How to improve mornings with ADHD child

[MysteriousFalafel]

I’m really struggling with 9 year old DS, diagnosed ADHD but currently unmedicated as somehow seems to still be managing ok at school (although I cannot get him to do
homework without a meltdown)

Mornings currently feel nightmarish. DH is out early (7am) so not a great deal of help and I also have a 4yo and 6mo to get ready - and myself to work when I go back next month! DS1 just…cannot. He needs multiple multiple prompts to do anything like eat, brush teeth and get dressed. I often need to get hands on to physically dress him myself, which he really doesn’t like because it’s embarrassing and I really don’t like because it’s not teaching him any skills or improving things but sometimes we just need to get out of the door.

I don’t allow any screens until he’s ready - in the morning this is TV but I have offered laptop time as an incentive to get ready and this was unsuccessful. He wants to but he just seems to block on the actual doing, which I know is a feature not a bug of the ADHD but I’m at a loss as to what I’m supposed to actually do to help him unblock. So far we have tried:

Countdown to a transition so in 3 mins I’m going to ask you to brush your teeth, timer goes off (I’ve got timers all over the house so it’s a visual countdown as well), ok please come and brush your teeth. I’m physically stood there to shepherd him but he will just lie down on the floor, dive into another room, wind his brother up, go and talk to the baby, run upstairs and get in bed…anything except brush his bloody teeth. I will then try to touch shoulder to get attention, tell him I’ll do it with him, try to make it a race or a game…still nothing. After me calmly repeating the instruction up to a further 20 times he will probably get up and do it. Sometimes I just get the toothbrush and do it while he lies on the floor.

Visual list of tasks - we had a board with those things to flip across when task complete. He loses the board, forgets to look at the board, forgets to flip the thing across then gets frustrated because the board looks wrong and that’s distracting enough to derail him completely.

Tried a reward chart, he’s not interested as collecting stickers just isn’t enough dopamine to motivate even if 5 stickers equals a mega treat.

The only thing I have been successful with is that I have completely stopped shouting and getting wound up as it was obviously the opposite of helpful but it’s soooo frustrating and time consuming and I just can’t find any resources to help. Everything seems to say structure! Routine! But we have everything structured and routine and happening at designated times and it still isn’t working.

Any suggestions? I’m currently getting up an hour before I need to to allow time for all this but I know he would like to have some more autonomy in the mornings and I would like to be less involved in every single step of it. Sorry it’s long I’m at my wits end with it all

I wouldn't be massively bothered about teaching skills first thing in the morning under pressure. You can teach skills at weekends, or in school holidays.

Your mornings sound similar to mine with AuDHD 11yo. I put her clothes out on the floor in human shape so she has a visual of what to get into. I very often brush her hair and teeth for her.

The only suggestions I can make that have worked for us are

• don't use too many words - this was actually DD's idea after she nicked my book "how to talk so kids will listen" 😂She carefully bookmarked the page for me and then brought it down and pointed to it for me. So instead of "come on DD, it's time to do your teeth, come on no don't go over there, it's not reading time, put the book down, it's time for teeth" I just say "Teeth!" And I give two reminders then I do it for her. 20 reminders is too many words.
• Backwards chaining - you do all the steps with or for him, then after a while you leave him to do the last step. Then the last and last-but-one step. Etc. So for toothbrushing you could do his teeth, the last step is that he puts his toothbrush back in the holder. Then move on to he rinses it and puts it back in the holder. Then he does the last few seconds of brushing, rinses it and puts it back in the holder. The only thing with this is it's a slow process, you don't move backwards one step per day!
• Forwards chaining - same thing but instead of him doing the last step, he does the first then you take over, then the first and second and you take over etc.

With the chaining this is more for children who aren't sure what to do or need the skill embedding so it may or may not work for yours. It has been helpful for mine but she also has support needs related to her autism not just ADHD.

I wouldn't have any sort of chart where the child has to do yet another thing in the morning even if it's just tick a box, flip a slider, move a PECS card etc as it's one more thing to do or forget to do.

Is there anything he loves or is motivated by? I can usually get DD to move if there is a silly cat video on my phone for her.

Also, structure and routine ARE working for you, if only because he would be a million times worse if you didn't have them - but "working" with ADHD kids in the morning is a very loose term! It is frustrating and time-consuming and it sucks, but every so often there is a real 'leap' of skills acquisition here. DD has just started taking her plate out to the kitchen when she's finished eating for example and we've been working on that for a while (next step: put it in the dishwasher!) It's easy not to see those leaps when the child is only achieving what others their age have been doing for ages, so one thing that is helpful to me is keeping an eye out for the little leaps and praising them rather than just thinking "FFS finally" and immediately expecting another stage.

Thank you for responding and sorry we’re both having similar mornings! He’s very capable and can absolutely do the task but it’s starting the task which is the hard part. Once he’s actually got a toothbrush in his hand he will brush his teeth and put the brush in the pot (mostly), but this is after 20 odd minutes of doing everything apart from picking up the brush.

Is he like this everyday, or just school days? Does he not want to go to school, because it’s a struggle for him?

I would reconsider medication.

If DS loses visuals but you think they will help, can you have them somewhere on a wall/walls so they can’t be lost? You could have ones that don’t require flipping so that DS doesn’t have to do that.

Some people find an Alexa helps. Then you are slightly removed because Alexa is giving the prompts.

Task initiation and executive functioning are part of being able to do the task. So although DS may seem like he can physically do the tasks, he might not actually be able to do them in the moment.

Do you think some of this is demand avoidance? If so, you might find the Declarative language handbook useful.

Homework wise, there are a few options to speak to the school about and try. Some find setting a specific time limit and stop whether finished or not helps. Others find doing it at school helpful. Does the school have a homework club? Some reduce homework to only a small amount. Others stop all homework.

Thanks I don’t think it’s demand avoidance it’s definitely the initiation of the task. Once he’s going he’s ok, it’s just like getting a brick wall going! I’m not convinced about visuals in a fixed spot because if he was not in the exact same spot they would pretty much cease to exist for him.

Homework I do need to speak to school about but historically they’ve been a bit well-meaning but crap. More than one teacher has blithely trolled ooh you’d never know he had additional needs! Well ok, but we do know, and pretending he doesn’t isn’t very helpful. He’s very well behaved and tries so hard at school so I suspect he flies below the radar. No homework club and even when I set a timer (we started with 1 minute) he ended up 40s in banging his head on the table.

He is like this every day but I deliberately don’t overschedule at weekends so it doesn’t matter if he’s still in his PJs at lunchtime. I always feel like he really needs a rest at the weekend as he’s so tired from making the effort all week but then he can also tip into the nag your brother/eat/screen desperation zone of dopamine seeking so it’s a tricky balance to get right as he definitely needs some activities across the weekend.

I would stop homework if it is causing that much of an issue.

Request a meeting with the SENCO. Also consider requesting an EHCNA.

The only thing that has worked so far is the tonie box which has a toothbrush train song and get dressed song. Works a bloody treat!

OP - it’s called task procrastination. See:

https://www.google.com/gasearch?q=task%20procrastination%20ADHD&source=sh/x/gs/m2/5#lfId=ChxjMe

DGD, diagnosed with ADHD has been like this, about getting ready for school for years. It’s because school is a struggle for her!

I wouldn’t pay any attention to the school’s view on DS additional needs. They might not have a clue! I’d request an ECHNA as a pp has said!

There’s an online magazine called ADDitude - it often has helpful articles on these things.