Anyone got ideas to help teenager's executive function?

[vivariumvivariumsvivaria]

DS15 is not SEN, but he definitely does not pick up on his body's cues - so he was very slow to wean/potty train/doesn't feel pain or hunger in the same way as most kids etc.

We are having a problem with him remembering to eat, brush teeth, take his medication, sleep and get up. He's 15, so it won't be long before he's off out into the world and I am concerned that he will live a life in front of a screen not moving and not eating.

He understands the issues, he just CAN'T remember to do them. It is exasperating to parent.

Tried everything, bribery, rewards, notes, alarms, diaries, whiteboards, punishments - nothing works. I do think it's an executive function issue - I left him to it at the weekend to see what he did. Got up at 2pm both days, didn't eat until dinner at 6 and then only a couple of nibbles because it wasn't his favourite one night, so I made his favourite the next and he ate 3 portions. Didn't wash, didn't move, played on his computer with his friends until midnight both days and thoroughly enjoyed himself.

He's not depressed, he's not defiant or sulking, he'll come on family activities that I organise and he'll happily do tasks if I tell him to, but, left to his own devices he initiates nothing.

He understands that exercise, sleep, studying and diet are important - but can't prioritise them. I don't think this is a maturity issue, it seems to be something more than that - I can remind him "feed your pet" and he goes to do it, gets distracted by a day dream half way through and wanders off. Then feels remorseful that he hasn't fed his pet, promises to do better, and repeat.

Anyone found an answer? I was wondering about an apple watch, whether it could be set to buzz when he needs to take his medication, brush his teeth, eat, etc.

It sounds like he needs some kind of prompt either from a watch or alarm reminder on his phone.

My daughter has ADHD and is quite similar. You can't guarantee that he won't ignore or forget about the alarm 5 minutes after it's gone off but it's probably worth a try.

I feel your pain. This is my son exactly, but he's 12. He needs constant checking and reminding to get him to do anything. Watching with interest as I haven't got a clue what to do with him either.

He's not diagnosed with anything, but, lots of people on his dad's side are neurodiverse. I do wonder if this is a spectrummy thing because it's so global and has been there since he was tiny.

He loves his phone, is never without it. Hadn't thought about using that. Might do that and say that if he keeps up the basics for a month I'll get him a watch.

In 2 years he'll be applying for whatever comes after school and he's so clueless about that too.

He's a great example of someone who lives in the moment. Never stressed, never unhappy, never difficult to be around. Nice friendships, lovely kind nature. Good kid.

None of that will stop him from turning into some sort of troglodyte though. I'm hoping that a beep from a phone will fix that.

Also feeling your pain. My 12 Yr old dd is just like this, also with huge anxiety which slows her down even more.

We have tried prompts, lists, Alexander reminders. Everything seems to lead to more anxiety.

I have bought her a sunrise alarm clock which might be helping a little (helps me massively and I'm sure I've adult ADD), and we're trying CBT for teens (she, unwillingly) in the evenings on Audible, just 10 mins a time.

We know she has very slow processing, working memory questionable.

Place marking. My 12yr old is like this. It's torturous.

My son is 14 and very daydreamy.
He has 101 alarms on his phone which works well. They include showers, teeth, packing PE kit etc which seems like overkill but it gets the job done. He's the type to get embarrassed about missing things which helps motivate him and helped him achieve things like attendance at all live lessons during lockdown.

@vivariumvivariumsvivaria

In 2 years he'll be applying for whatever comes after school and he's so clueless about that too.

He's a great example of someone who lives in the moment. Never stressed, never unhappy, never difficult to be around. Nice friendships, lovely kind nature. Good kid.

None of that will stop him from turning into some sort of troglodyte though. I'm hoping that a beep from a phone will fix that.

Are our sons twins? Mine is like that too but I need him to learn how to cope at taking over this sort of thing- especially if he goes to uni.

With my DD1 (who has dyspraxia) we used her phone. Not for basics, she could do them (though I never trusted her with a pet), but for everything else.

Even that needed rules.

1. put a reminder before the deadline. no point being reminded about something the moment it is late
2. never ever cancel an alarm because 'you'll do it in a minute', press snooze on it instead. then if you get distracted it will remind you again

No more than two tasks at a time.
Check on follow through, eg set alarm for task.
Set reminder to ensure completion of tasks.
Rewards and punishments are unfair as you are setting them up to fail.
Visual maps of their day can be helpful.
Post its Everywhere!

My sister was like this, she's now an ICU nurse, single mum and all round amazing and normally organised person.

Can he do it when he needs to - school deadlines, mate's party etc? Do you always catch him before he falls? If he really really can't manage then maybe it is worth an assessment. If not, then some teenagers are like this and do generally manage to pull themselves together later on.

If you think this is something that's been present since childhood (and not just usual teenage behaviour) then I would make an appointment for the GP and get him assessed. If you are in England you can use Right To Choose and get referred privately to skip the long NHS waiting lists (Psychiatry UK are who a lot of people use).

Honestly this sounds like my unmedicated ADHD, but for it to be that it has to be present in childhood too. If you suspect it is, it's worth getting looked at before he goes off to college or the world of work. I never struggled much as a child (because I had a mum to remind me to do everything and lots of rigid structure) but it all spiralled as I grew up and had to take on more responsibility.

There is a great book called Smart but Scattered teens which may help.

Will try to come back with more in depth stuff later.

I went on a parenting course about the teen brain and it explained how a teen's brain is editing material from the back forward - they really are missing parts of their brains functioning and their brains are not fully formed until they are 25. He sounds like my 14 year old son too.
But I have also been to parenting courses that explain if a child has a lot of screen time it effects their concentration. Because games and videos are designed so the user just follows them without having to think too hard - so these children can get distracted more easily when not on games.
I also think you might want to google infant reflexes not going dormant.

Another book Raising Human Beings has a brilliant framework for conversations about areas your kids are struggling with or find hard and how to brainstorm solutions with them - this makes it much more likely they'll be followed as they don't feel it's imposed.

Be aware my DS with executive function issues takes hours and hours to complete the discussion stage, but it's usually well worth it and helps them develop problem solvjng skills for the future as well.

WRT ADHD, it does need to be present in childhood but that doesn't necessarily mean it would have caused problems in childhood. Mine never did until I hit my mid teens. But the signs were there, I was always daydreamy and vague and dishevelled!

Sounds like my DD 14. I do think alot of it is to do with constant tech, phones, gaming etc. There is always something to do which keeps their brains busy so they forget real life stuff. Plus I think teens just don't prioritise things in the same way.

I do have a history of saving DD before she falls which I am trying to stop as I do think she needs to realise there are consequences (does not include pet care as that isn't fair on the pet)

I live with a young adult (21) like this and it's drives me mad. They don't want to be reminded about anything, but can't remember to do any task including personal care without a reminder. Hopeless at making sure for example they replenish loo roll before they've run out. Tips on how to not get frustrated would be welcome.

'He doesn't have SEN'

Hmmm. Another one of those. Sounds like he does.

What is the medicatinon for? Could that be making him foggy and forgetful?

He reminds me of myself as a teenager...my first thought was dyspraxia.

I've gotten better as I've got older though.
I'm still not great at housework though (I have a job and DC, thinking about housework always ends up at the bottom of the list of stuff in my head)

Sounds exactly like my ADHD teen & me to a degree - also ADHD, both primarily inattentive, no hyperactivity but definitely differently wired which manifests itself in lack of organisation, procrastination, messiness, scattiness & short term memory issues, daydreaming, poor time management, lack of ability to prioritise etc.

Loads of good resources here including a symptom checker which is useful to take along if you are interested in diagnoses/referral.

www.additudemag.com/

Some people don’t like being ‘labelled’, but I’ve personally found that knowing what you are dealing with allows you to then develop the tools to manage the situation rather than mask it (or as it sound like in the case of your DS just ignore it?). It can also be a relief to know why, if you do have ADHD you find tasks that neurotypical people find simple so challenging & that you aren’t ‘lazy’ or ‘stupid’ etc - just different & need to approach daily life slightly differently in order to function effectively.

ADHD & ASD are entirely different things, although ADHD is often co-morbid with ASD there are a lot of people who are one or the other and definitely not both. Neither DS or I have any autistic traits and ADHD is not the same thing or counted as being ‘on the spectrum’ (to use your terminology, I know some people aren’t keen on the term - but am repeating it to clarify the difference).

On the other hand he may just be being a teenager & not have developed the life skills necessary to get on with it yet, impossible to tell from a post on the internet! Possibly worth looking into potential ADHD though, without hyperactivity & in a bright and generally compliant child it is often missed.

This sounds identical to my son! He has a visual timetable on his chest of drawers that he can check what he has to do and when.
It sort of works...
When he has to go on his online learning he doesn't do the things on his timetable, but he doesn't do them later either"because it's not the right time"
He doesn't feel hunger or pain, or a full bladder most of the time.

Oh, wow, this is really helpful. Thanks, all.

Yes, I do see the "doesn't have SEN" is a bit questionable. It does run in the family, but, I guess I thought that if he doesn't need support at school it doesn't count. I had't thought about ADHD as it's autism in my inlaws side. Maybe.

Hadn't thought about the dishevelled thing - that is him. Never ties his shoe laces, can't manage to be tidy, can't wear this school shirt which is exactly the same as that shirt because this shirt is itchy. Cuts the labels out of stuff and wears socks inside out.

The saving him before he falls - guilty. I stopped this year, he's got to take responsibility for himself and I was babying him. He was a poorly kid, the medication is to manage his shocking asthma which is now under control - as long as he takes his tablets. Every single day I have to check that he's done it. That is my main worry, he is going to have to manage that independently when he leaves home, and at the moment I wouldn't trust him to. So I cluck about a bit, it was hard when he was little.

From childhood - now that I'm thinking about it, one of the reasons his asthma was so challenging was because he didn't seem to recognise when he was becoming unwell. One time school phoned me to take him home, he would have been about 6. I called 999 because I could see he was really sick. Ambulance men and teachers reassured me, they had me down as a neurotic mum because the kid was a bit pale but happily playing with Ben 10. His sats were 86% and he went straight to HDU. He did that all the time, just didn't seem to feel the panic most people would if they couldn't, you know, breathe.

Pet - to reassure, it's a snake, so only needs feeding once a week and clean water every day. I keep an eye on it all, the snake is well cared for, but I'd be really worried if he got a pet on his own.

I'd never heard of ADHD without hyperactivity. Hmmm.

Thanks, that is exactly him, bright and compliant and you couldn't be angry with him because he's genuinely not meaning to be annoying.

Also, sorry, yes, I know that spectrum is old terminology and that aspergers isn't a thing now. It's kind of hard to keep up when you're not in that world. Apologies, point taken.

I am autistic and your posts sound so familiar, especially now you have updated with his sensory issues re clothes etc. If he is autistic this will be a lifelong battle for him and there is no easy solution. Reminders etc do help but are not the full answer.