How are those Resolutions Going?

What ADHD, Accommodations, and Follow-Through Have in Common

By Dr. Brittany Sterling

We’re one month into the new year. A quick search on the internet reports about 80% (or more) of new years’ resolutions “fail.” For those of us who made resolutions, we’ve probably done some homework in an effort to not play into that statistic. For others, we don’t participate at all, perhaps in part because past efforts haven’t yielded much success. People will point out that New Year’s Day is an arbitrary starting point, that there’s too much pressure to succeed, etc. For those of us with ADHD, these dynamics are in play daily. Every day holds pressure to perform better, disappointment that we couldn’t meet the mark, and the dare to hope we can do better next time.

Many of us learn about ADHD through a school’s response to a child receiving the diagnosis. This tends to come in the form of accommodations. Intentionally or not, what is being communicated is that for this child to be successful, they will need accommodations from their environment.

It is true that accommodations from one’s environment are a helpful strategy for managing ADHD. Folks with ADHD tend to benefit from movement breaks, routine, structure, breaking tasks into smaller steps, working in small groups or with a partner, sitting at the front of the class, having access to fidgets, etc. What is equally true is that this child will be even more successful if they learn about how they function. Much of that can come from noticing how they respond to those accommodations and working with individual providers.

There is another accommodation that can often come with an ADHD diagnosis. That “other” accommodation is a caregiver who will work very hard to support their child. This accommodation is a wild card. Supportive caregivers are amazing! …Sometimes supportive caregivers can also accidentally disrupt a natural process from playing out. Caregivers want to protect their children while also wanting them to develop grit and resiliency. It is not uncommon for any of us to feel some additional responsibility for our children when we first recognize they have a learning difference or developmental delay.

ADHD is not new and nature makes us earn our keep. For natural selection to not eliminate ADHD from humanity, ADHD had to fit the broader landscape. There are examples of ADHD fitting in a world designed for all of us, not just the neurospiciest among us. Researchers found evidence that those with ADHD were likely better at foraging. Many of us with ADHD are deeply caring and fun to have around – making us great team members. Our gorgeously complex brains have systems that can temporarily make someone with ADHD function more like our neurotypical peers. For example, adrenaline helps us initiate tasks and hyperfixate. Our brains also see belonging as a fundamental need, which makes sense when you compare the odds of a one-year-old shark surviving on its own compared to that of a one-year-old human surviving on their own. Our brains registering belonging as a fundamental need can motivate us to do things if we perceive those behaviors as increasing our chances of fitting in. Nature has provided its own accommodations to support individuals with ADHD!

Our world is changing in such a way that natural consequences are more easily avoided. These days we’re blessed with an abundance of comforts. For many of us who are most privileged, we don’t often feel any sense of risk or instability. With increased comforts, we’ve seen gradual shifts in fashion, diet, exercise, work, healthcare, and education. We could spend our lives at home, in sweatpants, with ready-made meals delivered to our doors, interacting with others solely through Zoom, Facetime, email, social media, and video games. In general, it has become much easier to not leave our comfort zones. That’s a tough one for ADHD. Our brains don’t love a high-demand task so matching that to a lifestyle designed to eliminate them can actually be a real challenge. Caregivers of those with ADHD can make meals for us, micromanage our homework, clean the house for us, and absorb much of the responsibilities that might have been trickier to share decades ago. When you have a brain that thirsts for immediate gratification and easy reward, an environment that eagerly supplies it doesn’t encourage trying anything else.

We can provide scaffolding that ensures a degree of safety. Let’s use homework as an example. It is appropriate to teach a child where in the classroom they can find the homework assignments for the day. Some great scaffolding could be prompting that child to write down their homework assignments in the same spot every day, at the same time of day, until they get in a rhythm and do that independently. We could take it a step further and have “office hours” at home when you, as the caregiver, will be sitting at the dining table doing work every weekday at the same time with the invitation that all are welcome to join you in completing their own work. You are providing a visual prompt for your loved one to ask themself if they have work that needs to be done. You are also providing a welcoming, safe environment where they can feel connection and benefit from body doubling to keep them focused and keep the work progressing. A punitive addition would be to say your loved one needs to sit at that table with you every day at the same time and can’t leave until the assignment is done. That may make them feel like they’re crawling out of their skin, needing to wiggle, needing more stimulation, and risking connection with a loved one if they respond to those needs. The trickiest part here is that your loved one may choose not to join you at the dining table. Depending on the age of this individual, it is appropriate to let them make that choice and navigate the negative consequences. Your role becomes that of the person who does not shame or judge them and instead validates how hard these moments can be.

Supporting loved ones with ADHD is a nuanced process. Something may work for a while then stop working entirely. As a caregiver, it is important for you to have regular connection to others who understand ADHD and can offer validation and support. Partnering with providers can provide insights as someone joins you in the complexity and uniqueness of your specific family and the demands you’re facing. If you suspect you’ve been shielding your loved one from natural consequences too often, I suggest you let your loved ones try and fail. It’s uncomfortable to watch. It also helps.