Saline says that it’s distressing for kids when parents absorb and reflect their distress. Children in her practice want their parents to know, “If I’m upset and then you get upset, there’s nobody to help me rein it in and get back to center. If you lose it in response to my losing it, it’s kindling on the fire.” Kids with ADHD need adults to model how to manage emotions in the face distress. Remember that self-regulation is a skill -- something that children and adults can strengthen with strategic practices such as mindfulness training.
Saline likens ADHD to a constant barrage of “small ‘t’ traumas.” These children experience “the accumulation of a thousand paper cuts that wear down their positive self-concept.” If we want children with ADHD to develop self-compassion, they have to first experience it from others. When parents and adults constantly point out deficits, children run the risk of viewing themselves as inherently deficient. Saline says kids want to tell adults, “I need to you understand and accept me even if I don’t understand and accept myself.”
Saline describes compassion as “meeting your child where they are, not where you expect them to be. When you accept the brain that your child has and who your child is, it makes all the difference for them.”
If parents and teachers can project self-control and compassion, it becomes easier to collaborate with children on practical strategies that will help them grow. Saline advocates working together with children to find solutions rather than imposing top-down rules. “What kids tell me is that they want to have a say in the plans that are made that are supposed to help them,” says Saline. “They get feedback from people all the time on what they could be doing differently. When there’s buy-in from the child, there’s more participation, more collaboration and more value.”
Here’s a strategy Saline recommends to families and educators: sit down and jointly identify a list of things you want to work on -- things that will make daily life at home or school a little easier. “You may have 15 items on your list, and your child may have two. But those two things will also be on your list, so go with those two.”
For example, if you are constantly fighting because your child’s room is a mess, you will probably both identify that issue. So how do you teach organization? As the adult, you have to participate in this, at least initially, says Saline. “It’s not going to work to say, ‘Go clean your room.’ They will find one item and say, ‘Wow, where has this been?’ – and then they are gone.” Adults can be the child’s “double” and help scaffold their success until they have mastered the skill on their own. This might include talking through the plan and creating a checklist that you tackle together. Try turning needed tasks into a game, says Saline. “Turn on tunes that they like and say, ‘We are going to take 15 minutes and put your room in order together.'”
Saline describes a grandfather who sat in his grandson’s room and called out one item at a time (“Shirts!” “Socks!”) until the room was cleaned. “He was helping build the executive functioning skills of sorting, sequencing and prioritizing all at the same time.” When you model how to attack an overwhelming task, “you are helping your child build fundamental skills.”
Children with ADHD respond well to predictable routines that help them organize their day. This includes consistent rules and consequences. When possible, says Saline, “do what you say you will do” while recognizing that you are aiming for steady, not perfection.
Saline says that the kids she works with “can’t stand it when parents say they are going to do something and then they don’t do it.” For example, a parent might say, “I’m not going to pick up your stuff anymore,” and then clean up their child’s piles when they are at school.
“For concrete thinkers, this is very confusing,” says Saline. “They will continue to push you because they don’t know where the limit is. The limit keeps changing.”
Saline estimates that the ratio of positive to negative feedback ADHD children receive is 1:15. Kids often feel like adults only notice when they “mess up,” not when they try. Saline says that children and teens with ADHD can grow wary of feedback because it so rarely focuses on their strengths.
“We have to pay attention to kids trying, even if they are not succeeding,” says Saline. “Practice makes progress; we are looking for progress, not perfection. We have to focus on the process more than the product. It’s the process that will help the kids build the executive functioning skills they need for productive adulthood. When we notice that they are actually turning in homework four-fifths of the time when it used to be two-fifths? Well, that’s progress.”
Look for ways to celebrate your child’s strengths, says Saline. “They get up in the morning, they go to school, and they do it over and over and over again. That is a strength. Build on that desire to try. We often look at what the shortfall is. We have to tap into these strengths.” Pay attention to children’s interests and skills -- from technology to doodling to drama -- and explore ways children can use these interests to strengthen other areas of their life.
Saline describes one little boy she worked with who had big feelings to manage. She asked him if he would like to take an improv class. Four years later, he is a fixture in drama performances, an activity that builds executive functioning skills such as memory, planning, and focus.
Reversing the positive to negative feedback ratio isn’t always easy, says Sailne. “If you have a day where your teen is driving you crazy, and all that you can find to celebrate is the fact that they are showering and brushing their teeth, that’s what you are talking about: ‘You smell good. Nice T-Shirt.’”
Helping ADHD Kids Understand Their Brain
Saline says that medication can help some kids with ADHD but “but pills don’t teach skills.” Children need consistent support in developing their executive functioning skills. “You have to separate your brain with your sense of self. It’s easy for these kids to ask, ‘What’s wrong with ME? Why am I less than? Why am I failing?’” Instead, she talks to kids about how their brain works, how it grows, and what they can do to strengthen their executive functioning skills.
This type of language helps kids “create space between ‘what my brain is’ and ‘what I am,’” separating the experience from the person. For example, instead of “I am a distracted person,” kids learn to say, “I am training my brain to focus better. Here’s how I’m doing it.”
Teachers can help children with ADHD by overtly teaching executive functioning skills and integrating this language into their lessons. For example, when introducing a task such as writing a story, ask students what executive functioning skills they will need to use -- e.g. shifting from listening to thinking, planning and organizing -- and offer help if they find themselves struggling with one of these steps in the process. “Remember,” says Saline, “you are talking about the skills, not the child.”
The Good News for Parents
If your child has just been diagnosed with ADHD or if you are struggling to help your child manage their life, Saline offers these words of support.
First, development is in your child’s favor. “The brain is developing and will continue to develop. Where your child is now is not where they will be in a year. Focus on the now, not on your worries about the five years from now.”
Second, your efforts matter. “What kids tell me over and over again is that they wouldn’t get through without their parents. You matter more than you think you do.”