How ADHD Coaching Can Be Used In Speech Therapy Sessions
Author: Nimra Khan, Reg. CASLPO, Speech-Language Pathologist
Date: Wednesday, July 31, 2024
Table of Contents
Introduction
In the area of neurodiversity, Attention Deficit Hyperactivity Disorder (ADHD) presents unique challenges that can affect various aspects of life, including communication and speech. Coaching support for ADHD can target many aspects of a person’s environment (such as time management for organizing tasks), but communication is a specific and crucial area that many people first notice concerns. Within the framework of speech therapy, the integration of ADHD coaching plays a pivotal role in enhancing the effectiveness of the sessions. In this article, I will discuss how this support is specific to speech therapy as well as my personal experiences in my work.
Understanding ADHD and Its Impact on Communication
ADHD is a neurodevelopmental disorder characterized by difficulties with attention, hyperactivity, and impulsivity. These challenges can significantly impact communication skills, ranging from difficulties in maintaining focus during conversations to struggles with organizing thoughts and expressing ideas cohesively. For individuals receiving speech therapy, these symptoms can pose additional barriers to achieving communication goals. Some common experiences that clients have told me about include:
Interrupting others in conversation
Not being able to focus on one speaker for a long time without thoughts wandering, leading to losing their place in the conversation and appearing rude
Adding too many details or being too blunt
Speaking too quickly
Having flat intonation
Speech therapists are trained to address various speech and language disorders, including those influenced by ADHD. They employ structured techniques to improve articulation, language comprehension, and pragmatic skills. However, the incorporation of ADHD coaching into these sessions extends further to be even more holistic. Read more about ADHD and communication.
Executive functions (what I like to call the ‘orchestra’ of the brain) play a crucial role in facilitating effective communication. Here are a few ways that research has shown us they can play a role in communication:
1. Planning and Organization
Planning Conversations: Executive functions help individuals organize their thoughts and plan what they want to say before engaging in a conversation. This includes setting goals for the communication exchange and strategizing how to achieve those goals effectively (Diamond, 2013).
2. Initiation and Inhibition
Starting and Stopping Speech: Executive functions aid in initiating speech (e.g., beginning a conversation or responding to a question promptly) and inhibiting irrelevant or impulsive responses that may disrupt communication flow (Miyake & Friedman, 2012).
Turn-Taking in Conversation: In social interactions, executive functions help individuals regulate their turn-taking behavior, allowing them to wait their turn, listen actively, and respond appropriately (Barkley, 2012).
3. Cognitive Flexibility
Adapting to Context: Executive functions support cognitive flexibility, allowing individuals to adapt their communication style and content to different social contexts, cultural norms, and the needs of their communication partners (Diamond, 2013).
Problem-Solving in Communication: When faced with communication challenges or misunderstandings, strong executive functions enable individuals to problem-solve in real-time, generating alternative solutions and adjusting their approach as needed (Zelazo & Cunningham, 2007).
The Role of ADHD Coaching in Speech Therapy
Usually, “ADHD coaching” involves discussion around changes to a person’s daily life in how they manage time, plan for goals, and motivate themselves. ADHD coaching within speech therapy sessions is designed to address the specific cognitive and behavioral aspects of ADHD that impact communication (in 1-to-1 and group conversations). Unlike traditional speech therapy, which primarily focuses on technical aspects of speech and language, coaching interventions are tailored to improve executive functions such as planning, organization, time management, and emotional regulation. These aspects can be much more flexible, using some models to build up around but making it very specific to the individual’s life. Read more here about the importance of social skills.
In my experience, a balance of self-awareness, practice of difficult skills based on behavioural changes, and self-advocacy lead to the most positive changes in daily life.
Practical Applications of ADHD Coaching in Speech Therapy:
1. Building Executive Function Skills:
Goal Setting and Planning: ADHD coaching helps individuals set realistic communication goals and break them down into manageable steps. This process encourages better organization and planning, fostering a structured approach to communication tasks. By being more specific to your own daily life, you can measure your success. For example, your goal could be to use at least one self-advocacy skill in the next month. You can also read more about forming habits.
Time Management: Individuals with ADHD often struggle with time perception and time management. Coaching techniques can include strategies for prioritizing tasks during speech therapy sessions and improving punctuality.
2. Improving Attention and Focus:
Mindfulness Techniques: Incorporating mindfulness practices can enhance attentional control and reduce impulsivity during speech therapy exercises. Techniques such as deep breathing or guided imagery can help individuals stay focused on communication tasks. We can also discuss and practice how to check-in with conversation partners in conversation if you find that you get off-track easily.
3. Enhancing Communication Strategies:
Visual Aids and Prompts: ADHD coaching often utilizes visual aids and prompts to support communication. These tools can include cue cards, visual schedules, or digital apps that assist individuals in organizing thoughts and structuring conversations.
Role-Playing and Social Skills Training: Coaching sessions may involve role-playing scenarios to practice social skills such as turn-taking and active listening—skills essential for effective communication.
4. Emotional Regulation and Coping Strategies:
Stress Management Techniques: Speech therapy sessions integrated with ADHD coaching provide opportunities to develop coping mechanisms for handling frustration, anxiety, or emotional dysregulation during communication challenges.
Positive Reinforcement and Encouragement: Coaching emphasizes positive reinforcement to celebrate progress and build self-confidence, which are crucial for sustaining motivation.
5. Increasing self-advocacy
This can come in the form of speaking up for yourself when modifications could be made at work (i.e. more time, space, etc) or even within a work-related conversation by being upfront about how the information could be presented in a way that helps you.
The Collaborative Approach: Therapist and Client
In order to have the best experience, speech therapy sessions require a collaborative effort among the speech therapist and the client. The therapist provides expertise in diagnosing speech and language disorders, designing therapeutic interventions, and monitoring progress. The behavioural coaching complements these efforts by focusing on executive function skills and behavioral strategies tailored to the client's ADHD symptoms.
Key Aspects of a Collaborative Approach:
Being honest: It’s important to remember that discussion is a two-way street; as a client, you shouldn’t be afraid to be honest with what strategies work for you, what areas in your life are priorities, and how motivated you are to focusing on specific areas. The more open that you can be, the better. For the SLP, it’s ideal to be honest about expectations in therapy and being understanding of individual differences.
Customized Interventions: The therapist incorporates ADHD coaching techniques into speech therapy sessions, ensuring that interventions are individualized to meet the client's unique needs and learning style. This customization may involve adapting communication exercises, modifying the environment for optimal focus, or integrating sensory supports. For instance, I am often typing key points in a document while sharing my screen so that we can easily refer back to main ideas without having to hold everything in the moment.
Progress Monitoring and Adjustment: Regular monitoring of progress allows for adjustments in coaching strategies and speech therapy techniques as needed. Feedback from the client regarding their experience and challenges informs ongoing adjustments to ensure effective intervention outcomes.
The Impact of Integrated ADHD Coaching
Integrating ADHD coaching into speech therapy sessions enhances the overall effectiveness of treatment by addressing underlying cognitive and behavioral factors that influence communication skills. By addressing executive functions such as attention, organization, and emotional regulation, individuals with ADHD can experience enhanced communication abilities, increased self-confidence, and improved quality of life.
Resources
Here is a list of resources available to learn more about ADHD, including educational materials, support groups, and professional organizations:
1. Centre for ADHD Awareness Canada (CADDAC)
Website: http://www.caddac.ca
Provides information on ADHD, resources for individuals, families, and professionals, and advocacy efforts.
2. CHADD Canada
Website: http://www.chaddcanada.org
Provides resources, support groups, and educational programs for individuals with ADHD and their families across Canada.
3. Canadian ADHD Resource Alliance (CADDRA)
Website: https://www.caddra.ca
Offers clinical guidelines, resources for healthcare professionals, and information on ADHD assessment and treatment.
4. Canadian Psychological Association (CPA)
Website: https://cpa.ca
Provides resources for finding registered psychologists specializing in ADHD assessment and treatment.
Additional Resources:
1. Books on ADHD:
Driven to Distraction by Edward M. Hallowell and John J. Ratey
Taking Charge of Adult ADHD by Russell A. Barkley
2. Podcasts:
ADHD Experts Podcast by ADDitude Magazine
The ADHD Rewired Podcast by Eric Tivers
Conclusion
ADHD coaching integrated into speech therapy sessions represents a holistic approach to supporting individuals with ADHD in developing essential communication skills. By addressing executive function deficits alongside speech and language goals, this integrated approach maximizes therapeutic outcomes and empowers individuals to navigate their communication challenges with confidence and competence.
As awareness of neurodiversity grows, the integration of ADHD coaching into various therapeutic settings, including speech therapy, exemplifies a progressive shift towards personalized and inclusive healthcare practices. Moving forward, continued research, professional collaboration, and client-centered approaches will further advance the integration of ADHD coaching in supporting communication development and overall well-being for individuals with ADHD. You can also read more about my approach to speech therapy here.
References
https://www.hopkinsmedicine.org/health/conditions-and-diseases/adhdadd
Barkley, R. A. (2012). Executive functions: What they are, how they work, and why the evolved. Guilford Press.
Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64, 135-168.
Miyake, A., & Friedman, N. P. (2012). The nature and organization of individual differences in executive functions: Four general conclusions. Current Directions in Psychological Science, 21(1), 8-14.
Zelazo, P. D., & Cunningham, W. A. (2007). Executive function: Mechanisms underlying emotion regulation. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 135-158). Guilford Press.
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.
