Coaching Through the ADHD Life Cycle: Advice for Each Age and Stage
ADHD is a life-long condition, one that impacts patients through school and into their adult lives — perhaps into retirement. Although the condition is steady, its challenges are forever changing. An effective coach is one who is prepared to offer different strategies for different stages of life, from elementary school through adulthood. Here are some common challenges during each major life stage, and tactics that deliver results.
Attention deficit disorder (ADHD or ADD) is not merely a pediatric condition. It lasts a lifetime, evolving and changing with time, environmental and emotional stressors, hormones, and age. As such, challenges may change drastically as a patient progresses from elementary school through high school, and beyond into higher education and adulthood. Here, I address the most common ADHD challenges associated with each developmental phase, and offer advice for helping patients of all ages.
ADHD Coaching for Elementary School Students
From grades 1 through 5, students work to build a foundation in three main areas:
- Reading acquisition. Sitting and reading can be exhausting, physically and mentally, for students with ADHD who struggle to focus.
- Math skills. Distracted or bored students with ADHD often make what teachers often label “”silly mistakes – such as missing a digit or adding incorrectly.
- Understanding the social contract. Grade school is not only about academics. Children are also learning how (and why it is important) to control and regulate their emotions, express themselves with their peers, and moderate their behavior in the classroom.
Research shows that positive reinforcement is the only strategy that really works for students with ADHD. When elementary students struggle, negative consequences – punishment and harsh reactions – only further destroy their confidence and self-concept.
To make the biggest impact, set a time to discuss disruptive behavior outside of the classroom, after the immediate, stressful moment has passed. In that setting, tutors, counselors, or coaches can break down the moment, discuss possible causes of the behavior, and offer strategies to students, parents, and teachers.
Place a small stop sign on each student’s desk. Then, teachers can point to the sign to signal that a behavior adjustment is needed without bringing the whole class to a halt or singling out a student in front of his peers.
Use yellow index cards with black ink to break material into flashcards. This color combination is easily processed by the brain for memory. Students can use the flashcards for reading acquisition or any type of studying. This tool may help them take ownership of learning new words or memorizing new facts. When they see good results, their engagement and interest will inevitably increase.
ADHD Coaching for Middle School Students
In middle school, organization grows more complicated and schedules more complex. Students begin to use lockers and change classrooms; these transitions can be difficult. The extra demands on executive functions often drive parents to seek a coach’s help. Some strategies for success include the following:
- Create a homework system that helps the student:
- Know what is assigned
- Keep track of completed work
Even if the homework is listed on a school website, the physical task of recording it and prioritizing it makes it real, improves their executive functions, and provides and opportunity for positive reinforcement when they complete a task and can cross it off of their own list. Reach out to teachers, asking them if they might be open to emailing assignments until the student has mastered this transition.
- Break down the writing process. Writing assignments grow more complex in middle school, and they get harder from there. Many students with ADHD are overwhelmed by a blank page. Coaches can help them understand that a piece of writing is never perfect at the outset. Explaining how to edit a first draft, and how to move sentences and paragraphs instead of scrapping a draft and starting over is a valuable lesson and important skill set to master. Students will use this lesson through middle and high school – and even into college.
- Focus on building weak academic areas. Quizlet and Khan Academy are excellent resources to bolster learning in challenging subjects. But don’t just use them on the screen. Manipulate the information in various ways to help a student store and keep it in his memory. Print it out, write things down, combine study strategies that work for the individual.
ADHD Coaching for High School Students
In high school, teens learn to balance academics with an expanding social life. Their independence is growing, but they still benefit from parental help. Coaches can help families work through that transition with these tips:
- Create a system for managing electronics. Technology is a hot-button issue in most households. Many teens don’t get enough sleep because they are using some type of electronic device late into the night. Phones, tablets, and computers are unhealthy before bed. The blue light they emit interferes with sleep; having them in the bedroom also makes it difficult for parents to separate teens from their technology.Coaches can help find an arrangement acceptable to everyone – such as a basket at the bottom of stairs where devices are placed before bedtime, or a charging station in the pantry. The sooner parents put these systems in place, the easier it is to make sure everyone gets the sleep they need.
- Establish a routine for dealing with an online grade book. Systems like PowerSchool and Canvas can create conflict in families when parents confront unsuspecting teens about grades they might not even know had been posted yet. Coaches can help parents and teens set a time to check “report cards” together, review grades, listen to explanations, and communicate with teachers as necessary.This system should not deprive children of opportunities to negotiate and practice their executive function skills. They should understand it is their responsibility to follow up with teachers and to own the process of presenting and explaining their grades to coaches, tutors, and parents.
- Create a goal tracker to help students practice organization and executive-function skills. Instruct teens to create a to-do list and then estimate how long they expect each task to take. Finally, they should record the actual time each task took. This can help high-school students see where they are underestimating the amount of time needed. Learning to budget an hour instead of a 45 minutes can change the dynamic at school or at home. Students can use this tool as a reference to organize and prioritize – even after coaching sessions end.
- Ask, “Are you procrastinating or are you avoiding?” Then, talk it through to figure out what the teen is avoiding.
- Share the importance of having a defined space for work. Students must learn to put themselves in a quiet place, and to create a starting process with a list that breaks down tasks ahead. Together, these strategies can lessen procrastination and help students make quick progress on the tasks at hand.
- Explain the concept of pills AND skills. Many younger patients don’t realize that medicine doesn’t necessarily make them focus on academics. It may help them focus on whatever is in front of them, even if that is a video game. Explain the way medication can help them practice and improve skills, but that it does not work in isolation.If medication is part of the solution, let patients know is not only all right but even expected to try different medications and/or dosages under a doctor’s supervision. They should not give up immediately if the first prescription doesn’t work; it rarely does. Describe the value of nutrition, exercise, sleep hygiene, and structure. Balanced meals, 30 minutes of physical activity, and taking medication at the right time can create a significant increase in cognitive ability.
ADHD Coaching During a Gap Year
Teens with ADHD often benefit from a thoughtful and well-structured gap year that allows them to build skills as evidenced by the phone calls that often inundate coaches during the first semester of the freshman year of college. College students often report that the scaffolding of high school fell away, and suddenly they found themselves managing academics, their social life, and their laundry. Putting that all together for the first time is overwhelming, particularly for students with executive dysfunctions.
Don’t merely recommend that your clients take a year off. Students need a plan. They can apply to colleges, then defer acceptance for a year in order to participate in a career-focused internship, travel, or do volunteer work. Many programs allow students to earn college credits during a gap year or semester. A structured gap year can help encourage freshman year success by building confidence and skills.
ADHD Coaching for College Students
Choosing the right university is essential in helping students with ADHD succeed after high school. You can help your clients by doing the following:
- Find the best college fit for each student. This doesn’t necessarily mean pursuing the highest-ranked or most prestigious colleges. It means researching which courses are offered, which are required, and whether language waivers are available before deciding to apply or attend. If your student has always struggled with languages, for example, ask if sign language is an acceptable substitute.
- Research the disabilities office. Find out what accommodations are offered. Encourage students to call and talk to a counselor. Some schools offer a distraction-free room for taking tests, while others offer extended time. Other valuable accommodations include:
- A note taker is often another student, but it’s even more useful if the professor shares notes ahead of class so the student can review them in advance and add to them during the lecture.
- Help choosing classes can mean support in identifying content, professors, and assignment types that are a good fit for a student’s learning style. For example, a student who struggles with writing may want to seek out courses with multiple-choice tests.
- Priority registration can help students take the classes that best suit them.
- Breaking testing into shorter sections. For some students, chunking up long tests works better than extended time.
- Recording lectures. Listening to learn is a great technique. At some schools students can sign up to receive textbooks as audiobooks.
- Organize and schedule the semester. Gather all of the student’s syllabi, lay out assignments on a master calendar, and look at the entire semester. When is the test? When is the midterm? When are papers due? How can he best fit in parties and the social aspect of college? It all goes back to that seemingly simple advice – make a plan.
- Encourage students to visit professors. An important piece of college is overcoming the fear of talking with teachers about things that are painful or embarrassing. Meeting with professors allows students to hear new and nuanced descriptions of course material that they would not learn without office hours.
ADHD Coaching for Adulthood After Graduation
ADHD is a life-long condition. Coping with its vagaries can mean that adult clients need help with the following:
- Trying cognitive behavioral therapy (CBT)
- Testing to find an ideal career or area of strength
- Improving a resume
- Practicing interview skills
Patients often come in during major life changes such as becoming a parent, getting divorced, or recovering from addiction. They are overwhelmed and are looking for a place where they are accepted and feel safe discussing their struggles and concerns.
A survey of my patients found that their strongest need is to hear that they aren’t broken, that they don’t need to be ashamed. Although each day will not be easy, with coping strategies, there is a very strong possibility that, as I tell my own clients so many times, “Everything will be fine”.