The Therapy Place was founded in 2012 for occupational and speech therapy. The Therapy Place has three private practice clinics throughout New Jersey, all medically approved. In 2020, a sister company called CircleCare was founded, a therapy clinic for Applied Behavior Analysis (ABA) therapy. Visit The Therapy Place online to learn more about our services and how we can help your child develop and succeed.

Self-Regulation for a Child With ADHD

Self-regulation is described as one’s ability to manage and control their behavior, emotions and attention. This includes being able to use specific skills that monitor, evaluate and adjust for environmental demands in order to react appropriately.

Oftentimes, children with attention deficit/hyperactivity disorder (ADHD) struggle with self-regulation, and working with an occupational therapist (OT) can address these issues to help a child succeed in everyday life. Being able to self-regulate is key to success. It is necessary to learn these skills during the foundational childhood years in order to be able to carry them into adulthood.

Q: How does learning self-regulation skills help a child who has ADHD?

A: ADHD is a neurodevelopmental disorder usually diagnosed during childhood and is characterized by:

Trouble focusing

Impulsive behavior

Restlessness or hyperactive movement

Poor planning

Disorganization

Poor time management

Low frustration tolerance

Trouble with dividing attention amongst multiple tasks

Learning self-regulation skills early allows kids with ADHD time and opportunity to use and refine their own techniques as they age. With practice and the right tools, parents, teachers and caregivers may notice positive changes in any of the following areas:

Improved Attention and Focus:

The primary change that healthy self-regulation provides is increased attention and focus in daily tasks. This could include activities at home, school, sports or other community/social gatherings. In many cases, children with ADHD struggle with finishing homework, meals, chores, hygiene tasks, and a wide array of activities because their attention is so limited or because their minds have already moved on to another (albeit irrelevant) activity. By learning how to monitor their own behavior and to tune out environmental distractions, children with ADHD can complete necessary tasks from start to finish in a timely manner.

Reduced Impulsivity:

ADHD impairs a child’s ability to think before they speak or act, which means they may say or do something without fully understanding the consequences of their behavior. This may look like a child blurting out answers in class before raising their hand, jumping off a high point on a playground without thinking about where or how they’re going to land, or constantly interrupting conversations. Learning self-regulation skills may help a child reel in their reactions to consider the cause and effect of their choices.

Better Emotional Control:

Although it’s not listed as a diagnostic marker, a fairly new but common concept in ADHD is referred to as “emotional dysregulation.” Some children with ADHD may be prone to meltdowns or outbursts due to an overwhelming reaction to their own emotions and not knowing how to cope in a typical way. These emotional outbursts wreak havoc on social participation and successful completion of activities that matter to them. The right self-regulation tools can teach a child with ADHD emotional resiliency and how to dissipate or experience difficult emotions in a healthy way.

Improved Social Skills:

If a child can self-monitor their own behavior, emotions and attention, this will pave the way for them to develop productive and positive relationships with others. Often a child with ADHD has an energetic, social and fun-loving personality; however, it’s challenging for friends their age to appreciate these lovable traits when impulsivity, inattention, bossiness and other potentially aggravating issues surface. Self-regulation skills can help these children keep challenging behaviors in check. This allows them to foster long-lasting friendships.

Q: What specific strategies/techniques does an occupational therapist use to improve self-regulation in children diagnosed with ADHD?

A: Pediatric OTs use multiple interventions to help children with ADHD develop and maintain self-regulation skills. Here are a few common techniques used to help these children and their parents:

Create Structure/Routine:

Developing a relatively predictable, structured day-to-day routine for a child with ADHD is important. Although unexpected changes will occur, providing a child with some daily structure is extremely helpful for emotional, behavioral and attention regulation. The child can get used to carrying out their own successful routine without a parent’s or teacher’s supervision.

Provide clear expectations/break down tasks into smaller steps:

Let the child know what the goals of each task are: homework assignments, chores, games, hygiene tasks, etc. Describe very clearly what is expected of them and what it means to FINISH the task. For example, instead of hearing, “Go take a bath,” a child with ADHD may need a better explanation such as “get undressed. Turn the water on. Wash your hair and body with soap and water. Then get out of the tub and dry off with the towel.”

Encourage physical activity:

Like most children, kids with ADHD struggle with sitting still for long periods of time (like at a desk during school hours). It’s essential to encourage children with ADHD to participate in physical exercise or activities to meet desperately needed sensory-seeking needs. Once those physical needs are met, attention regulation greatly increases for all sorts of tasks that require sitting still.

Teach mindfulness/relaxation skills:

Mindfulness and other relaxation techniques are an excellent way for kids to tune into their own bodies while effectively blocking out unnecessary environmental distractions.

Teach self-monitoring:

An OT can help a child learn self-reflection techniques to help them identify when their emotions or behaviors need a tune-up. This takes time actively helping the child draw attention to themselves, helping them verbalize their feelings, and getting them to identify and make improvements when necessary.

Utilize positive reinforcement:

Kids respond well when the desired behavior is rewarded. Rather than primarily focusing on punishment for poor behavior (impulsivity, poor grades, tantruming), OTs introduce a system of positive reinforcement where a child with ADHD is recognized and rewarded (compliments, prizes).