The ADHD Challenge: Resolving Launch-of-the-day Problems in the Morning
by John F. Taylor, Ph.D.
If you are the parent of a child or teen with ADHD, you already know that getting through the typical morning routines is a very stressful and conflict-laden experience. Getting your child or teen up, dressed, fed, prepared for school and out the door on time can bring much fustration and many challenges during the process. One mother told me "Each day I tell myself: 'Today I will be calm and loving towards my child,' but by the time he is out the door in the morning, I've already failed!" You don't have to feel like a failure every morning. Here is what to watch out for and what to do to solve these challenging family stresses.
Many children with ADHD have difficulty stabilizing their blood sugar leval over extended periods of time. Protein-rich foods helps stabilize blood sugar level. Sleeping during the night often involves going without protein intake for twelve or more hours and can result in acute symptoms during the first half hour after arising. Even among children and teens with ADHD who don't have blood sugar stabilization difficulties, mornings can be times of stress and conflict with family members. Contrary to popular belief among some parents of children and teens with ADHD, you really can have peace and harmony in the morning.
Difficulties Waking Up
The first challenge is helping your child come out of the sleeping state to full wakefulness. To make wakening go smoother, plan for your child to get ten hours of sleep, not the eight hours that our society has embraced as the standard expected sleeping duration. If you child can attain the ten hours that children and teens with ADHD actually need, mornings will inevitably go better. I have found two general stratagies effective for helping the child or teen with ADHD wake up in the mroning. Both rely on your child's desire to be helped to waken. Neither should be given in anger or as a harsh enforcement by the parent.
One strategy is to modify the alarm clock. Consider purchasing a clock that is already engineered to have an extra loud bell or buzz. Another way to make an alarm clock sound louder is to place it in a metal pie pan where dimes hafve also been placed. An additional method is to place a metal cookie tin on it's side and put the alarm clock inside. It is best to place any alarm clock far from the bed so your child must walk over to it to shut it off. Forbid alrm clocks with the snooze feature that would allow extending the period for arising for an additional several minutes. When the alarm rings, it's time to get up, period.
The second general strategy is to put water on your child's face. A gentle mist squirted from a trigger spray bottle will work. Another method is to wipe your child's brow and cheeks gently with a cool damp cloth. While water in the face may sound comical or offensive, it generally works effectively to pull a child with ADHD out of the sleep state. Of course, you should be greeting your child warmly and lovingly while administering the wakeup water.
Becoming a "Scatterbrained Grizzly Bear"
Another morning challenge is the extreme irritability often shown by children and teens with ADHD during the first half hour after waking up. You may have noticed your child's being out of sorts, cranky, power strugglish, rude, or angry, for example. Hand in hand with this cluster of traits is extreme mental disorganization. The child may take fourty minutes to do a few activities that should take about five or ten minutes to accomplish. She may be forgetful, absent-minded, dazed, daydreamy and spacey. The combination of irritability and disorganization I refer to as the "scatterbrained grizzly bear" phenomenon. To diminish this difficulty, be sure to provide a protein-rich bedtime snack about 30 minutes before your child goes to bed in the evening. This simple maneuver alone will cut the scatterbrained grizzly bear phenomenon roughly in half for most children and teens who experience it.
Another useful tactic is to offer protein-rich food within the first half hour of arising. Many parents have found that they can administer protein by briefly wakening their child thirty minutes before the usual time of awakening. For example, if your child's alarm is set to ring at 7:00, waken him at 6:30, until he is conscious enough to swallow. Then the child lays his head back down on his pillow and resumes the last half hour of sleep. Upon arising at the regular time, you are much less likely to have to wrestle with a scatterbrained grizzly bear. Contact me through e-mail if you would like my personal brand choices of early-morning protein enhancement for this purpose. More and more physicians are picking up on this method and have discovered that they can provide a pharmaceutical imitation of it. Their solutions is to give a low dosage of short-acting stimulant one half hour before arising. Pharmaceuticals, however, give no nutritional support for the enhanced neuronal activity and they initiate in your child's brain. If you attempt to use pharmaceuticals for this purpose, the pre-awakening dosage should supplement, not replace, whatever is ordinarily prescribed to be taken by your child as the morning dosage.
Difficulties Preparing for the Day
Having to make decisions while still not fully awake and alert puts your child or teen in a position of being inneficient during morning preparations. To make everything go smoother, set out clothing or other relevant items the night before. Now your child or teen doesn't have to make any more decisions than necessary during the rushed and hectic morning time.
Getting Dressed
To help with the daily chore of getting dressed, consider color coding, labeling or putting pictures on the dresser drawers. Your child will know once-and-for-all where each item is. I suggest a logical sequence so that the top drawer is for items going on the face, head, and neck. The next drawer is for items that go onto the upper torso: seeaters, blouses, take tops, and shirts. The middle drawer is for the middle of the body so put underwear, lingerie, and sleepwear there. Below the middle drawer insert pants, slacks, shorts, and jeans. The bottom drawer might be dedicated to shoes, socks, hose, and slippers. Modify this sequence as needed for your family's individual needs, but adhering to a logical sequence such as this one helps.
Bathing
One of the sensory integration phenomena typical of many children and teens with ADHD is an attraction to take long showers and baths. This aspect of ADHD is a reflection of their hyperawareness of the sense of touch. To prevent conflict over access to the bathroom in the morning, let your child or teen take that long shower or bath in the evening instead. Even if the bathroom is monopolized for a lengthy period and all the hot water gets used up, nobody will care. Certain soaps can increase ADHD symptoms, so make sure your child is using a very mind, white, minimally perfumed variety. I recommend white Jergens or white Lux.
Getting Ready for School
Provide some sort of structured reminder of the time remaining before it is time to leave for school. Timers and buzzers may suffice, but often ADHD involves impairment of the ability to sense the passage of time. So even when the timer goes off, the child is amazed and not prepared for the fact that that the time has expired. The best solution is the silent Time Timer, which shows a red area that gradually shrinks in size as time goes on. The child stops pestering you about "Is the time up yet?" and "How much time is left?" because the disappearing red area is visible from any distance. Even small children who can't read a clock can understand how much time is left.
One of the most common concerns expressed by parents is that their child or teen with ADHD forgets to take needed items back to school. It is not uncommon for the child to do homework, then forget to take it the next morning. There is a simple solution: create an obstacle at the door. Put school books and notebook on a chair blocking or next to the door. Or put them in a basket mounted at your child's eye level next to the door, with a rope attaching the basket to the door knob. An additional version of the obstacle method is to sandwich the notebook between your child's shoes on the floor next to the door, much as a book might be held up by two bookends.
Difficulties at Breakfast
You have two major challenges to overcome with regard to breakfast: (1) providing a sufficiently nutritious meal that decreases ADHD symptoms or at least doesn't worsten them, and (2) obtaining a smooth process for harmonious family-wide enjoyment of the meal.
Providing Sufficient Nutrition
The purpose of meals is to provide basic nutritional needs. Breakfast is even more important as a nutrition source because of depletion of nutrients during the night. To help your child or teen function at her or his best for school, try to include vitamins, minerals, proteins, healthy fats, and water in the breakafast. At the same time, svoid empty calorie items, sugary foods, anything with aspartame or aspartate, toast, jams, and jellies, breads and rolls. Following the highly popularized "food pyramid" will worsten the symptoms for most individuals of any age who have ADHD. The so-called "continental breakfast" is a cruel joke on the body and brain of anyone with ADHD.
To make breakfast actually beneficial to your child, include protein-rich food. Avoid so-called breakfast meats if they contain huge amounts of chemical irritants likely to cause problems for your child. Pure meat without added irritant chemicals is a better choice. A pork chop, fish filet or beefy patty, for example, is superior to sausage or bacon as a breakfast meat for anyone with ADHD. Even foods not ordinarily thought of as breakfast items may work well. Leftover meat or cheese dishes from a previous meal may be quite satisfactory. The white potato changes rapidly into sugar and is not helpful in reducing ADHD symptoms, so breakfast potatoes are out. Mushroom slices sautéed in butter or some nuts beiefly warmed in the over would be better. Breakfast cereals based on protein-dense grains such as oats or wheat are preferable to those based on rice or corn. Wheat flakes, shredded wheat, puffed wheat, cream of wheat, oat circles, and oatmeal are excellent choices. The best cereal for most children and adults with ADHD is oatmeal.
The best sweetner for cereals served to an individual with ADHD is stevia. Unlike its much more neuro-toxic competitor aspartame, Splenda, available at super markets as a sugar substitute right next to aspartame, doesn't increase ADHD symptoms. A little sugar, brown sugar, maple syrup, Splenda, stevia, fresh fruit or honey is satisfactory for sweetening cereals and usually will not have any negative effects on symptoms.
Quick breads such as pancakes and waffles pose a challenge. While they are popular in our culture, they are risky meals for anyone with ADHD. Try to make French toast instead, because you can include egg and milk. If you offer quick breads, make sure you include an increased protein component. Put one or two eggs in to the mix or provide eggs as a side dish. If you want to provide syrup, use either pure maple syrup (from the tree sap) or a mixture of brown sugar and boiling water. Avoid commercially prepared syrups, which are likely to worsten symptoms in some children and teens who have ADHD. Fry in butter, not margerine. Butter is much preferred over any brand of margarine as the cooking and frying agent and the table spread for anyone of any age who has ADHD, Asperger's syndrone or autism.
Eggs are generally a wise choice. They are rich in a variety of amino acids useful for reducing symptoms. They also contain helpful healthy fats, beta carotene and minerals needed to facilitate brain function in individuals with ADHD. The bigger the better, so choose jumbo size to obtain maximum protein per egg. An omelet has the advantage of cheese protein and the inclusion of vegetables that contribute additional nutrients.
As a beverage for children and teens with ADHD, whole milk is superior to the psuedo milks (2%, 1%, and skim) for many reasons. Commercially contrived juice-flavored drinks are unwise substitutes for pure water or pure fruit or vegetable juice. Water is actually the best beverage during or immediately before any meal for anyone with ADHD.
Obtaining a Harmonious Process
Seat people around the table to prevent conflict. Your goal is to ensure a conflict-free breakfast, not a false sense of harmony simple because everyone is seated simultaneously at the table. Rearrange seating immediately whenever conflicting or fighting breaks out. Consider putting one child at a different table if necessary to ensure a peaceful morning. Also consider eating in shifts to avoid having any two morning combatants trying to eat at the same time.
Get your child or teen involved in menu planning, grocery shopping, and cooking of breakfast as well as other meals. This personal investment in the event pays rich dividends in terms of cooperation and genuine interest during meal times. Rotate breakfast-related chores among family members with a simple chart on the wall. Set out breakfast tableware the night before. Structure a pleasant discussion during the meal, starting with the anticipated activities and schedules of each family member that day. Close every breakfast with a clear physical demonstration of your love. Nothing beats a warm hug and "I love you."
By following these guidelines, you can rebulid harmony in the moring and make the launch of the day a more pleasant time for everyone.
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