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
Deldar, Z., Gevers-Montoro, C., Khatibi, A., & Ghazi-Saidi, L. (2020). The interaction between language and working memory: a systematic review of fMRI studies in the past two decades. AIMS neuroscience, 8(1), 1–32. https://doi.org/10.3934/Neuroscience.2021001
Husney,A. (2022) ADHD in Adults: Behavioural Strategies. HealthLinkBC. https://www.healthlinkbc.ca/health-topics/adhd-adults-behavioural-strategies
The ADHD Body Double: A Unique Tool for Getting Things Done (2024). Attention Deficit Disorder Association. https://add.org/the-body-double/
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.
