A chat with Terry Matlen, MSW, ACSW
“REMEMBER TO PUT YOURSELF IN YOUR CHILD'S SHOES,”says Terry Matlen, MSW, ACSW, a psychotherapist and consultant specializing in ADHD in adults, with a special focus on women. “No one likes to feel out-of-control and dismissed.” Matlen advises parents of children with ADHD to prepare for the season emotionally and to work with not against the ADHD, “even if your plans have to be nontraditional.”
A past coordinator of Eastern Oakland County CHADD in Michigan and a nationally recognized speaker on ADHD, Matlen is the author ofSurvival Tips for Women with ADHD (Specialty Press, 2005). She created two websites, momswithadd.com and addconsults.com. She is certified as a Senior Certified Coach (SCAC) through the Institute for the Advancement of ADHD Coaching. Matlen runs online coaching groups with Tara McGillicuddy at addactionclub.com, and she is also a community leader of the ADHD Allies community on Facebook. As a woman diagnosed with ADHD and the mother two young adults, one of whom also has ADHD, Matlen has a very personal perspective on the disorder and how to manage its symptoms.
How do you keep children focused on projects assigned over the holidays, but still allow time for a "break" from school work?
That's a great and difficult question. I would start off with a powwow with your child to discuss a plan and come up with a schedule that works for both you and your child. Kids need to feel like they have some control and therefore are more apt to go along with the program.
I would come up with a plan so that your child has time off to enjoy the holidays yet doesn't neglect his school projects. Perhaps working forty-five minutes per day works for him or maybe he does best chunking with, say, fifteen-minute sessions three to four times per day.
The best solution, though, is to work WITH him on a plan instead of enforcing what YOU think is best, then revisit how this approach is working and tweak as necessary. I would also suggest that if he is on meds, he stay on them during break if he needs to focus on such things as school work (among other things).
Each Christmas my son gets stuck on a toy and becomes totally absorbed by it. He will not notice anyone, any other toy, or any other activity for days and days. If we ask him to participate in anything that requires him to move his focus off the toy to something else or someone else he greatly resists. It is a source of holiday angst. We want to spend time with him and help him to have a life engaged with the family, but the toy becomes the center of it all. Any guidance on what we can do to help decrease the power of "the toy" and increase his social competence and enjoyment?
It's hard not knowing how old your son is, and I'm also wondering about a few things. Is ADHD his only diagnosis? Is he on the correct medication dosage? In general, again, a plan needs to be made AHEAD of time instead of dealing with this in the moment.
You can make up a schedule of time when he can play and when he needs to socialize. Now for many kids with ADHD, especially if there are co-existing conditions, being in the middle of a lot of chaos and commotion can be overstimulating. A normal reaction to that might be to retreat and play with toys.
You need to gauge if he is having a sensory overload due to the company and excitement of the holiday, and if that's the case, maybe reconsider his need to "chill" with his toys. There may need to be some compromise here if that's the case, where you ease up on your expectations a bit. If he's able to move away from his toys, even for a short while, compliment him for doing that.
During the holidays our family—with both Jewish and Christian sides—has a lot of activities. Sometimes they even tire me out! How can we help our pre-teen daughter, who has ADHD, appreciate them for what they are and stop "hating" (her word!) going these family events?
That is a tough one because many kids her age dislike these kinds of activities. Add ADHD to the mix and it's just more difficult. I would have a discussion with her and perhaps allow her to not attend every single event. If it's hard on you, it is much harder on her, given the ADHD piece.
So if there are a few events that are not mandatory for her, consider letting her stay home from those. If not, then ask her what she thinks will help her "get through" them better. Again, it could be something you aren't aware of—such as sensory overload—in which case you can help her come up with some solutions for that.
I have ADHD and this year's holiday gathering will be at my house. I feel unprepared; especially to deal with all the holiday tasks (meal prep, gift buying, travel arrangements for other family members). How can I best prepare myself ahead of time?
I have written extensively about just this! Those of us with ADHD must, must, must figure out ways to make holidays work for us. It's important to find ways to simplify all of these tasks, and also to learn to ask for help. My main message for all of you dealing with the stress of the holidays is figuring out what works for YOU. Not what is EXPECTED of you.
For example, if putting a large (or small!) meal together just puts you over the top, think of ways that work for you. For example: Ask others to pitch in by bringing in side dishes or order some, or even all of the meal, from a catering company. Or even go to a restaurant and pick up the food!
In my case, for example, I had a gang in from out of town for Thanksgiving. I knew I couldn't manage cooking for everyone (we've had a number of family crises lately), so I talked to my family and we all agreed that the importance of the holiday was not the food, not the decorations; it was about being together as a family. So I went out an hour before dinner and picked up all the food at a local restaurant!
As far as making traveling arrangements for family and so forth—you need to let others pitch in to help you with all these details. We tend to want to put on a tough front, that we are capable and able to do things like everyone else, but in reality, we often NEED more help than others.
Think of all the things you need to do. None are ADHD-friendly. So I suggest allowing ourselves to reach out, to make changes in how we "do" holidays so that they work for us.
My son is on medication for ADHD to help with getting school work and homework done. Since school is out for a week and a half, do I still have to worry about giving him his pills? Or can we skip it for a while and see how he does?
The first thing I would suggest is to discuss this with his doctor, as I am not a physician and cannot give medical advice. That said, kids (and adults) with ADHD have symptoms when they are at school, home, and anywhere else. My vote has always been to continue taking meds—if the doctor suggests it—because ADHD is with us 24/7.
We know that the meds help with more than just focusing at school; it helps kids maintain themselves behavior-wise, which makes them happier. No one likes to feel out of control or less capable of doing things due to hyperactivity or distractions.
How can I deal with other family members who don't understand ADHD? Family can sometimes be so critical of my child's behavior. I feel like everyone is on edge this time of year as it is. Factor in my son's behavior (he is seven years old) at holiday gatherings and it can be overwhelming!
I always advocate for education—getting people to read about ADHD. Sitting down and explaining it to them—what it means, how the symptoms express themselves and how it's not a character flaw, but a REAL medical disorder—can help.
Criticism of the child should not be allowed. You might want to pose it in a different way. For example, you could say to the critic, If a child had a visible disability, like a visual impairment, would you expect him to do certain things that are too challenging, if not impossible?
If it is so awful that your child is reacting to the negative comments, I might consider not being part of such gatherings. Your child's self-esteem is more important than that. You need to be firm with the family members who are unable to understand the behaviors.
To help your son, find out what works for him during the holiday gatherings. Perhaps he does better eating in a quiet room, away from all the people, but can then join in for dessert. It's a difficult situation when people don't understand and then criticize.
We want to try visiting friends during the holidays, and Thanksgiving visits with friends didn’t go too well for my twelve-year-old son who has ADHD. He stayed outside because he was too overwhelmed with even small groups of people. How can we prepare him for the next visit? We want him to socialize. Should we bribe him with a reward?
We sometimes forget how difficult this is for our kids. Noise, changes in routine, and so forth can be overwhelming! So we need to come up with alternative plans. We need to change our expectations; yet kids also need to learn coping skills.
One idea that works well is to have your child wear earphones or use an iPod to help filter out noise. That alone can help a lot. Of course, you want him to socialize, too, so come up with a plan where he takes them off on a regular basis, but that he knows that when he gets overwhelmed, he can put them back on.
Find areas in the home where he can retreat for downtime, and explain to him ahead of time that he can go there as needed, but needs to also come out to be with people.
Rewards: You can try that, but DO keep in mind that what you are describing—the noise, the excitement—is painful for many kids with ADHD. Bring a bag of quiet activities he can engage with to help settle him down. Applaud any efforts of his socializing. Always have a plan ahead of time so that he doesn't fail.
How can I best prepare my six-year-old daughter for a cross-country flight? With her ADHD, she can't sit still for ten minutes let alone four hours.
I had a similar problem when my daughter was that age, though our flight wasn't quite as long. I purchased a (large) bag of inexpensive toys—anything to keep her busy!
What I found, which really surprised me, was that when she was buckled into her seat, she was able to remain fairly calm. The restriction of the belt helped her. If she's calm in the car, belted up, it might be a clue. If not, and you don't think anything will help, you might need to talk to her doctor about medication interventions. Good luck!
I've always found the holidays a bit depressing (partly the season, partly because it marks the anniversary of the death of one of my grandparents). My partner is just the opposite—including hosting a holiday open house with a hundred of our closest friends. (I’m kidding on the size, but still a big party!) All this frenzy isn't good for our nine-year-old, who is pretty hyperactive to begin with. Do you have any thoughts on how to find the balance here?
Compromise is the key. Perhaps your partner can invite fewer people, for one thing. Holidays often make lots of people depressed. You need to think about your needs and your child's needs.
Ask yourself: what would work for me and my child? If he can't handle it, allow him to retreat at times to his room. We have to stop forcing ourselves to go with the status quo during holidays. They are supposed to be fun, happy times, not grueling, stressful ones.
My eleven-year-old stepson will be spending time over the winter break with his mother's family and with our family. Whenever he comes back from her house he is out of sorts, presumably because his routine is disrupted. How can I help keeps things consistent?
Good question and a difficult situation for all. As you know, consistency is key. Whoever is in contact with his "other" family, needs to coordinate things. Find out what time he goes to bed, gets up, types of foods, activities he's used to, and try and keep as much of the routine as possible the same.
By out of sorts, is it also possible that there's emotional "stuff" going on? Perhaps he's stressed or anxious or depressed. These things need to be figured out. Talk to him and get some clues. Also, make sure his meds are the same at your house as they are at his mother’s house.
In a large-group setting comprising family and other people, how can we handle the interaction between the children? Our eight-year-old son, who is impatient, looks very rude to other kids. We feel as if we have to reprimand him; but how?
I'd think more about educating versus reprimanding him. Reprimanding doesn't offer life lessons. Practicing beforehand is helpful. Set up situations you think will come up and ask him how he will deal with them.
Teach him how to share, how to listen, and how to play by role-modeling with him. Teach him that when he feels he's getting out of control or impatient, to come up with a "scripted" explanation or statement and then have him remove himself from the group as necessary.
My elderly mother-in-law is arriving on Saturday for the holidays. She can only stand my two kids, who have ADHD, in small doses. I've hired babysitters for two afternoons, but I'm not sure how to handle this situation. It is my house, after all! My kids are very lovable—but they were definitely not raised according to the "children-should-be-seen-but-not-heard" idea. Help!
Good plan getting sitters in! That is a great solution, though obviously not enough of a solution. It IS your house and you'll need to talk to both your mother-in-law and your kids to come up with a plan.
For example, give your MIL ways to get away from the chaos if she can't handle it—suggest she find places to retreat to when she gets overwhelmed, because it's not possible to control two young kids who have ADHD over a period of a week or so.
Also, find activities for your kids that can keep them quiet at times (though I know that is also not very practical in the scheme of a whole week). Your MIL needs to understand that the kids cannot help their behaviors all the time, and so she'll either need to adjust her expectations or consider staying for a shorter period of time—or finding a different place to stay.
It IS a difficult situation for all. Again, open communication as to what everyone thinks can work (not sure your kids are old enough), but it's worth a try. You may also need to educate your MIL about ADHD.
Do you have tips for a single parent around this time of the year? It is all so much to have to worry about.
Yes, it IS a lot to worry about. By using the word "worry,” is it possible that you have expectations of yourself that are not fair, given your situation? If so, what DOES work for you? MUST you do all that you THINK is expected of you?
Adults with ADHD often have a very hard time saying "no,” but it's something we all need to learn how to do. We tend to say YES because we're people pleasers, which may stem from childhood experiences of feeling bad for not being able to keep up with others' expectations. So think about what you CAN and WANT to do and make the holidays work for you.
During holiday get-togethers with family, my child's worst ADHD symptoms seem to come out, especially when he is around other children that he doesn't see very often. What is the best way to prepare him in advance for these family gatherings?
Often times, these behaviors are exhibited more when a child is feeling stressed, nervous, worried and overwhelmed. He may be feeling inadequate around other kids he doesn't know.
Role playing ahead of time can help; giving him cues and "scripts" to have in his toolbox, so to say, for when the time comes to connect with these other children. I also feel children with ADHD become over-stimulated easily and need ways to get away to calm themselves down.
I'd discuss with him a plan for calming himself as well: going into a quiet room to settle down, bringing a toy that he likes, iPod, etc. Whatever he does at home that is calming to him.
It is so hard for children who are trained to receive rewards to learn discretion when it comes to gifts. They are always expecting gifts, no matter how many discussions we have explaining NOT to ask. How do I help my child develop better present-receiving manners?
This is a problem for many kids, let alone kids with ADHD. Our society has promoted this via advertising, etc. Again, planning ahead is the key. Role-play and practice with your child how to be appropriate with gifts. This could also be part of his impulsivity. So lots of practicing will be needed.
Do you have any recommendations for ADHD-friendly gifts, either for a child or an adult?
In general, for kids, if they are hyperactive, give them toys that make them MOVE! There are loads of toys that are fun but also teach skills; for example, small trampolines for small children with motor deficits are great. Also good are beading, crafts, mazes, and so forth, for improving fine motor skills.
I actually think that some video games are good. I think there's too much criticism about that. For adults, some women hate jewelry but love computer games. Go with what they want, not what you think they should want.
Disclosure: My husband bought me an electronic paper organizer! I could care less about jewelry; I loved the idea of organizing my home office! There are also great purses with tons of pockets to keep women organized. Men might appreciate electronic gadgets that are fun but also helpful in keeping organized.
My boyfriend and I are thinking of moving in together, but he is awful with finances and goes really overboard with gifts. I'm trying to learn and be understanding about his ADHD, but it's hard. Is bad money management just part of the territory here, and I should accept it, or can he get better? Beside my mortgage, I've never bought anything without being able to pay for it in cash. He already has a huge Visa bill. What should I do?
Yes, difficulty with money management is a very common part of adult ADHD. Accepting that it's a problem is important, but that doesn't mean accepting his behaviors in dealing with it.
He may need help in curbing his impulsive spending. I would suggest a therapist or counselor who specializes in ADHD. There are also support groups for compulsive spending. And there's ADD and Your Money by Stephanie Sarkis.
My partner also has ADHD and really, really enjoys giving holiday gifts—and not just to family, but coworkers, neighbors, the mailman, the paperboy. Giving gifts is great, but it's not cheap and I dread the credit card bills every January! How do help him to tone down the money side of giving gifts without being Ms. Scrooge?
Is it possible that he's a people pleaser and uses gifts so that people will like him? Maybe it's time to have a talk with him about why he feels the need to give so many gifts to people. If he feels he is unable to stop that behavior, then ask him to compromise and come up with things that either don't cost anything (cards) or are inexpensive. Give him positive feedback for his wanting to give so much, but kindly point out the damage it does to him. There are workarounds that you two can plan out.
What would you say are the three most important things I should do for my child who has ADHD to make the upcoming holiday as enjoyable and memorable as possible?
First, prepare him! Does he have strategies that help him to stay calm and not to get over-stimulated? Work on scripts/strategies he can put in his toolbox.
Second, change his/your expectations. Don't expect him to be a hundred percent appropriate during all the excitement. Accept that this is actually a difficult time for him and other kids with ADHD.
Relax. Chill. Have fun. If you truly begin to accept ADHD in you and your loved ones, lots of these things will be less important and you'll roll with the punches much better. If you go IN expecting disaster, it will happen.
Instead, make accommodations for you and your child, like the time-out room for settling down, not for punishing. Give your child the tools he needs to stay calm and happy. Lastly, make the holidays work for YOU! If your child does better eating away from a large group of people—in front of a TV even—let him!
We need to make rules that work FOR ADHD not against it. Accommodations, too. Work with not against the ADHD, even if your plans have to be nontraditional and different. The idea is to celebrate the holiday and be with those you love.
Remember to put yourself in your child's shoes. No one likes to feel out of control and dismissed or punished. I hope you all use some of these tips and make it a great holiday for you and yours.