ADHD: Perspectives From A Neurodiversity-Affirming SLP - Part 3

 

Author: Kendra Wormald, Reg. CASLPO Speech Language Pathologist
Date: Wednesday, October 02, 2024

Table of Contents

 

Part 1 and 2 Recap

In Part 1 we learned that ADHD is a neurodevelopmental condition which may present differently across different populations, particularly based on the type of ADHD: impulsive/hyperactive, inattentive and distractible or combined type. Structural and chemical brain differences and research limitations were also reviewed.

In Part 2 we looked at a possible day in the life of someone living with ADHD. Implications on productivity, task initiation, time blindness, emotional regulation, completing tasks, memory and paralysis were exemplified. 

In this article, Part 3, we will investigate direct ways ADHD may impact communication, strategies to reduce these challenges and how a Speech-Language Pathologist can support you. 

 

Self-Awareness

An essential part of learning how to manage your ADHD challenges is to increase your awareness of how it impacts you. Do you relate to any of the following challenges? How and where do these show up in your life? What kind of impact do they have? Are some more impactful than others?

"It’s a process: you start by coming to know it, then you own it, and finally you’re able to work with it." (Barkley)

 Verbal Impulsivity:

  • Interrupting

  • Cutting others off in conversation when they’re mid-sentence 

  • Talking over people 

  • Conversations appear ‘chaotic” 

  • Blurting out inappropriate comments 

Speech Disorganization:

  • Struggling  with organizing thoughts before speaking, making conversation hard to follow 

  • Challenges staying on topic, going on tangents, 

  • Repeat yourself

  • Provide more information than needed

  • Others may ask you to repeat yourself or ask for clarity 


Inattention:

  • Reduced ability to focus or ‘listen’ during conversation, especially with several people involved in the conversation 

  • Losing track of the current topic or what you or your conversation partner had just said 

  • Missing information that was said 

  • Challenges bringing information together to understand overarching message

  • Misunderstanding message

  • Appearing disinterested in the conversation or social exchange 

  • Challenges observing non-verbal cues during conversation 

  • Difficulty maintaining eye contact during conversation

  • Limited social awareness, especially on context clues and tone of voice

Working Memory Deficits: 

  • “Remembering” information incorrectly 

  • May come across as “forgetfulness” 

  • Challenges with the process of listening to, remembering and multi-step following directions

  • Difficulty remembering a question long enough to answer it. Paired with impulsivity, this may impact how well-thought-out the response is 

  • Working memory is crucial for holding and sequencing information including sounds for spelling and connecting ideas verbally and in generating written text

  • Reading comprehension may also be impaired due to working memory 

  • Having to re-read several times to understand what the text is saying 

  • Planning and initiating tasks 

  • Reduced ability to divide attention between a task and facilitating a conversation 


Hyperactivity 

  • Restlessness interrupting attention 

  • Speaking quickly and excessively 

All of these challenges can negatively impact social interactions which may make you want to avoid conversation and social situations in the future. These challenges may also lead to relationship breakdowns socially and professionally. So, what can be done to help? 

 
 

ADHD Strategies

The following outlines a handfull of suggested strategies to support the above challenges. It is important to note that not all strategies will be helpful and that it is important to take time to figure out what does and doesn't support you. Having a go-to tool kit is vital in communication success when living with ADHD.

“ Telling someone with ADHD to ‘just focus’ is like telling someone with a broken leg to ‘just walk’.” (Unknown)



1. Environment Strategies
Sensory overload can exacerbate ADHD challenges. Consider how much input you’re receiving or not receiving. 

  • Overhead Light: Change your lighting to softer or adjustable lights, wear a hat or sunglasses 

  • Increased business, such as at a mall: wear headphones and a hat, listen to a familiar and liked song 

  • It may help to have a certain style of video or type of speaker in the background to support task engagement and completion 

  • Engage in grounding techniques 

  • Create a calm space within your home and/or workplace

  • Avoid certain places during peak hours 

  • Consider clothing that bring comfort 

  • Have a plan for what to say when you’d like to leave 

Application Example: 
Your boss wants to have a meeting with you. She tries sharing information to you at your desk but the clicking noise of computers and papers rustling along with the air closed and overhead light to be exchanged for a lamp. 


2. Supporting Active Listening, Working Memory and Reducing Speech Impulsivity

  • Repeat back information to ensure what you understood was in the intended message 

  • Write bullet notes or key-words about the conversation

  • Consider active listening strategies 

  • Generate a meeting agenda to stay on-topic 

  • Set goals for the meeting so you know the information you’re looking for

  • Engage more of your body. Sometimes movement like gestures (Example: head nodding) or even walking while talking can support focus and understanding 

  • Doodling while listening. You don’t have to draw intentionally, random lines without looking is just as effective 

  • Take 5 deep breaths before sharing your thoughts 

  • Reflect on the main message of what you want to share 

  • Don’t try to plan every single thing you want to say before you say it. Consider your main overall message. Take more frequent breaths in communication to support brain function, calm the nervous system and give you time to organize your thoughts

  • Reduce rate of speech

  • Use word finding strategies and build relations between words to help the storage and retrieval of words

3. Workplace Strategies 

  • Inform your boss and/or co-workers of your challenges if you feel it would help them understand you and your work habits 

  • Request direct and clear feedback that may be presented both verbally and in writing 

  • Break down tasks into manageable steps 

  • Reflect on how much time a task might take you, set a timer and see how accurate your assumption was. Take note of this for next time 

  • Consider the working environment. Being alone in a room to be productive is often very challenging for a person with ADHD. Can you work beside someone, engaging in body doubling 

  • If you are having challenges starting or maintaining a task, pair it with something that brings stimulation such as a fidget, music, special lighting etc. 

  • Use visual aids: calendar, timers, alarms, reminders, charts to breakdown complex information and instructions 

  • Establish a routine to support time management

4. Social and Romantic Communication Strategies 

  • Set aside intentional time to have deeper and/or challenging conversations 

  • Seek clarification and offer your understanding

  • Use aids to remember important dates, instructions, requests, likes/dislikes

  • Ask others to signal to you when you’ve gone off topic 

  • Take a conversation break to digest information and process thoughts

 

How Can an SLP Support ADHD?

As you’ve read, ADHD can have significant and frequent implications on communication across all areas of life. A Speech-Language Pathologist has specific training and developed skills to support these challenges. In addition to supporting the strategies mentioned above, an SLP may support you through:

1. Structured Conversation Training: Frameworks and ‘back-pocket’ phrases can be used to take the demand load off your brain when planning what to say. These phrases can also be used to support self-advocacy such as, “This conversation is important to me and I’m having trouble paying attention, could we talk about this later?” or  “This sounds important, could you please write that down for me?”

2. Social Skills Training: Did you have a communication breakdown this week? Bring that situation to session and your SLP can evaluate areas for growth and these kinds of conversations can be practiced through role-play and mock communication. Non-verbal communication such as gestures and eye contact, and self expression, turn-taking and word finding strategies can also be investigated and practiced.  

3. Pacing and Pausing: Reducing your rate of speech will directly support word finding, calm the nervous system leading to feeling more calm and in control, and increase your speech and message clarity and overall communication confidence. Breath, a foundational skill to communication, can be used to directly support these areas.


4. Counseling: A Speech-Language Pathologist has the unique ability to support these challenges from a communication counseling lens. This may include reflecting on limiting thoughts and assessing their impact on communication behaviors. For example, do you worry you’re going to forget what you want to say, so you speak faster, or you feel a significant amount of frustration with yourself for always being late or forgetting important tasks? Your SLP may also support you in using affirming statements such as “ What I say matters, I deserve to take my time to share my thoughts”.

 

Conclusion

If any of the information across the three parts of this article series have resonated with you, it may be beneficial to reach out to a Speech-Language Pathologist. By understanding the impact ADHD has on your communication and applying strategies to mitigate these challenges, you can more effectively build stronger relationships throughout your life.

 

References

 

To speak with a psychotherapist or one of the speech-language pathologists at Well Said: Toronto Speech Therapy, schedule an initial consultation by clicking the link below or calling (647) 795-5277.