Adult ADHD: Targeting Executive Skills to Manage ADHD in Adults – Kevin Blake

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Adult ADHD: Targeting Executive Skills to Manage ADHD in Adults – Kevin Blake

A young man calls you to make an appointment, saying once again he has lost his job and that over the last nine years he has lost, or been asked to resign from eight jobs. The appointed time arrives and he does not show. Later that day he leaves a voicemail apologizing for forgetting his appointment and asks to reschedule. He admits that even if he remembered the appointment he would not have made it because he lost his car keys. The appointment is rescheduled and he arrives 20 minutes late. As he sits down he shares he received a speeding ticket on his way here and has had over 50 previous citations. Also, he doesn’t understand why he keeps losing his jobs, as he was always known to make many sales. He then described a litany of stormy relationships with lovers even saying one girlfriend told him he is “reliably unreliable.” He appears disheveled, anxious and demoralized. Talking incessantly while not seemingly able to tell a story in a logical sequence.

Adults portraying Attention-Deficit/Hyperactivity Disorder (ADHD) often come to see you in hopes of making their life less chaotic and improving their day-to-day interactions with others. They really want to change but simply do not know how. You have your usual strategies to use, but will it be enough? Do you have the tools necessary to facilitate real changes and ease their pain?

Let Dr. Blake share with you tried and true evidence-based techniques, skills & methods that can be easily applied with your adult ADHD clients to immediately improve their quality of life. You will learn the latest strategies to treat impaired executive function, the core issue of difficulty in adults with ADHD. These practical, easy to apply methods will help your adult clients improve their time/task management, personal organization, & planning, thus improving many aspects of their life including employment, relationships, physical & mental health, grooming, driving, parenting, etc. Dr. Blake will also teach your how to coordinate treatment with other necessary professionals inclusive of physicians, speech-language therapists, professional organizers, ADHD coaches, job coaches, academic tutors, career counselors, etc.

1. Establish what executive function is and why it is so important to time management, personal organization and planning as it relates to treatment in clinical practice.
2. Analyze how Adult ADHD negatively affects executive function in relation to assessment and treatment outcomes.
3. Determine how ADHD, Inattentive Presentation (Sluggish Cognitive Tempo) is different from the ADHD that is in the DSM-5® and communicate why this is important as it relates to treatment planning.
4. Explore assessment tools used to identify deficits in executive functioning, to better inform your choice of treatment interventions.
5. Implement strategies to help adults with ADHD with their executive function difficulties in the workplace, in relationships, and in parenting.
6. Identify strategies that are appropriate for fostering executive function development or intervening when executive function difficulties are identified.

Diagnose ADHD & Measure EF in Adults
Diagnosis

• The Big 3
• Ratings scales
• Questionnaires
• Semi-structured interviews
• Impairment Index
• Collaterals

Measuring EF

• Adult executive functioning inventory
• Brief-A
• Comprehensive executive function inventory
• WAIS-IV and WJ-IV
• NIH toolbox cognition battery
• Barkley’s rating scales

Adult ADHD Treatment
The Big 4 & 4 Steps

• Therapeutic effect of diagnosis
• Medication-genetic testing
• Psychoeducation
• Accommodation
• Comorbidities: ADHD, Inattentive presentation-restrictive, or sluggish cognitive tempo
• Specific Learning Disorder
• Autism Spectrum Disorder
• Sleep disorders
• Depression & anxiety
• Personality disorders

EF Techniques & Strategies
Organization, Planning & Time Management

• Clinical Interventions to bring order to the disorganized mind
• The 30 to 40% rule for inattention, impulsivity/hyperactivity & ADHD

Impulse Control & Self-Regulation

• CBT & internalized speech
• Overcoming guilt & shame
• Automatize behavior
• What about mindfulness?
• Relaxation skills

Enhance Focus, Attention & Working Memory

• ”Neurotypical” forgetting vs. ADHD forgetting
• Chunking, mnemonics & other memory techniques
• Multisensory memory
• Loci
• Self-testing & self-imagining
• N-Back
• 5 ways to reduce cognitive load
• Technological prosthetics-assistive technology

Stop Executive Dysfunction from Sabotaging Your Clients’ Relationships

• Impact of EF difficulties on adult relationships
• Goal setting
• Self-monitoring & self-talk
• Social skills training
• Conflict resolution skills
• Anger identification
• Decode facial expressions & body language
• Making accurate facial expressions
• Better follow through with medical issues & self-care
• Tips to remember special dates, etc.

For the Workplace & Home

• ADHD work difficulties
• Career counseling
• Clutter control made simple
• Job coach & supervision; advocacy?
• Social skills, self-esteem & education
• Training & adult education accommodations
• ”Best” ADHD jobs
  

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