Ask the Experts

Q: Is My Child’s Chronic Indecision Tied to ADHD?

My son agonizes over even inconsequential decisions, taking forever to consider his options and then ultimately basing his choice on how other people act. Is this analysis paralysis a symptom of his ADHD? How can I help him?

Q: “My son is 9 years old and diagnosed with ADHD — emphasis on the H. My son has trouble making decisions. This is increasingly impacting daily life. His analysis paralysis seems rooted in anxiety. This includes decisions about what to wear, what to eat, picking something out at the store with a gift card, really anything. He will say “What do you think?” Or “What are you eating?” Often he’ll just choose based off what someone else has chosen. Either way he’s never really settled or happy with whatever decision is made. I have tried to direct the choice back to him, help him narrow down choices, give more time, think about it ahead of time, etc. None of this works. How is this (or is this not) tied to his ADHD brain?” — Anonymousmom

Hi Anonymousmom:

Short answer? Yes. The inability to make certain decisions is directly related to the ADHD brain. When working with students, I have found that decision-making becomes impaired for these main reasons:

  1. The options are open ended. There are simply too many choices to sift through and the brain just can’t process all the choices.
  2. Lots of information must be processed to get to an appropriate decision. The decision might be too big or too vague. Or the child can’t hold all that information in his or her working memory.
  3. The decision requires sequencing or prioritization, which young ADHD brains have a tough time doing. Meaning, they might have a hard time prioritizing tasks because all the options have the same level of importance. Or the notion of “If I chose this, then that might happen next,” is foreign to them.
  4. They fear making the wrong decision. Or, even worse, regretting past impulsive decisions that went terribly wrong.

So how can we help the decision paralysis? Here are a few of my favorite tips.

1. Limit choices. Visually. I know you mentioned that you have helped him narrow down choices. But have you tried visual limits? When my son was younger, too many choices put him into paralysis. By limiting the amount of clothing in his closet, the snacks in the pantry, the toys and games in the den, etc., the work to make a decision became much easier.

2. Remove unnecessary stimuli. What does that look like? Whenever possible, remove the decision making from a noisy or cluttered or over-stimulating environment. Take two clothing choices for the day and leave them in the bathroom for your son to consider. This way there are no other competing choices to get in his way.

I had a client once whose daughter had the same difficulties. So instead of taking her daughter to clothing stores where she would get overwhelmed and shut down, she brought the decisions home to her by ordering several good options and returning any rejected ones.

3. Play “this or that.” Do you want to start on your math or your science homework? Chicken or pasta for dinner? Black or blue ball? Here, you set the parameters and your son negotiates within them. And this will help build that decision-making muscle.

4. Write down past decisions. I love this idea and do it ALL the time with my students. It allows them to easily refer back to past decisions, which limits the decision fatigue dramatically.

Good Luck!

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Organization guru Leslie Josel, of Order Out of Chaos, will answer questions from ADDitude readers about everything from paper clutter to disaster-zone bedrooms and from mastering to-do lists to arriving on time every time.

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