It’s no secret that I believe that exercise is one of the most important ways to manage ADHD. Even with successful medication therapy, exercise is key to managing our brain chemistry. And if you have depression and/or anxiety like I do, you get twice the benefit from the exercise, as I also believe it to be crucial to managing those issues as well. And for the record, it’s not just me. There is more an more research all the time pointing to the neurochemical value of exercise. I’ve written a good deal about how to get a workout routine started in the past. I’ve also written about how to make it a habit and other similar topics. Today I wanted to share some recent successes I’ve had in my workout life. This is not to toot my own horn, but to share some new insights that I’ve recently gained. Let’s start with today since that’s what made me think about bringing this up. Well, actually, let’s rewind to yesterday… Or maybe we should rewind and I should share where I am in my overall workout life… My goal is to work out everyday… on average. That can mean many things. Typically I cycle through three different workouts: 5 mile run, usually on the treadmill at the gym, interval sprinting on the spin bike while watching hockey or Netflix, and one of three lifting routines. Sometimes I do two-a-days to balance out days that I don’t work out. Kind of maniacal, I know. But it works for me. I don’t necessarily recommend every do what I do. Anyway, I had taken a day off on Sunday and really didn’t feel like going on Monday. But I don’t take two days off in a row, so I forced myself to go to…

Rarely do I come across something that is so perfectly said that I don’t feel the need to put it in my own words. Please check this article out: 6 Reasons ADHD treatment fails https://us8.campaign-archive.com/?u=05c078d02e79a07f64018da62&id=729ed9eeb8&e=56e9d42595

See attached:  Here are the details as emailed to me from the doc. Participants can either be diagnosed with ADHD or ADD or have symptoms and need to be evaluated.  The medication is a long acting methylphenidate product (same as Ritalin or Concerta) but it lasts all day and into the evening so it should be very helpful for people who need coverage from morning to night.  It would be especially good for college kids (rather than giving them short acting stimulants that are more likely to be abused) or for men and women who need longer coverage during the day.  Methylphenidate is FDA approved for ADHD but this formulation of methylphenidate is being studied because of the unique delivery system.  Participants will receive a very extensive evaluation and testing (that is above and beyond what is done in ADHD clinics) and includes a physical, labs, IQ testing, SCID-5-CT diagnostic interview, tests of concentration and accuracy levels, and lots of rating scales, etc. plus observation by trained clinicians and raters during the visits. There are 2 simulated workplace days (held on Saturdays-one half day and one long day) in which their symptoms will be assessed throughout the day by trained clinicians and raters (and on the long day into the evening).  They will play group games that are fun and then take a 10 minute math test to assess their concentration and accuracy multiple times during those days.  The math tests are just addition and subtraction and are adjusted to the person’s ability and comfort level.  We make the days fun.  Most people enjoy the day and interacting with staff and other people their age with ADHD.  We provide breakfast, lunch, snacks and drinks (and dinner on the long day) on the Saturday visits.  Anyone who wants to stay at a local hotel,…

I’ve often posted my daily schedules as a visual aid. Having gone over scheduling with several new clients recently, I thought it was time to post another one. But this one is pretty specific. This is my schedule for Thanksgiving Day for 2018. Bear in mind that I am a former professional chef. So, I do a pretty legit spread even though it’s only for seven people.  So I’m pretty sure I”m posted a prep list before. But this is a really good illustration of how a list of what you have to do is an amazing start. But actually scheduling time is the best way to get things done before a deadline. In this case, I wanted dinner on the table at 5:30. Thus, I had to do all this stuff before then.  Key points: I made an initial list separated by day the previous weekend. Because there were things that I had to do ahead of time, like pick up the duck, butcher it, cure the legs, and make the stock. I also like to bake the pie the day before so I don’t have to worry about that. I also made this schedule the day before to make sure I had time to actually get everything done. If it looked like I wasn’t going to have time, I would have done more on Wednesday. Try not to get too overwhelmed by this schedule’s sheer number of things to get done. Remember that cooking puts me in my element. Put the principle is that whatever your “thing” is, you can use the same technique to manage very complex projects in real time.  By the way, dinner hit the table at exactly 5:30!  Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my…

I’ve posted about this once before… when I got my first tattoo about 2 1/2 years ago. I’m a punk rock kid at heart. I had my hair dyed orange and twisted up in spikes into my 20’s. I had 4 piercings until I had to take them out for culinary school and subsequent jobs. Why do I tell you this? Because I’ve always wanted a tattoo. But I didn’t want to go all ADHD and get something that I would regret. So I made a rule for myself: I wouldn’t get one until I had something that I loved and still loved it 5 years later. When my son was born I realized he was it. But it took me 5 years to really decide exactly what I wanted and to come up with a design that suited his personality, and then a bit longer to find the right artist.  Then my daughter was born almost 5 years ago. I started plotting her tattoo then. I pulled the trigger a few month earlier than 5 years, but the rule still applies. I “marinated” on several design ideas and color combos and waited for her distinct personality to emerge. So I have two great pieces of ink that I love and will never regret. It just took some planning and a whole lot of patience.  Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.

I was an English/History kid. But I’m also not the fasted reader, writer, or processor. That made it really hard to take honors/AP classes in those subjects. I had to make tough decisions about how to allocate my time. (I guess I still do.) It was pretty clear that I couldn’t take the classes that I wanted to and still carry a full load. So, my parents and I had a discussion before my freshman year about how to handle that. The basically asked me if I wanted to do high school in 5 years or take something during the summer to lighten the load during the academic year. That was an easy choice for me. I wanted to graduate with my friends. So we decided that I would take my sciences during the summer. I took Bio after my freshman year and took Chem after my sophomore year. I think I just sleep for two month after surviving my junior year. Of course that was one few class to have to worry about. Less homework, etc. But, it also gave me four extra blocks during the week to… do what? That’s the question. Back in the day at Newton North, underclassmen weren’t allowed to have free periods. So they wanted to stick me in study hall four more (total of six) periods a week. When I think about the idea of being in a classroom with 20 other kids who don’t want to be there and may not be so quiet trying to do work and having to mostly sit still, I think I’d rather be in science class. What I needed was to go find a quiet place, put on the discman (yes, I’m old) and do whatever I needed to do to survive high school. Sometimes that was staring…

I may have more accomodation posts, but I wanted to talk about the importance of a medication journal today. What, you may ask, is a medication journal? It is just a record of medications, dosages, changes, and symptoms. Finding the right medication is usually a process of trial and error. I think this is especially the case with ADHD meds. Or, perhaps I should say that the changes and effects happen so rapidly and there are so many options that the number of changes in a short period of time can be extensive.  I’ve been on the same stimulant regimen for almost 20 years. So there isn’t an issue there. My current antidepressant gets adjusted from time to time, but that’s only one variable and the effects are pretty obvious and rapid. My son’s meds are also pretty straightforward. So I’ve never really needed to keep track of them in a detailed matter. My daughter is a whole ‘nother story. I won’t get into detail about her journal, as it’s kinda personal. But it did prompt me to write this. So let’s start with the macro. Especially with our kids, who are constantly growing and changing during the period of time when we are responsible for their meds, it is extremely important to keep track of what meds, what dosages, what age/size, when, and for how long. Often parents will tell me, “he took Stimulant A when he was in 3rd grade but I don’t remember how much and I’m not sure why we stopped that one.” This is not meant to criticize those parents. In the moment things seem so obvious and memorable, but six years later when that kids is in 9th grade, how likely is anyone to remember all the details. Specifically, one reason this is important is that…

Fidgets are an important part of managing or physical restlessness. But, they have to be “respectful” fidgets. Check out Fidget to Focus. It will give you many great ideas. But the short version is that your kids (of your) fidget needs to be something that isn’t visually or auditorily distracting to everyone else. I would love to click a pen all day, but that would drive the rest of the world nuts. Something simple like a squeeze ball or a piece of putty are great. Even a paperclip or a piece of string can work. I would suggest having a variety of things in the school bag to rotate through so your fidgety-ness doesn’t bet bored.  For artistic kids, doodling can be a great option. I think I’ve mentioned this in a post before, but that won’t stop me. I have a client who’s in middle school who is quite the artist. We used to meet in person and I always let her doodle while we were meeting. She would be staring down at her paper, not making eye contact. But I could tell she was paying attention. And, I don’t think I ever asked her a question and she wasn’t present with the conversation. Many teachers, parents, and neurotypical people find this rather disconcerting. I would suggest they got over it. If an artistic kid focuses better while drawing, let ’em do it.  Lastly, when doing homework on one’s own fidgets can be a little less respectful and on a larger scale. I had an instructor at my coaching school who told us that he never finished a book in his adult life until he realized how kinesthetic his learning style was. He realized that he could read if he was actively rocking in a rocking chair. Now he…

Preferential seating is often offered, but in  very specific sense. Usually it meas front row center. This is great in some respects, but other options are better for other types of kids. For example, those of us who benefit from movement, might be better off on the side of the room with the understanding that it would help us to stand up at certain time during the class. I always liked to be up front but by the side so I could go for a walk without feeling like I was disrupting class. When I take classes, go to conferences, check out lectures at this point in my life, I prefer to grab a seat in the back and end up either standing up for much of the session or even sitting on the ground in the back to afford me the most possibility of moving around.  My point is that most kids could benefit from targeted seating, but that might not be the same for every kid with ADHD. It may even vary from class to class. And, it may be somewhat depending on who else in in the class and how long it is. Think it through with your kids. They might have an insight into this that you wouldn’t have thought they’d have.

Pretty much everyone gets extended time for tests as a standard accommodation. But there are some nuances to think about.  First, many systems require the student, even young students, to ask ahead of time for extended time. Why? I don’t know. I always had access to extended time. I couldn’t tell you how often I used it but it wasn’t all the time. So how was I supposed to know? This also puts a lot of pressure on kids who are reticent to be open about their accommodations to ask the teacher in front of the class for the extra time. It also puts pressure on kids who are somewhat conflicted about the idea of accommodations to take their time. Maybe they can finish but only if they rush? Lastly, I think it’s important to make sure the how and where of finishing is ideal for the student. Some teachers are worried about the integrity of the test. I guess that’s reasonable. But I have yet to meet a criminal mastermind who’s using the accommodations to game the system.  I guess I’ll throw this in while we’re on the subject of test taking. A quiet supervised environment outside the classroom might be best. Allowing the student to wear noise canceling headphone, and maybe even listen to music.  But the real crux of this post is that ADHD kids will often need extended time in on assignments, not just tests. On one level, this is important because the ADHD kid is usually fighting through organizational and other EF challenges just to get to the place where they can complete the work. It is also important because most of us take longer to complete much of our work due to attentional challenges and/or slower processing speed. But, fundamentally, the challenge is the sheer quantity of work most…

After my epic, cathartic, and very personal post from last week, I’m going to do a few weeks of quick tips around the holidays. I’ll start with a few on standard and not so standard accommodations for students with ADHD. The first is my favorite, though not so standard: Competency based grading.  For someone who processes slowly, has limited attention, and who’s kryptonite is boredom, doing 30 math problems every night is a problem. Especially since I was an English/History kind of kid, math also wasn’t my priority once I got to high school. My theory was always that I shouldn’t have to be tortured by all those problems if I knew the material already. (Of course that’s the key, knowing the material.) I figured if I could do the last five questions or the last one in each section, I probably knew my stuff. As it turned out, my performance on tests bore that out. Therefore I wouldn’t be graded down for only doing a part of the homework if I demonstrated reasonably mastery of the material.  No system that I’m aware of offers this and they usually fight it. They really cling to the idea of homework being integral to the learning process though many studies demonstrate the opposite. The have some idea that as ADHD kids we are trying to get away with something, like it’s not fair if we do less homework. Frankly, I think it’s unfair that my homework takes me twice as long as my intellectual peer sitting next to me. The school doesn’t seem to have a problem with that though. Anyway, ask for it if your kids need it. It can make a big difference. Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if…

This is a pretty personal thought… not that my blog is usually clinical and objective… I mentioned a few posts ago that my 4 1/2 year-old was diagnosed with Bipolar disorder and started medication. I’m sure someday she’ll be mortified that I have put these thoughts on the internet for eternity. But that’s how important I think this discussion is. So here goes. When I say that my daughter’s behavior was tearing our family apart, it is only a slight exaggeration. I was constantly on edge and yelling way more than I wanted to. My wife ended many a day in tears. And, my son, God bless him, was not getting the attention that he needed and had to walk on eggshells in a way that a nine-year-old shouldn’t. This had been going on for at least a year.  But there was no one symptom/behavior that you could point to and say, “that’s not right.” All kids have tantrums. All kids are unreasonable sometimes. Many kids have sleep issues. Many kids have separation issues with their Moms. Lots of kids struggle with eating real food. Some kids struggle following the rules at school. And, some kids are stubborn and defiant. But when you put all of those things together in one kid….? But what’s the deal? So as part of my continuing education in to ADHD for my career, I attend a three day conference every two years through MGH psychiatric academy called ADHD through the lifespan. The March 2017 conference had tremendous session sessions on ADHD and accompanying conditions. I learned a tremendous amount about dyslexia, tourettes, and bipolar—particularly pediatric bipolar. I had had this presentation in the back of my mind for a year-plus in regards to my daughter. But whenever I mentioned it, which wasn’t often, everyone thought I was…