Organization & Transition

 

People with attention deficits (ADD) or hyperactivity (ADHD) are often
thought to be willfully avoiding tasks or lazy. However, there are physical
reasons for disorganization and poor follow-through. The area of the brain
that initiates behavior, anticipates consequences, and controls short-term
memory is underenergized, causing poor task completion. In some people,
there is also decreased blood flow to the right hemisphere that handles
spatial perception and decision making. This can add to problems of losing
things or getting lost. Mark any of the following strategies that you think
would help you or your loved one with organization, memory, and helpful
habits.

ORGANIZATION

• Place important items for school or work on hooks or racks by the
  door the night before. Have the most organized family member
  monitor this until it is a routine.

• Designate places for important items at home, school, and work.
  Place items in their proper location as soon as they are not needed:
  keys, glasses, purses, lunch boxes, uniforms, bookbags, or
  briefcases.

• Buy furniture and containers with lots of drawers, shelves, and
  hooks. Label places for things and keep surfaces uncluttered.

Overorganization is important!

• Create file drawers and folders for important papers and schoolwork.
  Throw out items that are no longer needed.

• Put medications in weekly pill keepers. This makes it easier for others
  to monitor if medications have been taken until it is a routine.

• Have a weekend box for anything left out of place. Everything in the
  box must be put away before weekend free time begins. Place a bag
  of things that need to be put away in front of the TV.

• Do not let messes pile up. Clean up one activity before starting
  another. ADD people can create chaos.

• Avoid “to do” piles. Whenever possible handle paperwork only once.
  Throw it away, file it, or take whatever action is needed as soon as
  possible.

FORGETFULNESS

• Keep a “day list” by the door with everything you or your child might
  need: keys, glasses, notebook, lunch, snack, medicine, retainer,
  wallet, or sweater. Make a habit of scanning the list before you leave.

• Have a What-have-I-forgotten? list in your car or on a key chain, or
  have it memorized: hat, gloves, glasses, assignment book. Make
  children repeat their list five times as a consequence for forgetting
  items not brought home. Build the habit of asking the above question
  every time you leave a place.

• Use a “must remember” bag for nonroutine items that need to come
  home by placing high-priority items (car keys or snacks) in the bag.

• Call your answering machine and record reminder messages of
  things you need to do as soon as you think of them. Answering
  machines with flashing lights by the door are important.

• Use alarm watches for reminders to take medication, start chores, or
  leave a friend’s house. Set other timers for five-minute warnings
  before it’s time to leave for school or other activities. People with
  ADD lose track of time!

• Use assignment books that list homework, tests, and other important
  dates. Coordinate with teachers and monitor tasks until children
  establish a routine.

• Buy spiral notebooks with pockets in which to place assignments due
  the next day, or designate a special homework pocket in bookbags.

• Keep a calendar or planner for all important dates and events.

• Keep notepads and pens in the car, by the bed, or in your purse to
  write down ideas and things you need to remember to do. Read with
  a pen in hand for the same reason.

• Schedule weekly errands at the same time so they won’t be forgotten.

ESTABLISH ROUTINES

• Wake-up routines may include extra alarm clocks, water sprays,
  rambunctious pets, ice cubes, or ammonia swabs.

• Bedtime routines are important for both children and adults: bathing,
  watching (nonstimulating) TV, reading, calming music, and relaxation
  exercises.

• Be dressed and ready for school or work before eating breakfast or
  watching TV. There are many instant, nutritious foods that can be
  eaten on the way to work or school. Prized privileges can be withheld
  until a child is ready on time for school.

• Set clocks and watches ahead to decrease chances of being late.

• Make lists for routines and put them on white boards or Post-it Notes
  placed in strategic locations (refrigerator, TV, video control box):
  feed pets, have snack, put dishes away, do homework, make bed,
  put belongings away, free time.

• Monitor tasks that require a sequence of actions until it is
  independently mastered: “What do you need to do next? Next? Next?”

• Use a stopwatch to time how long it takes to complete (part of) a task.
  Then make a game of gradually decreasing time. Similarly, time how
  long a person can sit still in the car or at dinner and gradually work
  on increasing time.

• Break large tasks into smaller units and provide immediate rewards
  or breaks after each one is complete. Physical activity and stretching
  may be especially important.

• Make eye contact, announce instructions, say them and have them
  repeated—“I’m going to tell you what still needs to be done. You
  need to . . . What did I say?” Use many gestures or sign language if it
  helps focus attention.

• When something has been left out of place or a step is out of
  sequence, interrupt what you or your child is doing before returning
  to the desired activity. This reinforces neural links in the mind.

• Do not start a new task before completing a current one.

• Link undesirable tasks with high-priority activities: Domestic chores
  must be completed before using the computer. Place pill keepers in
  front of toothbrushes.

• Train organized family members to remind instead of nag—“I know
  you meant to . . . Would you do it . . . ?” “How about if the TV goes off
  after this show until . . . gets done.” Keeping expectations realistic will
  go a long way to increase patience.

• Reinforce routines with rewards. Pick one routine on which to
  concentrate and keep track of the number of days in a row it is done.
  Identify a reward and use it each time a record is broken. Once
  something is done 14 days in a row, it is a habit.

References

Beyond Retalin by Stephen Garber, Marianne D. Garber, and Robyn F.
Spizman (Harper Perennial, 1994).

Driven to Distraction by Edward Hallowell and John Rately (Simon &
Schuster, 1995).