If you have attention deficit hyperactivity disorder (ADHD) or you’re close to someone who does, you know there’s hardly an area of your life it doesn’t touch: Career, school, family, finances, and physical and mental health… the list goes on.
Because ADHD causes such wide-ranging difficulties, treating it takes a highly-individualized, multi-modal approach.
If you haven’t yet considered including an occupational therapist (OT) on your treatment team, now may be a good time to investigate how an OT can help you manage symptoms and improve your quality of life.
“Occupational therapists are good team players,” says Cara Koscinski, MOT, OTR/L, a pediatric occupational therapist and the author of six books on occupational therapy for children and young adults. .
Occupational therapy can address physical, social, educational, and organizational deficits with a plan focused on your individual skills, needs, and activities. Read on to learn more about how they can help to lessen the effects that ADHD has on everyday life.
Occupational therapy focuses on the skills that each person needs to be able to function independently in daily life.
An OT’s first step will be to talk with you to find out how ADHD impairs your (or your child’s) ability to succeed at home, at work, at school, in relationships, or in other areas.
Here are a few areas where evidence-based OT interventions have been instrumental in managing ADHD.
For someone with ADHD, complex projects, daily routines, time-consuming tasks, and deadlines are difficult — sometimes impossible — to manage. ADHD can make it harder to:
- create and execute a plan for an activity
- finish tasks in the right order
- complete work within the necessary timeframe
- recognize when it’s time to speed up or slow down
- set aside the right amount of time for an activity
Keep an analog clock in each room to help you or your child track time visually.
What the science says
Research shows that OT is effective in improving time-processing and daily time management abilities.
At the end of the intervention, students who worked with an OT showed a significant improvement in their awareness of time, their ability to orient themselves in time, and their ability to manage their time effectively during daily tasks.
Succeeding in school and on the job usually requires consistent organizational skills. ADHD interferes with the ability to:
- anticipate what you’ll need to complete a project
- keep up with materials and schedules
- separate complex tasks into smaller activities
“Occupational therapists are specialists in activity analysis,” Koscinski says. “This means taking a look at each activity and breaking it down into steps and performance factors or skills the child needs to succeed.”
Once a project has been broken into steps, an OT can help organize materials, develop simple systems, and create visual cues to help people track, remember, and follow through on one step at a time.
“Visuals are very important for kids with ADHD,” Koscinski explains.
Keep supplies well stocked. Store them in labeled containers or drawers that are easy for your child to reach, and help your child return all supplies to the labeled space where they belong.
An OT can work with a student to create an outline of the steps involved in a project, color-code different activities, make a model to demonstrate what’s expected, and show a student how to keep a clutter-free workspace.
What the science says
OT helps adults with organizational skills, too. In one
Executive functions include:
- working memory
- planning skills
- knowing how to stay attentive or shift attention
- setting priorities
- controlling impulses and distractions
Teach your child how to prioritize homework by helping them sort assignments first by the due date and then by how hard your child thinks the assignment will be. During homework sessions, help them tackle the hardest assignments first when their focus and energy levels are highest.
What the science says
A number of studies have shown that occupational therapy can be useful in building executive function.
- In one
2020 study, researchers found that children who participated in a horseback riding intervention supervised by OTs showed improved executive functioning after the program.
- Using a series of hands-on, engaging therapeutic activities called the
Cog-Fun (Cognitive Functional) program, children working with parents and OTs experienced significant improvement in executive function after therapy.
2017 studythat involved 44 students in China, along with their parents, found that a program targeting executive function skills was effective in improving executive function skills after 12 sessions. In the program, students used visual cues and repetition to practice their skills, while parents learned how to coach and support their children. ( Studiesshow that parent involvement is vital to the success of OT interventions.)
ADHD can have negative effects on social interactions. The disorder can cause people to act impulsively, interrupt others, and behave in aggressive ways.
An astute OT can be helpful in getting to the “why” underlying inappropriate social behavior. Koscinski explains that children with ADHD often “act out” because they’re frustrated. An OT working with a classroom teacher can ask:
- Is the student sitting close enough to the teacher to hear and understand instructions?
- Is the classroom environment over-stimulating the student?
- Is the individualized education plan meeting the student’s needs, and is it being followed?
- Is the student allowed to self-advocate in the classroom?
- Does the student need to take a break or move around physically?
“Giving kids breaks to move is so important,” she emphasizes. “Movement increases oxygen in the brain and gets the wiggles out.”
Children with ADHD can take short breaks to return books to the library or run other errands. Better still, the whole class can participate in quick brain breaks to restore energy levels.
Keep play dates to a smaller number of children, one or two, so that your child is not overwhelmed. Try to choose children who have good social skills so your child has an example of these skills to model.
What the science says
While there needs to be more research on the specific activities that help, there’s some evidence that OT improves social skills among children with ADHD.
Occupational therapists are especially good at training people with ADHD how to use devices that enable them to function more smoothly in daily life.
Koscinski points to several objects that make life easier for kids who need wiggle room and let them expend excess energy during a productive day:
- yoga balls
- scooter boards
- air cushions
- other personally-matched devices
A vibrating watch can be set to vibrate at regular intervals to remind an adult or child to stay on task or return to a task if they’ve been distracted.
What the science says
One 2013 study indicated that adults benefit from training on such assistive devices, too. Low-tech interventions such as weekly schedules and weighted blankets seemed to help most.
Here again, Koscinski has 7 tips for those looking for an occupational therapist to help with ADHD:
- Find an accredited OT. Make sure any prospective OT graduated from a graduate program accredited by the American Occupational Therapy Association and is licensed in the state where you live.
- Observe your child with the OT. If you’re a parent, watch how your child and the OT interact. You want to be sure that there’s a good personality match.
- Find a therapist who understands sensory processing. If you or your child have difficulty with sensory processing, does the prospective therapist have special training in that area?
- Ask to see the therapist’s assessment and therapy goals. It’s important that you and your therapist are communicating clearly right from the start.
- If you’re a parent, observe sessions, especially the early ones. Does the therapist encourage your child? Does the therapist show high energy and interest in the therapeutic activities? How does your child seem to respond?
- Does the OT listen to you? When you’re discussing your own or your child’s progress, do you feel the therapist hears your concerns? Mutual respect is a key part of the process.
- Ask for homework. Your child will progress more smoothly if therapy isn’t an isolated experience. Practicing at home will help build skills.
There are also the practical considerations. You may need to choose an OT in your insurance network or one close to home or school. You may be assigned an OT in your school district.
As you’re considering your options, talk to friends, relatives, and healthcare professionals you trust. Their recommendations could save you some trial-and-error.
Always trust your own instincts, too. If you don’t feel a particular therapist is a good fit for yourself or your child, find another option. You don’t need a reason to choose a different therapist.
A person with ADHD may experience a wide variety of symptoms. Since there is no lab test for ADHD, diagnosis is based on the symptoms an individual has. ADHD can significantly affect an individual’s relationships, education, and work life.
ADHD symptoms may include these and others:
- difficulty focusing on tasks
- very easily distracted
- fidgety or unable to sit still for very long
- difficulty listening or frequently interrupting when others are speaking
- emotional outbursts – fits of anger or frustration
- rarely plays quietly – is often loud or noisy
- forgetting to finish things they start
- using other people’s things without permission
- frequently makes “careless” mistakes
Occupational therapy focuses on building skills people need to function independently at home, at work, and in school. For people with ADHD, occupational therapy can be especially helpful in:
- developing better time management skills
- building better organizational habits
- improving executive functions
- practicing new social skills
- working with assistive devices to compensate for any deficits
A good occupational therapist will conduct a thorough assessment to see what skills and needs you have before creating a treatment plan to address your areas of concern.
It’s okay to take your time finding the right occupational therapist for yourself or your child. Working with a skilled, caring OT can mean the difference between struggle and success if you have ADHD.