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New research: Stimulants for ADHD Affect Wakefulness and Reward, Not Attention

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New research: Stimulants for ADHD Affect Wakefulness and Reward, Not Attention

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Stimulant medications target brain areas that control reward and wakefulness, not attention, suggests new research in the journal Cell that challenges prior thinking about ADHD treatment.

For decades, doctors have prescribed stimulant medications - methylphenidate and amphetamine - under the assumption that the drugs directly improve attention and concentration in individuals with ADHD. However, the new study led by a team of researchers at Washington University School of Medicine in St. Louis posits that prescription stimulants increase alertness and motivation in children with ADHD.

The researchers compared the resting-state functional MRI (fMRI) data of 5,795 children aged 8 to 11 years who participated in the Adolescent Brain Cognitive Development (ABCD) Study. They found that children who took stimulants the day of the fMRI scan showed increased activity in brain regions related to arousal and reward, but no notable changes in regions connected to attention.

"Essentially, we found that stimulants pre-reward our brains and allow us to keep working at things that wouldn't normally hold our interest - like our least favorite class in school, for example," lead author Nico U. Dosenbach, M.D., Ph.D., said in a statement.

According to parent reports in the ABCD study, children with ADHD who took a stimulant medication received better grades in school and performed better on cognitive tests than did children with ADHD who were not taking stimulants.

The study's findings also offer a new understanding of ADHD hyperactivity. In essence, ADHD hyperactivity may be less about having an abundance of energy and more about seeking stimulation and reward.

"Whatever kids can't focus on - those tasks that make them fidgety - are tasks that they find unrewarding," Dosenbach said. "On a stimulant, they can sit still because they're not getting up to find something better to do."

Stimulant Medications Benefit Sleep-Deprived Children

Another key finding from the study is that stimulant medications may mimic the benefits of a good night's sleep.

"We saw that if a participant didn't sleep enough, but they took a stimulant, the brain signature of insufficient sleep was erased, as were the associated behavioral and cognitive decrements," Dosenbach said.

The ABCD Study reported that children who got less than the recommended nine hours or more of sleep per night and took a stimulant received better grades in school than children who got insufficient sleep and did not take a stimulant. They also received the same grades as well-rested children who did not take a stimulant.

Children with poor sleep may have shown improved academic performance when taking stimulants, but the researchers caution that stimulants do not cure the effects of chronic sleep deprivation.

"While our results appear to show that the cognitive performance of sleep-deprived children benefited from stimulants, we caution that mounting evidence points to cumulative health consequences of long-term sleep deprivation, including increased risk of depression, cellular stress, and neuronal loss," the researchers wrote.

Signs of sleep deprivation, such as difficulty paying attention or poor working memory, overlap with ADHD symptoms and may lead to children being misdiagnosed with ADHD when the actual problem is insufficient sleep.

The researchers stress that findings from the study shouldn't undermine clinicians' confidence in the effectiveness of stimulants for ADHD. However, it's important to rule out factors like sleep deprivation before turning to medication.

"Sleep disturbance is a common comorbidity of ADHD and a common complication of stimulant treatment; therefore, clinicians should screen for sleep disturbance in children with ADHD both before and after prescribing a stimulant," they wrote.

Nearly three-quarters of children with ADHD experience a sleep disorder. Sleep problems last into adolescence and can aggravate ADHD symptoms during the day for many children.

"We know that teens with ADHD are more likely than their peers without ADHD to get insufficient sleep on school nights," said Stephen Becker, Ph.D., in his ADDitude webinar, " Why Am I Always So Tired? The Latest Science on Improving Sleep in Children and Teens with ADHD."

"We've also shown that poor sleep impacts academics, including academic performance, organization, and lower grades based on report cards that we've acquired from schools and college institutions," Becker said. "In some of our work with young teens, even after we account for a teen's initial levels of depressive symptoms or oppositional behaviors, those teens who had sleep problems went on to experience an increase in depressive symptoms and oppositional behaviors."

The researchers recommend that future long-term studies evaluate whether stimulant users are less likely to get adequate sleep and measure the cumulative effects of sleep loss over the lifespan. In addition, further research is needed into the long-term effects of stimulant use on brain function and whether stimulants increase task- fMRI activation in response to smaller anticipated rewards.

"The ABCD cohort includes a mix of children taking different stimulant medications and diagnosed with different ADHD subtypes; however, it is not powered to investigate the effects of specific medications or ADHD subtypes," they wrote. "Variability in scan duration and the lack of precise data on timing and formulation (e.g., immediate vs. delayed release) of stimulant administration limited our ability to account for pharmacokinetic effects in the ABCD cohort, potentially leading to an underestimation of stimulant effects on fMRI connectivity."

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Why is an article about Executive Function so critical?

If your child struggles with school (homework, trouble staying on-task, disorganized, problems with time management, avoidant, resistant, forgetful, overwhelmed, etc.), they probably struggle with Executive Function, and this article is literally the most important article I've written for you. You see, Executive Function is the #1 term parents and teachers must understand in order to help struggling students, . In fact, most parents and educators have never heard the term because schools don't educate people about it.

In this article I seek to demystify EF for parents and educators. I want you to walk away from this article thinking, "Wow, I now have a pretty good grasp of Executive Functions, I have a better understanding of my child, and most importantly, I have a better understanding of how to help."

I also created this printable PDF: - Your guide to why Executive Function is the most important concept we must understand in order to help struggling students succeed.

Outside-the-box learners need outside-the-box solutions rather than cookie-cutter approaches. They think, learn and process differently, and need strategies that are tailored to their unique personalities and idiosyncrasies. They tend to develop asynchronously within the various aspects of Executive Function, and when this is properly taken into consideration, we can empower these students with solutions that work.

The big problem for students who struggle with EF is that, by it's very nature, these problems can literally prevent them from reaching their goals and therefore their potential as adults. However, with the right support, we can help our children manage, compensate for and get accommodations for EF challenges so they can have the tools needed to build a remarkable future.

If you like this, please share it to help more people!
Thanks,
Seth

What is Executive Function? Defining it in Plain English

In simplest terms, Executive Function means the ability to get stuff done (homework, writing a paper or cleaning a room, etc.).In other words, to "execute​" complex tasks through to completion.

The brain must do a lot of things in order to accomplish a task or goal. However, adults sometimes take for granted how long it's taken them to develop their own executive skills, and they can be baffled at how difficult it is for kids to execute. A good example is homework. It's not uncommon for the parents I work with to say something like this, "I don't understand why he doesn't just do his homework and turn it in. It would make everything so much easier! What is going on?!" Because EF is still developing, the student literally doesn't have the series of skills needed to execute the task to completion. Therefore, it's not that they won't, it's that they can't. Of course, as some kids get older and more burnt out with school, there can be more "won't".

Things that sound simple to an adult can require more Executive Function than some kids have. Think about the homework example again. Common problems with homework include not knowing or remembering that there is homework, remembering but putting it off, doing part of it and not finishing, doing it and forgetting to turn it in, losing it, forgetting to put a name on it. All of these situations have the same result: the students grades don't reflect their ability. All of these can be EF issues and as stated above, are often a matter of can't rather than won't.

Does Executive Functioning impact my child or my students?

Students of all ages, elementary school through graduate school, have to learn many skills in order to navigate school. If they struggle with executive function, they might struggle with the following:

Homework - Not remembering what is for homework, not understanding homework requirements and details, forgetting to do homework, procrastinating, forgetting to turn it in, incomplete homework, missing or lost homework, not putting name on homework.

Planners - don't use them effectively unless they are forced to, don't understand long or short term planning strategies, don't like planning.

Grades - Grades are surprising low and do not reflect potential or ability, missing and late assignments affect grades, ineffective studying results in low test scores, forgetting to study affects grades.

Organization - school materials, papers, folders, desk, locker, backpack, bedroom.

Time management - often late, unrealistic perception of how long something takes to accomplish, procrastination.

Details - not noticing important details about assignments, not hearing teacher expectations on school work, not reading directions carefully, not checking math work and getting wrong answers even when they know how to do the work.

Preparation - not being prepared for class, don't have materials they need, forget pencils, homework, planner, books, not prepared to leave the house for school, sports, family activities.

Advocacy - don't ask for help, don't know what to ask for help with, don't understand that a teacher is a resource, don't raise their hand for clarification, don't email teacher when they have questions, don't go to office hours.

Overwhelm - they don't even know where to start because they are so overwhelmed with details, stressed, avoidant, procrastinate because they are overwhelmed, homework fights, resists help from parents.

Focus - can't pay attention to one thing at a time, incomplete work because they don't follow through, distracted easily, trouble concentrating, can't focus on reading a passage effectively.

Writing papers - trouble organizing writing, ideas go in countless directions, inability to edit effectively, trouble clarifying ideas, takes longer than it should, they may be able to verbally communicate ideas but can't write them clearly.

Why most parents and teachers aren't aware of Executive Function

Unfortunately, most of the literature on Executive Function is not in layman's terms, thus making it challenging for parents and educators to learn about. For example, if you search the internet for Executive Function, here are some of the confusing definitions you'll find:

"Executive functions (also known as cognitive control and supervisory attentional system) is an umbrella term for the management (regulation, control) of cognitive processes."

"Executive function is a set of mental processes that helps connect past experience with present action."

"Executive function refers to a set of mental skills that are coordinated in the brain's frontal lobe. Executive functions work together to help a person achieve goals."

So let's keep it simple with one of the definitions I listed earlier: Executive Function means being able to get stuff done.

In order to get stuff done, you need to be able to do things like plan effectively, organize, focus, self-start, stay on task, avoid distractions, make good decisions, have a realistic perception of time, persist when you don't feel like it, and do several other things in order to execute. These are some Executive Functions in plain English. You must be able to "regulate" your thoughts, emotions, and actions in order to accomplish these goals and in order to get your needs and wants met in the long term.

When speak about EF with language that relates directly to the problems these kids are experiencing, we can do a much better job of helping them.

EF in the brain

The prefrontal cortex is where EF takes place. This is a whopping ⅓ of your brain and is located behind your forehead. The brain develops from the back to the front, so for kids who struggle with EF, the prefrontal cortex is still developing. The good news here is that it continues to develop well into our 20s, and EF skills can get better with time, practice and proper guidance. Unfortunately, most schools don't teach EF skills effectively, so the ones who struggle are often misunderstood and shamed.

The Aspects of EF

How do we help someone do what they need to do, in their own best interest, when they seem like they can't or won't do it? We don't give up. Babysteps work. The brain DOES change. EF continues to develop well into your 20s. The following are my interpretation of the aspects of EF, aka the things your brain must do in order for you to "execute" complex tasks. (Note: Various experts break down EF differently. I choose my words in order to make the concepts more relatable to relevant problems your child may be having.)

1. Plan - The ability to have a realistic perception of the steps necessary to accomplish a goal or task.

2. Time management ​- The ability to manage time or to have a realistic perception of how long things take. Important in planning and scheduling too.

3. Organize - ​The ability to create systems of doing things or keeping track of things, that are organized enough so goals can be met effectively.

4. Prioritize ​- The ability to know and do what is most important at any given time.

5. Inhibit​ - This refers to one's ability to hold back, to pause, to think before you act, to not be too impulsive, to have self-restraint. Inhibit thoughts, emotions, behaviors that are inappropriate or that go against long term goals and wellbeing. When we do not inhibit well we are thought to be impulsive or hyperactive.

6. Focus​ - The ability to manage and sustain attention, focus, concentrate, be "on task", stick to it. Resisting temptation to shift when trying to focus, avoid distractions, redirect thoughts.

7. Task initiation ​- Self starting or activation. Getting the ball rolling, getting the train moving.

8. Task persistence​ - Continuing to try until finished, working to completion.

9. Transition​ - The ability to shift from activity to activity effectively.

10. Working memory​ - Verbal and visual strategies that help us keep things in mind as we work through things. It's like juggling balls, being able to track the important details during a process. Includes self-talk and visual imagery.

11. Details​ - Remembering and managing important details.

12. Reflection - ​Reflection is all about self-awareness, consciousness, mindfulness, introspection. It refers to one's ability to take a step back and reflect in order to problem solve. A lot of people with EF problems have trouble learning from their mistakes. They don't connect the dots well and continue to repeat self-defeating behaviors. Reflection also involves to self-checking details schoolwork (think checking work in math for example or checking to see if your name is on the paper).

13. Emotional regulation​ - Having tools to truly regulate and work through challenging emotions.

Executive Function Lies

Unfortunately, kids with Executive Function problems often internalize these negative messages:

I'm dumb, stupid.

I'm not smart enough.

I'm lazy.

I don't care about school.

I'm a failure.

I can't do anything right, so why try?

Teachers and parents don't intend for kids to get these messages, but nevertheless, many do. How can we help? The first step is to be very aware of the words we use and how they affect kids. We need to understand that these kids are struggling with legitimate Executive Function challenges. Therefore, beware of saying things like this:

You aren't trying your best.

You have so much potential.

I know you're smart, you just need to care more about school.

Motivate yourself.

You need to be more disciplined.

Just focus.

You're making bad choices.

How do we change these harmful messages? This is a big topic, but generally speaking, we need to reframe the entire dialogue to take EF into consideration and build upon strengths. Of course this is very challenging when our kids are experiencing compulsory schooling which is dire need of massive reform and rethinking. Our schools tend to do very little to value their unique interests, curiosities, learning differences, strengths and idiosyncrasies. Instead, our systems have been designed to reward compliance rather than true critical thinking, personal growth and personal choice. We teach what to think rather than how to think. But I digress... here's a video I made that will help with communication.

Finally, one practical tip I use with parents is to research "attachment theory" and "somatic therapies". Understanding these will help you to understand how to create safe and healthy emotional attachments with your children as well as how our minds and bodies influence behaviors. Here are two books to get you started: and

A word about diagnosis

I work with a lot of families, and there is a lot of misunderstanding about having a diagnosis of some sort. There are several possibilities here:

Some students who struggle with Executive Function are not tested for anything

Misdiagnosis, or some are tested but with bias (example: a gifted child without adhd is tested for adhd by a family doctor who does not have much training about learning issues. The symptoms look like adhd, so the diagnosis is made, meds are prescribed, and it doesn't work or causes harmful consequences, like anxiety problems.)

Underdiagnosis - some kids are never diagnosed, but there is something going on that needs to be diagnosed. If the correct diagnosis were made, it'd be a positive game-changer for this child.

Overdiagnosis - Child is diagnosed with more than is actually there.

While a diagnosis may be helpful, it's not always necessary. What is necessary is that a student get the support they need - executive function strategies (coaching, tutors, books, my videos and blog), emotional support (therapists for kids who are dysregulated or when family dysfunction runs deep), physical support (restful sleep, healthy diet, substantial exercise and movement are critical)

Ways to help kids who struggle with Executive Functions

There are countless ways to support your child, and this is a list I made to give you a good starting point. Read through it and apply what you like. It should give you a few nuggets.

1. Foundations - Here's the foundation of strong EF: Restful sleep, food that nourishes the body, adequate exercise.

2. Routines - Effective routines, predictability, groundedness (routines for updating planners, overhauling backpacks, homework, studying, transitions, waking up, bedtime, fitness, etc.)

3. Metacognition - Metacognitive understanding of emotional needs and implementation emotional regulation practices.

4. Systems - Personalized systems to effectively manage backpack, folders, planners, sacred study space, homework, etc.

5. Ownership - Ownership and buy-in are critical if your child is to be engaged. Too often we just tell kids what to do and don't give them any say in the process.

6. Listen - Compassionate support.

7. Hacks - Visual and auditory tips, tricks and tools.

8. Organizing papers - If binders don't work for you, replace with simple color coded folder system.

9. Visuals - Flag books with stickies. Flag and label important papers so they stand out visually in backpack.

10. Labels - Outta sight, outta mind. Therefore, label everything BIG AND BRIGHT.

11. Alternative note-taking - Draw your notes. Great for visual kids. Use an audio recorder to study creatively.

12. Archive - Make an archive (see blog). Do not keep every paper in your folders and backpack. Only keep currently relevant items, archive the rest (the truth is that you probably will never need it anyhow).

13. Study groups - Study partners work wonders.

14. Chunk - Chunking assignments down into bitesize pieces. Chunk by time or by task.

15. Plan - Make a plan even when you don't want to. These kids do not know how to plan, and it's one of the most important skills.

16. Advocacy - Self advocacy and advocacy from supportive people (Know your rights. Start with IDEA.)

17. Microsuccesses - Look for all small successes and build upon them. Make goals reachable. It all counts.

18. Timers - Use timers and alarms to calibrate time management skills.

19. Mindfulness - The BEST tool ever: Mindfulness. Meditation works wonders. Period.

What makes Executive Functioning worse?

1. Processed foods.

2. Sleep problems, electronics interfering with sleep.

3. Lack of exercise.

4. Stress, overwhelm, dysregulation, adrenal fatigue.

5. Sensory issues, sensory overwhelm.

6. Useless busywork, meaningless assignments and misinformed adults.

7. Unclear expectations.

8. Shame.

9. Fear Resistance, avoidance, procrastination, unwillingness.

10. Inability to articulate systems. Lacking ownership and buyin with system development.

Systems Self-assessment Checklist - what systems do kids need?

I use this regularly with my students (see my free course for a complete breakdown of how to use this successfully). This serves as a guide to explore important areas to problem solve within. Feel free to cut this out and keep it handy:

1. Foundations - Sleep? Nutrition? Fitness?

2. Backpack - Overhaul completely once a week, folders, papers, etc.

3. Planner - How well is it working and being used? Update long term and short term. Need planner routine or it won't work.

4. Routines - Is study routine/workflow optimal? Manageable? How to make it more focused and less distracted?

5. Grades - Check online grades at least once a week? Make a to do list of missings and incompletes.

6. Advocacy - Who do you need to communicate with? Be proactive not reactive when possible.

7. SSS - How effective is your Sacred Study Space? How well can you focus there?

8. Relationships - Family, friends, how's it going? What do you need? How's your relationship with yourself?

9. Stress - What are your biggest stresses lately? What is overwhelming or frustrating? Minimize? Reframe? Breathe. What are solutions?

10. Beliefs - Limiting? Scarcity? Abundance? Growth or fixed mindset? Self-talk, defaults, reframe.

11. Technology - Is computer optimized for school? Page blocker? Distraction free? Tabs/bookmarks for all relevant school links? Online calendar set up?

Executive Function Resources

Seth

Please CLICK below to share.

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What is EXECUTIVE FUNCTION (in plain English) Seth Perler

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If your child struggles with school (homework, trouble staying on-task, disorganized, problems with time management, avoidant, resistant, forgetful, overwhelmed, etc.), they probably struggle with Executive Function, and this article is literally the most important article I've written for you. You see, Executive Function is the #1 term parents and teachers must understand in order to help struggling students, .

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Beyond BookSmart: Executive Function Coaching & ADHD Support

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Our personalized and evidence-based approach to Executive Function coaching helps people of all ages become more effective at managing their demands

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Evidence-Based Education on Adult ADHD blog 

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Evidence-Based Education on Adult ADHD blog 

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Unlock your true potential and embrace your strengths.

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ADHD facts, based on research curated by Stephan Faraone

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ADHD facts, based on research curated by Stephan Faraone

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What are we to make of adults who exhibit the diagnostic criteria for ADHD, but are nevertheless high-functioning and successful? A trio of British investigators has just published six case studies that explore this question. It would have been better for them to have conducted a much larger, controlled research study but, in the absence of such data in the area, these case studies are intriguing and may help guide more informative research.

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The authors recruited six successful men between the ages of 30 and 65 from a National Health Service tertiary service in London. Four were in long-term relationships, with children. All had good jobs.
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In open-ended taped interviews of up to an hour in length, each was asked three questions:

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1. What do you think are the advantages and disadvantages of having ADHD?
2. Please describe a time when you felt that your ADHD helped you to achieve something?
3. What aspects of your ADHD would you miss if it went away?

Hyper-focus in ADHD is generally considered a deficit, inset-shifting, and task-switching. But the authors report that participants associated it with productivity. One said, "I think the energy that the ADHD brain seems to have....it's unfocused, quite scattered, chaotic and a bit random...but give that brain something that you can tune into, and it's your interest, then all that random stuff just goes boom... I get this incredible intense concentration and that's great for work."
Participants also saw advantages in divergent thinking, with one stating, "I'm an artist.... a creative type... a Bohemian.... you are most likely to be a creative person if you are a divergent thinker....and not convergent... I am very creative and that's through and through... I'm a fine art graduate, a musician, a published poet, an entrepreneur, a performer."

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All the participants reported being seen as nonconformists. Depending on a viewpoint, that can be seen as either detrimental or advantageous.
Impulsivity is a core symptom of ADHD. Participants however related it to bravery, and more specifically adventurousness, spontaneity, and thrill-seeking. One said, "thrill-seeking is an ADHD thing... I can list in my life have done white water rafting, bungee jumping, hand-glider pilot ... I have done a lot in my life and achieved a lot and experienced a lot... Furthermore, I would see a lot of that as being quite positive, and a lot of that is ADHD drive."
Another common theme was high energy and "spirit." One participant said, "I've got all this energy.... a lot of energy... whatever it's to do with... nature/nurture/spiritual stuff."

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These testimonials are useful as a check on the usual narrative of impairment. ADHD does not predestine all it afflicts to an unfulfilling life. Many, often assisted by medication, still lead exciting, successful, rewarding lives. Yet, we must be cautious in concluding that these individuals were successful because of their ADHD. It is possible, even likely, that they had other strengths such as high intelligence that compensated for their ADHD symptoms. We can not know from this report if their lives had been even more fulfilling or successful in the absence of ADHD. See, for example, my blog about highly intelligent people with ADHD: https://www.linkedin.com/pulse/20141126141502-65669938-smart-people-can-have-adhd-too/.

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While the authors concede that "generalizing the findings of this study is not easy to do," they inexplicably "also argue that the positive aspects we found are relevant to other adults with ADHD regardless of sample size, age, gender or ethnicity." It is not possible to draw such a definitive conclusion without a much larger sample.
On a hopeful note, they conclude, "This is a study that reaches out to people with lived experience of ADHD: service users, patients, family members, carers, partners, to say that not all symptoms of ADHD are maleficent. Recovery, high functionality, and flourishing with ADHD are possible. Too often people with lived experience hear about ADHD deficits, functional impairments, and associations with substance misuse, criminality, or other disadvantages on almost every level of life (school, work, relationships). ... This study affirms the positive human qualities, assets, and attributes in ADHD that can promote and sustain high functioning and flourishing." I fully endorse the idea that those with ADHD can have wonderful lives, especially if they receive appropriate treatment, both medical and psychological.

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Cutting through noise to bring you what the scientific community has taught us about ADHD.

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Adult ADHD Strategies: ADD Productivity, Time, Health, Organization

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Adult ADHD is real. And ADHD symptoms such as distractibility, impulsivity, disorganization, and emotional sensitivity impact everyday life. Here, find good strategies for managing time, health, re...

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ADHD doesn't diminish - like your hairline or stamina - with age.

In fact, symptoms of attention deficit hyperactivity disorder ( ADHD) may flare and grow after midlife - especially when mixed with normal age-related cognitive decline, worsening physical health, and the lack of structure that often comes with retirement. Why then, do the unique needs of this large (and growing) population of adults with ADHD remain largely ignored in diagnostic tests, accepted treatment practices, and peer-reviewed research?

The status quo is not working for older patients with ADHD; we need new protocols. Drastic clinical changes must take place to improve outcomes for underdiagnosed, undertreated, and overlooked older adults. Doctors face unique challenges when managing ADHD in this population, so professionals must take equally specialized steps to better diagnose, treat, and understand seniors with ADHD.

What Does ADHD Look Like in Older Adults?

Preliminary research is beginning to paint a picture of what ADHD looks like in adults over the age of 60. I have conducted in-depth interviews with more than 130 women and men diagnosed with ADHD, covering their symptom progression, their experience with medical professionals, and their biggest challenges (both ADHD-related and otherwise) associated with aging.

Findings show that ADHD can look markedly different throughout a person's lifetime - symptoms shift during the transition from childhood to adolescence and young adulthood, again when a person enters midlife, and again during the senior years. While every subject has a unique symptom profile, the following patterns appear fairly consistently in older adults with ADHD:

"Swiss cheese memory," or a memory that is not consistently failing, but also can't be reliably counted on. Certain things are easy to remember for her subjects, she said, while others slip through the cracks.

Other working memory issues such as being easily thrown off course mid-task

Misplacing items

Forgetting words or names

Brain going "blank" periodically

Difficulty learning new things

Talking too much, often without realizing it

Interrupting others

Trouble following conversations

Difficulty maintaining relationships and keeping in touch

Difficulty maintaining order within their homes

Tremendous struggles to make ends meet financially after a lifetime of poor money management

[Take This Self-Test: Symptoms of ADHD in Adults]
These symptoms, not always present in subjects' younger years, could have pervasive negative effects. Adults with ADHD need a lot more support than do average aging adults. They struggle to manage their time, conduct themselves appropriately in social settings, and/or accomplish short- and long-term goals - especially after retirement and the loss of a reliable day-to-day routine.

When asked to identify their biggest challenges, older adults with ADHD pointed to the following five:

1. Not getting things done - procrastination, lack of self-discipline

2. Out-of-control emotions - feeling irritable more frequently than in the past, struggling with anxiety and/or mood disorders

3. Time-management challenges - setting and sticking to a daily routine, being aware of time's passing

4. The "remnants" of hyperactivity - feeling restless, talking too much, "random thoughts whirling in my head"

5. Social challenges - feeling misunderstood or judged, speaking impulsively, missing social cues

Some of the challenges of later years parallel those faced by young people with ADHD as they're leaving home. Both groups lose much-needed structure as older adults leave the workplace or young adults leave their parents' supervision, and both groups are at risk for developing poor sleeping or eating habits (or otherwise neglecting their self-care) as a result. This can, in turn, make ADHD symptoms significantly worse.

ADHD? Cognitive Decline? Dementia? Or Just Aging?

One major concern - for both patients and clinicians alike - is that the ADHD symptoms found in older adults (particularly those related to memory, routines, and executive functioning) don't immediately signal attention deficit to most clinicians. They more often are interpreted as mild cognitive impairment or even dementia - conditions more familiar to medical or mental health professionals.

Mild cognitive impairment (MCI), an intermediary stage between "normal aging" and dementia, can result in memory lapses, impulsive decision-making, or decreased executive functioning skills. When seniors - particularly those who haven't been previously diagnosed with ADHD - visit their doctor complaining of memory loss, doctors commonly assume MCI. Even when the patient has an ADHD diagnosis, it can be difficult to differentiate symptoms of MCI from those of attention deficit, as it's possible that the two conditions can occur together. The distinction between the two is a hugely important question that deserves greater research.

According to the Mayo Clinic, 10 to 15 percent of MCI cases progress to full-blown dementia. There is no evidence of a direct link between ADHD and dementia or Alzheimer's disease. Some studies have found a slight association between Lewy Body dementia and ADHD, but the connection remains murky - particularly given the lack of understanding we have about ADHD's presentation in seniors. Some researchers have hypothesized that any apparent link between ADHD and dementia may be attributed to lifestyle patterns - poor sleeping habits, unhealthy diet, etc. - that appear regularly in people with either condition. In addition, both dementia and ADHD are highly hereditary, however attention deficit was seldom diagnosed in the parents of today's seniors, who have an incomplete family medical history as a result. Importantly, in making the diagnosis in a senior, it's incumbent upon the clinician to ask about succeeding generations - whether there is ADHD diagnosed in their children and/or grandchildren.

Regardless, cognitive decline is a natural part of aging, as blood flow to the brain decreases over time. This is particularly true for women, for whom hormonal changes can exacerbate cognitive challenges. Clinicians must learn to differentiate this normal decline from symptoms of ADHD in order to not dismiss people who come to us with genuine ADHD that would benefit from treatment.

Difficulties in Diagnosing and Treating ADHD in Older Adults

Difficulties separating ADHD symptoms from signs of normal aging stem from the way most clinicians currently diagnose (and understand) attention deficit. Most ADHD symptom criteria and diagnostic questionnaires are appropriate for the diagnosis of children, not adults. Patients aged 60 (and beyond) without a formal diagnosis may exhibit symptoms of ADHD that differ significantly from those listed in the DSM. They also may not be able to consistently recall when their symptoms started or how they've changed over time.

Researchers need to develop an ADHD screening tool specifically for identifying symptoms in old age. In the meantime, doctors evaluating symptoms like those described above should take a full patient medical history (including family background) and dig deep into symptoms, particularly if they suspect MCI. Of utmost importance, to further rule out ADHD, clinicians should determine whether symptoms are new or span a lifetime - which is certainly not indicative of mild cognitive decline.

Many clinicians misdiagnose ADHD later in life due to lack of specialized training. Most physicians receive 20 minutes (or less) of instruction on ADHD in medical school, and nearly all that time is spent on pediatric diagnosis and treatment. In one survey, 40 percent of primary care physicians said they had never encountered an adult patient (of any age) with ADHD. In reality, that's an impossibility. Rather, the likely problem is that they have absolutely no idea what ADHD looks like later in life.

Finding treatment is a formidable roadblock as well. Even after being diagnosed, many adults with ADHD frequently report trouble getting a doctor to prescribe them ADHD medication - even if they'd taken it without incident earlier in life. Concerns about cardiac issues, conflicting medications, or side effects make some doctors reluctant to prescribe stimulants to adults over 60.

We need to develop some parameters with which physicians can be comfortable to ensure that seniors aren't denied access to critical ADHD treatment.

Next Steps for Patients and Clinicians

Our world is becoming both friendlier to adults with ADHD - because of all the digital supports - and more stressful with its myriad new distractions. Older adults with ADHD face new and exceptional challenges - one subject was nearly evicted because of his inability to organize his apartment, while countless others were still working well into their 80s because they hadn't saved enough for retirement. Many face relationship challenges that persist into their later years. Research indicates a greater likelihood for people with ADHD to end up alone due to a higher-than-average divorce rate among couples touched by ADHD.

But aging with ADHD is not all negative - not by a long shot. Some of the subjects of my research are having the time of their lives. Finding a more supportive romantic partner after a divorce has had a significant positive impact on the lives of many, as has being active in one's community - volunteering at a local church, for instance, or participating in social events at a nearby senior center.

I have noted a huge range of outcomes, from very positive to very sad. A lot of that is hugely affected by individual circumstance. In order to guarantee the most optimal outcomes, we really need to educate healthcare providers.

To better serve this population, the medical community must devise better diagnostic tools for seniors, conduct in-depth research on the difference between ADHD and cognitive decline, and become more comfortable with appropriate treatment practices. My own research is still in progress, but one key point has become clear: There are a lot of people out there who could greatly benefit from our help.
[Symptom-Management Strategies for Older Adults]
The following information came, in part, from Kathleen Nadeau's 2018 APSARD presentation titled "Still Distracted After All These Years: The Unexplored Territory of ADHD After 60" which will also be the title of her upcoming book on older adults with ADHD.

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A Critical Need Ignored: Inadequate Diagnosis and Treatment of ADHD After Age 60

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Preliminary research suggests that seniors with ADHD experience unique and evolving symptoms that are commonly mistaken for - and overlap with - normal signs of aging. Misdiagnosis and mismanaged treatment after age 60 are serious problems, says Kathleen Nadeau, Ph.D. Here, she outlines her emerging research and explains how clinicians can better serve older patients.

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ADHD can be a struggle, but it doesn't always have to be. Every Monday, join William Curb, as he explores ways that you can work with your ADHD brain to do more of the things you want to do. If you have ADHD or someone in your life does and you want to get organized, get focused and get motivated then this podcast is for you. Part of the ADHD reWired Podcast Network.

ADHD can be a struggle, but it doesn't always have to be. Every Monday, join William Curb, as he explores ways that you can work with your ADHD brain to do more of the things you want to do. If you have ADHD or someone in your life does and you want to get organized, get focused and get motivated then this podcast is for you. Part of the ADHD reWired Podcast Network.

Keeps me coming back

In true ADHD form, I've gone through phases of listening to a lot of different podcasts about ADHD. I tend to find a few episodes that are of interest and then find then find episodes to be repetitive. This podcasts keeps me coming back over and over. I like the wide range of topics and presenters and the length is just right for me. I'd definitely recommend

ADHD predominantly Hyperactive/ impulsive

I love your show and the formatting including the shorter segments and main take aways.

I am wondering if you could speak more on ADHD hyperactive/ impulsivity type in women. I have found little content on this and would find it helpful.

I am a late diagnosed woman with all the criteria for ADHD hyperactive/impulsivity type and only two from the inattentive type. This appears to be really rare in the ADHD community and I would love to hear more about it. Thank you for your show!

I love everything about this show

The host is funny and charming, the information is very easy to digest!! To say the advice is helpful is an understatement, I'm so grateful for this podcast and the shifts I've seen already in my thinking and habits.

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ADHD can be a struggle, but it doesn't always have to be. Every Monday, join William Curb, as he explores ways that you can work with your ADHD brain to do more of the things you want to do. If you have ADHD or someone in your life does and you want to get organized, get focused and get motivated th...

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Mental Health Podcast · Updated Weekly · Nikki Kinzer and Pete Wright offer support, life management strategies, and time and technology tips, dedicated to anyone looking to take control while living with ADHD.

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The podcast for adults with ADHD. Hear stories, learn strategies, and get great productivity tips as we talk about the real-life struggles and what it takes to achieve success. Host, Eric Tivers, LCSW, is a psychotherapist, coach and entrepreneur (with ADHD) in private practice. Eric interviews a variety of guests. Many are people just like yourself, as well professionals, entrepreneurs, and ADHD experts.

The podcast for adults with ADHD. Hear stories, learn strategies, and get great productivity tips as we talk about the real-life struggles and what it takes to achieve success. Host, Eric Tivers, LCSW, is a psychotherapist, coach and entrepreneur (with ADHD) in private practice. Eric interviews a variety of guests. Many are people just like yourself, as well professionals, entrepreneurs, and ADHD experts.

Always interesting, informative, and entertaining!

This is such a great show that provides a TON of information, life hacks for ADHD, and compassion for some of complications that come with it all. Full of empathy AND practical tools/applications to help those who suffer. 🫶🏻🌸❤️

A Neurodivergent Teacher's Gratitude

THE BEST ADHD PODCAST!! I use what I learn here and then pass it on in my classroom. I especially love the recap!!! Makes me laugh how it alleviates my "I know I didn't retain all of that" anxiety. Well done!

So Very Useful

I started out listening to the earliest episodes and then skipped ahead to the newest ones ones. It's so fun to watch the change over time although I kind of miss the old ones because they weren't so highly polished. In classic ADHD style I listened obsessively to this podcast for a time and recommended certain ones too many of my friends. I do still come back now to check out topics of interest though. It is so helpful to hear about neurodiversity from someone who has both experienced it and done a lot of research and learned around it.

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The podcast for adults with ADHD. Hear stories, learn strategies, and get great productivity tips as we talk about the real-life struggles and what it takes to achieve success. Host, Eric Tivers, LCSW, is a psychotherapist, coach and entrepreneur (with ADHD) in private practice. Eric interviews a...

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Supporting neurodiverse children can be both rewarding and confusing. Holly Blanc Moses shares her strategies to support children diagnosed with ADHD and/or Autism. If you want to learn more about emotional health, behavior, social interaction and academics, this podcast is for you.

Supporting neurodiverse children can be both rewarding and confusing. Holly Blanc Moses shares her strategies to support children diagnosed with ADHD and/or Autism. If you want to learn more about emotional health, behavior, social interaction and academics, this podcast is for you.

Great podcast

I am so impressed with this podcast. Great information, delivered in a personable approachable way. Thank you for this resource, it's already helped considerably and I've only had time to listen to 3 episodes. Looking forward to diving into the rest!

5-Star Review - Dr. Tay

Holly's podcast is engaging, informative, and educational. As a licensed child psychologist, I find this podcast valuable and love listening to other professionals in the field.

Autism and Suicide

This was my first time to hear this broadcast and it was very eyeopening. Her guest was so enlightening and also shared example of all the things neurotypicals do wrong because of ignorance. I have a teen grandson with autism and ADHD who struggles daily. Thank you for your program.

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‎THE AUTISM ADHD PODCAST on Apple Podcasts

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Supporting neurodiverse children can be both rewarding and confusing. Holly Blanc Moses shares her strategies to support children diagnosed with ADHD and/or Autism. If you want to learn more about emotional health, behavior, social interaction and academics, this podcast is for you.

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TiLT Parenting, from parenting activist, speaker, and author Debbie Reber, features transformational interviews and conversations with authors, parenting experts, educators, and other parents aimed at inspiring, informing, and supporting parents raising differently-wired kids (giftedness, ADHD, austim, 2e, learning differences, sensory processing issues, anxiety, and more). TiLT aims to help parents feel empowered and in choice in how they parent, have more peace in their daily lives, and parent and advocate for their child from a place of confidence and awareness so that our children can thrive in every way. https:/tiltparenting.com

TiLT Parenting, from parenting activist, speaker, and author Debbie Reber, features transformational interviews and conversations with authors, parenting experts, educators, and other parents aimed at inspiring, informing, and supporting parents raising differently-wired kids (giftedness, ADHD, austim, 2e, learning differences, sensory processing issues, anxiety, and more). TiLT aims to help parents feel empowered and in choice in how they parent, have more peace in their daily lives, and parent and advocate for their child from a place of confidence and awareness so that our children can thrive in every way. https:/tiltparenting.com

Amazing resource

What an amazing resource to parents who want to learn more about supporting their children well. No matter what kind of struggles you are facing. A loving and safe place to talk about hard things and have tools. Thank you!!

AMAZING RESOURCE

I just barely found this podcast and have been listening to several episodes per day (and taking lots of notes!). Each one is filled with great information and I am starting to feel more hopeful and less alone in the journey of parenting a neurodivergent child. Thank you for creating such a helpful resource, I will be sure to recommend this to all my friends in similar situations!

5-Star Review - Dr. Tay

As a licensed child psychologist, I am such a big fan of this podcast and the authenticity Debbie brings in every episode! This is a podcast I will be recommending to my patients and their families.

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tilt parenting: raising differently wired kids

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‎TILT Parenting: Raising Differently Wired Kids on Apple Podcasts

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TiLT Parenting, from parenting activist, speaker, and author Debbie Reber, features transformational interviews and conversations with authors, parenting experts, educators, and other parents aimed at inspiring, informing, and supporting parents raising differently-wired kids (giftedness, ADHD, aust...

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A deep dive into ADHD emotional dysregulation in the classroom

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A deep dive into ADHD emotional dysregulation in the classroom

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ADHD and Emotional Regulation

When Emotional Dysregulation Creates a Barrier to Learning for Students with ADHD How to Help in the School Setting

I was collaborating on a student who was exhibiting concerning " behavioral" problems in the first grade classroom. The child was frequently melting down and having atomic reactions to "not getting their way". Ripping up the worksheet if they couldn't have the blue marker, hysterics when it was time to clean up, refusal to participate when they couldn't have a certain spot on the rug, and explosive during most peer interactions throughout the school day.

When I explained that the child was diagnosed with ADHD , the teacher questioned " But that's it?". Confused as to what role Attention Deficit Hyperactivity Disorde r would play in the serious emotional outbursts of this child.

ADHD is globally misunderstood as a disorder that impairs a child's ability to pay attention and causes hyperactivity. While these visible outcomes may be true for some, they are incomplete. The emotional component of ADHD is nearly as profound as it is underestimated.

ADHD above all else is a disorder that impacts an individual's ability to self regulate.

ADHD above all else is a neurodevelopmental disorder that impacts an individual's ability to self regulate. Individuals with ADHD, will have substantial difficulty regulating attention, activity, emotions, verbal expression, thoughts, sensations ect.. due to differences in the development of the nervous system.

They experience emotions in a far more intense and prolonged way than other children.Inattention, impulsiveness, poor planning and episodic memory problems inherent to ADHD impact the child's ability to develop emotional regulation skills in par with peers making them more susceptible to emotional dysregulation. With ADHD an innate hypersensitivity magnifies the input and then deficient self regulation exaggerates the output.

Most interventions designed to teach emotional regulation are ineffective for children with ADHD because they rely on using the executive functions to control the emotional brain. These are the students that can easily tell you or an upset friend exactly what to do to regulate their emotions. But once that little Einstein is upset, the very strategies just mentioned a moment ago are out of reach. The child will continually fail to regulate their emotions despite their best intentions, they internalize this as personal failure, increasing emotional dysregulation and setting the stage for dangerous secondary complications. .

What is Emotional Regulation?

There are multiple theories to about human emotion generation. Emotions can be defined as a complex reaction pattern, involving experiential, behavioral, and physiological elements, by which an individual attempts to deal with a personally significant matter or event.(APA) Most theories agree that emotions are generated by our primitive instinctual brain based on sensations and past experiences to give meaning to our experiences.

The limbic system connects with the prefrontal cortex ,our thinking brain, tothen manage or regulate the physiological and behavioral expression of the emotion. Emotion regulation follows a similar pattern/process to impulses, using both lower and higher brain structures.

Situation : a subjective experience generates a feeling

Attention: Situation has meaning to the person and they bring attention to it

Appraisal - The person accesses the situation with cognitive processes

Response: the emotion creates an experiential, physiological, behavioral change or expressive response.

While emotions are instinctual and automatic ,our capacity for regulating our emotions, is a learned process that requires substantial cognitive ability.

Inhibit Responses : The ability to pause and assess the significance of the situation

Direct Attention and , Memory , emotional vocabulary : Ability to recognize the emotional significance of perceived stimuli ( I feel disappointed)

Working Memory/Prioritization :Appreciate the need for regulation- (to calculate the costs of reacting outwardly or suppressing actions not in our best interest. ( But it is important I complete my reading work.)

Task Initiation: Select and implement an appropriate strategy (I will use a strategy to feel better so I can do my project)

The Process Model of Emotion Regulation, James Gross (1998), explains that emotion regulation is our capacity to strategically up-regulate and down regulate emotions depending on the person's goal.

Gross describes the five types of strategies that humans use to regulate emotions.

Situation Selection: "Proactively changing our circumstances that support desired emotions.

Situation Modification- "Proactively modifying aspects of the situation so as to alter its emotional impact

Attention Deployment: Selecting the aspect of the situation to focus on in order to help control the emotional response.

Cognitive Reappraisal -Changing how we appraise the situation we are in to alter its emotional significance

Response Modulation- After the response is generated, attempts to directly Influence the physiological, experiential, or behavioral response" to the emotion. .

ADHD Emotional Dysregulation in the Classroom

Understanding how emotions are generated and regulated , one can appreciate how a child with ADHD and undeveloped response inhibition (pause and suppress ) and working memory (calculate the costs from past and future) would have difficulty regulating emotions. Evidence suggests that individuals with ADHD are unable to effectively use the cognitive processes resulting in more frequent emotional dysregulation. Their regulators are OFFLINE.

ADHD's impact on emotional regulation is often characterized by emotional impulsivity, rumination, hypersensitivity and avoidance in the classroom environment.

Emotional Impulsivity: These students may struggle to inhibit behavioral responses to their emotions and moderate the intensity of their emotions.

signs of a low frustration tolerance

quick temper

Intense disproportionate emotional reactions

Difficulty calming down and moderating their emotions.

Get easily thrown into panic mode, they get super-stressed and super excited .

Not getting the blue marker will temporarily feel like a life or death situation, because without cognitive appraisal the brain's can't tell the difference between a life-threatening situation and minor problems, leading to over-the-top and intense reactions to both.

Rumination: Students with ADHD often have difficulty refocusing attention from emotionally provocative events. This focus on one emotion crowds out other important information that might help regulate behavioral responses. They become flooded in one salient emotion and have problems shifting their focus to other aspects of a situation. Poor working memory results in a struggle to compare the current experience with past experiences and use typical self-soothing strategies, such as self-speech and visual imagery.

Increased Sensitivity: Students with ADHD may appear extremely sensitive to disapproval, criticism and rejection. They might interpret a teacher's constructive feedback as harsh criticism or insult, Red marks on their papers, grades and feedback used to improve performance can be painful. They tend to react with knee-jerk defense.

Avoidance- because of the extreme and overwhelming response to emotions some people with ADHD quickly develop avoidance behaviors. They avoid any indication of possible failure, making it hard to initiate tasks.

Understanding the Co-Regulation Needs of Students with ADHD

Co-regulation describes the interactive process in which adult caregivers shape and support self-regulation development. As children grow into young adults, they slowly learn to self regulate and adults contribute less to balance the process.

There are three broad categories of co-regulatory support that caregivers provide to children to help them to develop and expand self-regulatory skills as they grow (Murray et al., 2015) .

Provide a warm, responsive relationship where children feel secure and cared for.

Structure the enviroment to make self-regulation manageable and buffer against excessive stress.

Skill instruction and coaching to scaffold self-regulation enactment.

Students with ADHD may be 30% behind peers in the development of executive function and self regulation skills. They will require an increased amount of co-regulatory support from their caregivers to fill the bucket to effectivly manage the situations across the school day.

Effective Interventions for Emotional Dysregulation

Interventions and support for students with ADHD in the school environment need are proactive and positive and focus on using co-regulation to support the development of emotional self regulation. By providing intervention to the "non-cognitive" parts of the process, we can empower development of strategies that work for the lifespan.

Situation Selection and Modification Interventions

Before children are able to regulate their own emotions, adults use extrinsic situation selection/ modification strategies to set up their environments. Teachers and caregivers can select and structure the situation (environment and demands) with support for emotional regulation. It is important to understand that the situation is not limited to the physical externally observable environment. The " situation" contains the adult's emotional state, the perceived safety of the environment and the child's underlying state.

Creating a "Situation" of Non-Judgmental Curious Compassionate Curiosity

Students with ADHD can be very challenging to develop relationships with. Many have had years of contingent teacher relationships and can be cautious and defensive. When caregivers are carrying the heavy load of our own stress, and feel frustrated, triggered or even threatened by student behaviors, it can be incredibly difficult reacting to disproportionate emotional responses and challenging behaviors with compassion and empathy.

Caregiver Education Parents and teachers require a complete understanding the neurodevelopmental implications of ADHD and how they impact the emotional regulation process for the individual student. These students are NOT willfully non-compliant. It is easy to misinterpret the frequent meltdowns of an intelligent mid elementary school child as a " spoiled child" who only melts down when they do not get what they want and needs to learn to just take no for an answer.

Caregivers must understand that a child will not learn how to self regulate just by being told to " calm down". They will not stop experiencing intense flooding levels of disappointment because an adult says that " it's not that big of a deal, it's just a blue marker." And they will only learn not to trust their feelings when told " You get what you get and you don't get upset ".

These all too common messages, that I myself am guilty of, further dysregulate the child and reinforce a cycle of shame and low self esteem in which a child does not possess the ability to self correct.

Reframe Behaviors : Co-regulatory strategies will develop self regulation skills rather than just manage the behavioral responses. We can strive to reframe and understand challenging behaviors as expressions of poor self regulation. When we recognize and respond to behavior cues as signals of unmet skill development we can provide the needed support in times of stress.

Regulate Yourself First: A dysregulated adult can NOT calm a dysregulated child: Regulate yourself first. Before interacting with the dysregulated student, the caregiver must get to a calm state or you will escalate the situation. This is much easier said than done.Walk away, take deep breathes and wait until you are calm.

Use Reflective Language: Use reflective language to validate the students experience and emotions . We need to recognize that all problems are equally valid to the nervous system regardless of our reality. The blue marker is a life or death situation to that child right now ( meaning it needs the life or death coping tools).

Name and validate students' experiences/ emotions no matter how disproportionate.

Separate how you address students' emotions from how you address their actions.

Be mindful of perceived criticism when providing feedback.

Provide a 4:1 positive to corrective feedback ratio to reduce defensiveness.

Check Physical Presence: Our physical presence, including body language, proximity and eye contact impacts students perceived safety and regulatory state.

Keep an open, non-threatening body posture .

Use a quiet or moderate volume with a serious, calm, steady tone v to model calm when a situation is escalating.

Use a compassionately curious posture and tone of voice to frame questions.

Getting on or below a students' eye level to balance power.

Using proximity as a signal for support but avoid standing over/rushing toward a child.

Environmental Structuring for Self Regulation

Students with ADHD function best in a calm, safe and structured environment with clear and consistent externally represented expectations. Environments that have low demands on impulse control, working memory and cognitive flexibility will support the child's cognitive state for improved emotional regulation.

Increase Predictability: Predictability creates emotional safety. Clear and consistent, predictable routines and expectations promote a sense of security by providing clear goals for behavior regulation.

Create visual reminders of what will be happening each day.

Follow a Consistent Routine

Have Daily and Weekly Visual Schedules

Provide Visual Expectations of Routines and Procedures

Reduce extraneous environmental stimulation: The ADHD brain has significant difficulty with regulating input, all input. Due to difficulty with prioritization, input can appear to be all at the same importance level. For example, the buzzing of the AC is processed at the same volume as the teacher's voice. Reduce extraneous cognitive load present in the learning environment.

Minimize extraneous distractions

Adjusting the lighting

Provide alternative seating options

Create a "reset and return "space where students can go to calm down

Create a Safe Reset and Return Space : An effective "Reset and Return" space provides a place to go and reset before you return to the classroom demands. Reset and Return areas provide a space to downregulate big emotions before they get out of hand. They house helpful tools that externalize the cognitive processes that the student has trouble accessing.

They are safe spaces are for the whole classroom use (including teacher), never to be used as a consequence and need to be trialed by every student to reduce novelty.

R&R spaces typically contain:

Visuals of emotion charts

Visuals of the regulation strategy choices

A bean bag chair or soft comfortable seating

Fidget toys or stuffed animals

Sensory blocking tools like soundproof headphones or a weighted blanket.

Check on TPT and the Whole Hearted Counseling linked below for Free Resources.

Scaffolding Emotional Self-Regulation Skills

Therapist and teachers can support the development of emotional self regulation skills through modeling, instruction, point of performance practice with prompts for skill enactment. Therapists and teachers can provide externalized scaffolding for attentional deployment and cognitive reappraisal.

Externalize Attentional Deployment

Attention deployment is where the individual selects the aspect of the situation to focus on in order to help control the emotional response. We can help students develop a mindful awareness of their emotional states by using frequent check ins and body scans.

Frequent "Systems" Checks - Students with ADHD very often have difficulty noticing and responding to their internal sensations (interoceptive cues). Explicit teaching of interoceptive awareness will improve emotional regulation skills. The Interoceptive Curriculum is highly recommended.

Helping students develop improved interoception allows them to detect a trigger and calm an emotional storm on the horizon. They may need frequent check ins that bring awareness to their feelings, emotions and sensations.

Systems Check / Body Scan:

Check my surroundings

How is my breathing?

Body Scan?

Am I hungry?, Am I thirsty?Am I tired?

Do I need the bathroom?

Temperature: Am I hot or cold or just right ?

Do I have any pain?

Emotions? Scale of the feeling.

Empty the Stress Bucket Regularly: Reduce emotional vulnerability by providing regularly scheduled movement and whole class stress relief. Movement breaks, brain breaks, one minute mindfulness and breathing exercises will increase a student's underlying stress tolerance. Offer variability to help a student find what works best for them.

Externalize Cognitive Appraisal to the Environment

Because students with ADHD have difficulty accessing the prefrontal cortex to think about their emotions before expressing it, we can externalize this process through development of Emotional Plans of Action, practicing gratitude and providing visual choices of down regulation strategies .

Emotional POA: . To scaffold poor episodic or working memory, we can consider upcoming events and how students might feel in them .We can list concerns and develop a plan of action to cope, on paper. This gives kids the chance to think about their emotions when calm and regulated in advance of an event, and plan how to proactively manage those emotions. Remind students of available supports or strategies, when they might not be at their best. How did you handle the assembly last time? What worked for you? (In the moment , "Check your POA")

Gratitude/Glimmers Habit - "What wires together fires together". Evidence supports that practicing gratitude on a regular basis will lay more positive neural networks to build up the underlying defense. Incorporate finding three things that you are grateful for or three things that went well today into the class routine to build a reparative habit.

Key TakeAways

Children with ADHD have a developmental difference or delay in their ability to learn how to self-regulate their emotions. ADHD's impact on emotional regulation is often characterized by emotional impulsivity, rumination, hypersensitivity and avoidance in the classroom environment. Emotional dysregulation impacts capacities to think clearly, increases cognitive load demands and stresses working memory capacities. Emotional dysregulation can be a formidable barrier to learning.

These students will not learn how to effectively self regulate without increased co-regulatory support from an adult. The typical self regulation strategies that students learn throughout childhood will not salient without explicit practice and co-regulatory support.

Teachers, parents, coaches, mentors can help the child develop self regulation skills by modeling and scaffolding the five type of strategies humans use to regulate our emotions,

We can co-regulate to fill their individualized regulation bucket to match the expectations of the classroom environment by:

The key is not to totally avoid situations that are difficult for kids to handle, but to coach kids through them and provide a safe , non judgmental supportive framework that will work for them long after they leave our classrooms. We can systematically scaffold emotional self regulation, ❤️

Tools for School

Emotional Regulation Strategies and Visual Supports: Includes a copy of this article and 21 pages of caregiver education and student visual supports.

Interoceptive Curriculum - I use this prior to any emotional language. Becoming a detective of our own body cues is essential.

Whole Hearted Counselors - I own many of her resources in digital and print format.

The three titles linked below are a must read . Dr. Ross Greene, Dr. Lori Desautels and Dr. Mona Delahooke brilliantly illustrate co-regulation and its powerful impact on behavior.

References
Gross, J.J., Sheppes, G. and Urry, H.L., 2011. Emotion generation and emotion regulation: A distinction we should make (carefully). Cognition and emotion (Print), 25(5), pp.765-781. Van Stralen J. Emotional dysregulation in children with attention-deficit/hyperactivity disorder. Atten Defic Hyperact Disord. 2016 Dec;8(4):175-187. doi: 10.1007/s12402-016-0199-0. Epub 2016 Jun 14. PMID: 27299358; PMCID: PMC5110580.

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ADHD and Emotional Regulation - OT 4 ADHD

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When Emotional Dysregulation Creates a Barrier to Learning for Students with ADHD How to Help in the School Setting I was collaborating on a student who was exhibiting concerning " behavioral" problems in the first grade classroom. The child was frequently melting down and having atomic reactions to "not getting their way".

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Article about ADHD from Coaching Company 

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Article about ADHD from Coaching Company 

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Coaching "tools" and "performance and collaboration platform for individuals & teams" - mentions Jenny Dearborn!

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Fingerprint For Success (F4S) is a collaboration and performance technology that empowers individuals and teams to achieve amazing things at work and in life. Based on more than 20 years of research, F4S' revolutionary predictive analytics have achieved more than 90% reliability in forecasting personal and team motivations, behaviors, and performance. In 2020, F4S launched the world's first AI Coach 'Marlee' to help users optimize their talents and bring out the best in themselves and their teammates.

What did our study on ADHD in the workplace measure?

From July 2022, we pioneered a global study What are the superpowers of ADHD at work? We wanted to find out whether people who experience ADD/ADHD have distinct motivations or cognitive patterns that drive them at work. F4S surveyed more than 700 people from 71 countries, with a range of respondents from different age brackets (Gen Z, Millennials, Gen X and Baby Boomers).

We aimed to explore how individuals with ADD/ADHD thrive and realize their full potential at work, and to help leaders provide a supportive workplace that embraces and celebrates cognitive diversity.

So, what did we learn?

Overall, what are the advantages of having ADHD?

According to F4S research, having ADHD offers a range of advantages that contribute to workplace success. An ability to hyper-focus on the details, along with an unconventional approach to work problems makes ADHDers born to break ground and innovate.

People with ADHD are also highly adept in remote work settings and have demonstrated greater tolerance for different workstyles and approaches to problems.

F4S research highlights the unique advantages of ADHD at work

It's still early days, but we've uncovered groundbreaking findings on the advantages of ADHD in the workplace. We believe these preliminary findings, combined with the existing scientific literature, will have wide-ranging implications for the future of work, and people with ADHD's place within it.

Here are some of the most exciting preliminary results, relativized to the US working populations, with 50% being the average.

Remote work is a win for ADHDers

According to our research, individuals with ADHD have a high preference to work uninterrupted and in solo spaces ( Solo Environment). This may include working alone, being in a space where people can't spontaneously interrupt, and blocking out time to work individually on tasks. While some people have mixed feelings about the shift to remote working, many ADHDers across the working world likely rejoiced. The general 'hum' of an office can be highly distracting for people with ADHD. Chatty coworkers may easily be ignored by a neurotypical person, but to an ADHDer, it can be kryptonite to their productivity.

It's little wonder that people with ADHD exhibited a strong preference for working in solo spaces. In their own space, they can be in control, and eliminate distractions. It's here that people with ADHD are able to hunker down, focus and thrive.

What can we learn from this? It means that people with ADHD are far more motivated to thrive in remote working environments and virtual teams. In a new era where remote or hybrid work are more common, many people with ADHD are able to access their talents more than ever.

While it isn't common knowledge, there is strong evidence to suggest that Leonardo Da Vinci ², Alexander Graham Bell ³, and Thomas Edison ⁴ would have been diagnosed with ADHD if they lived today. What each of these great innovators had in common was a need for their own solo working spaces, this is where they could get into the mindset they needed to work their magic.

The question is: how many other ingenious innovators have been cooped up in a noisy office until now?

Overall the research found most people with ADHD are far better able to access their unique genius when they're alone. Given that remote work is now much more common, we may well be on the cusp of a wave of ADHD-powered innovation.

Watch this space!

People with ADHD have a high motivation for identifying problems

This was one of the most revolutionary findings in our research study, as it indicates many people with ADHD are highly motivated to solve and identify problems ( Away From Problems). They are likely to thrive in projects and roles where they can prevent and deal with complex challenges, and navigate around roadblocks.

People with ADHD are far more energized by navigating awayfrom and solving problems than by setting and achieving goals. While much of our culture lionizes the importance of goal setting, actually, a robust, disruption-ready organization also needs people who are problem-oriented.

In an increasingly tumultuous business landscape, the prevalence of this trait among ADHDers highlights the tremendous value they have to forward-thinking organizations.

ADHD employees drill down into the details

When it comes to an area of expertise, passion or something they genuinely love and are highly motivated by, our preliminary findings show that ADHDers on average have the ability to really drill down into the details ( Depth). This is known as hyperfocus, and it's one of the key superpowers that give people with ADHD a distinct advantage. ⁵ They're often so focused on what's occupying their attention that nothing else matters.

Consider the stories of a young Bill Gates (who was later diagnosed with ADHD ⁶) when he was writing the code that would become Microsoft.

Gates famously worked day-in, day-out. He often fell asleep at his desk, woke up and immediately began writing code again. These intense bouts of focus came at the exclusion of all other things that weren't related to what interested him most: Building Microsoft. ⁷ While we at F4S believe in a healthy work life balance, Gates' story does illustrate the tendency we see in people with ADHD to dive deep into the details, and lose track and awareness of time. To a casual observer, the young Gates' bedraggled appearance and lack of care for mundane daily tasks may have appeared as a lack of attention to detail. In reality, he was so deep in the details of what interested him that there was no room for anything else.

ADHDers are open-minded and value diversity

Our preliminary findings show that people with ADHD are highly motivated to accept and appreciate the unique styles, customs, perspectives, and rules of others ( Tolerance). A high emphasis on this motivation promotes a supportive work culture that prioritizes psychological safety, open communication, inclusivity, and the uniqueness of others.

With their sensitive nervous systems, ⁸ people with ADHD can be highly empathetic towards different types of people. For this reason, they're adept at understanding and tolerating differences in others. ⁹ On a sociological level, people with ADHD have often felt othered, or ostracized for simply being themselves, and so they may feel a natural affinity with other people who are different. ¹⁰ They have also been found to have a higher injustice sensitivity, making them great advocates for fairness and tolerance. ¹¹

This trait makes people with ADHD natural allies for marginalized groups, and they can bring extra passion and energy to roles related to social justice.

Take the highly acclaimed director of Barbie and ADHDer 12 Greta Gerwig for example.

Gerwig is noted for her ability to actively encourage actors to include their own personalities in their performances. ¹³ It isn't uncommon for writers and directors to be prescriptive of what they want from their actors, but this isn't Gerwig's style. Instead, she takes the role of facilitator. This is typical of leaders in the workplace who have a strong bias for tolerance, they listen, and appreciate the unique perspectives their employees bring to the table.

People with ADHD are out of the box thinkers

Our research found that ADHDers are overall less energized by following company rules ( Compliance), and are highly motivated to be creative out-of-the-box thinkers ( Indifference). This motivational combination is incredibly useful for breaking new ground and inventing diverse ways of working.

When outside-the-box thinking is needed, adherence to the rules can only get you so far. That's where people who aren't motivated by status quo thinking can become your most valuable asset. And people with ADHD, overall, were found to have this trait in spades.

Children with ADHD are often stereotyped as being rule breakers and mischievous, but given the right conditions, this same trait can lead to high achievement in adults.

Take the late founder of IKEA and (you guessed it) ADHDer, ¹⁴ Ingvar Kamprad.

At the age of 5, Kamprad began running his own business selling matches. While this might not sound too mischievous, keep in mind that this was 1931. A time when small children "should be seen and not heard." He was oblivious to the "rule" that 5-year-olds didn't run businesses; he was too busy marching to the beat of his own drum. Fast forward 12 years later, and he founded IKEA. Under his leadership, IKEA became the largest, most groundbreaking homewares retailer in the world and has maintained its innovative, always moving and evolving, very ADHD brand identity ever since.

So, we can see that the pioneering, entrepreneurial spirit is alive and well in people with ADHD. But does this mean ADHDers are always ignoring the rules?

Your ADHD team members are reliable, and motivated by consistency

Our research findings show that ADHDers derive energy from maintaining stability and consistency ( Sameness). They have a strong preference for finding patterns, mapping new information against what they already know. Surprisingly in some situations, ADHDers very much enjoy doing the same things over and over and may often prefer things to stay the same.

But wait, aren't they also trailblazing innovators who ignore the status quo?

The answer is complicated - they're often both.

To reach their goals, many people with ADHD have learned to be highly disciplined. They may adhere to their own personal unwavering systems and processes, and rely on them to create order in their lives, and this tendency is often present in the workplace. It may not necessarily be an in-built trait, rather, an adaptation to their condition. And indeed, many ADHD coaches, or therapists teach these skills. ¹⁵

Take, arguably, the most decorated athlete of all time and proud ADHDer, Michael Phelps, ¹⁶ for example.

Phelps was known, even when compared to other elite athletes, to have a highly structured and regimented training program. ¹⁷ He swam 13 kilometers a day, 7 days a week, even on birthdays. And that's just in the pool. He also had his weight training (3 days a week), his stretch routines that bordered on the religious, and his highly monitored and optimized diet. But this lifestyle didn't come naturally to Phelps. As a teenager, he struggled to pay attention and to keep up with the day-to-day routine of school life. The strict routines that he later developed were an adaptation that his coach, Bob Bowman helped Phelps to implement.

So, while people with ADHD may not be naturally motivated by consistency, Phelps's story and our research demonstrates that they can, and do adapt. With the right coaching or assistance, people with ADHD can be highly systematic and process driven, more so than the broader population.

ADHDers are highly motivated by commercial performance

Another finding from our research study was that people with ADHD have an interest in the commercial and financial aspects of business ( Money). This may manifest as a focus on grounding projects, products, services, and business ideas in the commercial space, or feeling empowered to carefully track and monitor financials.

Take founder of Kinko's and author of Two Billion Dollars in Nickels, Paul Orfalea, for example.

Orfalea was born in a time when awareness of ADHD was low. He was labeled a "problem child". Though he struggled in the classroom, he had a well attuned business acumen with a focus on dollars and cents from a young age. After scraping his way through school and into university, it was there that he noticed professors and students were paying US$0.10 to make copies of their class materials. After crunching the numbers, he saw that he could provide a much cheaper service, and Kinko's was born.

With an estimated net worth of US$250 million, Orfalea credits his struggles with ADHD to his success with business. As a struggling teenager, he was forced to forge his own path and find opportunities to leverage his strengths, which is exactly the path he took in business as an adult.

The bottom line: ADHD is a win for the modern workplace

In short, our preliminary findings demonstrate that it's time to start thinking of ADHD as a huge asset to any organization. Companies that foster their ADHD talent can fully leverage the unique magic they bring to the workplace. ADHDers' problem-solving acumen, ability to spot threats and weaknesses and unconventional approaches are traits that companies are wise to embrace.

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Our new research reveals the amazing advantages of ADHD in the workplace

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Discover the incredible advantages of ADHD in the workplace

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Great resource for all things LD/ADHD/NVLD etc

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Great resource for all things LD/ADHD/NVLD etc

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When children have learning problems, their parents are usually the first to notice that something is just not right. Teachers often notice a child having trouble in their class. And when they notice, they want reliable information so they can help their students.

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ADHD is a common condition that makes it hard to focus, keep still, and think before acting. Some people with ADHD mainly have trouble with focus. (This is also known as ADD.) ADHD can also impact other skills, including managing emotions.

It's not clear exactly how many people in the United States have ADHD. But estimates are between 5 and 11 percent.

ADHD doesn't just go away as people get older. Most of the time, hyperactivity and impulsivity lessen or disappear by the teen years or a little longer. But trouble with focus usually continues. Some people aren't diagnosed with ADHD until after high school or as adults.

No matter when people are diagnosed with ADHD, there are treatments that can make symptoms more manageable. And there are supports that can make things easier at school and at work.

People with ADHD have trouble with executive function, which is the "management system" of the brain. Because of that, people with ADHD often struggle with:

Managing time

Getting and staying organized

Setting priorities

Planning

Managing emotions

Paying attention and remembering things

Shifting focus from one thing to another

Getting started on and finishing tasks

Thinking before saying or doing things

There's one confusing sign of ADHD. People who have trouble focusing most of the time can often "hyperfocus" on tasks or activities they find really interesting.

Signs of ADHD can pop up at any age. Kids can show signs as young as preschool. But many don't show signs until later on, as school gets harder and they have more to juggle. Some people don't realize that what they experience is ADHD until they're in college or working.

The research shows that brain development is very similar. But the areas involved in executive function take longer to develop in people with ADHD. That's why kids with ADHD may act one to three years younger than other kids their age. Research also shows some differences in how the brain functions.

These differences have nothing to do with intelligence. People with ADHD are just as smart as people who don't have it.

Researchers are also looking at the role of genetics. ADHD tends to run in families. A child with ADHD has a one in four chance of having at least one parent who has it. And there's a strong likelihood that another close family member also has ADHD.

There are no tests for ADHD. Instead, evaluators use a variety of tools to determine if a child has ADHD. One is a questionnaire about behavior. Another is a clinical interview.

Here are some types of professionals who may diagnose ADHD:

General health care providers, including pediatricians

Psychiatrists

Developmental pediatricians

Neuropsychologists

Psychiatric nurse practitioners

Clinical psychologists

There are a few types of treatment for ADHD. They include:

Behavior therapy: This type of therapy involves creating a rewards system for changing a child's behavior. It's different from cognitive behavioral therapy (CBT), which helps people look at their thoughts, emotions, and behaviors, and make positive changes. CBT may be helpful to some people with ADHD, but it's not a treatment for ADHD.

Alternative treatments: There's no shortage of companies that claim to have an all-natural fix to ADHD. Most have no evidence to back up their claims. Learn more about alternative treatments for ADHD.

ADHD doesn't go away. But with the right treatments and supports in school, at home, and at work, people with ADHD can thrive.

Understood is not affiliated with any pharmaceutical company.

Key takeaways

ADHD is a biological condition that can impact focus, organization, and self-control.

ADHD is not a problem of laziness or willpower.

With the right support, people with ADHD can thrive.

About the author

About the author

The Understood Team is made up of passionate writers and editors. Many of them have kids who learn and think differently.

Reviewed by

Reviewed by

Thomas E. Brown, PhD has written many books on ADHD, including "Smart but Stuck: Emotions in Teens and Adults with ADHD." He's the director of the Brown Clinic for Attention and Related Disorders.

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What is ADHD? Use this ADHD guide to understand attention-deficit hyperactivity disorder and how people with ADHD (or ADD) can thrive.

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ADHD sucks, but not really | Salif Mahamane | TEDxUSU

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Body, relationships, gender, and sexuality

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Body, relationships, gender, and sexuality

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Unlocking ADHD in Singapore | Practical Resources and Support

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Living with Attention Deficit Hyperactive Disorder (ADHD)? Unlocking ADHD in Singapore - We provide practical resources and support to help ADHDers and their families to live life to the fullest!

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ADaptHD: latest research, personal narratives, tips & tricks, etc. Monthly newsletter - not overwhelming. 

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ADaptHD: latest research, personal narratives, tips & tricks, etc. Monthly newsletter - not overwhelming. 

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Curated info and articles for
parents, teachers, mental health professionals, and researchers.

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Celebrating neurodiversity in the workplace: The Dell example

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Celebrating neurodiversity in the workplace: The Dell example

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There is a tremendous amount of untapped talent among those in the autism spectrum community who stand ready and able to contribute to the workforce. Thanks to an increasing number of companies who value a culture of diversity and inclusion and go the distance in implementing the proper accommodations, there is less untapped talent and more bright, motivated autistic folks at work than there would be otherwise. Dell Technologies is one such company.

It comes as no surprise that Dell has chosen to pursue a culture of neurodiversity. CEO Michael Dell has been quoted as saying "diversity and inclusion helps drive innovation and growth, and is critical to the long-term success of our company. I'm proud of the legacy we are building as an employer of choice for all." New ideas from a diversity of perspectives result in a greater capacity for problem solving. New ways of thinking are incorporated into the technology offerings, fostering greater accessibility. And the autistic employees benefit as well. As such, Dell's Autism Hiring Program is a win-win-win proposition: for the company, for its people and for its customers.

When asked to speak about their employment experience at Dell, a few of the autistic members of Dell's workforce have had wonderful things to say, as have their nonautistic colleagues. These folks admit to being eager to learn and to try new things. They value having an impact on those around them and being able to teach others. Dell affords them these opportunities, and taking advantage of them instills in them a sense of fulfillment, empowerment, belonging and connectivity with their colleagues. The business impact of these outcomes is the enhancement of team spirit, cohesion and focus.

There are abilities which are prevalent among many on the autism spectrum, including me, which lend themselves well to careers in technology. Attention to detail, commitment to quality and consistency and capacities for analytical and "outside the box" thinking are common. I would not be half the information technology consultant I am today if it weren't for these skills and work habits. With respect to commitment and consistency, there is a correlation between these and longevity at a company. Dell reports a significantly lower turnover rate among its autistic employees. I am in my 25 th year of employment at my company, largely because I see value and take pride in loyalty, and because I prefer the predictability and structure associated with going to the same workplace, working with familiar people and attending to the same kinds of tasks day after day. The evolution of the technology with which my colleagues and I work has kept the job interesting and stimulating over the long term.

When Dell launched their Autism Hiring Program in 2018, they recognized the need to re-think the hiring process and how to best attract talent. They chose to partner with an organization connected to the Autism Resource Center (ARC) of Philadelphia, known as Neurodiversity in the Workplace (NITW) in order to achieve these goals. The Neurodiversity in the Workplace Initiative connects autistic folks to jobs that fit their skill sets. NITW partners with Human Resources departments in helping to identify the right candidate(s) for the company's open position(s). They support managers and other nonautistic co-workers as to how to best interact and work with new autistic hires.

Candidates are thoroughly prepared for long-term careers. They are trained to advocate for themselves which promotes independence. They learn how to manage differences between how they and their coworkers process sensory input. Emotional regulation and expression, understanding the unwritten rules of the workplace, teamwork with managers and colleagues, and navigating e-communications are also addressed. NITW helps implement an onboarding process after the hire is made, providing onsite training as necessary to ensure success. Finally, the organization's work in supporting a neurodiverse workforce is promoted to the community.

Dell's Autism Hiring Program was first put to the test at one of their Massachusetts-based locations and was later implemented at the company's headquarters in Texas as a result of its initial success. The program allows candidates to demonstrate their skills outside the traditional job interview which is often problematic for folks on the spectrum. Interview proficiency requires both strong verbal and nonverbal communication skills. The latter is a particularly common challenge for autistic people, and I am no exception.

Throughout my youthful years and into adulthood, I didn't even understand what nonverbal communication entails, much less be competent at it. I could only comprehend spoken words and only the most obvious gestures, like how somebody's face looks when she is angry or overly excited. Relatively subtle and nuanced forms of nonverbal communication almost always eluded me, and so I would be unable to respond accordingly. As such, I did not fare well when it came to dating and romance. I can't even recall having kissed a woman with my eyes closed during my bachelor days, not once. If I did, it was purely by coincidence, and without any awareness of what I was actually doing. Considering that a date and an interview have much in common, certainly with respect to body language, it becomes evident that a traditional job interview will often fall short of doing an autistic candidate justice, leading to unfavorable and misleading yet all too important first impressions. Kudos to Dell Technologies for recognizing this reality and for offering a more equitable path to employment.

Candidates entering the Autism Hiring Program are initially screened for their interest in the open employment opportunities and for the pertinent skills, experience and qualifications. If they qualify, they are invited to a two-week skills assessment/mentorship session. Those who succeed move on to a 12-week Summer internship from which several have been hired as full-time Dell employees. Cyber-Security, Artificial Intelligence and Software Engineering are among the technology areas that are taught during the internship. Ample opportunity exists within this kind of framework for candidates to showcase their talents, prove what they are capable of, build self-esteem and grow along the way. No high stakes "all or nothing" job interview which, if it happened, could very well deny the organization of a worthy asset.

Now is as good a time as any for more companies to follow Dell Technologies' example and that of other companies who implement accommodations for neurodiversity in the workplace. Folks on the autism spectrum and others who are neurologically different (including people diagnosed with ADHD) are all too often overlooked because they are typically not thought about by those who make recruiting and hiring decisions. And yet, neurodivergent people who are able and ready to get to work represent phenomenal levels of untapped talent and potential eagerly waiting to be put to use. Consequently, the unemployment rate is regrettably and disproportionately too high among neurodiverse individuals. Now is the time to re-imagine who can be successful members of the workforce and how to best bring them in.

Sam Farmer wears many hats, among these father, husband, musician, computer consultant, and autism spectrum community contributor. Diagnosed later in life with Asperger's Syndrome, he writes blogs and articles, records coaching videos, and presents at conferences, sharing stories, ideas, and insights as to how one can achieve greater happiness and success in life despite facing challenges and adversity that often interfere in these pursuits. To learn more, visit .

"A Long Walk Down a Winding Road: Small Steps, Challenges, & Triumphs Through an Autistic Lens" is available on Amazon and can be purchased at all major booksellers.

Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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Celebrating neurodiversity in the workplace: The Dell example

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Autistic people have much to offer employers.

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Feeling misunderstood because of your ADHD? These relatable illustrations help explain how our brains work. You’re not alone! Check out the ADHD comics now.

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Attention Deficit/Hyperactivity Disorder (ADHD), although not a learning disability, can affect one's ability to succeed. Individuals with ADHD often have trouble paying attention, sitting still, or finishing tasks. Read more about the prevalence, symptoms, and treatment of ADHD.