence of a bad choice then they will never learn from that decision. The outcome of a poor choice is usually enough to teach your child without you needing to interfere. Just be there for them.

Don’t forget to praise your child for rising to the challenge and learning from their mistakes. Also, emphasize with them ( I know how hard this is) Keep building them up, they need to know that mistakes and failures happen but it’s important to keep going.

More Skills

It’s normal for children with ADHD to require extra time and teaching when it comes to developing social-emotional skills like problem-solving.

Read this list: 38 skills kids need to be successful

You’ll find lots of other skills and teaching tips to help your child develop all the skills they need.

The Take-Away

There are a few key points I hope you took away from this guide.

• Individuals with ADHD are, on average, about 30% behind their peers when it comes to all executive functions , including problem-solving skills.
• You need to set developmentally appropriate expectations.
• Children with ADHD need extra practice and extra time to learn and develop these skills
• Be a mediator that provides guidance instead of taking over and dealing with problems for them.
• Children need to experience the natural consequences of their actions
• Praise your child for trying, even if they aren’t a competent problem-solver yet.

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10 Surprising Benefits of Having ADHD

People with ADHD have high energy and resilience, among other strengths

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• Next in Adult ADHD Guide How to Focus With ADHD

There are some surprising benefits to being diagnosed with  attention deficit hyperactivity disorder  (ADHD). Strengths, or ADHD "superpowers," include high energy levels and creativity. People with ADHD can also have challenges in life, like difficulty focusing and impulsive behavior.

This article will go over some strengths that people with ADHD may have, as well as the challenges of living with ADHD.

Verywell / Jessica Olah

ADHD Strengths and Benefits 

People with ADHD have  physical characteristics in their brains  that lead to symptoms  of the disorder, including impulsive behavior and trouble paying attention.

However, these characteristics can have benefits, too. For example, even though not being able to sit still (hyperactivity) can be frustrating, research suggests that it also means people living with ADHD have higher energy levels than people who don’t have the condition.

There are other benefits to having ADHD that can touch on many aspects of a person’s life.

Individually

• Energy : A small study found that some people living with ADHD liked having more energy than other people.
• Self-awareness : The treatment for ADHD  often includes therapies that help people learn to manage emotions and behaviors (self-regulation). People with ADHD often learn their triggers and patterns, as well as how to control them. In time, they may become more skilled at self-regulation than some neurotypical people.
• Self-reliance : Some people with ADHD learn how to soothe and regulate themselves (a skill that many neurotypical people can struggle with) as part of their treatment plan.
• Resilience : The ability to bounce back from difficulties (resiliency) is a predictor of success. Many parents and teachers describe kids with ADHD as being resilient.

At Work or School

• Creativity : Creative problem-solving is very important for success at school and work. Research has found that people with ADHD have more creativity and are better at idea generation than people without the disorder. This creativity can lead to outside-the-box thinking that is needed for discovery and innovation.
• Hyperfocus : Many people with ADHD become hyperfocused on things that interest them. This can lead to extreme focus and attention to detail, as well as a passion for school, work projects, and hobbies.
• Risk tolerance : People with ADHD often have a higher risk tolerance than people without the condition. In some situations, this can be beneficial. For example, a person with ADHD might be more empowered to try a solution to a problem.

In Relationships 

• Clear expectations : To cope with symptoms, many people with ADHD have open, honest conversations about expectations with the people they’re close to. This open communication benefits both people and can strengthen the relationship.
• Impulsivity : While there are situations when impulsive behavior can be a downside, qualities like impulsivity and playfulness help keep a spark alive in long-term relationships.
• Receptiveness to therapy and behavioral approaches : Many people living with ADHD are receptive to trying therapies or new approaches, which can be helpful if the relationship they are in encounters challenges.

Are ADHD Superpowers Real?

There’s been a lot of focus on the harmful symptoms of ADHD. There’s less research on ADHD superpowers, but many people with ADHD feel that they are more energetic, creative, courageous, and resilient than people who don’t have the condition.

While more research needs to be done on the benefits of ADHD, focusing on the “superpowers” can help you or your child have a more positive view of life with the condition.

Benefits of ADHD Medication 

About 62% of children with ADHD take medication as part of their treatment plan. Data on ADHD in adults is a little harder to come by, but estimates suggest that of the 4.4% of adults in the United States who have been diagnosed with ADHD, about 4.1% report being treated with medication.

ADHD medications, including stimulants and non-stimulants, can have many benefits. For example, if a person's ADHD symptoms are reduced because they take medication, they might find it easier to focus on and complete tasks at school or work.

People with ADHD who are on medication also have a lower risk for:

• Accidents (including motor vehicle accidents)
• Substance use disorder (addiction)
• Falling behind at school 

That said, medications for ADHD also have side effects and risks, including weight loss and trouble sleeping. Medications for ADHD also aren't right for everyone. Talk to your provider about whether it would be a safe and effective part of your treatment.

The term “ADHD benefits” can also refer to the services and assistance that some people living with ADHD may be able to access. This includes resources like IDEA accommodations in school or SSDI benefits if they are unable to work, for example.

Balancing ADHD Skills and Challenges 

While there are some perks to “ADHD brain,” the negative aspects of living with ADHD are real. People with ADHD learn to strike a balance between managing the symptoms that negatively affect their lives while enjoying the positive effects of having the condition. 

Organizational Hacks

It may take some trial and error, but many people with ADHD find strategies and organizational hacks that help them in life. Therapists can work with people who have ADHD to brainstorm ideas, too.

Simple things like sticking to a schedule, putting essential items like keys in a designated spot, or taking a few minutes to meditate before starting the day can all make a difference for people living with ADHD who have a hard time staying organized.

Mental Health 

People with ADHD are at higher risk for other mental health conditions, including depression and anxiety. If you begin to experience symptoms of depression and anxiety, reach out to a mental health professional who has experience working with people with ADHD.

ADHD Celebrities and Advocacy 

Organizations like CHADD  (Children and Adults with Attention-Deficit/Hyperactivity Disorder) offer resources and support for families touched by ADHD.

In addition, many famous people have spoken openly about their challenges and successes navigating life with ADHD, including:

• Olympic gymnast Simone Biles
• Singer-actor Justin Timberlake
• Olympic swimmer Michael Phelps 
• Singer Adam Levine
• Actor Channing Tatum
• Football player Terry Bradshaw
• Singer-songwriter Lily Allen
• Director, screenwriter, and actor Greta Gerwig
• TV personality Ty Pennington
• Foo Fighter’s singer Dave Grohl
• Actor Mark Ruffalo
• Chef Jamie Oliver
• Actress Zooey Deschanel
• Media personality and business owner Paris Hilton
• Dancer Karina Smirnoff
• Astronaut Scott Kelly
• Late-night host of The Daily Show Trevor Noah

Having ADHD  affects many areas of your life . Not all the effects of having ADHD are negative. Increased creativity and energy levels can be positive aspects of having ADHD.

Some people find that managing the negative effects of ADHD through medication helps them enjoy the positive aspects. Learning coping strategies to help with daily tasks like organization is also key for living well with ADHD at any age.

It’s easy to focus on the negative impacts of ADHD, but there are benefits to the condition as well. People with ADHD report being energetic, creative, courageous, and resilient. Learning how to lean into these strengths while controlling symptoms can help you reach your full potential, despite ADHD.

Sedgwick JA, Merwood A, Asherson P. The positive aspects of attention deficit hyperactivity disorder: a qualitative investigation of successful adults with ADHD . ADHD Atten Def Hyp Disord . 2019;11(3):241-253. doi:10.1007/s12402-018-0277-6

Chan ESM, Groves NB, Marsh CL, Miller CE, Richmond KP, Kofler MJ. Are there resilient children with ADHD?   J Atten Disord . 2021;10870547211025629. doi:10.1177/10870547211025629

Boot N, Nevicka B, Baas M. Creativity in ADHD: Goal-directed motivation and domain specificity .  J Atten Disord . 2020;24(13):1857-1866. doi:10.1177/1087054717727352

Centers for Disease Control and Prevention. Data and statistics about ADHD .

PBS News Hour. A ‘perfect storm’ led to an ADHD medication shortage. Here’s why .

Chang Z, Ghirardi L, Quinn PD, Asherson P, D’Onofrio BM, Larsson H. Risks and benefits of ADHD medication on behavioral and neuropsychiatric outcomes: a qualitative review of pharmacoepidemiology studies using linked prescription databases .  Biol Psychiatry . 2019;86(5):335-343. doi:10.1016/j.biopsych.2019.04.009

KidsHealth. ADHD medicines .

CHADD. Insurance and public benefits .

Department of Education.  About IDEA .

CHADD. Organizing the home and office space .

ADDitude Magazine. Famous people with ADHD .

By Kelly Burch Burch is a New Hampshire-based freelance health writer with a bachelor's degree in communications from Boston University.

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8 Tips for Living With ADHD as an Adult

Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health.

Claire Eggleston, LMFT-Associate is a neurodivergent therapist and specializes in and centers on the lived experiences of autistic and ADHD young adults, many of whom are also in the queer and disability communities. She prioritizes social justice and intertwines community care into her everyday work with clients.

Anchiy / Getty Images

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental diagnosis that involves issues with attention, executive functioning, hyperactivity, and impulse control. Typically, ADHD symptoms emerge in childhood, but some people go undiagnosed—and untreated—until adulthood.

ADHD may not be diagnosed until later in life if the condition is mild, if it wasn't previously recognized by family members or others, or if it was well-managed until adult demands set in. Regardless of the reason, if you are an adult with ADHD whose symptoms are interfering with your functioning, these tips and strategies may help.

Figure Out What Works For You

Countless books, blogs, and articles have specific and detailed suggestions for living with adult ADHD. Although well-intentioned, these suggestions often require the same executive functioning skills that ADHD interferes with.

People with ADHD are often pressured to stick to schedules and systems that work for neurotypical brains. If you have difficulty sticking to a particular system, it is okay to let go of that expectation.

Notice what tends to work for you, and lean into that. For example, many people keep their keys on a hook by the door so they don't get lost. But people with ADHD might struggle to remember to return their keys to the hook or follow that organizational system .

Instead of choosing the best location for your keys and trying to remember to put them there, notice where you tend to put them naturally. Then, designate that location as the spot where your keys go.

Keep Things Visual

One sign of ADHD is forgetfulness . If something is out of sight, a person with ADHD may not remember it. Visual cues can keep important things at the forefront.

If you need a regular reminder of something, keep it in a basket in a location you pass regularly. Keep a schedule where you can see it. A whiteboard allows you to jot down what you need to remember each day.

Determine Your Optimal Level of Stimulation

Although ADHD is marked by specific symptoms, each person is unique and has different needs. Some people need background noise to focus on a task—though white or brown noise might be more distracting than music, a television show, or a podcast. Others might require silence to maintain focus.

Through trial and error, figure out what works for you. Then, set up your workspace to fit those needs. Remember that your needs might change over time, so be flexible and change your system as needed.

Remember That Your Brain Craves Novelty

ADHD brains process the neurotransmitter dopamine differently than neurotypical brains . Because of this, people living with adult ADHD will often find it easier to focus on things that are new. Regular changes to the environment or workspace can keep the brain engaged.

When you notice that your routine is not holding your attention as it did before, make a small change to keep things interesting and keep your mind engaged. People with ADHD tend to thrive in positions where they do a variety of tasks. This makes teacher, engineer, and small business owner all good jobs for people with ADHD . In these roles, their duties vary so they remain interesting and novel to the ADHD brain.

Practice Self-Compassion

Many people with ADHD also experience anxiety and depression. They often struggle to live up to neurotypical standards and keep neurotypical schedules. Even when these standards are not essential for functioning, society often punishes or ridicules people for diverging from them.

If something works for you and is not harmful, that is okay. Know that you can follow different routines, and that is not a reflection of your value as a human. Practice being kind to yourself and letting go of expectations that do not serve you.

Getting down on yourself for having different needs or brain functioning can be a vicious cycle, making you try harder to force yourself to meet these arbitrary expectations and becoming more upset with yourself when you are unable to do so.

Break Tasks Down

People living with adult ADHD can get overwhelmed by projects or tasks that seem too big or have too many steps. This can cause difficulty with motivation .

When starting a task or project, remember that you do not have to finish it all at once. You can do part of a task and then take a break. For example, if washing the dishes feels like too much, just wash one plate, and then stop. Half done is better than not starting, and it is okay to stop even if you have not finished everything.

If you find that starting the task gives you the energy to keep going, you can wash more. However, take things one step at a time, and give yourself permission to take breaks as needed or stop and start.

Use Alarms and Reminders

People with ADHD might experience meta-forgetfulness, or forgetting that they tend to be forgetful. You might find yourself thinking, “I don’t need to write that down; I will remember it.”

Instead, tell yourself that it is okay that you will not remember it. Now, you can write it down and set a reminder for yourself. People with ADHD also often lose track of time , so frequent cues and reminders can help you stay on track.

You might have to set multiple reminders for different things—since it is easy to dismiss an alarm, and you might forget that you dismissed it. Having several reminders or cues can help you follow through and remember what you are doing.

Try Body Doubling

“ Body doubling ” refers to having another person present while you complete a task. People with ADHD tend to do well with another person present while they work on something as this is a physical cue to remind them of the task and acts as an accountability booster.

Although research is lacking on the benefits of body doubling, some adults with ADHD have reported that this practice helps them stay on task and improve executive functioning. They've found it helpful when doing activities such as studying, doing dishes, and exercising.

There are many ways in which people living with adult ADHD can adjust their schedules and complete tasks. If you find that you're having a hard time staying on task, a mental health professional can help you create solutions that are tailored to your needs.

National Institute of Mental Health. Attention-deficit/hyperactivity disorder in adults: What you need to know .

Salavert J, Ramos-Quiroga JA, Moreno-Alcázar A, et al. Functional imaging changes in the medial prefrontal cortex in adult ADHD .  J Atten Disord . 2018;22(7):679-693. doi:10.1177/1087054715611492

Zhou R, Wang J, Han X, Ma B, Yuan H, Song Y. Baicalin regulates the dopamine system to control the core symptoms of ADHD .  Mol Brain . 2019;12(1):11. doi:10.1186/s13041-019-0428-5

Centers for Disease Control and Prevention. Attention deficit/hyperactivity disorder (ADHD): Data and statistics.

Molavi P, Nadermohammadi M, Salvat Ghojehbeiglou H, Vicario CM, Nitsche MA, Salehinejad MA. ADHD subtype-specific cognitive correlates and association with self-esteem: a quantitative difference .  BMC Psychiatry . 2020;20(1):502. doi:10.1186/s12888-020-02887-4

Brooker RJ, Moore MN, Van Hulle CA, et al. Attentional control explains covariation between symptoms of attention‐deficit/hyperactivity disorder and anxiety during adolescence .  J Res Adolesc . 2020;30(1):126-141. doi:10.1111/jora.12506

Eagle T, Baltaxe-Admony LB, Ringland KE. Proposing body doubling as a continuum of space/time and mutuality: An investigation with neurodivergent participants . Proceedings of the 25th International ACM SIGACCESS Conference on Computers and Accessibility. 2023;85:1-4. doi:10.1145/3597638.3614486

By Amy Marschall, PsyD Dr. Amy Marschall is an autistic clinical psychologist with ADHD, working with children and adolescents who also identify with these neurotypes among others. She is certified in TF-CBT and telemental health.

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Signs and symptoms of ADHD in adults can be hard to spot. However, core symptoms start early in life — before age 12 — and continue into adulthood, creating major problems.

No single test can confirm the diagnosis. Making the diagnosis will likely include:

• Physical exam, to help rule out other possible causes for your symptoms
• Information gathering, such as asking you questions about any current medical issues, personal and family medical history, and the history of your symptoms
• ADHD rating scales or psychological tests to help collect and evaluate information about your symptoms

Other conditions that resemble ADHD

Some medical conditions or treatments may cause signs and symptoms similar to those of ADHD . Examples include:

• Mental health disorders, such as depression, anxiety, conduct disorders, learning and language deficits, or other psychiatric disorders
• Medical problems that can affect thinking or behavior, such as a developmental disorder, seizure disorder, thyroid problems, sleep disorders, brain injury or low blood sugar (hypoglycemia)
• Drugs and medications, such as alcohol or other substance misuse and certain medications

Standard treatments for ADHD in adults typically involve medication, education, skills training and psychological counseling. A combination of these is often the most effective treatment. These treatments can help manage many symptoms of ADHD , but they don't cure it. It may take some time to determine what works best for you.

Medications

Talk with your doctor about the benefits and risks of any medications.

• Stimulants, such as products that include methylphenidate or amphetamine, are typically the most commonly prescribed medications for ADHD , but other medications may be prescribed. Stimulants appear to boost and balance levels of brain chemicals called neurotransmitters.
• Other medications used to treat ADHD include the nonstimulant atomoxetine and certain antidepressants such as bupropion. Atomoxetine and antidepressants work slower than stimulants do, but these may be good options if you can't take stimulants because of health problems or if stimulants cause severe side effects.

The right medication and the right dose vary among individuals, so it may take time to find out what's right for you. Tell your doctor about any side effects.

Psychological counseling

Counseling for adult ADHD generally includes psychological counseling (psychotherapy), education about the disorder and learning skills to help you be successful.

Psychotherapy may help you:

• Improve your time management and organizational skills
• Learn how to reduce your impulsive behavior
• Develop better problem-solving skills
• Cope with past academic, work or social failures
• Improve your self-esteem
• Learn ways to improve relationships with your family, co-workers and friends
• Develop strategies for controlling your temper

Common types of psychotherapy for ADHD include:

• Cognitive behavioral therapy. This structured type of counseling teaches specific skills to manage your behavior and change negative thinking patterns into positive ones. It can help you deal with life challenges, such as school, work or relationship problems, and help address other mental health conditions, such as depression or substance misuse.
• Marital counseling and family therapy. This type of therapy can help loved ones cope with the stress of living with someone who has ADHD and learn what they can do to help. Such counseling can improve communication and problem-solving skills.

Working on relationships

If you're like many adults with ADHD , you may be unpredictable and forget appointments, miss deadlines, and make impulsive or irrational decisions. These behaviors can strain the patience of the most forgiving co-worker, friend or partner.

Therapy that focuses on these issues and ways to better monitor your behavior can be very helpful. So can classes to improve communication and develop conflict resolution and problem-solving skills. Couples therapy and classes in which family members learn more about ADHD may significantly improve your relationships.

More Information

• Cognitive behavioral therapy

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Lifestyle and home remedies

Because ADHD is a complex disorder and each person is unique, it's hard to make recommendations for all adults who have ADHD . But some of these suggestions may help:

• Make a list of tasks to accomplish each day. Prioritize the items. Make sure you're not trying to do too much.
• Break down tasks into smaller, more manageable steps. Consider using checklists.
• Use sticky pads to write notes to yourself. Put them on the fridge, on the bathroom mirror, in the car or in other places where you'll see the reminders.
• Keep an appointment book or electronic calendar to track appointments and deadlines.
• Carry a notebook or electronic device with you so that you can note ideas or things you'll need to remember.
• Take time to set up systems to file and organize information, both on your electronic devices and for paper documents. Get in the habit of using these systems consistently.
• Follow a routine that's consistent from day to day and keep items, such as your keys and your wallet, in the same place.
• Ask for help from family members or other loved ones.

Alternative medicine

There's little research to indicate that alternative medicine treatments can reduce ADHD symptoms. However, studies indicate that mindfulness meditation may help improve mood and attention in adults who have ADHD , as well as those who don't have ADHD .

Before using alternative interventions for ADHD , talk with your doctor about risks and possible benefits.

Coping and support

While treatment can make a big difference with ADHD , taking other steps can help you understand ADHD and learn to manage it. Some resources that may help you are listed below. Ask your health care team for more advice on resources.

• Support groups. Support groups allow you to meet other people with ADHD so that you can share experiences, information and coping strategies. These groups are available in person in many communities and also online.
• Social support. Involve your spouse, close relatives and friends in your ADHD treatment. You may feel reluctant to let people know you have ADHD , but letting others know what's going on can help them understand you better and improve your relationships.
• Co-workers, supervisors and teachers. ADHD can make work and school a challenge. You may feel embarrassed telling your boss or professor that you have ADHD , but most likely he or she will be willing to make small accommodations to help you succeed. Ask for what you need to improve your performance, such as more in-depth explanations or more time on certain tasks.

Preparing for your appointment

You're likely to start by first talking to your primary care provider. Depending on the results of the initial evaluation, he or she may refer you to a specialist, such as a psychologist, psychiatrist or other mental health professional.

What you can do

To prepare for your appointment, make a list of:

• Any symptoms you've had and problems they've caused, such as trouble at work, at school or in relationships.
• Key personal information, including any major stresses or recent life changes you've had.
• All medications you take, including any vitamins, herbs or supplements, and the dosages. Also include the amount of caffeine and alcohol you use, and whether you use recreational drugs.
• Questions to ask your doctor.

Bring any past evaluations and results of formal testing with you, if you have them.

Basic questions to ask your doctor include:

• What are the possible causes of my symptoms?
• What kinds of tests do I need?
• What treatments are available and which do you recommend?
• What are the alternatives to the primary approach that you're suggesting?
• I have these other health problems. How can I best manage these conditions together?
• Should I see a specialist such as a psychiatrist or psychologist?
• Is there a generic alternative to the medicine you're prescribing?
• What types of side effects can I expect from the medication?
• Are there any printed materials that I can have? What websites do you recommend?

Don't hesitate to ask questions anytime you don't understand something.

What to expect from your doctor

Be ready to answer questions your doctor may ask, such as:

• When do you first remember having problems focusing, paying attention or sitting still?
• Have your symptoms been continuous or occasional?
• Which symptoms bother you most, and what problems do they seem to cause?
• How severe are your symptoms?
• In what settings have you noticed the symptoms: at home, at work or in other situations?
• What was your childhood like? Did you have social problems or trouble in school?
• How is your current and past academic and work performance?
• What are your sleep hours and patterns?
• What, if anything, appears to worsen your symptoms?
• What, if anything, seems to improve your symptoms?
• What medications do you take?
• Do you consume caffeine?
• Do you drink alcohol or use recreational drugs?

Your doctor or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your time with the doctor.

• Attention-deficit/hyperactivity disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. https://dsm.psychiatryonline.org. Accessed Jan. 26, 2019.
• Attention-deficit/hyperactivity disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml. Accessed Jan. 26, 2019.
• AskMayoExpert. Attention-deficit/hyperactivity disorder. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
• What is ADHD? American Psychiatric Association. https://www.psychiatry.org/patients-families/adhd/what-is-adhd. Accessed Jan. 26, 2019.
• ADHD. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/ADHD/Overview. Accessed Jan. 26, 2019.
• Adult ADHD (attention deficit hyperactive disorder). Anxiety and Depression Association of America. https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/adult-adhd. Accessed Feb. 11, 2019.
• Geffen J, et al. Treatment of adult ADHD: A clinical perspective. Therapeutic Advances in Psychopharmacology. 2018;8:25.
• Adult ADHD. American Association for Marriage and Family Therapy. https://www.aamft.org/Consumer_Updates/Adult_ADHD.aspx. Accessed Feb. 11, 2019.
• Kooij JJS, et al. Updated European consensus statement on diagnosis and treatment of adult ADHD. European Psychiatry. 2019;56:14.
• Fields SA, et al. Adult ADHD: Addressing a unique set of challenges. Journal of Family Practice. 2017;66:68.
• Mitchell JT, et al. Mindfulness meditation training for attention-deficit/hyperactivity disorder in adulthood: Current empirical support, treatment overview, and future direction. Cognitive and Behavioral Practice. 2015;22:172.
• Bhagia J (expert opinion). Mayo Clinic, Rochester, Minn. June 13, 2019.
• Hyperthyroidism (overactive). American Thyroid Association. https://www.thyroid.org/hyperthyroidism/. Accessed June 13, 2019.
• Low blood glucose (hypoglycemia). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/low-blood-glucose-hypoglycemia. Accessed June 13, 2019.

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Children’s ADHD Skill Packet

Problem solving skills, following a routine, and deep breathing are valuable techniques for the management of ADHD in children. In our digital story about ADHD, The Kangaroo Who Couldn’t Sit Still , the character Kangaroo implements each of these techniques to manage their symptoms.

The Children’s ADHD Skill Packet was created to accompany The Kangaroo Who Couldn’t Sit Still . After reading the story, use this packet to teach children and their caregivers how to practice the same skills used by Kangaroo.

The information in the Children’s ADHD Skill Packet will largely be implemented by parents and caregivers, but the packet is written at a level appropriate for children, allowing them to follow along. The colorful artwork and simple language can help build motivation and improve buy-in for each technique.

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PARENTING HUB

57 Top Behavioral Interventions for ADHD

Dr. roseann capanna-hodge.

• August 16, 2023

Every parent wants the best for their child, especially when that child has Attention Deficit Hyperactivity Disorder ( ADHD ) and their child is prone to dysregulation . As parents, we sometimes feel lost and confused about how to best support our children, especially when conventional treatments, like ADHD medications, may not be enough or may have side effects. The good news is that behavioral therapy, specifically behavioral interventions for ADHD, can provide significant assistance and even improve outcomes for children with this condition.

Behavioral Parent Training for ADHD

Behavioral Parent Training involves teaching parents effective strategies for dealing with their child's ADHD behaviors. This can include setting clear and consistent rules, offering positive reinforcement for appropriate behaviors, and maintaining a structure that benefits the child's unique needs.

• Positive Reinforcement : Recognize and praise your child's good behavior. When your child behaves in a desirable way, provide immediate and enthusiastic praise. This could be verbal, like saying, “Great job tidying your toys!” or physical, like a high-five or a hug (Eyberg, 1988).
• Clear and Calm Instructions: Make sure your directions to your child are clear and calm. Too many instructions at once can overwhelm a child with ADHD. Break down tasks into smaller, manageable steps (Sanders, 2008).
• Skill Development: Encourage the development of key skills such as problem-solving and communication. This could be through games, role-play, or guided activities (Kazdin, 2005).
• Consistent Routines: Establishing consistent daily routines can help a child with ADHD understand what is expected of them and reduce anxiety. Make sure the routines are structured and predictable (Kazdin, 2005).
• Limit Setting: Set clear, reasonable limits for your child and stick to them. This can provide a sense of security and help your child learn self-control (Barkley, 1987).
• Modeling Appropriate Behavior: Children often learn by imitating adult behavior. Try to display behaviors you would like your child to adopt, like patience, calmness, and perseverance (Eyberg, 1988).

School-Based Interventions

School-Based Interventions are also a crucial part of managing ADHD as they help children with ADHD improve their academic and behavioral performance at school.

• Establish Clear Classroom Rules: Work with your child's teacher to set clear and consistent rules for the classroom. Ensure the rules are visually displayed and regularly reviewed (DuPaul, Eckert, & Vilardo, 2012).
• Use of Visual Aids: Teachers can use visual aids to help children with ADHD follow along with lessons. This can include charts, diagrams, or color-coding (DuPaul, Eckert, & Vilardo, 2012).
• Preferential Seating: Arrange for your child to sit closer to the teacher and away from windows or doors to minimize distractions (DuPaul, Eckert, & Vilardo, 2012).
• Break Down Assignments : Large assignments can be overwhelming for children with ADHD. Teachers can break down tasks into smaller, more manageable parts (DuPaul, Eckert, & Vilardo, 2012).
• Frequent Feedback: Teachers can provide regular feedback to children with ADHD, highlighting positive behaviors and gently correcting inappropriate behaviors (DuPaul, Eckert, & Vilardo, 2012).
• Incorporate Physical Activity : Regular movement breaks during the school day can help children with ADHD burn off excess energy and improve focus (Verret et al., 2012).
• Provide Additional Time: Allowing extra time for tasks can help children with ADHD work at their own pace and reduce the pressure they might feel to rush through their work (DuPaul, Eckert, & Vilardo, 2012).
• Peer Tutoring: Working in pairs or small groups can help children with ADHD improve their social and academic skills (DuPaul, Eckert, & Vilardo, 2012).
• Use of Technology: Assistive technology, such as speech-to-text software or digital organizers, can be beneficial for students with ADHD (DuPaul, Eckert, & Vilardo, 2012).

Self-Management Interventions

Self-Management Interventions can also be highly beneficial, as they empower children with ADHD to take control of their own behavior. Self-regulation is the foundation of learning in all areas and it is critical in the development of executive functioning. 

• Goal Setting: Teach your child to set realistic, achievable goals and create a plan to reach them. This helps improve their planning and organizational skills (Shapiro, 2011).
• Self-Reflection and Self-Regulation: Encourage your child to engage in self-reflection exercises to identify triggers, recognize their emotions, and develop self-regulation strategies. This intervention promotes self-awareness, impulse control and emotional control (Barkley, 2012).
• Self-Monitoring: Help your child learn to monitor their own behavior by keeping a diary or chart of their positive and negative behaviors. This awareness can promote self-control and responsibility (Shapiro, 2011).
• Visual Reminders: Using visual reminders, like stickers or charts, can help children track their progress towards achieving their goals (Shapiro, 2011).
• Cognitive Behavioral Techniques: Encourage your child to identify and challenge their negative thought patterns. This can help promote more positive thinking and behavior (Knapp, Dahl, & Swift, 2013).
• Time Management Strategies: Teach your child effective time management techniques, such as creating schedules, using timers or alarms, and breaking tasks into smaller, manageable steps. These strategies can help improve their organization and ability to prioritize tasks (Barkley, 2012).
• Self-Reward Systems: Implement a self-reward system where your child can earn rewards or privileges for meeting specific behavioral goals or completing tasks. This intervention can increase motivation and reinforce positive behaviors (Barkley, 2012).
• Problem-Solving Skills: Teach your child problem-solving techniques, such as identifying the problem, brainstorming solutions, evaluating options, and implementing the best course of action. This intervention enhances their critical thinking and decision-making abilities (Power, Karustis, & Habboushe, 2018).

Social Skills Training

Children with ADHD often struggle with social interactions. Social Skills Training can help them develop the necessary skills to navigate social situations effectively. This training focuses on improving communication, empathy, problem-solving, and other essential social skills. Through structured activities and guidance from professionals, children with ADHD can gain confidence and build meaningful relationships. Acquiring these skills not only improves immediate interactions but also sets a foundation for long-term social competence and success.

• Role-Play: Use role-play to practice appropriate social interactions and self-regulation . This could include taking turns, sharing, or responding to conflict (Shapiro, 2011).
• Practice Social Scripts: Role-play and practice social scripts with your child for common social situations, such as introducing themselves, joining a group, or initiating a conversation.
• Teach Conversation Skills: Guide your child in maintaining eye contact, listening attentively, and waiting their turn to speak during conversations (Shapiro, 2011). 
• Cooperative Games: Arrange activities where your child needs to cooperate with others. This can improve teamwork and negotiation skills (Shapiro, 2011).
• Provide Social Opportunities: Arrange playdates, outings, or group activities to provide regular opportunities for your child to interact with peers and practice social skills in different settings.
• Encourage Cooperative Play: Encourage your child to engage in cooperative play activities, such as building with blocks, completing puzzles, or playing board games, which promote turn-taking, sharing, and collaboration.
• Model Social Skills: Be a positive role model by demonstrating effective social skills yourself. Use polite language, active listening, and respectful behavior in your interactions with others.
• Prompt Social Behaviors: Provide gentle reminders and prompts to your child when engaging in social situations. Encourage them to greet others, ask questions, and express empathy or compliments.
• Teach Conflict Resolution: Guide your child in learning constructive ways to resolve conflicts or disagreements. Teach them strategies such as compromise, active listening, and finding win-win solutions.
• Promote Perspective-Taking: Encourage your child to consider others' perspectives and feelings. Discuss different points of view and help them understand the impact of their words and actions on others.
• Teach Empathy: Help your child understand and respect the feelings of others through stories, videos, or real-life examples (Shapiro, 2011).
• Foster Emotional Intelligence: Help your child develop emotional intelligence by encouraging them to recognize and label their emotions, understand the emotions of others, and respond appropriately in social interactions.
• Peer Modeling: Encourage your child to observe and learn from positive social behaviors exhibited by their peers. Peer modeling can provide valuable examples and help your child understand appropriate social cues and responses (Bellini & Akullian, 2007).
• Social Skills Groups: Consider enrolling your child in social skills groups or classes specifically designed to teach and practice social interaction skills with peers. These groups provide structured opportunities for learning and practicing social skills in a supportive environment (Laugeson, Frankel, & Mogil, 20 10).

Sensory Processing Interventions

In the realm of supporting children with sensory processing challenges, various interventions can make a significant difference in their daily lives. Sensory Processing Interventions encompass a range of strategies and activities aimed at helping children with sensory sensitivities or difficulties. 

By addressing the unique sensory needs of each child, these interventions provide targeted support to enhance their sensory experiences, promote self-regulation, and improve overall well-being. 

• Sensory Integration Therapy: Engaging in activities that involve the simultaneous input of multiple senses to improve sensory processing and integration (Watling & Hauer, 2015).
• Environmental Modifications: Making adjustments to the physical environment to reduce sensory distractions and create a more sensory-friendly space (Watling & Hauer, 2015).
• Sensory Diet: Create a “sensory diet” with a variety of sensory activities tailored to your child's needs, such as swinging, jumping on a trampoline, or deep pressure exercises (Bundy & Murray, 2002).
• Sensory Breaks: Provide regular breaks for sensory activities throughout the day. This can help your child stay focused and calm (Bundy & Murray, 2002).
• Fidget Tools: Use fidget tools, like stress balls or putty, to help your child focus and self-regulate (Bundy & Murray, 2002).
• Weighted Blankets: These can provide deep pressure which may help calm and comfort children with ADHD (Bundy & Murray, 2002).
• Deep Pressure Therapy: Applying deep pressure through techniques like weighted vests or deep pressure massages to promote a calming effect and sensory regulation (Koegel et al., 2012).
• Visual Supports: Using visual aids, such as visual schedules or cue cards, to enhance comprehension and provide structure in daily routines and activities (American Occupational Therapy Association, 2020).

Coping Skills Techniques

Coping skills techniques are invaluable tools that can empower children to navigate challenges, manage emotions, and build resilience. For children with ADHD, developing effective coping strategies is particularly important in promoting their overall well-being and success.

• Relaxation Techniques: Teach your child deep breathing exercises or progressive muscle relaxation techniques to help them manage stress (Sukhodolsky et al., 2005).
• Problem-Solving Skills: Help your child develop problem-solving skills by working through challenges together, step by step (Cunningham, 2006). This helps not only with frustration tolerance but also improves communication skills .
• Anger Management Skills: Teach your child to recognize signs of anger and use coping strategies like counting to ten or deep breathing (Sukhodolsky et al., 2005).
• Resilience Building: Encourage your child to learn from setbacks and persevere. This could involve discussing challenges and brainstorming ways to overcome them (Cunningham, 2006).

Mindfulness and Relaxation Techniques

Mindfulness and Relaxation Techniques provide valuable tools for promoting calmness, self-awareness, and emotional well-being in children. In the fast-paced and often demanding world we live in, children with ADHD can greatly benefit from these practices to enhance focus, reduce stress, and improve overall mental health.

• Mindfulness Exercises: Practice mindfulness exercises with your child, such as guided meditation or mindful coloring (Zylowska et al., 2008).
• Yoga: Encourage your child to practice yoga. Yoga can help children relax, focus, and improve self-awareness (Haffner et al., 2006).
• Neurofeedback: Teach your child to control their body's responses (like heart rate) using biofeedback and neurofeedback techniques (Monastra, Monastra, & George, 2002).
• Guided Imagery: Use guided imagery exercises to help your child relax and focus. For instance, have them visualize a peaceful place (Zylowska et al., 2008).

Contingency Management

Contingency Management is a powerful approach that helps children with ADHD develop positive behaviors and make effective choices. By utilizing rewards , consequences, and structured systems, this blog section explores the concept of Contingency Management and its application in supporting children's behavioral development. 

From implementing reward systems and behavior contracts to ensuring consistent consequences and using daily report cards, these techniques provide practical strategies for parents and caregivers.

• Reward System: Create a reward system for positive behavior. Use tokens or points that can be traded in for larger rewards (Fabiano et al., 2009).
• Behavior Contract: Develop a behavior contract outlining expected behaviors and consequences for not meeting those expectations (Fabiano et al., 2009).
• Consistent Consequences: Ensure consequences for inappropriate behavior are consistent and immediate (Fabiano et al., 2009).
• Daily Report Cards: Implement a daily report card system where your child's behavior is evaluated and rewarded each day (Fabiano et al., 2009).

As parents, we feel inspired by the transformative potential of learning about behavioral therapy, positive reinforcement, and parent training programs as empowering alternatives to ADHD medications for supporting our children with ADHD. 

By equipping ourselves with the knowledge and tools to implement these interventions, we have the opportunity to make a positive impact on our children's lives. Behavioral therapy offers a holistic approach, teaching our children new skills and strategies that can help them thrive. 

By implementing positive reinforcement techniques, we can create an environment that celebrates and reinforces their positive behavior, nurturing their growth and development. 

Parent training programs serve as invaluable resources, guiding us in navigating the challenges of ADHD and empowering us with effective strategies. By embracing these treatments, we can foster positive behavior and support our children's journey with attention deficit hyperactivity disorder ( ADHD ) in a manner that aligns with our values and aspirations. 

Through these interventions, we, as parents, have the power to create a nurturing environment that promotes positive behavior and enables our children to flourish.

Grab our free resource , “147 Therapist-Endorsed Self-Regulation Strategies for Children: A Practical Guide for Parents,” is a game-changer. 

American Occupational Therapy Association. (2020). Occupational Therapy Practice Framework: Domain and Process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 1-658.

Barkley, R. A. (1987). Defiant children: A clinician's manual for parent training. Guilford Press. 

Bundy, A. C., & Murray, E. A. (2002). Sensory integration: A. Jean Ayres' theory revisited. In A. C. Bundy, S. J. Lane, & E. A. Murray (Eds.), Sensory integration: Theory and practice (pp. 3–33). F.A. Davis. LINK

Cunningham, C. E. (2006). COPE: Large group, school-based, family-centered intervention. In R. B. Mennuti, A. Freeman, & R. W. Christner (Eds.), Cognitive-behavioral interventions in educational settings: A handbook for practice (pp. 447-472). Routledge. 

DuPaul, G. J., Eckert, T. L., & Vilardo, B. (2012). The effects of school-based interventions for attention deficit hyperactivity disorder: A meta-analysis 1996–2010. School Psychology Review, 41(4), 387-412. LINK

Eyberg, S. M. ( 2008 ). Parent-child interaction therapy: Integration of traditional and behavioral concerns. Child & Family Behavior Therapy, 10(1), 33-46. LINK  

Fabiano, G. A., Pelham, W. E., Coles, E. K., Gnagy, E. M., Chronis-Tuscano, A., & O'Connor, B. C. (2009). A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical Psychology Review, 29(2), 129-140. DOI: 10.1016/j.cpr.2008.11.001

Haffner, J., Roos, J., Goldstein, N., Parzer, P., & Resch, F. (2006). The effectiveness of body-oriented methods of therapy in the treatment of attention-deficit hyperactivity disorder (ADHD): results of a controlled pilot study. Zeitschrift für Kinder-und Jugendpsychiatrie und Psychotherapie, 34(1), 37-47. DOI: 10.1024/1422-4917.34.1.37

Kazdin, A. E. (2005). Parent management training: Treatment for oppositional, aggressive, and antisocial behavior in children and adolescents. Oxford University Press. LINK

• Knapp, P., Dahl, M., & Swift, J. K. (2013). Handbook of cognitive-behavioral therapies. The Guilford Press.
• Laugeson, E. A., Frankel, F., & Mogil, C. (2010). Social skills training for young adults with high-functioning autism spectrum disorders: A randomized controlled pilot study. Journal of Autism and Developmental Disorders, 40(7), 867-876. DOI: 10.1007/s10803-011-1350-6

Monastra, V. J., Monastra, D. M., & George, S. (2002). The effects of stimulant therapy, EEG biofeedback, and parenting style on the primary symptoms of attention-deficit/hyperactivity disorder. Applied Psychophysiology and Biofeedback, 27(4), 231-249. DOI: 10.1023/a:1021018700609

Sanders, M. R. (2008). Triple P-Positive Parenting Program as a public health approach to strengthening parenting. Journal of Family Psychology, 22(4), 506-517. DOI: 10.1037/0893-3200.22.3.506

Shapiro, E. S. (2011). Academic skills problems: Direct assessment and intervention (4th ed.). The Guilford Press.

Sukhodolsky, D. G., Kassinove, H., & Gorman, B. S. (2005). Cognitive-behavioral therapy for anger in children and adolescents: A meta-analysis. Aggression and Violent Behavior, 10(3), 247-269. LINK

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She is the founder and director of The Global Institute of Children’s Mental Health and Dr. Roseann Capanna-Hodge. Dr. Roseann is a Board Certified Neurofeedback (BCN) Practitioner, a Board Member of the Northeast Region Biofeedback Society (NRBS), Certified Integrative Medicine Mental Health Provider (CMHIMP) and an Amen Clinic Certified Brain Health Coach.  She is also a member of The International Lyme Disease and Associated Disease Society (ILADS), The American Psychological Association (APA), Anxiety and Depression Association of America (ADAA) National Association of School Psychologists (NASP), International OCD Foundation (IOCDF) International Society for Neurofeedback and Research (ISNR) and The Association of Applied Psychophysiology and Biofeedback (AAPB).

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Language: English | Turkish

The Effectiveness of an Interpersonal Cognitive Problem-Solving Strategy on Behavior and Emotional Problems in Children with Attention Deficit Hyperactivity

Kişilerarası sorun Çözme eğitiminin dikkat eksikliği ve hiperaktivite bozukluğu olan Çocukların davranışsal ve emosyonel sorunları Üzerindeki etkisi, celale tangül Özcan.

1 Gulhane Military Medical Academy, School of Nursing, Ankara, Turkey

Fahriye Oflaz

Tümer türkbay.

2 GGulhane Military Medical Academy, Department of Child and Adolescent Mental Health, Ankara, Turkey

Sharon M. FREEMAN CLEVENGER

3 Gülhane Indiana/Purdue University Center for Brief Therapy, Fort Wayne, Indiana, USA

Introduction

This study was designed to evaluate the effectiveness of the “I Can Problem Solve” (ICPS) program on behavioral and emotional problems in children with attention deficit hyperactivity disorder (ADHD).

The subjects were 33 children with ADHD aged between 6 to 11 years. The study used a pre- and post-test quasi-experimental design with one group. The researchers taught 33 children with ADHD how to apply ICPS over a period of 14 weeks. The Child Behavior Checklist for Ages 6–18 (Teacher Report Form) and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition Text Revision (DSM-IV-TR) Based Disruptive Behavior Disorders Screening and Rating Scale (parents’ and teacher’s forms) were used to evaluate the efficacy of the program. The scales were applied to parents and teachers of the children before and after the ICPS program.

The findings indicated that the measured pre-training scores for behavioral and emotional problems (attention difficulties, problems, anxious/depressed, withdrawn/depressed, oppositional defiant problems, rule breaking behaviors, and aggressive behaviors) were significantly decreased in all children post-training. In addition, children’s total competence scores increased (working, behaving, learning and happy) after the ICPS program.

According to the results, it is likely that, ICPS would be a useful program to decrease certain behavioral and emotional problems associated with ADHD and to increase the competence level in children with ADHD. An additional benefit of the program might be to empower children to deal with problems associated with ADHD such as attention difficulties, hyperactivity-impulsivity, and oppositional defiant problems.

ÖZET

Giriş.

Bu araştırma dikkat eksikliği hiperaktivite bozukluğu (DEHB) tanısı konulan çocuklara uygulanan bir kişilerarası sorun çözme eğitim programı olan “Ben Sorun Çözebilirim (BSÇ)” eğitiminin etkilerini incelemek amacıyla yapılmıştır.

Yöntemler

Araştırma örneklemini DEHB tanısı konulan 6–11 yaş arası 33 çocuk oluşturmuş, tek gruplu ön-son test deseninde, yarı deneysel olarak planlanmıştır. DEHB tanısı olan bu çocuklara 14 hafta boyunca bilişsel yaklaşıma dayalı BSÇ eğitimi uygulanmıştır. Programın etkinliğini değerlendirmek için “Dikkat Eksikliği ve Yıkıcı Davranış Bozuklukları için DSM-IV’e Dayalı Tarama ve Değerlendirme Ölçeği” (anne-baba ve öğretmen formu) ve “6–18 Yaş Grubu Çocuk ve Gençler için Davranış Değerlendirme Ölçeği (öğretmen formu-TRF/6–18)” kullanılmıştır. BSÇ eğitimi öncesi ve sonrasında anne-baba ve öğretmenlerden bu ölçekleri doldurmaları istenmiştir.

BSÇ eğitimi sonrasında karşı gelme, dikkatsizlik, hiperaktivite/dürtüsellik, anksiyete/depresyon, sosyal içe dönüklük, suça yönelik davranışlar ve saldırgan davranışların azaldığı saptanmıştır. TRF/6–18′nin yeterlilik alanına ilişkin “sıkı çalışma, uyum, öğrenme ve mutlu olma” alt testlerin toplamından oluşan “toplam yeterlilik” alt testinde BSÇ eğitim sonrasında yeterlilik düzeyinin önemli oranda arttığı görülmüştür.

Sonuç

Bu çalışmanın sonuçlarına göre, BSÇ eğitim programı DEHB olan çocukların duygusal ve davranışsal sorunların azaltılmasında ve çocukların yeterlilik düzeylerinin artırılmasında faydalı olabilir. Bu programın bir diğer yararı ise bu çocukların DEHB ile ilişkili sorunlar (dikkat eksikliği, hiperaktivite/dürtüsellik ve karşı gelme sorunları) ile baş etmelerini güçlendirebilir.

Attention deficit hyperactivity disorder (ADHD), which is one of the most prevalent childhood psychiatric disorders, is a neuropsychiatric disorder characterized by developmentally inappropriate levels of activity, distractibility, and impulsivity ( 1 , 2 ).

Behavioral problems in children with ADHD include acting without adequate forethought as to the consequences of their actions and inability to postpone gratification with impulsive decisions and behaviors. ADHD negatively influences social interactions with peers, interpersonal relationships with parents, teachers and peers as well as academic success and social functions ( 2 , 3 ). Children with ADHD face problems such as increased incidence of defiant and aggressive behaviors, and are at higher risk of comorbid disorders (such as oppositional defiant disorder, conduct disorder) compared to typically developing children ( 4 , 5 ). Behavioral problems commonly seen in children with ADHD affect the overall quality of children’s lives ( 2 , 6 , 7 ), and reduce the quality of life of their family members. Specifically, the family experiences overall increased levels of stress, decreased feelings of belonging and competence and disruption of routines and structure ( 2 ). Additional problems include: conflicts and exclusion among peers, inability to manage or prevent anger efficiently, communication/social skill difficulties, inadequate problem solving, and difficulties in relationships ( 2 , 5 , 8 ).

Multifocal treatment programs for children with ADHD may improve outcomes in a more robust manner than medication alone or behavior/cognitive management programs alone. Social skills training programs encourage problem-solving ability and support cognitive and behavioral skills ( 2 , 9 , 10 ). Some cognitive-behavioral approaches consisting of psychosocial treatments result in improved impulse control, increased assessment capability before reaction and enhance considered and tempered actions ( 11 ).

The “I Can Problem Solve” (ICPS) program is based on Interpersonal Cognitive Problem-Solving methods. The basic objectives of this program are developed mainly to deal with the social problems of children ( 12 ). The ICPS is a problem solving approach to prevention of high risk behaviors in children and provide children with assessment abilities to help them solve their problems ( 12 , 13 , 14 ). By strengthening the capacity of children with ADHD to solve problems that lead to socially undesirable behaviors such as physical and verbal aggression, impulsivity, inability to wait, inability to take turns, inability to delay gratification, over emotionality in the face of frustration, inability to maintain friendships, high risk behaviors may be reduced ( 12 ). It should be noted that, children with ADHD need extra support and structured training although other children easily can learn problem-solving skills through these programs and adapt them to real life as well ( 15 ). However, there is limited data relating the ICPS training program for children suffering from ADHD ( 10 , 12 ).

The primary aim of this study was to evaluate the effectiveness of the ICPS program on children with ADHD. It was hypothesized that ICPS program would be useful to decrease behavioral and emotional problems (oppositional defiant problems, attention problems, hyperactivity problems, anxious/depressed, withdrawn/depressed, rule breaking behavior, and aggressive behavior), and would increase the total competence scores (working, behaving, learning and happy) in children with ADHD.

Study Design and Sampling

The main purpose of this study was to evaluate the improvements between pre- and post-ICPS training in measured behavioral and emotional problems in children with ADHD and their competence in term of the effectiveness of the ICPS program. This study was designed as a pre-post-test quasi-experimental design with a single group. The study group consisted of children diagnosed with ADHD in two elementary schools in Ankara/Turkey, between ages of 6 and 11, diagnosed with ADHD according to DSM-IV-TR criteria ( 1 ). The mean age of the participants was 9.1±1.1 years. All of the children were Caucasian. The socio-demographic characteristics of the children such as gender, grade, mother’s and father’s education years, father’s/mother’s profession as well as medication use for ADHD are outlined in Table 1 .

The Socio-demographic characteristics of the participants (n=33)

Inclusion criteria were: the diagnosis of ADHD according to DSM-IV-TR criteria, 6 to 12 years of age, and child/parents volunteered for the research. Exclusion criteria were: the history of head trauma or neurological illness, developmental delay or any other axis I psychiatric disorder except for oppositional defiant disorder, making a change in her/his medications during the study if the child has been taking any medication for ADHD, and failure to attend the training.

Instruments

Data collection and assessment tools used in the research were as follows:

The DSM-IV-TR Based Disruptive Behavior Disorders Screening and Rating Scale

This is a screening and assessment instrument, which was developed based on DSM-IV-TR diagnostic criteria, consists of 9 items inquiring attention problems; 6 items inquiring hyperactivity; 3 items inquiring impulsivity; 8 items inquiring oppositional defiant disorder and 15 items inquiring conduct disorder. The adaptation of this scale to Turkish society, and the validation and reliability analyses were completed in the year 2001. The Cronbach’s alpha was 0.88 for the sub-scale attention problems and 0.92 for the sub-scale disruptive behavior disorder in the reliability analysis ( 16 ).

The Child Behavior Checklist for Ages 6–18 (Teacher Report Form-TRF/6–18)

This form was developed to evaluate 6–18 age group students’ adaptation to school and their faulty behavior through information obtained from teachers in a standardized way. TRF includes 118 items related to behavioral and emotional problems. 93 of these items correspond to the items on the Child Behavior Checklist for Ages 6–18. The scale provides information regarding adaptation as well as basic functions such as school- and student-related information. In the second part of the scale, behavior problems are inquired under the categories “internalizing” and “externalizing”. Within the “internalizing” category, there are withdrawn/depressed, somatic complaints and anxious/depressed subtests, while within the “externalizing” category, there are disobedience to rules and aggressive behaviors sub-tests. There are also sub-tests such as social problems, thought problems, attention problems and other problems that do not belong to either of the two categories ( 17 ). TRF was first developed by Achenbach in 1991, and verification and validation studies in our country were conducted by Erol at al. ( 18 ). The Validity and reliability of the Turkish version of the TRF was 0.82 for Internalizing; 0.81 for Externalizing and Cronbach alpha=0.87 for total problem.

The 49 children from two elementary schools were interviewed and examined by a psychiatric practitioner trained in child psychiatry. To exclude other psychiatric disorders, the Children Depression Inventory, the State-Trait Anxiety Inventory and the Learning Disorders Checklist were applied. 37 of the 49 children met the diagnostic criteria for ADHD. The study was introduced to 37 children and their parents in an introductory meeting. Permission and written informed consent were obtained from them (n=37). Parent reports were obtained with the DSM-IV-TR based Disruptive Behavior Disorders screening and assessment scale; teacher reports were obtained with both the DSM-IV-TR Based Disruptive Behavior Disorders Screening and Assessment Scale, and “Child Behavior Checklist for Ages 6–18 (Teacher Report Form)(TRF/6–18).

Due to various reasons, such as being diagnosed with another psychiatric disorder besides ADHD and the failure to attend the training etc., four students were excluded from the study. Finally, the remaining 33 children were taken for evaluation.

The lessons of ICPS were taught to the children in small groups. The children fell into the groups based upon their school and whether they attended morning or afternoon classes resulting in 7–9 children per group. The training program was 14 weeks in length and included 83 structured lessons. Each lesson was completed in approximately 30 minutes twice per week which could be prolonged considering children’s motivation.

The ICPS training program is based on “Interpersonal Cognitive Problem-Solving Strategy”. The ICPS program was developed by Myrna B. Shure (1992) ( 19 ) for purposes of social skills training in children and adolescents. The adaptation of this training to Turkish has been made by Öğülmüş ( 14 ). The training was provided by a primary researcher who had previously been trained exclusively by Öğülmüş. The ICPS program teaches children how to think and how to evaluate their own thoughts. Behaviors are modified by focusing on the thinking processes. The ICPS program encourages children to think about finding as many alternative solutions as possible when they deal with a problem. It teaches children to learn how to think of solutions to a problem and of potential consequences to an act. The ICPS encourages children to do their own thinking instead of offering solutions and consequences ( 12 , 13 , 14 ). ICPS with enhanced critical thinking, creativity, and reasoning skills are concerned more with how a person thinks rather than what a person thinks. ICPS attempt to enhance interpersonal cognitive skills, and thus, lead to successful alterations in overt social behavior ( 12 , 13 , 14 ). The guideline book of ICPS program included 83 structured lessons using pictures, toys, puppets, games, stories, drama, role-plays, and dialogues based on real life conversations. There is a defined goal of each structured lesson in the ICPS program book ( 19 ). The examples of goals of the ICPS lessons are as follows:

To Think About their own Feelings

To learn to identify people’s feelings and to become sensitive to them (other’s feelings) or (to gain the ability to put themselves in other’s shoes)

To increase their awareness that other’s point of view might differ from their own

To recognize that there is more than one way to solve a problem

To learn being assertive without physical and verbal aggression

To learn that different people can feel different ways about the same issue

To think of both alternative solutions and means-ends plans (weighing pros and cons)

To be aware of what might happen next and to learn how to think of solutions to a problem and consequences to an act

To decide for themselves whether their idea was or was not good in the light of their own and others’ feelings and of the possible consequences.

To learn that sensitivity to the preferences of others is also important in deciding what to do in situations which situation?

To increase understanding that thinking about what is happening may, in the long run, be more beneficial than immediate action to stop the behavior

To control impulse, including to delay gratification and to cope with frustrations

Examples of ICPS Dialoguing (Problem-solving process) ( 12 ).

“What happened, what’s the problem, what’s the matter?”

“How do you think she/he feels when.. ?” (e.g., “When you hit him/her?”)

“What happened (might happen) next when you did (do) that?”

“How did that make you feel?”

“Can you think of a different way to solve the problem (tell him/her/me how you feel)?”

“Do you think that is or is not a good idea? Why (why not)?”

Ethical Approval

This study was approved by the local ethics committee of Gülhane Military Medical Academy and School of Medicine, and Ankara Provincial Education Directorate. For ethical considerations, the purposes and methods of the study were explained to the children and their parents. After receiving their consent, the study was started.

Statistical Analysis

SPSS Ver. 13.0 for Windows (SPSS Inc., IL, USA) was used for the statistical analysis. All descriptive statistics were presented as mean ± standard deviation (SD), median and number/percentage universal tests, then normal distribution fit tests (Shapiro-Wilk test) were employed for the data used. Pre- and post-test measurement data were evaluated as dependent variables scores were compared by using the Paired-Samples T-Test or the Wilcoxon Signed-Rank Test (when variances are unequal). The significance level was assumed p<0.05.

The differences between pre-and post-training scores were statistically significant for all subscales of the DSM-IV-TR Based Disruptive Behavior Disorders Screening and Rating Scale ( Table 2 ).

Comparison of the Subscales Scores of the DSM-IV-TR Based Disruptive Behavior Disorders Screening and Rating Scale before and after the ICPS Training

t: Paired-Samples T Test, z: Wilcoxon Signed Rank Test (when variances were unequal),

According to the TRF/6–18 test scores for both pre-and post-training, the all internalizing problem behaviors including “anxious/depressed”, “withdrawn/depressed” and “somatic complaints”, and the all externalizing problem behaviors including “rule-breaking behavior” and “aggressive behaviors” were found to be significantly reduced after the ICPS training ( Table 3 ). The sum of the scores for four adaptive characteristics (“working”, “behaving”, “learning” and “happy”) displays an “adaptive functioning profile” on the TRF/6–18. The difference between competence levels of these sub-tests were found to be statistically significant based on the comparison of these levels for pre- and post-ICPS training (p=0.03). The higher total competence scores indicate the better competence ( Table 3 ).

Comparison of Problematic Behaviors Scores Identified by TRF/6–18 for Pre- and Post-ICPS Training

t: Paired-Samples T Test, z: Wilcoxon Signed-Rank Test (when variances were unequal),

The effectiveness of ICPS training for children with ADHD resulted in significant improvement in ADHD symptoms as well as in such problem areas like internalizing and externalizing behavior problems. These results suggest that ICPS training might reduce problematic behaviors and improve problem-solving skills and behavior among children with ADHD.

Pharmacotherapy tends to be a first-line therapy targeting biological implications for children with ADHD. Approved pharmacological agents for the treatment of ADHD include psychostimulants and atomoxetine. Psychostimulant medication has positive effects on children with ADHD in their ability to focus and pay attention in school settings, thereby, resulting in improvement in the overall learning environment. The therapeutic effects of pharmacological agents may be temporary, as symptom reduction occurs only when medication is active in the system. The lack of long-term efficacy has been issue of concern ( 2 , 20 ). Although the effectiveness of psychostimulants for reducing ADHD symptoms have demonstrated efficacy ( 21 , 22 ), there are potential unwanted side effects of pharmacological agents ( 23 , 24 ). Because of worrying about potential and known/unknown negative effects of pharmacotherapy, some children with ADHD may be reluctant to use any medication for ADHD, and may possibly discontinue medication treatments without their prescribers’ knowledge. Furthermore, follow-up studies have demonstrated that ADHD frequently persists into adolescence and adulthood ( 2 , 25 , 26 ). In addition, adults and those in whom ADHD was diagnosed in childhood often continue to suffer ongoing significant behavior problems ( 2 , 9 , 27 ). Accordingly, if these people with ADHD use a medication as the first and only treatment for ADHD, they will have to use the medication throughout life. As a result, non-pharmacological treatment seeking, and the use of complementary are on the rise ( 26 ). In addition, children with ADHD have not only core ADHD symptoms, but have also comorbid disorders that increase complexity of treatment such as anxiety, disobedience to rules, aggressive behaviors, oppositional defiant behaviors and other social problems ( 2 , 4 ). These comorbid conditions and associated features not only add to ADHD’s clinical complexity, but also have significant implications for treatment ( 28 ). Therefore, alternative options, including psychosocial treatment approaches, may have utility for amelioration of ADHD symptoms, and have significance in reversing the risks and long-term outcomes associated with ADHD, especially if combined with medication ( 3 , 9 , 28 , 29 ). However, some studies indicated that treatment with a combination of medicine and psychosocial treatment has little or no better result compared to medicine only treatment ( 20 , 30 , 31 ). The Multimodal Treatment Study of Children with ADHD (MTA) compared four treatment options in a 4-group parallel design. Combination treatment and medication management were both significantly superior to behavioral treatment and community care in reducing the symptoms. In certain conditions (such as oppositional-defiant/aggressive symptoms, internalizing symptoms, teacher rated social skills, parent-child relations, and reading achievement), combined treatment was superior to behavioral treatment and/or community care ( 21 ).

On the contrary, other studies have demonstrated incremental results for adding behavior therapy to psychostimulant medication in terms of reductions of ADHD symptoms ( 32 , 33 ). Similarly, psychosocial interventions such as ICPS have been found to be effective for children with ADHD ( 34 ). In support of this, some studies have reported that, psychosocial therapies provided along with medication had positive effects on comorbid internalizing and externalizing behaviors ( 35 , 36 ). Diller and Goldstein ( 37 ) have emphasized: “more than one hundred studies demonstrate that parent and teacher training programs improve child compliance, reduce disruptive behaviors, and improve parent/teacher-child interactions and a number of short-term studies have scientifically demonstrated the effectiveness of psychosocial interventions for ADHD”.

Problem-solving strategies that is one of psychosocial treatments engages both the cognitive and social skills that arise from daily life experiences. Problem-solving skills are considered an important aspect that effects how one reacts and deals with these problems ( 38 ). ICPS program might be useful for both children with and without medication and may contribute to reductions in problematic behaviors. These strategies may also reduce the severity of comorbid disruptive disorders and emotional problems. ICPS training improve problematic behaviors by engaging children in thinking about their actions, the impact of their behavior on themselves and others, the possible consequences of their actions, and other options they have. However, previous studies evaluating the effectiveness of ICPS program in normal children ( 12 , 39 ) concluded that that non-ADHD children with naturally developed problem-solving thinking skills and behavior strategies benefit from ICPS as well as children with ADHD ( 12 , 38 ). There are limited studies related to children with ADHD in the literature to evaluate the effectiveness of ICPS program which we used in our research ( 12 ). In one of the initial studies with single subject design, Shure (1999) has cited that, Aberson (1996) taught ICPS to parents of 3 children with ADHD (12. ??, problem-solving skills and behavior may be improved through the use of ICPS strategies. It is important to recognize that children with ADHD trained in ICPS might learn how to find alternative ways to express their anger, handle anger, and to recognize consequences of their behavior. However, the above mentioned improvement in social and emotional adjustment lasted 4 years after training ended ( 40 ). In another study ( 10 ), also with single subject design, ICPS was conducted to teach 8 children with ADHD who already had been maintaining treatment with psychostimulant drug. While the researcher was teaching ICPS to 8 children with ADHD at an observation class, their mothers observed the ICPS lessons. The mothers applied the learned strategies to their children and used the ICPS dialogs during problem-solving process at home in real-life situations. It was suggested that ICPS program may make an additional contribution into the children treated with a psychostimulant medication to deal with their problems. In parallel with the emphasized idea of the studies ( 12 , 40 ), our data have shown that both ADHD related symptoms and non-ADHD related symptoms were observed to decrease through the use of ICPS strategies.

It was proposed that children with ADHD would need help in learning those skills and the training should be provided in a controlled setting, although normal children might easily learn problem solving skills ( 15 ). Aberson et al. ( 40 ) emphasized that, such initiatives, if applied under special circumstances, could have significant effects on problematic behaviors in children with ADHD. These special conditions were meant for parents to teach their children the skills, and to implement ICPS childrearing techniques altogether; the child learns to internalize the newly acquired skills, and to adapt them to real life. Children with ADHD may need help to generalize and internalize these skills because they could have difficulty to adaptation these skills for a changing environment and generalizing to conditions in real life. In addition, because, rehearsals through games could complement these techniques, during our study, drama and envisaging techniques were used in order to enhance and generalize the acquired skills.

The limitations of this study include: small sample size and the absence of a control group. Other significant limitations of the study could be regarded as not making a comparison with other treatment modalities and, the grading scales used were based on declaration rather than being objective. The present study was planned in a pre-posttest quasi-experimental design with one group. Further research comparing ICPS with other treatment modalities and different factors are needed.

Conclusions

ICPS training based on Interpersonal Problem Solving skills may reduce the level of problems in behaviors of children with ADHD and increase the quality of interpersonal communications. Although American Pediatrics Academy ( 41 ) stated that, psychosocial interventions were found to be effective in treating mild and moderate symptoms of such cases as in the ADHD treatment guidebook published, there is not sufficient evidence for this treatment to be applied alone. Hence, integrated and multimodal treatment approaches may be more convenient hypotheses. ICPS training is relatively easy to learn and to utilize in school settings, and may be conveniently used by most disciplines working with children. Consequently, it is thought that, the ICPS is beneficial training for children with ADHD in order to modify problematic behaviors that interfere with quality of learning, socialization and overall quality of life.

Process of the study

Conflict of interest: The authors reported no conflict of interest related to this article.

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Adults with ADHD see a problem, then lose control

December 2007, Vol 38, No. 11

Print version: page 12

Adults with attention-deficit hyper-activity disorder (ADHD) are ruled by their impulses when faced with a problem to solve, says a study in the September Neuropsychology (Vol. 21, No. 5). A study group composed of adults with ADHD and controls demonstrated a marked difference in problem-solving strategies, with the ADHD group chucking planning out the window in favor of haste.

"You could say they favored speed over accuracy," says study author Susan Young, PhD, a clinical psychologist at the Institute of Psychiatry in London.

Young and her team tested the groups with an assignment known as the Tower of London task. In the task, participants are shown three rods on a computer screen with rings of various sizes hooped around the rods. By touching the screen, participants can move the rings around to different rods and stack them on top of each other in various arrangements. At the top of the screen is a target arrangement that participants are supposed to match by moving the rings around. There are varying degrees of difficulty, with different puzzles requiring a minimum of three moves, four moves or five moves.

Young and her team initially tested the participants' motor speed as they touched the screens. Then, she measured their planning times, or the period between the puzzle's appearance on the screen and participants' first move.

On the lower-difficulty puzzles, the ADHD group and the control group spent about the same amount of time planning for the puzzles. But as the difficulty increased, the control group took more and more time to plan, while the ADHD group plowed through at a constant planning pace. As a result, the ADHD group's overall accuracy on the puzzles declined.

"The people with ADHD didn't give themselves any time to figure out what they were going to do," Young says. "Instead, they employed ineffective, haphazard strategies."

Using measurements from the DSM-IV checklist, Young was able to correlate this lack of planning with symptoms of impulsivity. So her results might not be limited to people with ADHD, she says, but could also include other cognitive disorders characterized by impulsivity.

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The Positives – there’s so many!

The most important part of raising a child with ADHD is to recognise their attributes . Focus on the positives and leave the negatives out! Remember – your child has a very different brain which makes him/her remarkable.

• Innovative and imaginative, lateral thinking
• Readiness to volunteer
• Kind, friendly and outgoing demeanour
• Good rapport with younger children
• Rises to a challenge if given responsibility
• A keen sense of justice and fairness

Visit https://adhdembrace.org/famous-adhd to see the well-known people who have/had ADHD and yet gone on to reach great heights.

Curious, Problem Solving Ability : ADHDers thrive on solving problems and puzzles. Give them an interesting problem to solve and they won’t be able to drop it until they’ve found the solution! Inventor Thomas Edison is believed to have had ADHD

Creative : Hands-on jobs are great for those who are restless or easily bored at a desk. They often offer the use of creativity and problem solving skills — areas people with ADHD often excel in. Research supports the common idea that people with ADHD are more likely to reach higher levels of creative thought and accomplishment. The racing ideas in the minds of people with ADHD can contribute to creative thinking. Writers, painters, musicians, film makers, designers, sculptors, comedians – the list goes on! Artistic talents are abundant. Composers Mozart and Beethoven are believed to have had ADHD.

Energetic: Yes, we all know about the hyper-activity but turn that to good use! It’s no secret that thoughts are constant and moving very fast for most people with ADHD. Harnessing that attribute can mean success on the job.  They thrive in an environment that is stimulating.

Eager: Many people with ADHD are motivated by interest and urgency. Jobs where you’re passionate about the subject matter provide motivation and focus, which can help you succeed. This can be any field that you have a deep interest in — the sky’s the limit. 

Sees connections others miss : Many ADHDers feel that they have a unique way of looking at the world, a perspective that others just don’t understand. You might say that they’re on their own wavelength!

Hyper-Focussed : The ability to hyper-focus is something that can be used to advantage. When kept under control and directed towards productive tasks, like accomplishing goals and living dreams, it can be an incredible asset that allows tem to get the job done, and done well!

Spontaneous

Persistent and Driven : When an ADHDer is bored with a task, completing it can seem like torture. But give them an interesting project to work on and watch out! When they want to succeed, and have the necessary tools to do so, there is no stopping them!

Entrepreneurial: Not only does an entrepreneur start their own business, but they are willing to take risks and think innovatively. Those are two positive skills inherent in many people with ADHD. It must be a field they are passionate about though, since running a business also requires areas where people with ADHD struggle, such as planning, organization, and self-motivation. Successful entrepreneurs with ADHD include Sir Richard Branson, founder of Virgin Group; David Neeleman, founder of JetBlue Airways; and Ingvar Kamprad, founder of IKEA.

Sense of Humor/Comedic Flair : Most ADHDers love to laugh, and many also have a knack for making others laugh! Famous comedians with ADHD include Whoopi Goldberg

Resiliency : There’s no denying that even though there are many great qualities that come along with ADHD, there are also challenges. But ADHDers have an incredible ability to bounce back from those challenges and to keep moving forward.

Intuition : ADHDers have a sharp sense of intuition. This may be due to highly tuned levels of perception, or great insight into the human mind, or something else that we have yet to understand. Whatever the reason, it’s a very useful gift!

Idea Generating : ADHDers are wonderful idea generators. They don’t usually like to be bothered with details, but can come up with ideas at lightning speed! They’re a true asset in brainstorming meetings.

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What is the theory behind this ADHD Problem Solving Worksheet?

Problem solving skills are a part of executive functions of our brain. A common symptom of ADHD is executive dysfunction which means children have a hard time dealing with these complex functions. They need to be taught these crucial life skills to enable them to adjust with their condition just as well as their peers. 

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CBT Must Be Adapted for Adults With ADHD

The case for adhd-adapted care when using cbt..

Posted July 5, 2024 | Reviewed by Kaja Perina

• What Is ADHD?
• Take our ADHD Test
• Find a therapist to help with ADHD
• Cognitive behavioral therapy (CBT) adapted to adult ADHD is an established, evidence supported treatment.
• Research on CBT for adult ADHD included assurances that study therapists were appropriately adapting it.
• A recent study from the UK used adult ADHD clients' feedback on their experiences in CBT in community care.
• When not adequately adapted and conducted by therapists unfamiliar with adult ADHD, clients do not benefit.

Cognitive-behavior therapy (CBT) has achieved the status of an evidence-supported psychosocial treatment for adult ADHD as determined by Division 12 (Society of Clinical Psychology) of the American Psychological Association. 1 CBT is also the psychotherapy treatment of choice for adult ADHD in the UK per the National Institute for Health and Care Excellence (NICE), which also published treatment guidelines for the diagnosis and management of ADHD. 2

These are positive developments for the treatment options for adults with ADHD, as CBT combined with effective medication treatment is a potent, effective one-two punch. The forthcoming inaugural US guidelines for the assessment and treatment of adult ADHD will provide yet another summary of the standing of CBT for adult ADHD in the overall treatment planning options for adult ADHD.

The Need For Access to ADHD-Adapted Care

But an ongoing stumbling block with all existing, research-supported treatments for adult ADHD is access to expert or at the very least ADHD-competent care. A recent study of the experience of adults with ADHD who received CBT in the UK through routine, community practices illustrate the importance of access to expert care and ensuring that treatment, in this case CBT, is adequately adapted to the needs of adults with ADHD. 3

Problems When CBT Is Not ADHD-Adapted: Recent Research

Forty-six adults (33F/13M) were surveyed, and another ten adults (7F/3M) participated in semi-structured, in-depth interviews regarding their treatment in CBT for adult ADHD. Therapy was provided by either National Health Service (NHS) clinicians, independent providers, and a few participants were unsure of their therapist’s affiliation.

The three main themes that emerged from surveys and interviews were (1) difficulties with the general CBT approach, (2) difficulties with the therapists, and (3) the lingering consequences of their therapeutic experiences. When CBT was not adapted to ADHD and was conducted by a therapist inexperienced with adult ADHD, the generic approach was rated as not relevant to their needs and ineffective. Moreover, following a rigid structure in each session and having only a limited number of sessions was also unhelpful in terms of not being tailored to the needs of adults with ADHD for skill development. Core facets of adapted CBT for adult ADHD that make it effective 4 were ignored, such as executive functions , working memory problems, and emotional dysregulation issues. The exclusion of these therapeutic elements meant that even the overarching goals for treatment did not seem relevant to the clients.

These disconnects between the therapists understanding of and experience working with adults with ADHD, which informs effective delivery of the adapted CBT approach, unsurprisingly led to less than ideal therapeutic relationships, which is an important part of CBT, generally, and especially for adults with ADHD who are so often misunderstood in their day-to-day lives.

Lastly, most participants reported that they gained extraordinarily little from treatment, including reports of feeling worse off and less hopeful about their prospects than before.

Conversely and importantly, one participant reported that effectively adapted CBT for adult ADHD delivered by a therapist who identified as having ADHD was a collaborative and helpful experience. This client found the well-adapted CBT to be “very transformational,” gaining a better understanding of how their mind works and how to collaborate with it.

Relevance of Problems with Non-Adapted CBT for Women with ADHD

It is important to note that of the 56 clients who either completed surveys or were interviewed, 40 were women. This is important because women with ADHD often get diagnosed later than males because their problems are often first identified as stemming from depression or anxiety , which often co-exists with ADHD, but because of ADHD.

Hence, most therapists are well-trained in identifying and treating depression and anxiety and not at all in identifying and treating adult ADHD, so they go with what they know to do. If all you have is a hammer, all you see is a nail. But these frustrations only further delay effective treatments for women with ADHD and might lead many to abandon hope, altogether.

The Need for Adequate Clinical Training in Adult ADHD

An embedded issue in the results of this study and for all the excellent and forthcoming assessment and treatment of adult ADHD guidelines is that they will not magically make clinicians competent in the assessment and treatment of adult ADHD, especially for psychosocial clinicians delivering evidence-supported CBT for adult ADHD on a person-by-person basis.

Even the clinician-researchers who developed the CBT manuals for adult ADHD will say that their approaches should be used flexibly in clinical practice, tailoring the steps and the session order to the needs of clients, which requires an understanding of the experience of their clients.

None of this means that clinicians themselves must have ADHD to provide competent and collaborative care. Instead, the “accurate empathy” that is a cornerstone of CBT means experience and understanding that helps clinicians be able to see the world through their clients’ eyes in a way that make the treatment and the therapeutic relationship effective, empowering, and safe for doing the challenging bur rewarding work of coping with ADHD.

1 https://div12.org/treatment/cognitive-behavioral-therapy-for-adult-adhd/

2 National Institute for Health and Care Excellence (NICE). (2019). Attention deficit hyperactivity disorder: diagnosis and management . Author. PMID: 29634174.

3 William, S., Horrocks, M., Richmond J., Hall, C.L., & French B. (2024). Experience of CBT in adults with ADHD: a mixed methods study. Frontiers in Psychiatry, 15 , 1341624. doi: 10.3389/fpsyt.2024.1341624

4 Ramsay, J. R. (2021). Adult Attention-Deficit/Hyperactivity Disorder. In A. Wenzel (Ed.), Handbook of cognitive behavioral therapies, Volume 2, application (pp. 389-421). American Psychological Association. https://doi.org/10.1037/0000219-012

J. Russell Ramsay, Ph.D., is a licensed psychologist with an independent virtual practice. He is retired as a professor of clinical psychology at the University of Pennsylvania’s Perelman School of Medicine.

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The rise of adhd: 5 ways to address sleep challenges.

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Sleepless woman suffering from insomnia

In recent years, the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) and sleep challenges among adults has surged, significantly impacting the workplace. According to recent data by the Centers for Disease Control and Prevention, ADHD reports in the US have increased by 37.3% from 2003 compared to the latest ADHD stats in 2019. With approximately 8.7 million Americans diagnosed with ADHD, it's crucial to recognize how ADHD can affect your sleeping routine, with 25-50% of ADHDers experiencing issues like insomnia, sleep apnea, and more.

The Growing Concern of ADHD in the Workplace

As remote work blurs the lines between professional and personal life and digital distractions become ubiquitous, understanding and addressing these issues is crucial for maintaining productivity and employee well-being.

ADHD, traditionally considered a childhood disorder, is increasingly recognized in adults. According to the National Institute of Mental Health, approximately 4.4% of adults in the United States have ADHD, a number that is likely underestimated due to underdiagnosis and misdiagnosis. ADHD in adults often manifests as difficulty in concentrating, hyperactivity, and impulsivity, which can significantly impede work performance and career progression.

The U.S. has witnessed an increase in ADHD cases reported since 2003. When comparing 2003 data to 2019, Utah comes out on top with an increase in reports by 96%, with 10% of parents reporting that their child has been diagnosed with ADHD. Colorado also witnessed an increase in ADHD diagnoses, with cases rising by 93%, respectively, over the past decade and a half.

Impact on Work Performance:

1. Attention to Detail: Individuals with ADHD may struggle with tasks requiring sustained focus and meticulous attention to detail, which can lead to errors and decreased productivity.

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2. Time Management: Procrastination and difficulty managing time effectively c an result in missed deadlines and constant overwhelm.

3. Interpersonal Relationships: Impulsivity and difficulty regulating emotions can strain workplace relationships, leading to misunderstandings and conflicts.

The Silent Epidemic of Sleep Challenges

Simultaneously, sleep challenges have become a silent epidemic, exacerbated by modern work habits and lifestyle choices. The National Sleep Foundation reports that 45% of Americans say that poor or insufficient sleep affects their daily activities at least once a week. Chronic sleep deprivation and disorders such as insomnia are linked to numerous health problems, including impaired cognitive function, mood disorders, and decreased immune function.

The Intersection of ADHD and Sleep Challenges

Research indicates that there is a significant connection between ADHD and sleep disorders. According to the Sleep Foundation , 25-50% of individuals with ADHD experience sleep issues, including insomnia, narcolepsy, and sleep apnea. These problems are related to neurological factors such as disruptions in circadian rhythms and overactive thoughts, which make sleeping difficult.

Expert Insights and Tips for Improving Sleep in Individuals with ADHD

Shelley Farnham, Founder of Complex Connexions CIC said: “ADHDers may struggle to switch off in the evening and make that transition to go to bed and then to sleep. If they’ve struggled to complete tasks during the day due to procrastination or finding it difficult to initiate tasks, and they are then able to start those tasks late in the day, it can be difficult to stop as they’re unsure when they’ll be able to get back to being productive. They may make that transition to get to bed, but then find it difficult to calm their racing thoughts enough to fall asleep.”

A healthy sleep routine and sufficient sleep allow the brain to function better, especially for individuals with ADHD. Martin Seeley, Sleep Expert and CEO at MattressNextDay , offers practical tips to address these challenges:

1. Establish a Nighttime Routine:

Use reminders on your phone or apps like Bedtime or Sleep Cycle to help you wind down for bedtime.

2. Avoid Stimulating Tasks Before Bed:

Keep a notepad by your bed and write down tasks you're thinking about doing, so you can revisit them at a more appropriate time.

3. Limit Screen Time:

Try to avoid screens at least an hour before bed and keep your bedroom screen-free. If you need your phone as an alarm, consider charging it across the room.

4. Create a Relaxing Sleep Environment:

Introduce some small changes to your sleep environment to make it more relaxing. Consider using a relaxing pillow spray, changing your sheets, or journaling before bed.

5. Choose the Right Mattress:

Some individuals with ADHD struggle with hypersensitivity, so investing in the right bedding, such as weighted blankets, cooling pillows, and soothing pillowcases, can help improve the sleep experience.

Last but not least, discussing these options with your coach or therapist can help you find new ways to adapt your sleep current and make it less stressing.

The increasing prevalence of ADHD and sleep challenges makes it crucial for employers and employees to acknowledge and tackle these issues. Creating an atmosphere of empathy and assistance can help companies improve employee well-being, productivity, and overall organizational success. In a world where mental and physical health are becoming more intertwined with professional performance, taking proactive measures can have a significant impact.

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Problems Solved!

Adhd parenting tips for helping your child learn problem-solving skills that will help her achieve success at school and at home..

It’s no secret that impulsivity is a key ADHD trait.

For children with attention deficit, this may bring more than its fair share of challenges, from acting on impulse to repeating the same problems over and over. It also makes it more difficult to overcome challenges .

A child with ADHD may rush into grappling with a problem without thinking it through, and it’s our job as parents to help them break this habit.

Instill Self-Reliance

Methodical problem-solving doesn’t come naturally to children with ADHD, but it can be taught. And learning to tackle challenges on his own, using solutions he came up with, will boost your child’s self-esteem .

Here’s how three parents built their children’s problem-solving skills while meeting three tough challenges:

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#1: Jill and her mom had nightly fights over homework.

At the end of a rough week, Jill’s mom sat down with her daughter. She asked, “What can we do about the homework battles that make us both unhappy?”

Jill told her mom she felt “bottled up inside” when she came home. They brainstormed a few solutions. Jill proposed walking the dog before starting homework, or having her mom help her prioritize her assignments. Mom suggested setting a timer — and racing to beat it — while working on each subject. She also offered to fix a healthy snack, “for munching between tasks.”

After discussing, and discarding, many ideas, Mom asked, “Which solution do you want to try first? It’s OK if it doesn’t work. We can try a different idea next week.”

Jill decided to have her mom help her arrange her work on the dining-room table. The next week went much better. When her mom asked, “How do you think your plan worked?” Jill gave herself credit for being a good problem-solver. They also decided to add the munchies.

[ Never Punish a Child for Behavior Outside His Control ]

#2: Karen was sad because no one wanted to play with her at recess.

Her mom and dad decided to hold a family meeting, to solicit suggestions. Sam, her big brother, said, “Karen always asks her friends to play her game.” They developed a list of ideas. Karen decided to invite two girls over for a play date , but didn’t think the idea was successful. “I still can’t get them to play what I pick,” she said.

Next, Karen decided to try joining in whatever activity other girls were already playing at recess. At that week’s family meeting, Karen smiled and said, “It’s more fun to try new games than I thought it would be.” Karen’s parents told her she should be proud of herself for finding a solution.

#3: Robert was always yelling at his little sister.

Each outburst left her feeling hurt and Robert feeling guilty. One evening, Robert and his dad sat down to talk about it. “I think your sister wants your attention. When she can’t have it, she does things to annoy you, and you respond by yelling,” said Dad.

Armed with this insight, Robert came up with ideas. “Let’s lock her in her room,” he suggested. Dad didn’t think that would be fair. Finally, Robert came up with a plan: “I will tell Sara that I will play with her after school for 20 minutes. If she doesn’t bug me, I’ll add five minutes. If she bugs me before our playtime, I’ll take away five minutes.”

At first, Robert’s sister lost playtime, but after a few days, she began to earn extra minutes. Robert invited Sara to join in the evaluation session, and she said she liked the time they spent together. “I guess we won’t have to try the ‘lock up’ idea,” he said with a smile.

[ Positive Charge: How to Reinforce Good Behavior ]

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