Introduction 

What is ADHD?

ADHD (attention deficit hyperactivity disorder) is a brain disorder that influences behaviour. Symptoms of this condition include inattention, hyperactivity and impulsivity, and these 3 symptoms are the main hallmarks of the disorder. Some individuals may show more inattention than hyperactivity, and vice versa, or can exhibit all symptoms simultaneously.

ADHD greatly impacts how people with it live their day-to-day lives, as they may struggle with time management, focusing on given tasks and following instructions fully, which can affect individuals academically, socially and in the workplace.

Occupational therapy targets individuals who may have difficulties performing everyday tasks and helps them overcome these issues. They create plans tailored to the unique needs of an individual and create goals, and in the case of individuals with ADHD, they can offer interventions to help people with ADHD manage areas of life they may struggle with.

How ADHD affects daily life 

Challenges in children and adolescents

• Struggles in making and maintaining friends due to trouble with controlling attention and impulsivity and thus may miss social cues
• Can face difficulty in paying attention to schoolwork, which can cause children to fall behind academically
• Adolescents may struggle with increased responsibilities as they get older as they may find difficulty in balancing different commitments e.g. school, jobs etc.

Challenges in adults

• Workplace struggles, managing personal responsibilities, and maintaining relationships
• May find difficulty in the workplace due to deadlines and struggle to finish projects in a work setting
• Can struggle with maintaining relationships due to impulsivity and inattention

How occupational therapy helps with ADHD

Occupational therapy involves collaboration with individuals to prioritise areas to work on as well as choose different models of OT (can be occupation-focused or client-centred). The general aim of occupational therapy is to empower individuals to gain independence in activities and tasks that are more difficult to carry out due to ADHD. There are a few key areas occupational therapy may focus on to help individuals with ADHD.

Key areas OT focuses on for ADHD

Sensory processing

• Individuals with ADHD may have issues with sensory integration, a term used to describe how outside sensations are processed in the brain to allow for behavioural functioning. In ADHD, this is impaired and results in individuals experiencing sensory overload which could impact their mood and concentration. They can also experience sensory hyperactivity, meaning a lack of exposure to a certain sensory stimulation which is shown to decrease attention span and productivity
• Occupational therapy can help with sensory processes by working with individuals to control and pay attention to how much sensory stimulation they experience. They can also help identify situations where issues with sensory processing occur and take steps to regulate their sensory intake. For example, headphones can be used in an attempt to reduce excess noises that may result in sensory overload, which can be particularly helpful in a work or school environment where concentration is required

Executive Functioning

• Problems in executive functioning are also commonly seen in ADHD, where individuals find difficulties in the organisation and initiation of tasks, particularly the act of following through with tasks
• Occupational therapy can help improve specific skills that improve executive function such as creating activities that involve building on organisation and problem-solving skills. They may also help individuals analyse the tasks they struggle with and break down the different processes to make it easier for individuals with ADHD to approach certain tasks

Emotional regulation

• One other important aspect of ADHD that occupational therapy can tackle is emotional dysregulation, where individuals may struggle to control their emotions and adapt to them depending on their environment
• Occupational therapy can introduce techniques that help individuals with ADHD feel more in control of their lives and thus emotions, which may be through following a routine in their day-to-day lives, creating structure and therefore reducing the stress that may worsen emotional regulation

Social skills

• Due to the impulsivity and inattention seen in ADHD, individuals may struggle with social skills and painting relationships with others, as they may be prone to zoning out in conversations, or in childhood be aggressive and thus isolate themselves
• Occupational therapy can utilise methods such as role-playing to build on social skills and how to interact with others acceptably, and this regular practice can help individuals make more appropriate social choices and improve their relationships with others

Daily living tasks

• As ADHD has a significant impact on the ability to carry out everyday tasks, occupational therapy can be very effective in building habits to work on the skills needed to complete these tasks without assistance, thus helping individuals take control of their lives and their independence, which is ultimately the goal of occupational therapy
• An occupational therapist may tailor a routine or plan based on what the individual struggles with in terms of daily tasks, which may occur due to the previously mentioned issues associated with ADHD such as lack of time management, inattention and impulsivity. For example, an individual may frequently lose or misplace personal belongings, and an occupational therapist may suggest incorporating visual cues in an individual’s home to ensure they do not forget about such tasks and belongings

Examples of OT in different settings 

In schools

• There are ways that occupational therapists can help children in school with ADHD. They can work closely together with a child’s teachers and guardians to identify what the child struggles more with and tailor therapy plans accordingly
• For example, if children show difficulty in executive functioning, they can try and break down specific tasks and create aids (which can be visual e.g. signs) to help children remember to complete tasks they may frequently forget or struggle to start
• Another example may be a child struggling with impulsivity, where self-regulation methods may be taught to children, and this can be in the form of breathing exercises and mindfulness activities to increase awareness about emotional state and thus reduce heightened emotional states and impulsivity

At work (for adults)

• Workplace accommodations that involve occupational therapy can be utilised for individuals with ADHD in the workforce. For example, to ensure all work tasks are completed without triggering executive dysfunction, specific tasks can be broken down and explicitly written down to make it easy for individuals to follow
• For memory issues, regularly recording important meetings or noting down the process of tasks in a position where it is always visible will make it easier to remember important information needed for jobs. Headphones may also be used to manage inattentiveness to block out noise and possible interruptions
• All of these employ principles of occupational therapy, where an individual is empowered to improve areas in life where they experience difficulty, through self- tailored strategies and collaboration with employers to set these accommodations in place

Summary

• Occupational therapy has shown to have many benefits for individuals with ADHD, as it allows for tailored approaches to help individuals tackle challenges they face in their day-to-day lives. This is done through focusing on areas like inattention, impulsivity and executive dysfunction
• Occupational therapy can be implemented through school in collaboration between schools, therapists and guardians for children with ADHD to create strategies that help them achieve better in school in addition to developing their social skills
• In the workplace, occupational therapy can be implemented through workplace adjustments adhering to the needs of the worker with ADHD, and private occupational therapists can also work with adults to implement further plans if needed
• To conclude, occupational therapy can empower individuals with ADHD to make changes in areas of life they struggle with, helping them complete daily tasks better and thrive in work and social settings, improving their quality of life