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ADHD: Attention Deficit Hyperactivity Disorder
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Develop Routines, Organization and Expectations

Margaret V. Austin, Ph.D., edited by C. E. Zupanick, Psy.D.

8. Develop routines

planner pageRoutines provide structure. Consistent routines teach children what to expect and when to expect it. Our daily routine begins with waking up. Caregivers can establish a morning routine by getting children up at the same time each day. Get ready for the day in same order, each day. For instance: Wake, walk dog, shower, get dressed, eat breakfast, make lunch, place lunch in backpack, go to the bus. When establishing routines, allow enough time for the unexpected (spilled milk) so that the routine is not disrupted.

Just as you established a morning routine, you establish an afterschool routine. Come home, have a snack, play outside for 30 mins, do homework, eat dinner, play video games, get ready for bed. Establish the routine of turning off the phone during homework time in order to minimize distractions.

Caregivers should ensure that breaks are routinely built into the schedule. Caregivers can also build a routine of checking and updating the planner daily. Establish reasonable bed times and a bedtime routine. Even older children can benefit from a nighttime routine such as 30 minutes to read in bed before lights out.

9. Demonstrate and teach organizational skills

We've mentioned the importance of providing structure and order. Closely related is the need to demonstrate and teach organizational skills. This is especially important for caregivers because a child's home is typically a less structured environment than a school.

The motto, "A place for everything, and everything in its place" rings loud and true. Caregivers should demonstrate organization themselves. A chaotic, disorganized home environment is particularly difficult for ADHD children. If parents need help learning organizational skills, there are professional resources to help them.

A consistent place to do homework is an example of organization. The location should be relatively quiet. Ideally the location should be a place where the caregiver is readily available. As teens get older, they often want to do their homework in their own room. This may not be a good idea. First, it's inconvenient for the caregiver when help is requested. Second, it's more difficult for caregivers to monitor whether their child is staying on task. If older children want to work from their bedroom, caregivers should evaluate if children remain productive when sequestered like this. Caregivers and teens can organize the room for maximum efficiency, while minimizing distractions.

10. Identify expectations, establish consistent rules, and provide clear instructions.

Children with ADHD need to know exactly what others expect from them. They do not perform well in ambiguous situations that leave them guessing about what others want. A guideline for communications of this sort is as follows: Keep it simple. Keep it brief. Keep it visual. Keep it novel.

The "simple" and "brief" portion of the guideline are pretty obvious and self-explanatory. However, "keep it visual," and "keep it novel," require some explanation. Children with ADHD usually do better with visual, rather than oral, information. Caregivers can use this knowledge to create visually interesting chore lists, or daily routines. When providing instructions to the child, try to present information in new and interesting ways. For example, when teaching math facts, it is not enough to repeat them verbally. Children would learn more easily with a color coded table or one with images to accompany the numbers. Songs that help teach math facts may also be useful. Remember, the goal is not just to make learning fun for the child. You want to engage them in learning process so that they remember the information more easily.

Establishing rules and expectations should be done in a stepwise fashion. It's tempting to demand too much too soon. This can overwhelm the young person. Therefore, caregivers should choose three behaviors to focus on. Once the child demonstrates consistent mastery of these three expectations, move on to three more. Working with a professional ADHD coach or therapist can help caregivers narrow the focus to just a few specific behaviors.