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Organising Children With ADHD

 

This episode is all about organising children with ADHD. Dr Russell Barkley, a clinical professor of Psychiatry and leading expert on ADHD joins Lily and Bonnie to share some essential ideas about children with ADHD. If you want to know how to help a child with ADHD get organised and stay that way, this special episode is not to be missed.

 

***COMPETITION***

Want to win a free copy of Dr Barkley’s newly released book? Leave a rating and review on Apple Podcasts or our Facebook Page to enter. Competition closes 10.11.2020 – winner drawn the following day.

 

SHOW NOTES

GUEST BIO

DR RUSSELL BARKLEY

Dr Russell A. Barkley is a Clinical Professor of Psychiatry at the Virginia Commonwealth University Medical Center, Richmond, VA. Dr. Barkley is a clinical scientist, educator, and practitioner who has published 26 other books and more than 300 scientific articles and book chapters related to the nature, assessment, and treatment of ADHD and related disorders.  He is the founder and Editor of the clinical newsletter, The ADHD Report, now in its 28th year of publication.

Dr. Barkley has presented more than 800 lectures in over 30 countries and has received numerous awards for his lifetime achievements, contributions to research and clinical practice, and the dissemination of science.  You can find out more at www.russellbarkley.org

Episode Transcript

BONNIE: Hello and welcome! I am Bonnie

LILY: and I am Lily, and this is Little Home Organised, the podcast dedicated to helping you declutter, get organised and reclaim time for the things you love.

*MUSIC*

BONNIE:  Hello and welcome. Today we will be joined by Dr Russell Barkley to talk about organising children with ADHD.  We will chat about some of the essential ideas to remember about children with ADHD and how we can help them be more organised.  As a mother of a recently diagnosed child with ADHD I am really excited about this episode.

LILY: I am very excited to Bonnie but first things first lets introduce our guest, so Dr Russell A Barkley is a clinical profession of psychiatry at the Virginia Commonwealth University Medical Centre in Richmond Virginia.  Dr Barkley is a clinical scientist, educator and practitioner who has published 26 other books and more than 300 scientific articles and book chapters related to the nature, assessment and treatment of ADHD and related disorders.  He is the founder and editor of the clinical newsletter The ADHD Report now in its 28th year of publication.  Dr Barkley has presented more than 800 lectures in over 30 countries and has received numerous awards for his lifetime achievements, contributions to research and clinical practice and the dissemination of science.  You can find out more at russellbarkley.org.  My goodness welcome Dr Barkley.

Dr RUSSELL BARKLEY: Wow, who is the guy?

BONNIE: He is amazing and that’s the shortened version.

Dr RUSSELL BARKLEY: My life was flashing before my eyes and at my age that is not a good thing.  Well what a pleasure to speak with you.

LILY: Oh, we are so delighted to have you here today, we are really excited to cover this topic and clearly, we are speaking to the expert on it which is really awesome.

BONNIE: Yes thank you for joining us Dr Barkley we really appreciate it.  As I was mentioning to you before my daughter has just been diagnosed with ADHD so for the last 3 months I have been researching like a mad woman everything I can and I first came across your 3 hour lecture in Canada I think it was in 2014 and I just soaked it up like a dry sponge it was just life altering and so that is why I knew that we had to come and have you on the podcast because there are so many other parents and grandparents who would really benefit from your knowledge and wisdom.

Dr RUSSELL BARKLEY: Thank you, thank you, well I really appreciate the invitation and having been to Oz many times I love the country, my children went with me for 5 weeks and didn’t want to leave, do  you believe that, they didn’t want to come home they just thought this was the greatest country they had ever been to so I have many friends down there and it is a lovely place so when you invited me how could I say no.  I mean it is always good to speak to people Down Under right?

LILY: Oh you are too kind

BONNIE: Well we appreciate it anyway.  Now Russ you have got a new book coming out, you have written a lot of books before but you have got this new one that is coming out right about now, can you tell us a little bit about it.

Dr RUSSELL BARKLEY: Yes I wrote the book because about a year ago I began thinking about I am coming to the end of my career, I am 70 probably will retire in a few years, not sure of that yet but it forces you to look back on your life and saying what mattered? What were the most important things from my 44 years of clinical work and practice from all of my research, plus I review all research published in the world every week, so I have hundreds of thousands of articles and references, what can you do with that information to distil it into the key ideas that parents need to know.  You know at the end of the day what is the most important stuff, so I created a lecture and I gave it a couple of times in various places in the world and people loved it because it was kind of one of those distillations of wisdom from all these different sources of information and then I wrote the book over the winter months so it is call the 12 principles for raising a child with ADHD and it literally truly is what I think are the best ideas that if you have somebody in your family with ADHD you must know these ideas, you can forget the rest of the stuff but this is crucial.  So that’s the book that is coming out here in the next week or so.

BONNIE: I am so excited to read it myself I have to admit and Russ has been generous enough to give us a copy of his book to hand out to one lucky listener so if you would like to win a copy of Russ’s new book because you might have a child or a loved one with ADHD please leave a rating and review either on the Little Home Organised Podcast page or over on Apple podcast, send us a screenshot and you will be in the chance to win that and we will draw that within the next 2 weeks but before we go any further

LILY: Yes

BONNIE: Let me ask you a question Russ, what is ADHD and what are the common misconceptions about it?

Dr RUSSELL BARKLEY: Well that’s where we need to start because principle no 1 in the book is that you need to understand ADHD as to what it really is not how it is presented in our diagnostic manual, not how you might read about it in the mainstream media, you know on a particular website, those are very superficial descriptions of ADHD as a problem with hyperactivity, impulsiveness and inattentiveness.  Those are surface features of ADHD and they really trivialise the underlying problem because under the hoods so to speak, in the mind what is going wrong is that the part of the brain that develops self control, self regulation known as the executive brain at the front part of the brain is not developing properly, it is about 2-3 years behind, it is about 30% behind in its connectivity and activity and that creates a wide swath of problems for people with ADHD and if you don’t understand that ADHD is a disorder of self regulation and the executive brain then you have missed the point alright, this is not an attention disorder, the name should be changed but it never will because of legal and other regulatory issues so we are stuck with it, but it is a bad name that I think does not foretell the scope….the difficulties so there, I am just going to list them, there are 7 executive functions in this part of the brain and they interact to allow us to become self regulating independent people who can look after ourselves and see to our welfare and so if they are not developing that is what you are going to loose and that is why these children have such difficulties in, growing up in school, in life, with peers and then later in life as well.  So I will just be very quick because I know our time is limited.  The first executive ability is self awareness, paying attention to yourself, they don’t do that very well,  so as a result they don’t understand how bad they can be and how much trouble they are in because they are not monitoring their behaviour the way other people do,  the second is inhibition, you all ready know that, the mind breaks, it is out of control, they are not able to inhibit actions both words and gestures as well as emotions, they are very emotional because of this inhibition problem, so you know the ideas are up, out, done before they have even contemplated what they are about to do so a lot of impulsivity.  Number three is what we call working memory and I am going to come back and talk about that, working memory is a very special memory in the frontal lobe, remembering what you are doing and how to get there, so it is the goal, it is the steps to the goal, it is the progress towards that goal that you are making and we actively hold it in mind when we are engaged in any behaviour directed toward a task or toward the future, so I will come back and talk about that as one of my key principles and then there are two kinds of working memory, visual imagery and the minds voice, self speech both of those are very problematic for people with ADHD so that is going to lead to some other problems I am going to talk about which is time blindness, ADHD disrupts the ability to sense time and then to control yourself relative to time and it creates a massive disorder of time management, there is no psychiatric disorder that interferes with timing and time management the way ADHD does, so people have to look at this as a form of time blindness and I will come back and talk about that and what we need to do about that too,  and then the last ones are emotional self control, self motivation and planning and problem solving, they all go together, it is like a Swiss army knife of mind tools that interact by the time you are an adult.  It takes 30 years to get them all, each takes about a decade or more to develop, they develop in a sequence but by adulthood you better have all 7 or you are going to be in big trouble.

BONNIE: Wow that is amazing.

LILY: Yeah I think you kind of hit the nail on the head there that there is this like misunderstanding out there or this simplification of what ADHD looks like and so when you really do break it down you realise that it is quite a complicated issue and no wonder when we are speaking about children especially it is not as simple as Oh they are a bit energetic, there is a lot more going on.

Dr RUSSELL BARKLEY: And that’s because in the preschool years that is kind of what you see because the executive functions are only just beginning to emerge, I mean we don’t get the voice in our head until between 5-8 years of age, so we don’t see that they can’t use language to guide themselves, to follow an instruction, to tell themselves what to the way other children are doing, we don’t begin to get visual imagery really until about 3-5 years of age and even then it takes a decade but visual imagery that is thinking back about the past and using images to guide us is where we get hindsight from which leads to foresight, looking back to look ahead to get ready for where I am and they have none of that, so there is no looking back, there is no looking ahead, they live in the now, and that is why they keep making the same mistakes over and over again, the past doesn’t matter, it just doesn’t come forward to guide behaviour so I mean I could go into much more detail, I have books written on this view of ADHD as an executive disorder but the principle no 1 is you have to understand it is a disorder of self regulation, it is neurological and genetic in origin, so it is very biological, it is one of the most genetically influenced psychiatric disorders that we know of other than autism spectrum disorder, it is not due to bad parenting, it has nothing to do with schooling, it has nothing to do with screen time and how much you are playing video games, it is not due to your diet or sugar and all these other misconceptions.  It is a heavily neuro genetic disorder which is why we call it a neuro developmental disorder and you have to understand that too, you know, you didn’t cause this by the way you raised this child, even though other people will tell you that, you know we are very good in both of our countries at what I call mother bashing, and that is anything wrong with children is the mother’s fault.

LILY: Yes

Dr RUSSELL BARKLEY: And so, you get these glares and these snide comments in public places and why can’t you control that child, and what’s wrong with you, and

LILY: The big C word, control

Dr RUSSELL BARKLEY: And what they don’t understand is, you know you have a child who is biologically out of control which really is a disability so you have to step in and become their executive brain, there frontal lobe and that is exhausting because you are in the trenches 24/7 because of this failure to develop self regulation

BONNIE: Mmmm

LILY: So when you were talking there Russ about it being genetic is it highly hereditary?

Dr RUSSELL BARKLEY: Yes

LILY: Like what are the stats on it?

Dr RUSSELL BARKLEY: Well just very quickly run through it,  there is only one other disorder as genetic and that is autism spectrum so about 80-90% of the variation in the human population in ADHD symptoms, so just take the entire planet, it you look at all humans and how much variation in their self control, in their ADHD is genetic it is about 80%  which is almost that for human height, which is a physical trait, so we have a psychological trait that is almost being as genetically influenced as a physical trait and the reason for that is that it is crucial to our survival.  This really is the means by which people survive and when it is not developing properly your survival is at stake, your ability to function effectively, so I don’t want to go into all of that evolutionary stuff but it really is important that people understand the biology of it.  If a parent has ADHD, half of their children will get this disorder that is stunning, if a child has ADHD a third of their siblings also will have it so it is just amazing, you know 25-40% of the parents of ADHD children are still actively ADHD themselves and now we know it is genetic because we study twins, we have mapped the human genome, we are identifying multiple sites in the genome that are contributing to risk for this disorder so this is not hypothetical this is a fact in the bag that ADHD is so highly genetically influenced in humans but that is because self regulation is so genetically influenced and ADHD is just the lower end of the trait of self control, so if you think about height for instance, if you think about somebody who is really small maybe to the point of dwarfism, you know that is just the lower end of the height trait and ADHD is the lower end of the self regulation traits that we have, so it fall along the spectrum, we all have a little bit of it but when I becomes so frequent, so severe, so delayed that it causes harm to a child that is where we draw the line and put a label on it but it is dimensional and as a result people vary in how much ADHD they have including typical people but it is very severe in people with the diagnosis.

BONNIE: Mmmm

LILY: Yes

BONNIE: Okay so I am a parent with a child with ADHD what is my role? How do I help them?

Dr RUSSELL BARKLEY: That is a great question because principle No 2 in my book is that if you understand number 1 and what we are really grappling with here and that you have a literally neurologically disabled youngster that you are trying to raise, that should engender a couple of things in you.  Number 1, it should trigger a grief reaction because none of us like to jettison the notion that our child

BONNIE: I will try not to cry

Dr RUSSELL BARKLEY: is not typical.  It is okay I have done it myself, I will tell you a story some other time.  So the first thing is we grieve and we grieve the loss of normalcy of our children and that is important and clinicians need to be aware of that, acknowledge it, help with it if necessary but the end stage of grieving is where I need you to be which is acceptance and if you are struggling with this and you are listening to this program just goggle Welcome to Holland. Welcome to Holland is a short story of a mum from her pregnancy to the delivery of her developmentally disabled child and that transition, that stark change from what I had hoped for, what I planned for, where I was going turns out to be this and the basis of the story is she said it was like I was planning to go to Venice and I wound up in Stockholm, both very nice places but you weren’t prepared for Stockholm, you don’t know the language, it is not where you wanted to be, so the issue here is grieve the diagnosis, that is fine we want you to, but come to acceptance,  you have to own it, this is my child, that is not my child anymore, that child I had all these dreams and hopes about, I don’t have that child anymore, this is the one I have, I have to get you there to that spot of acceptance and then acceptance leads to compassion.  When we understand that we are dealing with a disabled youngster, that should elicit from us a willingness to help, to protect them, to accommodate them, to make the changes we need for them, to advocate for their needs, there is a role here that comes with compassion of someone who suffers from a developmental disorder and so I need you to move through those stages and if you do that properly we get to principle No 2, your role as a parent is a shepherd not an engineer and the reason I say that

LILY: Wow that is great.

Dr RUSSELL BARKLEY: Is that parents these days think that they designed their children, that they can turn them into anything they want to with baby Einstein toys and playing classical music to your uterus when you are pregnant and every little think I do in the home, so we are helicopter parents, we are all over the place, you know because we think that every little molecular interaction with this child has this profound deterministic effect on who they are going to be and their outcome and their traits and everything and so parents get overly invested in designer children um trust me evolution and nature would never have allowed this to happen, so I need you to back off and understand you are a shepherd not an architect, you don’t get to change this child.

LILY: Russ I think that is actually really liberating

Dr RUSSELL BARKLEY: It is, it should be

LILY: because I feel like a lot of

BONNIE: It is very freeing

LILY: A lot of parents have a lot of anxieties around you know making sure that they are giving their child every possible opportunity and you know it is all those crazy, you know this toy they have to have this toy, this is the toy that is suppose to help them with this thing and you know the idea of shepherding is like it is very beautiful but is also liberating for a parent too.

BONNIE:  Especially because with ADHD you feel like you are a bad parent

Dr RUSSELL BARKLEY:  Yes you do and the public accentuates that, the people who don’t know ADHD are just going to reinforce that.  So I want you to step back and understand this is the gift I was given, is this child and I have to adjust to this, that is what shepherds do, shepherds don’t turn sheep into dogs or cats, they are responsible for the sheep okay it is a very important job, nobody is saying just leaving them a loaf of bread and go off to Auckland and play the slots you know,  we are basically saying that your role is not a designer okay it is a shepherd and a care giver and with that role and that change in perspective is so profound, one is it is very liberating and I am glad you pointed that out, the other thing is that if you think you are an engineer and your child turns out well you think you take the credit, if you think you are an engineer and you have a disabled child you get the blame, it is your fault and so there is a downside to thinking you are an engineer and that is what if you have a child with problems and they are not your fault but you think they are and now I have got two patients on my hands, I have got a depressed parent and I have got this child I have to deal with so to me the shepherd metaphor for parenting a developmentally disabled child, any child not just, I mean even typical children, emphasizes where you put your time alright,  your time is not involved in what am I doing in my house and the little molecular things, the most important decision you make is the pasture, where do I rent, where did I buy my home, what is the school, what is the peer group, what is the neighbourhood, what is the recourses.  So the pasture you choosing has a profound influence over a child’s outcome much more than anything you will ever do inside your home short of child abuse, so yet  parents think it’s the other way around, everything I do in my home is shaping my child for who they are going to be and you know the outside world can you know just be gone and it actually the other way around.  The external influence is going to be profound, the peer group, the schools, the resources, all of that matters, what you are doing on a day to day basis doesn’t matter quite so much.  It is important, especially for your relationship with your child but it is not going to determine who they are going to be.  That is out of your hands.  So your child is a unique genetic mosaic of your family, recombined into this classy little gift of a package that you get to raise, so part of it is do your job as a shepherd okay so protection from the elements, safety, nourishment, stimulation, great pastures and then sit back and watch the show, the rest is really out of your hands and there is a good part of chance involved in that too, so it can be liberating okay you can kick back and say this is what I got lets deal with it. On the other hand there are responsibilities of being a shepherd okay and that is that you have to look after the sheep and do your job and if you do that then it will be a wonderful collaboration.

LILY: Alright and before we get into more details of how you can be a responsible shepherd I think we are going to take a little break for a clutter confession

CLUTTER CONFESSION

MUSIC

Dr RUSSELL BARKLEY: Oh my

LILY: So our clutter confession is all about something weird wacky or wonderful that you have held onto Russ that someone else might walk into your house and go that is unusual, have you got anything in mind?

Dr RUSSELL BARKLEY: Well I will just point out if you look at the shelf behind me there is a bit of clutter there because I pick up mementos from all over the world, wherever I go just so that when I look at it, it reminds me of when I was in the country, I have got stuff from Oz over there, I have got boomerangs and I have got

BONNIE: Nice

Dr RUSSELL BARKLEY: You know some aboriginals stuff so it is really cool but some people would think that is cluttered but it has very personal meaning to me but the real clutter is if you came to my house and went into my guest bathroom you would see a bunch of rubber ducks, little yellow rubber ducks and of course you would wonder what is going on here

LILY: Yes

Dr RUSSELL BARKLEY:  And what is it doing all over the bathroom, so here is the story, it is a very cute story, I love it

BONNIE: Oh fabulous

Dr RUSSELL BARKLEY: How did I get involved in cluttering up my house with rubber ducks, about 3 years ago when I moved to Richmond to help with my grandson who is on the autism spectrum, he was quite young, he was only about 4 at the time, 3 ½ and so I took care of him for 3 hours a day and I worked with him along with the 7 hours of therapy that we arranged through our local autism centre and became a second father to him and after 2 years of working with him along with all the other therapists and his parents and everybody lets give credit where credit is due I needed a break and so I took a 2 week 3,000 mile road trip around the US just to get away and recharge my batteries so I could come back and keep going, and the day before I left I took my grandson with autism to the carwash and they handed out little rubber ducks at the carwash and we named him Magelin – Magie for short. And so the next day I am leaving town and I am trying to think of how I can stay connected to my grandsons especially this little boy now that I am going to be away from him so I put Magie on the dashboard of my pickup truck and I headed out and Magie was my guide all over the US and I have pictures of Magie in my car, in restaurants, in Starbucks, meeting new people

LILY: Oh this is awesome

Dr RUSSELL BARKLEY: And everywhere we went Magie was introduced to everybody and everybody had to give me a picture and everyday I wrote a newsletter for my grandchildren, this is what Magie did today and Magie was swimming in a lake in Canada and Magie crossed the lake Michigan from Michigan to Wisconsin on a ferry boat and um Magie got put in timeout for stealing chocolate raisins and you know it was just a really, it was a great trip and everybody around and I met, I was lecturing in Wisconsin and I met one of the centuries greatest psychologists Donald Meichenbaum who is a friend of mine and Don and I were lecturing together and when I told him and his wife the story they started finding rubber ducks for me and then other people started finding rubber ducks for me and then as I was traveling and meeting people they gave me the rubber ducks that they had for their children so my duck was collecting family all over the earth, so I have fireman ducks, I have police ducks I have all kinds of duck

LILY: I love it

Dr RUSSELL BARKLEY: In the bathroom and I still have the collection of a daily reports from Magie on the road that I wrote to them with pictures of all of that, so if I have clutter it is a deeply personal clutter that tears me up whenever I even think about it because they loved it, absolutely loved it.

BONNIE: That is great

LILY: You sound like a great grandpa Russ

BONNIE: Yeah

Dr RUSSELL BARKLEY: I am enough of a nut that I do zany things and I am a little bit disinhibited ADHD is in my family and I get a touch of the disinhibition genes for sure but so it leads me not to care as much about what I do as other people do and therefore I take chances and I do nutty stuff.

LILY: You know that you are going to have to do now, you are going to have to take a photo of the ducks and send it to us so we can share it

BONNIE: We want to see the ducks.

Dr RUSSELL BARKLEY: Okay

LILY:  Oh yes I want to see these ducks

Dr RUSSELL BARKLEY:  all right

BONNIE: Fantastic

Dr RUSSELL BARKLEY: So that is my clutter confession, I am a duck collector

LILY: That’s beautiful

BONNIE: You are a duck collector, I am just trying to image you driving back at the end of your road trip with this pick up full of ducks, know people just seeing all these ducks

LILY: Driving down the highway, were they ducks?

Dr RUSSELL BARKLEY: They were mailing them to me when I got home, oh how’s Magie, they didn’t care how I was doing, how’s the duck, what is he doing today?

BONNIE: This sounds like the start of a great book

LILY: You know what and potentially now there is an international audience listening to this podcast who might be wanting to send their ducks

BONNIE: Yes

Dr RUSSELL BARKLEY: So that duck went everywhere

LILY: Oh it did, and if you have a clutter confession that you have been meaning to send in, make sure to head to the Little Home Organised Facebook page, send your file as an audio message and we can play it on an upcoming episode and don’t worry we will keep it anonymous, just remember to send us in something weird, wacky or wonderful you  have held onto maybe it is a pile of ducks.

MUSIC

BONNIE: Ok so back on topic Russ, one thing that I have to ask is just tell me about time, time with ADHD kids, how do you organise it?

Dr RUSSELL BARKLEY:  Yes well the first thing, principle No 3 I have already sort of mentioned but it is this, ADHD is time blindness, they cannot cope with time, the biological clock is broken, there is no internal sense of time developing and what that means then is when you start assigning time limits, as children get older we begin to say you have got 20 minutes to do this, 30 minutes for that, a week for a book report, you are dealing with somebody who can’t cope with that.  You immediately disable somebody with ADHD when you put time into the task, either as a time limit or a deadline or you separate the steps of the tasks by large blocks of time, like a book report that you have to read and then write and it is two weeks later before the project is ended and you get your grade, that is a disaster for people with ADHD so the first thing is understand the clock is broken, they’re blind to time, you cant talk about the past and the future, you have to help them cope in a world that values this timing dimension and the way we do that is if the internal clock is broken you have to make time physical, external, so for instance you have given them something to do, there better be a spring loaded cooking timer or a counter or your digital stopwatch on your cell phone but time has to be visible in front of them.  Go to amazon and you can buy a one foot clock with a giant red disk that goes up to an hour and you set if for the time limit and they can see the red disappearing as the clock goes.  There has to be an external reference to the time dimension, or they can’t cope with that.

LILY: So Russ what you are saying it is more than just like an analogue wall clock or a digital clock but the actual seeing the movement and seeing time passing

BONNIE: Like sand going through the hourglass

Dr RUSSELL BARKLEY: That’s why

LILY: Something visual

Dr RUSSELL BARKLEY: The analogue clock is far better than digital because digital you are just seeing the current number, with analogue I am seeing the past and the future, where I have gone, what lies ahead, what are the beauties, that is why many of us still keep analogue clocks around is that your sense of yourself in time is better with an analogue device and that is also true for ADHD children.  So you have to make time real, you have to make it physical, it has to be in front of them in the visual field in the setting where the timed task has to be done, now that causes some problems because some assignments are long term, take the book report, so how do I deal with that, I mean I don’t have a clock that runs for 14 days so how do we do that, well we take long term tasks and we break them into baby steps, into the little units of time and we do that by take the book report, you are going to read 3 pages with me today, we are going to take some notes today, you are going to write two sentences about what you just told me and we are going to do this everyday.  So we are going to build a, take these baby steps, think of them as bricks of time and we are going to build these bricks into a bridge across the time gap of 2 weeks but it is going to be done on a daily frequent small quota basis with frequent rewards along the way and then we can bridge time, but you are not going to stand on one side of the river of time, point to the other side and keep admonishing the child, it is due, you have 5 days, where are you, what have you done, you know you are of no value to somebody with ADHD when you point at the future.  You are of great value if you will break the future into small pieces and bring a piece into the now every day and then when we get there we built a bridge, so and don’t tell me that oh well they are going to have learn to do this, they don’t okay, so they will wind up in where ever they do in life they will wind up doing things that do not emphasize that kind of time the way other people do.  So it gets better, the clock gets better, they do develop an internal clock, it is never where it is suppose to be.  They are always behind other people, so that is to me principle No 3 is nobody talks about the timing issue unless you have read my books but it is in the literature in our science, we have known about this for 20-25 years that this disorder has something very specific that it is doing to devastate the timing circuit in the brain and we have to help them with that, admonishing them doesn’t replace the clock, they need accommodations, compensations and other things to deal with time, as one 30 year old mum told me she said I have ADHD and I have never understood what you people mean by time, it escapes me, I cant sense it, I cant react to it, I cant cope with it, I don’t how much time I have spent, how much time I have left, you know where as if I ask you, you will have a general subjective sense of time, and they don’t have that.  It is devastating because the simple best predictor of occupational success is time management.

LILY: Whoo

BONNIE: That’s a big one

Dr RUSSELL BARKLEY: What does that tell you.

LILY: Yes absolutely

Dr RUSSELL BARKLEY: I want to before we wrap up that principle come back to one of the implications that I mentioned earlier but we are going to turn it into another principle.  I said that ADHD is a neuro-genetic disorder, neurological disorder of the executive system of the brain and it is delaying your child’s development by about 2-3 years of brain maturation and psychologically it is about 30% to average, just a rough rule of thumb, so this becomes incredibly important as one of our principles, you need to learn your child’s executive age, you know their chronological age, they are 10, what is their executive age, it is about 7.  What does that do for you, it tells you that you can not ask for 10 year old functioning, you cant ask this child to do 10 year old length homework, classwork, schoolwork, chores, you cant ask them to organise their life and plan around time and avoid distractions and control their impulses and handle their emotions, all those executive things I mentioned are like that of a 7 year old and that is where they are and you keep asking for 10 year old, you know why aren’t you like these other kids, I mean you are the same size as the other kids, you  are in the same classes with these other kids, why cant you be like these other kids, they can’t.

LILY: Yep

Dr RUSSELL BARKLEY:  And so our job is to take our expectations and reduce them by 30% down to that age and there is nothing, I mean everything in life can be adjusted this way, I will just give you some examples.  If a teacher gave your child 2 hours of homework at age 10, you should laugh at them,  that is incredibly ridiculous because this child can probably do about 10 minutes on their own before they are off task and dis-regulated and you have given her several hours.  You are now asking for a fight at home, you are going to see such family conflict that you are asking parents to impose a demand that a disabled child cannot do, and you didn’t tell the parents that, so what you need to do, is you need to cut that homework assignment down to somebody who is 7 and then they can do it, even then they are going to need some help but they can still do it.  So part of a job as a parent in helping make our kids organised and better and successful in school and at home is making these adjustments down to where they are, you do it for a child with intellectual disability, you do it for a dyslexic child when it comes to reading, you need to do it for this child when it comes to self control, organisation, time management, they don’t have it and so I will give you a second example here in the US at 16 your child is going to want to drive a car, subtract 30% off of that and now answer the question, should they drive? No you just gave a an 11 year old a motor vehicle, I didn’t say they can’t get a licence I said what do you have to do teach an 11 year old to drive

BONNIE: A lot

Dr RUSSELL BARKLEY: Well guess what, that is what you have got to do, longer is learners permit, under supervision, very strict, a lot of accounting going on here and monitoring of the vehicle and you know for like $35 you buy a little device that plugs into your dashboard and it blocks all cell phone signals in the car because you will not, you cannot trust them with technology while they are driving, it becomes incredible source of distraction and life threatening so you know suppose you have a 14 year old daughter and the family next door comes over and they have a 3 month old and they want to go to dinner and hire your daughter to babysit, well your daughter has ADHD, subtract 30% off of that, are you going to let her go over there and babysit when she has got the self control of a 9 year old, no so do you see what I am talking about, or if I did I would go with her, we would do it together and if would be our thing and she would start to learn how we are doing this, but I would never allow that child to do what other children are able to do independently of me once I apply the 30% rule to computer their executive age.  So, parents know the executive age because that’s where we work and we not working at normal, we are working at where they are at.

LILY: I can see why you are emphasizing that the first step is parents accepting and getting to that point where they do go through the grief and they do get to the point that they are accepting where there child is at because only once they truly accept it are they going to stop looking at their child with this lens of comparison between other children and age and start going no we need to do things differently with you but I have come to terms with that but yeah if you don’t get that sorted out it is going to be a losing battle.

BONNIE: Mmmm

LILY: So that is really important

Dr RUSSELL BARKLEY: Precisely and part of your job as an advocate is to make other people aware of that, make the school, make the teachers, make the others know, like the coaches that are coaching your child when you go to soccer practice, or swim, you know they need to know that you have got a child here whose self control is a lot less mature than the other students you are working with and I will give you some suggestions and maybe we will leave a little report card where you are going to rate their behaviour every 20 or 30 minutes while they are with you as the coach to give them a  little accountability and structure but you cannot expect them to be as controlled as the other children, that is why they get kicked out all the time, they can’t handle the independence that other children can handle and then people blame them, you know, its your fault, get out, you are off the team, you know, when in fact if they just made a few modifications he could be on the team and as good as anybody else.  I mean look at Michael Phelps, you know the worlds most decorated Olympic swimmer, his mother had his day planned down to the 15-minute unit up until he graduated high school.

BONNIE: Wow

Dr RUSSELL BARKLEY: Every day

LILY: Wowsers, That’s a pretty organised household.

Dr RUSSELL BARKLEY:  It sure is

LILY: So a lot of our focus of course is applying these things that we are learning with very educated people such as yourself, we recently spoke to a psychologist who specialises in children who are on the autism spectrum disorder about how can we in our homes when we are people who are maybe trying to like declutter and organise our homes and keep our children you know, keep their spaces a bit more organised, how can we adjust our expectations, how can we come together and set everybody up for success, so when we are working with children in our home who have ADHD and you maybe your house is quite chaotic or you are wanting to declutter, what are some considerations you think are really important

Dr RUSSELL BARKLEY:  Well I think for me when you look at the workspace and the things they have to do, whether it is chores or homework or you know anything else you are asking them to do, you have to come back to the point I made earlier and this is my next principle, working memory isn’t working, working memory is the part of the brain where we hold in mind what we are doing, the steps we want to use to get there, the progress that we are making, it is an active form of memory, it is remembering to do, it is what you loose at 55, I have been loosing it big time for the last decade, you forget what you are doing, I don’t forget things, knowledge, information you know my past but you know God help me if I go to the mailbox I am just going to get pulled by the nose of whatever I see out there from the weeds in the garden to the paper in the driveway, to the trash can out in the street, and I never get to the mailbox.  So the environment takes over because my working memory is getting week and ADHD kids are like old men x 10.  They start one thing and loose track where they are going and get pulled by whatever else is going on around and not working memory is shot, it is like Swiss cheese it has been erased and so they can’t remember what they were doing and they won’t go back to it anyway.  So you have to understand that you can’t give your child lots of information and expect them to hold that in mind.  So the phrase I use for dealing with the working memory problem is off load the information onto another device,  it is a techy term for what I want you to do and that is get it out of this form of memory and get it onto a physical kind of memory device in front of you and what are those things. Well they are sticky notes and lists and cards and signs and symbols that you have in your visual field that are going to control you better than the frontal lobe is going to be able to do.  So look at that workspace, should there be rules here for homework.  My child has chores to do, feed the dog, empty the dishwasher, clean their bedroom, that should be on a 3 x 5 file card with every little molecular stack listed on it and the time limit here and the reward you are going to get and when you say to do the chore you give them the card, you have now off loaded working memory onto a piece of paper with the time limit with a reward and the steps here we go, set your timer.  That is how you organise them but you don’t just yell up a flight of stairs to a second story bedroom, clean up your room, are  you doing your homework, you know and while you are cooking or you know having a glass of wine or whatever you are doing

BONNIE: Cause you can’t cope after a tough day

Dr RUSSELL BARKLEY:  Tell me, so my point then is that if you know that there is no working memory you will start giving them information to put in working memory and you will put it around them, schools can do this with rules for reading, rules for science, rules for maths.  Another way of doing it is what I call becoming proactive, before you start any transition to the next activity whether it is going from playtime to homework time to bath time and whatever you stop and take a minute and you get proactive, here is what we are doing, here are the 3 rules, say them back to me, what are they, you can even write them down and hand them to them ok.  Here is the reward, this is what you are going to earn, it could be points, tokens, privileges, money, electronic time on a game, whatever but there has got to be win for your child there, so what is the reward, next, what is the punishment, what are you going to loose if you break these rules.  Okay I am going to take points away, you are going to loose that electronic game, whatever

LILY: Desert

BONNIE: Yes

Dr RUSSELL BARKLEY:  Now we start the task and you give them something active to do in the task, that is a transition plan, you can do that before you go into a store, before you go in a church before people come to your house, before you go from you know dinner time, to homework time, to bath time, to bed time, every transition of a major activity should involve a 1 minute plan, up front, external out here, we are all on the same page, lets go alright, and that is how you organise them, but you don’t sit there and say oh well you should be like other children and be able to do this without me cause that tells me you didn’t get it, you don’t know ADHD, you don’t know what you are talking about.  So for somebody to say you know we need to help ADHD kids become organised for ever, well you just told me you don’t know what ADHD is, that is never going to happen, right, so they are always going to need more scaffolding, more structure, more time devices, more ways of breaking life down than other children are, and my response to that is Yeah and so what, we put ramps into all the buildings in the United State so that people with motor disabilities can enter the building, I don’t see anybody running around saying why do we do it for them when we don’t do it for the other kids, because they are disabled for God’s sake right so, this is like building a ramp for an ADHD child, when you do the things I just went over.  This is their ramp, don’t tell me to take it away because that is a ridiculous idea, you know we help people with disabilities by creating artificial devices to compensation for the disability and you know that is what this game is all about so you know you have to stop thinking normal and think what are the needs of my child has and to me that is this structure and scaffolding and externalising of memory and time devices and everything and once you get that it is no big deal, it is automatic for you, you know what you gotta do.

BONNIE: I love all your use of the visual, you know the bridge of time, the taking the ramp away, all that stuff for me who is a really visual person

LILY: It makes it very tangible doesn’t it

BONNIE: It does and especially when you think about the physicality of making time physical and making that working memory physical, like that is really helpful as a parent to know that.  Ok I have one final question before we let you go Russ.  I know we have gone a little overtime so thank you

Dr RUSSELL BARKLEY:  Ok happy to do it, its my life

BONNIE: Yeah that’s right, when you are passionate about something you can talk all day, um

Dr RUSSELL BARKLEY:  I could

BONNIE: How much of an affect does a chaotic environment have for a child with ADHD?

LILY: Are you talking about physical chaos Bonnie?

BONNIE: Yes physical

Dr RUSSELL BARKLEY:  Ah, it is horrible, and the reason they are more likely to encounter a chaotic environment is a third of their parents have the same disorder, so now I have got you know especially in a household like that where both the parent and the child have it, it is going to be chaotic, so just a couple of things.  One is you want the non ADHD parent handling anything that is time sensitive with that child, appointments, deadlines, paying bills, you take the non time sensitive stuff, it might be the dishes, it might be the laundry, it might be cutting the grass but there is no deadline here, second thing is the non ADHD adult drives the kids, unless the ADHD adult is on medication, okay that is just for safety reasons okay, then you need to increase your monitoring of your kids, you can do that by setting your timer on your microwave, to random intervals and when it bings go find your kids, where are they, what are they doing and obviously if they are doing well you reward them, if not then you have caught them early, but you need some kind of random reminder to supervise the way other parents would supervise instinctively because you are not going to be doing that so much. The next thing I want you do is do what you do for autism,  go onto the internet there are picture sequences for most of the household routines that kids do, from dressing to bathing, to toileting, to washing, to brushing, print out the picture sequences, they work as well for ADHD kids as for kids on the spectrum and you need to have these at critical points in your home that visualises what the steps of the sequence are, including if you happen to be distance learning at home like we are in the US now, you should even have the day on the refrigerator broken into blocks, so that  your child can see where we are in the day, point to it, understand what is coming next and so on.  So organise the house, make the organisation visual, physical, external so we all see what it is right and then monitor your child very frequently for what they are doing, I mean I could go on and on with all kinds of suggestions but that should help.

BONNIE: No that is brilliant, like some really good practical steps to get started.  Ok we definitely need to wrap up because you have got other things to do in your night, um if people because I know parents will listen to this and think I need to get my hands on that book, where can they get it.

Dr RUSSELL BARKLEY:  Well any major book seller will carry it, Guilford publications, Guilford press is the publisher so you can just go to Guilford.com or just Google my name Russell Barkley, my website always comes up first and if you hit it you will see all my books that are listed there, under the books page and directory and by the way if you go there, go to my fact sheets page, I have got lots of fact sheets for parents that they can print out about ADHD and other topics including the world federations explanation of ADHD that came out this year that the world federation of ADHD association has put together, so you know you can go there, we have our national organisation CHADD.org, go there they have 38 blogs on sheltering in with an ADHD child. I mean it is incredible the amount of information that they have for all the topics that might concern you because that is our national charity for ADHD here in the US.  So there is lots of stuff out there if you know where to find it and I would start with those websites.

LILY: Fantastic, well thank you so much Russ it has been so wonderful speaking with you today, I know that we have both learnt a lot

Dr RUSSELL BARKLEY:  Thank you it has been my pleasure

BONNIE: Yeah we absolutely have so thank you so much and check out russellbarkley.org if you could like to learn more information.

Dr RUSSELL BARKLEY:  Thank you.

LILY: And that’s all for this weeks episode.  Thanks for choosing to have us in your ears.

BONNIE: And remember PROGRESS NOT PERFECTION.

LILY: See you later

BONNIE: Bye

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