Improving concentration - Autism & ADHD

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DS2 is 12. Has autism, inattentive ADHD & epilepsy (come on with onset of puberty) In Year 8 at mainstream secondary school. At primary was getting 32.5 hours 1:1, gets about 20 at secondary school. Has EHCP, in place since Year 1.

Due to the heavy levels of support he needed, we were unsure whether to send him to mainstream secondary. We took the risk & he positively thrived. Showing particular aptitude for languages (is an international school, so this is great). Working at or around expected level in most subjects. In history, he was falling behind so teacher suggested a reduced curriculum for him, which we agreed to. He won an effort prize in Geography & also the overall year group prize (210 students in the year).

Fast forward to Year 8. He still loves it & works very hard. Can do most of the work when practical/formulaic eg maths, art, languages. But seems to struggle hugely with anything like reading comprehension or research homework tasks & can only do these with our support. Is also very forgetful, again linked to concentration, I feel.

I wonder if it is his concentration holding him up. He needs prompting to do everything, eg getting dressed, eating etc. So does anybody know how to boost concentration in this kind of child? Should we be looking at adjusting his ADHD meds dosage- he currently has Xaggitin. He has put on roughly 1 stone since his last check up. Will the epilepsy be affecting his concentration? Are there any strategies for helping with reading?

Thank you if you have read this far & any advice gratefully received!

Any tips at all please?

Sounds like the best place to start would be a review with his doctor and see about changing the dose or type of meds if they're no longer adequately meeting his needs.

Yes, I was wondering about that, as he has grown a lot & started puberty, which could possibly have an effect, I imagine?

If anybody has any other things we could try, I would love to hear them!

The fact the he can do some types of knowledge and not others suggests it's not a concentration issue per se.

History, reading comprehension and most of the humanities depend on inference about human beings and human society.

You have to reason about what individuals and groups think and try to work out why they do what they do.

For example key to understanding the reign of Henry the eighth is that there had been a civil war only recently and Henry believed that a civil war would break out again on his death unless he had a legitimate son.

Whether this belief was true or not no-one will ever know, but it drove much of his actions.

For someone with autism being mentally prepared to work with "false" beliefs and reason in that system is very difficult.

I'd suggest finding someone to work with him on social understanding - either a speech therapist working on social comms (although that was not terribly successful with my son) or a primary English teacher to work on reading comprehension.

I'm sure that has a lot to do with it too @Octavia64. His reading comprehension definitely needs working on. We can't afford a tutor, but I can try myself with some books or online resources.

I do feel like his concentration difficulties affect every part of his life, so want to try to improve those, too.

Even on meds, I struggle to read anything lengthy that doesn't fascinate me. I can re-read the same paragraph 5 times and still not have understood a word of it.

My solution for when I need to do this for work, is to stand/pace/dance on the spot while I read. Makes a huge difference for me.

I think being a young person with autism/adhd is really hard.

Not only do you have all your growing up to do and a load of hormones to deal with but you have school.

As an adult I don't really have to do stuff that doesn't interest me, but as a teen you have to slog through all your GCSEs.

I think History is especially hard, I didn't get good at it until my 40s when it became a special interest. You need to understand so much about people and what motivates them.

I think you are doing an amazing job and so is he.

With my son what we did was have a film club every Saturday with popcorn etc and we watched the film as a family and then discussion tended to happen naturally.
He struggled with reading whole books but the same content in films is a lot easier to take in and expands experience in the same way.

For the concentration not sure I have any suggestions - upping meds is the obvious one but maybe he also needs an additional boost in the evening if he takes his main meds in the morning?

Sounds like executive functioning and working memory is playing a part too.

I think requesting additional input from an ed psych to review learning needs at this age could be helpful.

As for working on concentration, as an ND person I'd say to remember that concentration is not a muscle that can be worked to make it stronger.

Thank you, these are all food for thought. He is bright & absolutely loves school & is loved there, but we need to make sure his academic needs are being met in the right way.

At the same time, he is building friendships, which he has never had before, learning independence & dealing with puberty & the shock of epilepsy, so he absolutely does have a lot going on in his life. He deals with it far better than either of our NT DSes could, he is phased by nothing!

So, a couple of weeks on & things seem to be getting worse 😭

Not only is he losing his PE kit every week & failing to come out to the car on time after school, he is also not doing so well in lessons. His SENCO just rang to report they have noticed he can't start off tasks, keep on track or finish tasks. He will talk about other things & has even been a bit rude.

I am really worried right now. SENCO is going to try a timer in lessons & a list of what he needs to do. She is going to request another educational Psychologist assessment (at my request).

I am going to put him back on Omega 3 supplements & chase paediatrician review. But I am so worried & don't know what to do 😭

Reading comprehension can be made to be formulaic. So you could start with having a set process of how to read text

Sounds like he needs to be scaffolded during each task as well as given assistance with starting and finishing.

Omega 3 isn't evidence based AFAIK - look at studies on Pubmed though as my knowledge is out of date on this one.

We did notice an improvement in him before when he took Omega 3 supplements (Equazen). Although this was before he developed epilepsy.

At this stage, I will try anything & it can't hurt, can it?! 😬

I was the same. Tried anything and everything. Lots of exercise helps - does the school do the daily mile? Does your son get brain breaks? Maybe ask for regular shirt exercise breaks.

Because it is a secondary school, they don't do the daily mile. However, he does get natural brain breaks as he has to move classrooms each period. This was one thing that really seemed to go in his favour last year, but today apparently he seemed lost & confused 😥 He also struggles with exercise as he has hyper mobility & poor muscle tone.

One other thing which I wonder about. We are very busy as a family, in evenings, weekends & school holidays. Pretty much every evening either he has an after school activity or one of his brothers does & he has to tag along. So bedtime is not always at the same time. Varies from 8pm - 10pm. He gets up at 6.30am, to leave at 8am. Seems like a lot of time but he is very slow at getting ready & would not manage otherwise. Could this be having an effect? If so, there is not much we can do about it 😥

We use routine, checklists and alarms for a DS with similar issues.
He still forgets things, loses things and occasionally wears the wrong uniform but he is getting better.
I am thinking of getting him a smart watch so that he can have alarms /reminders on that for things like bringing home sports kit.

Also, might screentime (phone, tablet) have a negative effect?

Could he be having more episodes of epilepsy than you think? Maybe absence seizures hence the confusion?

No other advice except it's hard our DD is autistic and really struggles academically.

Does he need/want to do all the activities he does?

Does he need to go along to his siblings activities? At 12 can he stay home alone instead?

Maybe quieter, more routine evenings would help a bit. My DS has autism and a good predictable routine, less screen time and more time outdoors has a major positive impact on him.

I don't think so, but it's worth mentioning to the consultant when we see her next month.

He only does Scouts & drama club (which is a Tuesday lunchtime at school). And a gardening club once every 3 months. Scouts is hugely beneficial for him in terms of social skills, independence & practical skills. It is mainly activities for his brothers that disrupt the routine - either they clash or DH is not home from work & I have to do it all & take him with me or vice versa.

I'm sure most 12 year olds could be left home again, but not DS. He has a lesser sense of danger than eg DS3 who is 9 & also he may have a seizure. He can be left if DS1 is there, but DS1 is usually the one with activities.

My son is the same and so am I tbf. If it interests me I can read it ok, otherwise it’s just text, I skip sentences and paragraphs without realising until I’ve read it a few times and still forget what I’ve read and then I give up.
As for remembering things, I still am fully organising everything daily, checking for homework and what lessons he has and packing bag accordingly, reminding him to shower, deodorant, brush teeth etc.
In primary my son had a lot more flexibility, he did sensory circuit everyday and was able to walk out when he wanted but now the second he leaves his seat he’s told to sit down, then he gets agitated and won’t concentrate and his work has gone downhill but he’s always struggled sitting and concentrating and not once met targets throughout his time at school.

Have you had a look at assistive software?

It can be quite pricey, but is what is offered at uni through dsa and is worth a look.

Mindview for mind mapping
Read and write for... Reading and writing

There are others. The amount of stuff they are able to do is astronomical. Converting pdf to be readable by reading software. Grammar, but even so far as checking homophones. Picture dictionary. A place to keep all research together.

They are proven to support students.

Also we always get told off at assessments and told no screen time, only audio books