Supportive Management in ADHD
Supportive management in ADHD
Children with ADHD can struggle in various aspects of life due to their inattention, impulsiveness, and hyperactivity. They also frequently face co-existing conditions that affect multiple areas of their life, including learning difficulties, diminished working memory, sleep issues, trouble prioritising tasks, maintaining effort until tasks are completed, anxiety, emotional regulation challenges, poor self-esteem, difficulty in sustaining relationships, lack of meaningful friendships, and risk-taking behaviours, such as substance use.
Medications are just one aspect of ADHD treatment. They are like wearing glasses to see better, and this analogy humanises the idea of using stimulants for ADHD. However, effective ADHD treatment requires support from several other team members, including a psychologist, an occupational therapist, educational specialists, and an ADHD coach, alongside a paediatrician and a specialist general practitioner. Properly managing ADHD not only enhances focus and behaviour but also lowers a child’s risk of developing other addictions and risk-taking behaviours later in life.
ADHD and Screens
The frontal cortex, which is responsible for executive function and decision-making, is still developing in children with ADHD, making it more challenging for them to weigh consequences or stay focused on a single task. Excessive screen time can worsen their difficulties, and children with ADHD are susceptible to the addictive nature of the online world.
The fast-paced and constantly changing nature of digital content, driven by algorithms, especially on social media and gaming platforms, fuels impulsivity and distractibility. These platforms are designed to grab and shift attention rapidly. For a child with ADHD, this can make staying focused, regulating emotions, or transitioning away from screens without distress even harder.
Excessive screen time can lead to overstimulation, making it more difficult for these children to relax, and may worsen their impulsive behaviour and inattention. An underlying learning difficulty, anxiety, or other co-existing conditions could also be aggravated.
Screen addiction can be a significant concern for children with ADHD. One of the most common signs is dysphoria—a generalised feeling of discomfort or irritability—when screen time is limited. It’s an indication that the child may be showing behaviours similar to addiction. When screen use begins to interfere with sleep, school, therapy, or family life, it’s a warning sign. There is increasing evidence that excessive screen time can diminish the effectiveness of ADHD treatments, including both medication and behavioural therapy.
A few strategies to reduce screen time
- Utilise the various settings on your phone to minimise screen time. Ex timers
- Turn the mobile off or put it in flight mode when not in use.
- Consider screen-free days, such as weekends.
- While working on other tasks, keep the phone out of sight in a different room. Having a phone nearby is known to distract and reduce attention span.
- Mindful use of the phone – before picking it up, take three breaths and see whether you need to check it right away, or if it can wait.
- Avoid opening multiple windows while working on screens.
- Closing and signing out from websites and emails once the work is done. Closing the laptop completely will serve as a reminder that the job is done, and it’s time to do something else, such as relaxing.
- Keep the phone in a designated spot, preferably away from your study or work area, to reduce the temptation to check it frequently.
Finding the right balance in a screen-dominated world is challenging, yet essential. By understanding how screen exposure uniquely affects children with ADHD, parents and clinicians can collaborate to create healthier, more supportive environments, both offline and online.
Sometimes, placing too much emphasis on reducing screen time can paradoxically lead our minds to think about screens more frequently. A more productive approach is to engage in other social activities and enjoy time away from the screen.
Reframing the manifestations of ADHD
Having a diagnosis of ADHD can set these children apart from other seemingly “normal children.” It’s helpful to recognise that children with ADHD possess different gifts and are an integral part of the community with the potential for immense contribution. A quote that’s much applicable to ADHD is, “if you judge a fish by its ability to climb a tree, it will always feel inadequate throughout its life.” It’s the water that fish thrive in. Therefore, it’s essential to identify areas where children with ADHD can flourish.
Children with ADHD are highly creative and often enjoy exploring new ideas; this aspect can be reframed as something other than inattention. If properly channelled, their impulsivity allows them to take bold, audacious risks that may be necessary in certain situations. Reframing some signs of ADHD as gifts can help us view this condition more positively.
I tell my patients that the power of an ADHD brain can be as strong as nuclear power. If harnessed for the right reasons, it’s highly efficient and cost-effective. However, it comes with many safety regulations and responsibilities in operating it. Conversely, if misused, it can lead to substantial destruction. An ADHD brain is similar; when the energy is harnessed for positive purposes, the creativity is impressive. But if not managed well, it can result in harm to oneself and others.
Seeing the positive side and reframing their issues can help us understand these children from a different perspective and channel their energy towards productive outcomes. Our schools seem to cater primarily to neurotypical individuals, where predictability, order, and obedience are often rewarded. However, adjusting schoolwork to meet the needs of children with ADHD may be crucial; for instance, allowing these children to move around periodically could assist them in self-regulation.
Other supportive management strategies
The recommendations for managing children with ADHD go beyond medication or psychological support. A holistic approach would include
- Prioritising good sleep hygiene
- Establishing structured routines
- Engaging in occupational, psychological and behavioural therapies
- Reducing screen time, especially unsupervised access to social media or gaming platforms.
- Mindfulness and engaging in relaxing meditation
- Engaging in hobbies, such as knitting and listening to music.
- Redirecting energy – outdoor sports, exercise, gymnastics, martial arts
ADHD coaches
Children with ADHD can have varying degrees of severity, and the issues faced by one child can be different from those faced by another. Seemingly trivial things like losing things at school, spacing out, etc, could be part of ADHD manifestations, although by themselves wouldn’t be the key components. However, identifying these manifestations can allow exploration of some actionable steps to circumvent these issues.
The underlying problem in ADHD is not inattention but instead regulating attention. Children with ADHD can hyper-focus on things they get excited about or enjoy. Channelling some of these energies productively can help children cope with their condition.
ADHD coaches can provide practical strategies for managing the daily problems faced by children, such as
- Making a list of things to do given reduced working memory
- Using a timer to overcome a poor sense of time
- Fostering the positive side of ADHD, such as creativity
Suggested resources
- Jessica McCabe. This is what it’s really like to live with ADHD. TEDx Bratislava, July 2017.
- Brooke Matson. ADHD redefined. TEDx Spokane. October 2021
Disclaimer: There are several supportive strategies; however, they depend on individual circumstances. Your physician and other allied health specialists will help you understand the various techniques that may work best for the child, taking several factors into account. This article is intended for general informational purposes only and should not be considered a substitute for recommendations from experts involved in the child’s care.