ADHD, Uncategorized

How to use visuals for children & adolescents with ADHD

The SHORRR Fire way (c) to get ADHD Done Differently with visuals

Have you been told that visuals are vital for children with ADHD, but no matter how many times you have tried them, they just “don’t work” for your child?

Well, you are not alone. The use of visuals for children with ADHD can work an absolute treat. Honestly, my house looks like a school. We use visuals for all sorts of things, and they are such a fantastic way of supporting children with ADHD.

If you want to know how you can implement and thrive using visuals for children with ADHD, at home, in school and in your clinics: keep reading!

Why Use Visuals?

Children with ADHD have extreme difficulty initiating and maintaining attention during tasks. They also have difficulty re-engaging in tasks once they have been distracted, especially when boring or mundane. They can also have trouble regulating their emotions, with self-motivation and often have poor working memory. Working memory is necessary to hold all the information in mind to complete a task.

So, when we are asking them to do a complex and/or tedious task, visuals can act as:

  1. A reminder to start or continue with a task
  2. A reminder to re-engage with a task once they have been distracted
  3. An external example of how to regulate emotions
  4. As a motivation to finish a task
  5. An external working memory to remind them of what to do next

And that’s only the beginning of the benefits.

However! It isn’t as easy as just putting up a visual and expecting them to use it. First thing’s first… Make sure you are sticking to…

The THREE Golden principles of visuals

  1. Visuals need to be specific to the child’s developmental and cognitive level and take into consideration any learning difficulties the child might have.

Giving a child with co-occurring Dyslexia, a written list of instructions will not be helpful. So you could try giving them pictures instead. An adolescent might not take too kindly to you, giving them a cartoon visual full of pictures to get ready in the morning, but a printed list of instructions would be accepted.

2. Collaborate with your child

I also really encourage you to talk to your child or adolescent about what type of visual they feel would help. It could be something as simple as a list of steps, or even a post-it note here and there to keep them on track. But the more input they have into designing the visual, the more likely they will use it.

My children, for example, all use different visuals for the same schedule type.

My 11-year-old son uses a plainly written list that he can now mostly keep track of himself. He didn’t want to have to tick things off anymore as he does them.

My 8 year old daughter is a fantastic reader and so also just has a list of steps. However, she will often skip steps she doesn’t enjoy doing (like brushing her teeth), so we included a tick box, so she can visually see what is left to do.

My 7-year-old daughter is still learning to read, so her visuals have pictures and words, with checkboxes to remind her of the steps and increase accountability for her to use the visual.

3. Phase out visuals when they are not needed anymore

You are not going to have a visual for everything your child does. But use them for the most challenging jobs for them, or somewhere they need some additional support.

It might be a while, but eventually, visuals can help children to internalise the steps required in a task, so you can slowly phase out the visual. Most of the time, you will find that your child phases them out by themselves as they become more and more familiar with the task.

So How do I actually Use visuals?

Here is where the super simple SHORRR Fire Way (c) to use visuals for children and adolescents with ADHD comes in.

The SHORRR fire way to teach visuals is outlined below.

I have used a packing the lunchbox printable as an example.

S – SHOW ME:

The first step is modelling HOW to use a visual. You can introduce the visual with positive language.

You could say: “I have noticed it’s been tough for you to remember what needs to go into your lunchbox. Let’s use this visual to make it easier for you.”

You can then demonstrate HOW to use the visual. Narrate what you are doing as you do it

“What does it say I have to do first? Get a fruit break snack. Ok, I’ve found the mini cucumbers and put them in my lunchbox. Let’s tick that off the list. Now, what does the visual say I should do next?”

At this stage, it will be almost 100% you introducing the visual, with your child watching and helping.

H – HELP ME:

Once you have shown your child how to use the visual several times, move onto the Help me step. This is a partnership between you and your child. This step is where you start to ‘hand over’ the activity and visual use to your child. They will continue to need a lot of support.

You could say: “Let’s see how you go packing your lunchbox now with my help. What does the list say to do first/next?”

At this stage, you and your child or adolescent will be doing approximately 50% each of the job. Remind them often to look back to the visual as a reference. This is still you teaching them to use the visual, but with a bit less direct support.

O – OBSERVE ME:

This is where we transition to our child taking most of the responsibility for implementing the visual. However, you stay close by and are there for when they need assistance throughout the routine.

You could say: “I want you to use your visual today by yourself! I’m here if you need me though!”

R – REMIND ME:

Your child will more than likely continue to need a reminder here and there to refer back to their visual if they become distracted. Almost eleven years of using visuals, my son still needs a reminder every morning, at least once to get back on track. It is usually for the jobs that he isn’t motivated to do, like make his bed or clean his room.

You shouldn’t have to remind your child or adolescent of specific steps at this stage. Still, they might just need a verbal reminder to refer back to the visual if they get distracted.

You could say: “Where are you up to?”

R – REVIEW:

Children with ADHD have interest-based brains. This is due to abnormalities in the dopamine pathways in their brain. They engage with activities or visuals when they are novel and exciting. This is why you may implement a visual and it goes really well for a week or two, and then it loses its effectiveness. So review them frequently. It might be as simple as a new picture or moving the position of the visual.

You might also find that the visual you have chosen isn’t specific enough or is too specific. You might need to change it. That’s fine! Review them as much as you need to.

This week for example, I updated my children’s packing their lunchbox visuals, as I wasn’t specific enough for them in the first visual.

R – REWARD

Children with ADHD have minimal self-motivation ability, particularly if what they are trying to do is boring or not valued by them. Children with ADHD require more salient and immediate rewards for doing what you have asked.

So, build in a reward system into the visuals. For example: When everything on the list is completed, they are allowed 10 mins of screen time, if there is time before they need to leave the house. It is amazing how motivating that can be for children with ADHD. Particularly if you are like us, and don’t allow screens during the school week typically.

But regular verbal, physical and tangible rewards throughout the activity, while using the visual schedule assists in increasing their motivation. So, pats on the head with a “wow! You brushed your teeth! Well done” or a high-5 or token system per activity can aid enormously in compliance with visuals.

I can’t wait for you to give them a go!

Let me know how you go with implementing your visuals at home to get ADHD Done Differently.

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