Strategies for Operationalizing Executive Functioning
Phone Apps for ADHD: most have subscription costs, I have only listed a few, there are more. I have tried Focus Genie- it is excellent but that does not mean these others are not as good or better.
Focus Genie -Organizer, Task Manager
Inflow- Manage Your ADHD
Clarity CBT Thought Diary
Focus Keeper- Productive Timer
ADHD Organizer Planner
Routine Flow- ADHD Organizer
Goal Setting
Setting Goals should be specific and measurable and timed. Break down into smaller more doable units. Prioritize and do most important first. Avoid multitasking. To prioritize, make a chart listing tasks and then categorizing by importance.
Urgent Important Important but not urgent Not urgent nor important
Do now, 1st Do 2nd Do 3rd Do last.
Break down tasks by what needs to be done, how long it will take set reminder on phone.
Must do Math homework, 30 minutes ; Studying for test 20 minutes.
If resistant to doing task, then break into 10-15 min. segments:
Task: get year-end data together for taxes; total expected time to complete 6hrs.
Work in 15 min increments. After each increment is complete stop and take a break-move! Then take in what you have just accomplished and notice how that feels (we are looking for a feel-good moment-a Dopamine hit). Then decide if you can knock out another 15min. Repeat after that 15, until task is complete, bet it in one or be it in multiple sessions.
Rule: Find a home for every article of clothing, every piece of mail or paper- no piles allowed!
Mindfulness
Developing a mindfulness practice takes daily practice but becomes easier by the day if you stay with it. When we are in awareness of being, we are in the present moment, noticing what is. When we are doing that, we are in a different part of our brain where there is no I-Me chatter- it is quiet- yes quiet! If you have racing thoughts and this seems a challenge- try practicing the first part of Flow- a coping skill. Video instruction is available at https://herbcohen.one go to video tab scroll to Practice Flow video. After part one you will be in awareness and can notice how being in awareness effects your ADHD. If this is very positive, practicing will condition being in awareness all the time.
Anxiety can take you out of awareness. To rapidly remove anxiety without medications, Go to my website again, but now search for two videos- Rapid Grounding Tools and Exercises to Move Out of Dorsal Vagus. If anxiety has become a steady state or is causing great distress, then you should call and make an appointment as I have powerful therapeutic tools to permanently take anxiety down. As I mentioned earlier growing up with ADD/ADHD can result in experiences that are traumatic. In fact, I came to study ADD/ADHD because most of my trauma clients also have ADD/ADHD.
Sleep and Diet
Sleep. Stimulant medications can disrupt sleep; thus, it is important to partner with a prescriber who can help you modify timing, dosing, or choosing another option. Good quality sleep, optimally 7 hours, is very restorative and facilitates our brain’s ability to clean out waste a debris resulting is better focus and clarity.
Diet. Stimulants can also affect diet by diminishing appetite. That might sound like a benefit in a society that has a 60% obesity rate, but it becomes serious as one’s self-regard is already compromised from ADD/ADHD. That is core to someone developing an eating disorder. In Families where love is transactional, and we are judged by appearance. I have worked with people whose job was to photoshop fashion photos of models already emaciated from anorexia. Society offers idealized female forms that are not accessible feeding this dilemma. The shame of not being able to perform as others colludes with distorted body image and not having an appetite from stimulants is fertilizer for any underlying eating disorder. SNRI’s can be an alternate option. But we are what we eat, thus if we eat a lot of sugar and fat, we are not going to feel good nor function well. We will create peaks and valleys in blood sugar, and this will impact our energy, which impacts focus and functioning. I am not going to go into what constitutes healthy eating as a generalization as each of has different requirements and needs. I will say that if you are reading this, I am assuming you are taking managing ADHD seriously and I am suggesting you understand that our executive function is directly impacted by diet and sleep as medication options. This site will not be suggesting one diet or eating philosophy over another, but I strongly suggest working with someone to explore what you are currently doing and what might work better. Functional Medicine is more aligned with a holistic approach to care. Functional Nutrition comes from that perspective. Audrey Stimpson is a Functional Nutrition Coach specific to ADHD. She can be contacted via her webpage at www.audreystipson.com.
Accommodations
Accommodations are things we or others can do to increase successful functioning with ADHD.
Thus, there are self-accommodations, practices we develop to compensate or mitigate our experience. External Accommodations can also be things we ask our school, employer, spouse, or partner to do or provide.
Disclaimer: Examples provided are for the purpose of stimulating thinking in this manner but are not an attempt to provide a comprehensive list of such as that would not be possible. The intent is to supply a flavor of what accommodations can be so one can be creative within your own personal milieu.
External Accommodations
Exercise (30 min.) is known to mitigate, restlessness, increase and prolong focus and calm. Thus, for children in school, getting exercise early in the day would be optimal to learning so asking for a schedule to make that happen is an accommodation and children with ADHD should be entitled to such. Moving a desk within a class to a least distracting location will help. Allowing extra time to take a test or do a writing assignment. Using audio books for texts where possible and recording lectures. Being allowed to take breaks at work, movement breaks and having a desk that can allow one to work standing up or sitting, so change is possible. Ask for a desk in a more isolated area or an office rather than an open floor with cubicles.
Personal Accommodations
Using noise cancelling earbuds to limit external distraction. Use auto payments for bills to declutter tasks. Use timers and planners- see phone APPS. Take good notes, write things down-use sticky motes, bridging cards (post cards with To Do instructions). Use GPS trackers for keys, phone, wallet. Walk through lunch but do not skip meals. If you learn a way to quiet your mind-like the 1st part of the Flow exercise- if you practice that daily, you begin to condition quiet and now are creating an improvement by your own action. Use clear bins for storing and organizing so contents is visible. Choosing an occupation that has more movement and change will be a better fit than a a static office type job. Practice reframing: Instead of self-shaming for making mistakes, say” I have learned from this experience and now I am better because of it. I will be a better person in the future if I learn from my mistakes in the past so we can be grateful for those wonderful learning opportunities! If an employment situation is too challenging, consider finding employment that is a better fit. It is not a reflection of who you are, rather what it is you can do best.
ADHD Assessments
The list of Executive Function and ADHD assessments is a sample of what is used or available. I have no experience with any and so have no opinion or preference but will provide their names. One exception is a big no to gene testing. Genesight, ClarityX and Myogenes are examples to avoid.
Cambridge Brain Screening
MindPrint Learning
WISC-V
CTOPP-2 , CPT3, TOVA, CELF, GORT 5, IVA
BOT-2 Sensorymotor
MO BAK KG ( Kindergarten)
Stoop Color-Word Test
BDEFS (Adults)
BRIEF-A
FrSBe
Quotient Test
WCST
Linkages
Counseling, Anxiety, OCD, Coping Strategies
Herb Cohen, LCAT, ADHD Certified Clinical Services Provider
81 New Street Huntington, New York 11743 (631) 697-9850
Parenting Children with ADHD
Richard Formica, PhD
NJ and Oregon Licensed Psychologist
PsyPact APIT Certified Psychologist
Website: www.drrichardformica.com
Prescribers