Why Do Kids with ADHD Struggle with Transitions?
By Dr. Mary Rooney, Ph.D.For many kids with ADHD the most difficult times of the day are those that happen when they are transitioning from one activity to another. At school, it may be when they are ending an academic period and getting ready to head to art class or to lunch. Or it may be during more subtle transitions, like when they are moving from circle time on the rug to classwork at their desk. At home, challenging transitions come up when a child needs to settle down for homework time after playing video games, or when they need to transition into their bedtime routine.
Transitions are so much a part of our daily lives that they aren’t something we spend much time thinking about. In general, we tend to assume that transitioning between activities is something that is easy for kids, and it should go smoothly most of the time. In reality, transitioning between activities is anything but simple, especially for kids with ADHD. Why? Transitions tap into several cognitive skills simultaneously – and these happen to be the very cognitive skills (or executive functioning skills) that are areas of weakness for kids with ADHD.
Let’s look at the different steps required for successful transitions and the cognitive skills associated with each step.
- Stopping an activity. Before a child can transition to a new activity they first need to stop the activity they’re doing already. This may seem simple enough, especially if the activity isn’t particularly enjoyable. However, for kids with ADHD stopping or inhibiting an ongoing behavior can be very challenging. This is because the same cognitive skills that are used to “put on the breaks” and stop an impulsive behavior like calling out in class or grabbing something they want out of their friend’s hands, are the very same skills that they need to use when abruptly stopping an activity. Putting on the breaks more difficult at certain times than at others. It’s particularly challenging when a child with ADHD is hyper-focused on an activity, when the activity is something that’s particularly rewarding (like screen time), or when the upcoming activity is something they would prefer to avoid (like a writing assignment or bedtime).
- Starting a new activity. After a child with ADHD has successfully stopped his or her previous activity, he or she is now faced with the task of initiating a new one. This can be something fairly simple, like lining up by the classroom door, or something more complicated, like starting homework. Either way, it requires the child to tap into his or her cognitive skills related to initiating a new activity. For many kids with ADHD – particularly those with the inattentive subtype - initiating a new activity can be overwhelming and exhausting. Not surprisingly, the less rewarding the new activity, the harder it is for a kid with ADHD to muster up the mental resources needed to get started on the new task.
- Following multi-step instructions (quickly). Starting a new activity often involves following multiple steps in a specific order. If the transition isn’t routine, these steps can be a lot for a child with ADHD to process - especially if the instructions are presented verbally and very quickly. Why? Most kids with ADHD have weaknesses in either working memory (the ability to hold information in your short- term memory, and then manipulate this information in your mind) or processing speed (the ability to process information quickly). Some kids with ADHD have weaknesses in both areas. As a result, they may not have fully processed the necessary instructions making it nearly impossible for them to transition successfully.
- Managing a chaotic environment. Transition points are often the most chaotic times of the day. Imagine 25 kids shuffling papers, chatting with their neighbors, racing to their cubbies, grabbing all their things and lining up at the door for lunch. Now imagine trying to block out this noise while you struggle to stop your activity and follow a sequence of steps that you’ve only half-processed. When you look at from this perspective it’s easier to see why kids with ADHD literally get lost in the shuffle and struggle to follow through.
- Coping flexibly with changes in a routine. Not all transitions are planned. Things come up at school and at home that require kids to be flexible and adjust to a new routine on the fly. For kids with ADHD who struggle with cognitive flexibility, quickly wrapping their head around even small changes can be a big challenge.
- Managing frustration and emotions. Lastly, but perhaps most importantly, dealing with transitions requires managing emotions and dealing frustration. Kids may feel upset because they don’t want to stop the fun activity that they’ve been doing. Or they may feel frustrated because they didn’t have enough time to finish everything they’d hoped to accomplish. They may feel overwhelmed by all of the noise and activity in the room or feel a sense of dread about the upcoming activity. Regulating emotions and tolerating frustration are areas of weakness for most kids with ADHD. Compared to other kids their same age, it’s not uncommon for kids with ADHD to have emotion regulation skills that are about 2 years behind. This means that at times of transition, the expectations placed on a child’s emotional capacity may exceed their actual ability level.
Understanding the underlying challenges that make it difficult for kids with ADHD to navigate transitions throughout the day is the first step in ultimately making transitions easier for the child (as well as their parents and teachers). In my next post I’ll provide concrete steps you can take to provide the support a child with ADHD needs to transition between activities successfully.
ABOUT DR. MARY ROONEY
Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.
ABOUT HUNTINGTON
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This website does not provide medical advice, diagnosis, or treatment. The material on this site is provided for educational purposes only.
