Understanding and Managing ADHD (and How Occupational Therapists Can Help)

When it comes to talking about ADHD, there’s often a lot of confusion—and it starts with the name itself. Attention Deficit Hyperactivity Disorder? That can be misleading, and here’s why: ADHD is often misunderstood because it’s more about directing attention regulation than a deficit.

People with ADHD don’t lack attention—they struggle with shifting it. Their brains aren’t on a one-to-ten volume dial like a neurotypical brain; it’s more like driving a race car with bicycle brakes. In other words, they experience extremes rather than a deficit—some activities can bring hyperfocus, and some activities are hard to get started with a buzzing brain. ‍

The Big Picture‍

ADHD is a chronic neurodevelopmental disorder that affects around 5% of children and 4% of adults in Canada¹, which means over 1.5 million Canadians are navigating life with ADHD. 

ADHD is often diagnosed in childhood and is experienced as difficulty staying focused (especially when the task isn’t something you are interested in), being over-focused and not being able to break or shift focus if you’re really into something, and not prioritizing focus (focusing on the most important thing) when something else is more distracting or stimulating. There are three main types or classifications (from Johns Hopkins Medicine):

ADHD, combined: impulsive and hyperactive. Kids have trouble paying attention and are easily distracted.

ADHD, impulsive/hyperactive: impulsive and hyperactive. But they don't have trouble paying attention.

ADHD, inattentive and distractable: inattentive and easily distracted.

However, everyone with ADHD will experience it differently, and it can vary widely depending on what the person is doing. A child might hyper-focus on a video game but struggle to focus in school, for example.‍

Beyond the Surface: What ADHD Really Looks Like‍

ADHD is more than just those three types. Experts often describe it as an iceberg—what we see and the underlying factors that make up a small portion of the whole, much larger and more complex, picture. ADHD can impact everything from memory and planning to emotional regulation and sensory processing.‍

Where Occupational Therapy Fits In‍

Occupational Therapists (OT) play a key role in supporting those with ADHD by addressing areas like:

• Attention (focusing, concentrating)
• Executive function (planning, decision-making)
• Sensory processing (how we process and respond to the world around us)
• Motivation (getting started and sticking with tasks)

At Sprout, our OT’s approach is all about promoting participation in daily life while navigating the unique challenges ADHD presents.‍

The Tools That Make a Difference‍

There are countless strategies out there, but here are a few recommended by our OT that can be game-changers for planning:

• Paper Planners: Bullet journals or books like Passion Planners aren’t for everyone but can be great for structure, memory, routine, and time management. 
• Digital Planners: Google Calendars, iCal, Outlook calendar tools are also fantastic for planning but can cause distractions, so they aren’t right for everyone. 
• Visual Schedule: Images or drawings in a sequential order that show the next steps (such as a morning routine).
• Wall Planners: a great visual reminder that can be shared with the family. 
• To-Do Lists: work well alongside a planner. Breaking tasks into master lists and daily lists can help kids (and adults) stay on track. You can make these lists in a planner or use sticky notes on the wall planner.‍

Motivation and the Procrastination Battle

‍Procrastination is a common struggle in kids with ADHD, and it’s rooted in several factors—overwhelm, lack of interest, boredom, or even fear of failure. Fortunately, there are tools that can help create motivation and momentum. 

Body doubling, working on a task alongside someone else, like a homework buddy, walking buddy, or workout buddy, is a productivity strategy that helps reduce potential distractions and builds accountability. 

The Dopamenu, created by Jessica McCabe, the creator and host of How To ADHD, is a menu of stimulating activities that ADHD brains can choose from when they need stimulation. Think appetizers like playing outside or listening to a favourite song, entrees such as walking the dog or baking, and sides that you can do simultaneously to make boring tasks more interesting, such as playing a podcast or using a fidget. Sprout OTs can work with you to tailor a Dopamenu, if you’re interested in learning more, give us a call or email!‍

Worst First is another way to manage procrastination, with rewards or preferred activities coming after the no-fun task. For example, three spelling questions and then a movement break. ‍

Time Management and Time Blindness‍

ADHD impacts time perception. People with ADHD may struggle with time management, be prone to hyperfocus, and experience a different perception of the passage of time, known as “time blindness.” It can be difficult for ADHD brains to perceive how much time has passed or how much time is left. 

Here are four strategies Sprout’s OT recommends for parents to help their kids with time blindness: 

• External strategies include keeping clocks in every room, wearing a watch (analog is better than digital), wall calendars, and time timers (these include visual cues to “show” the passage of time.
• Create routines for different parts of the day. Morning routines, getting ready, after school or work, and bedtime.
• Add buffers or margins of flexibility when your kiddo needs to do something on time. Provide extra time than anticipated if they need to be able to leave for school or an activity on time, for example.
• Use quantifying numbers. Instead of “10 more minutes” at the park, say “five more slides down the slide.” This helps them understand the parameters of the activity. 

‍A New Way to Think About ADHD ‍

ADHD isn’t just about attention deficits. It’s a nuanced condition that depends on context and varies widely. By developing our understanding, we can better support our kids and family members in managing life with ADHD, embracing the strengths that come with it while addressing the complexities.