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Ep. 50 ADHD and Internal Language (Interview with Michael McLeod)




(Soundbite)


Donae Cannon 0:00

Welcome to ADHD Crash Course, today we have Michael McLeod, an ADHD executive functioning specialist. He also has the GrowNOW model for internal language, which is a really important piece of executive functioning. We have him here today as a guest to tell us a little bit about that. Welcome, Michael.


Michael McLeod 0:46

Thank you so much. It's definitely a privilege to be here. Thank you for inviting me and for reaching out. My name is Michael McLeod. I am an ADHD executive functioning specialist, and owner of GrowNOW ADHD. This is a private practice located in the Philadelphia region, but we work with students all across the country and internationally. What we do differently is we created this GrowNOW model for strengthening executive functions based off of the most recent research on ADHD. ADHD is really one of the most misunderstood disorders affecting so many students and adults.


There's so many inappropriate labels, even the name ADHD is a terrible name. It's so important to educate others, and discuss with others exactly what this disorder is truly all about. Discuss what's truly happening internally, which creates what we see externally, and how we can help these students the best we can.


Donae Cannon 1:27

Right. Yeah, I completely agree with you. I find with my work, executive functioning skills and emotional regulation are two pieces that are so much more impactful that don't always get touched on when we're talking about ADHD. They're really big pieces of the puzzle. I'm super curious. I did hear Michael speak at Tefos. Is that the Executive Functioning Online Summit? Is that what it stands for?


Michael McLeod 1:26

Yeah, I believe so, that's the acronym.


Donae Cannon 2:04

Yeah, so it was super good. I forgot exactly the title of his talk, but I really enjoyed it and thought it'd be super valuable for my listeners to hear more about internal language, how we can work on that, and what it looks like to work on that. Tell us a little bit about it Michael. Tell us about working on internal language, because this is a toughie.


Michael McLeod 2:38

For sure. This phrase, internal language, is really something that I've coined to describe what's truly happening with ADHD and executive dysfunction. In the past, ADHD was really looked at as this external behavioral based disorder. This is why we have these misleading labels of attention deficit, hyperactivity, and inattentiveness. It was all things that we can see with our eyes. It was externally, kids who can't sit still, can't focus, kids who are disinterested, kids who are lazy.


This whole concept of attention deficit is really not about attention at all. It's definitely not an attention deficit. It's an abundance of attention, having too much attention to give. That is what's really happening internally, that creates these external behaviors that we focused on so much in the past. The executive skills that we look at, we're not looking at time management, organization, all these external things, that was the old focus of executive functions.


The 4 Executive Functions

1. Self Regulation


Now, we're looking internally at self regulation. This means regulating your emotions, your language, your body, and your behavior in various environments towards various stimuli. I'm sure many parent listeners out there know about self regulation for kids with ADHD and managing their emotions, especially when they're told to get off screens or to do a non-preferred task.


2. Self Motivation


That leads us into the second one, self motivation towards non-preferred tasks. This is something that's not instantly gratifying, being able to motivate yourself. Of course, in today's world, the biggest non preferred task of them all is school, schoolwork, and homework. It's being able to self motivate towards non-preferred tasks.


3. Self Evaluation


The next is self evaluation. This is the ability to learn from past experiences, apply it to the present, and not repeat the same mistakes over and over.


4. Self Awareness


Then overall self awareness where you're more aware of your actions, your behaviors, how they affect others, how they affect yourselves, being aware of your environment, and being able to perceive your environment. These are all executive functioning skills. These four executive functions, these foundational four pillars, self regulation, self motivation, self evaluation, self awareness, all of those skills are founded upon internal language.


All executive functioning starts with internal language. It's very important to know the foundation of those skills. Internal language is two separate skills that need to work together in harmony. Those two skills are number one, non-verbal working memory, which more simply said is the visual imagery system of the brain. This is basically both our hindsight and our foresight.


With our ability to reimage the past, we can make healthy and positive choices in the present, and also have the ability to visualize the future. We can know what the future looks like, and what the future feels like. We can plan, prioritize, and problem solve for what's to come in the future. That is our mental movies, our movie theater or DVD player of the brain, like Dr. Russell Barkley talks about. It's so important to be able to stop and inhibit yourself, like the old phrase, stop and think. We stop and we visualize.


We create a mental movie of what things are supposed to look like, then what things currently look like, what we learned from the past, and what the future looks like. The visual imagery system is foundational to executive functions. This is being able to hold an image in mind, manipulate, see yourself moving through time and space, and learn from past experiences.


It starts with mental movies. Then as we have those mental movies, we have to talk to ourselves, so we know what the future looks like. Then we say, okay, if the future looks like that, then right now I need to do this. Verbal working memory is the second part of internal language. That is the self talk system. It starts with mental movies, where you visualize, and then you talk to yourself as you're creating these movies.


Verbal working memory is just the ability to talk to yourself, have an internal dialogue, an internal system of checks and balances, and to talk to your brain. In the past, we looked at these ADHD kids as kids who were lazy, disinterested, hyperactive, but really they don't have the internal brain coach that neurotypical kids have. They can't talk to themselves to self regulate, self cope, see what's happening in the environment, and see what everyone else is doing so that they can do what everybody else is doing.


This ability to visualize to themselves, and the ability to talk to themselves is internal language. That's really what's missing in these kids.


Donae Cannon 7:39

Right. When you talk about that, what I imagine is the foundational piece of the mental movies and (I know already with the adults that I work with, this is tough) imagining what's next for your future self. It's part of what makes breaking things down so difficult, is not being able to picture the end, or even picture the future. What are ways that, if this really isn't available to somebody, they strengthen it or work on that?


Michael McLeod 8:08

Yeah, so just like any other muscles- you know, you want to get your arms stronger, you want to get your legs stronger, you work them out- you have to practice using them. That's really how the human body works.


It's how the brain works. If you want to learn a new language, you practice every day, and you learn a new language. If you want to learn to play a new sport, you practice every day, and you know how to play a new sport. The more that these things are practiced, used, and felt success with, the more they are strengthened. It would be beneficial if a student practices creating what the future looks like in a structured environment with a therapist or a neutral third party. It's very hard to do with parents, because of the emotions involved there and things like that.


It's always good to find a counselor or a therapist. To practice these skills one on one, you could be visualizing the future, acting out what's to come, gesturing through it, figuring it out, talking to yourself out loud, or modeling it. That's really what our therapy looks like. Executive functions aren't strengthened by sitting at a desk, doing worksheets, doing things from Teachers Pay Teachers, writing in an agenda, and those sorts of things.


You have to get up, move, figure things out, plan, go through an activity, and all of those things. The more these things are practiced, the more you're able to use them in the natural environment.


Donae Cannon 9:26

Okay, yeah. That makes sense. I think a lot of times people with ADHD are looking for the magic system, the magic organization or time manager, whatever.


It could be a myriad of things, right? It's depending on who you are. There is no magic system, and also with ADHD, you get tired of your system. Really having that foundation of why this is working for you, and what you're going towards is more key than the magic planner. I hate that for everybody. I know we want to buy our planners.


Michael McLeod 9:57

Yeah, you can create all these external systems. You can have star charts, agendas, whatever it may be. You can have these alarm clocks, and all of these things. The name of the game, when it comes to ADHD and executive functioning, is a lack of independence. They don't have these internal skills of visual imagery and self talk, which allows them to regulate and motivate.


They're so reliant on the outside world to do the executive functioning for them. That tends to fall on the shoulders of the parents. Parents are super stressed. All the research being done on being a parent of a kid with ADHD, it's incredibly distressing, it's really hard. It's super hard for these parents, because you're being the executive functioning for yourself, and the executive functioning for your child.


The biggest thing to remember is, whatever prompts you're giving them, whether it's a morning routine, getting their homework done, getting off a screen, you need to focus on helping fade back those prompts over time. Your child becomes more independent. You want them to have the internal skills, so they can say to themselves, "I've been playing Minecraft for five hours, now it's time to go do something else."


"If I get my homework done now, I'll have more time for fun later," or, "Hey, I need to really speed things along in this morning routine, because it's really upsetting my parents who drive me to school," or "I'm going to miss the bus again, and I don't like that feeling, I have to work towards something else." You can be helping them develop these internal skills so that they are self cueing, and giving the prompts to themselves, instead of you constantly prompting them. That's really what we have to focus on.


Donae Cannon 11:38

Right. That makes sense. You were talking about how not only are these mental movies for the future, but they're for the past to assess what went wrong. This happens a lot, even with working with adults. Sometimes we just didn't do the thing. Well, okay, tell me about it. What jammed you up? What was it? Instead of being really hung up on not doing the thing, get curious about where it broke down.


Was it not that important? Was there something you didn't plan for? You're just figuring out what happened. Is that the same process you're doing with the kids?


Michael McLeod 12:09

Yeah, of course, you really want to look back on past experiences and learn from them, both positive and negative.


You want to think of times that they were successful, and use the tasks, strategies, what they did in the past that was successful, and help them learn from it so they can repeat it. You also want to go back into the past to see things that weren't successful. You do want to find the breakdown, but even more importantly, you want them to remember the feeling.


It's so important for them to look back at a time that they were unsuccessful. Look at a time things didn't go your way and focus on how did that make you feel? How did you feel when that person didn't want to be your friend? How did you feel when you got a zero on that test? How did you feel when you lost your phone for a couple of days? They have to remember the feeling of how it was because they'll forget it and they'll move back to the present moment.



The ADHD brain is really stuck in what's most gratifying in the moment. That lack of visual imagery, the nonverbal working memory where we use our hindsight and our foresight, is so weakened that these kids are really stuck in the now. They're stuck in the present moment.


They're not learning from the past, they're not forecasting into the future. They're stuck in the moment, which is why so many of these kids have screen addictions and video game addictions. Nothing's more gratifying in the moment than a video game, a screen, YouTube, or watching a video of somebody else play a video game. All of this is gratifying, because they're not thinking, "oh, I can't do this for five hours, I have other things to do," or "last time I did this, I hurt myself," or "I made things bad for myself," whatever it is.


Try helping them to use information from past experiences and how it makes them feel, because they'll forget about it. They'll move on to something else more gratifying. The feeling is what drives the motivation.


Donae Cannon 14:01

It's more important than just teasing out what went wrong. It seems to be much more of a motivator.


Michael McLeod 14:07

Oh, yeah. You have to drive the motivation.


Donae Cannon 14:11

That's the working memory piece. Then, you're adding the internal language that you mentioned in the second piece of this, or are they happening at the same time?


Michael McLeod 14:21

Yeah. Internal language is the working memory. Internal language is non-verbal and verbal working memory, and teaching them to work together in harmony. You're visualizing and you're talking to yourself with the visuals, so they're working together.


Donae Cannon 14:37

The verbal and non-verbal are happening at the same time?


Michael McLeod 14:39

Exactly. With ADHD, both systems are weakened and disconnected. If kids with ADHD are visualizing to themselves, or talking to themselves, they're probably visualizing their favorite YouTube video or game. That's why you tend to see these kids pacing back and forth, talking to themselves, mouthing different words, and those sorts of things.


It looks more like an autism behavior, something you see of kids walking back and forth acting things out, but kids with ADHD do it as well. They'll focus specifically on preferred tasks and things that are gratifying to them. If they are talking to themselves, and they are visualizing, it's those sorts of non-helpful, non-productive things. They're not coaching themselves to actually change their behavior.


Donae Cannon 15:26

Right. That makes sense throughout your lifetime. That's not necessarily just kids, you see that with adults, too. I just spoke with somebody who said, "I really want to make good decisions for future me, but I can't seem to pull the trigger on them. I can't seem to do the thing that I know I'm going be glad I did.


Michael McLeod 15:45

Yep. That's the task initiation piece of executive functions. Probably they're not realizing that "those things are good for future me" in the moment. It's not until 5, 6, or 7 hours of video games and screens, where they look back and say, "hey, I really should have gone outside. I really should have rode bikes. I really should have gotten my homework done. I really should have gotten my chores done. I should have walked my dogs."


It's so important to really be able to stop, think, and call on your working memory in the moment before you get stuck in that gratifying task. This is why parent coaching is so important. Parents need to learn how to have screen time structure in the home.


Donae Cannon 16:35

There's more of a vulnerability with ADHD.


Michael McLeod 16:39

Parents really need to get into the mindset of non-preferred before preferred. Get the homework done, get the chores done, get the outside play, get the exercise, sign them up for clubs after school, sign them up for the YMCA, get them in karate, get them in Boy Scouts. Get them in all the things they don't want to do at first, but are happy once they get comfortable there.


Sign them up for all those things, keep them busy, keep them away from the screens. As for the games, use that as something that's only available to them after the non-preferred is completed. If you allow a student with an ADHD or executive dysfunction brain to get stuck in such a gratifying task, the non-preferred is never going to get done. Get these kids in the mindset. Build the brain pathways where they learn, "let's get the boring stuff, the difficult stuff, the challenging stuff done first, before I spend hours doing my thing."


Donae Cannon 17:35

That makes sense, even when you just think about rewards. The ADHD brain wants the rewards. Those far out rewards are not so motivating, right?


Michael McLeod 17:43

That's part of ADHD, it really limits the time horizon, or how far into the future they're able to see. You do want to have more distinct and more direct consequences, whether they're a positive or negative consequence. People hear the word consequence, and they think of only just negative things. There's also positive consequences. You want to have a positive consequence and a negative consequence in the moment where they get their homework done, they move on to something good, they go out and play, they move on to something that they like, etc. You want to have more direct and more instant positive and negative consequences.


Donae Cannon 18:32

Right. Now, I know obviously internal language impacts emotional regulation, which is a big piece for all of us with ADHD. Any thoughts or wisdom to share with us about how this impacts emotional regulation, and what we can do about it?


Michael McLeod 18:51

Oh absolutely, self regulation is really the foundation of this disorder. It's much more of a self regulation disorder than it is about attention, hyperactivity, or inattentiveness. This is truly self regulation deficit disorder.


Parents know this better than anybody else. It's that management of emotions. It comes from the lack of internal language. They're stuck in the present moment. All they're focused on is in the moment. They'd rather get into a three hour fight with mom than do five minutes of homework.


They'd rather feel the power rush and the thrill of being able to manipulate mom's emotions, and have her go from happy and calm to yelling, screaming, and crying, than do five minutes of homework. They get that power rush from that in the present moment.


They have the inability to learn from past experiences, take times of success, apply it to the present, and forecast into the future. These kids are stuck in the now, they're stuck in the present moment. Sometimes the most gratifying thing in the moment is to manipulate your parents emotions and have them focus on you.


Kids with ADHD get probably even more of a thrill, and more of an intrinsic motivation for negative attention than positive attention. They love having their parents put all of their focus on them, whether they're screaming at them about not taking a shower, being on screens for too long, or not doing homework. They enjoy getting that instant gratification and thrill of, "my parents are focused solely on me, mom's not doing her thing, she's yelling at me, she's focused on me." You're getting all this attention, words, directions, and monologues. "Everything is focused on me," and they're getting a thrill from that.


Donae Cannon 20:43

That definitely tracks, seeking out the intensity. Do you have advice for parents?





Michael McLeod 20:51

Yeah. Parents, what you want to learn to do is use 90-95% less language. When you notice your kid is dysregulated, you're going to want to take a reset, and explain to them what their choices are. You can either get your homework done, or you can lose your phone. You can get your homework done, or you can lose your Xbox. Whatever it may be, you can go outside and play with friends, you can do this, you can do that. Give them the choices and walk away.


Anytime you can, create visuals, write things down, make pictures, print them out, laminate them, use visuals, use gestures, like having both your hands up in a calming motion. Never get into that verbal back and forth, that argument vortex. You never want to get into that verbal back and forth with these kids, because they love it. That's exactly what they want.


Donae Cannon 21:41

To sit back with that 90%, that's a big number, right? Especially those of us who have ADHD, we're parenting kids with ADHD (probably a lot of us), and that takes some self awareness to to talk a lot less.


Michael McLeod 21:41

We want our kids to grow, and it's going to take time for them to grow and mature. It's going to take time for us as parents to get used to these parenting techniques.


We expect a lot out of our kids, we should expect a lot out of ourselves. It's going to take a lot of time and practice for us to get used to not using so many words. To us as parents, it's so obvious, and we see that the child's making the wrong decision. We think we can just use our words, and the kids are going to say, "aha, that's it."


These kids need to feel life for themselves. They need to feel natural consequences, they're not going to take your words. To change their behavior, they need to feel it for themselves. They need to feel the consequences that you place on them, whether you take away their screens, games, whatever it may be. They need accountability. They need more accountability than your neurotypical child.


Practicing using less words, and just having distinct and natural consequences is important. If you have to walk away from your child, put headphones on, go to a safe place, do whatever you need to do. Let them know this will be discussed in 24 hours. You're going to have to go through some hard times until your child learns, "hey, I can't manipulate mom the way I used to."


Donae Cannon 23:20

Yeah, and I'm sure it gets worse before it gets better with that. Now, what about thoughts for educators? How about using some of these ideas and how you integrate that in a classroom?


Michael McLeod 23:32

Yeah, of course. In the schools, a lot of what teachers do is go off of that lecture, listen model, where you're providing a lecture, kids have to listen, and they have to regurgitate it back onto a test. You really want these kids to dive deeper into the material, get a feel for it, and bring their emotions into it.


Before class starts, ask them to make a couple of predictions about what they think is to come. Ask them to make a mental movie of what they think the class is going to look like, what they think they're going to learn, and help them to visualize what you're learning.


You don't want them to just just take rapid notes, study their notes, and that's it. We want them to be able to create mental representations in their head of the material. The more you can take the time and use visuals, use pictures, the better. Have them do group work, where you pair them in groups, and they describe the material to each other.


"I'm picturing this, what are you picturing? What's happening?" Ask these questions that get them to think using declarative language, reflexive questions. Ask them these questions. It's not just a right or wrong answer, have them walk through it step by step in terms of what they're visualizing, what they're seeing, and how they're coaching themselves to really grasp this topic.


Donae Cannon 24:51

Now when you say declarative language, what do you mean by declarative?


Michael McLeod 24:56

This book right here, the Declarative Language Handbook by Linda Murphy, is a great parenting book that helps parents change the way they use language with their child to help them visualize and use language. The opposite of declarative language is imperative language. For example, "go and get your coat." That's imperative, you have to go and get your coat.


You can say something like, "I'm wondering how you're going to feel when you go outside, because it's really cold outside." That's declarative language. It's taking what you're wondering about, and externalizing it.


If a kid is learning to pack his own lunch, "I'm wondering how you're going to feel at lunch tomorrow. I'm wondering what you're going to be in the mood for. I'm wondering what you're going to need tomorrow at lunchtime." That triggers a student to think, "Okay, tomorrow at lunch, I'm going to be hungry. I'm going to need my food. Let me go put my lunch together."


Imperative language is keeping the child dependent on you. Finding ways to use declarative language and externalize what you're thinking about and what you're wondering about, helps the student to understand how your brain works. It helps them understand how your brain wanders, how your brain figures things out, and teaches them to do it themselves.


Donae Cannon 26:19

Okay, the kids use that declarative language to immerse themselves more in the subject matter. It's a great tool for parents and educators. The book again, I'll link that too because that sounds good.


Michael McLeod 26:35

The Declarative Language Handbook by Linda Murphy, speech and language pathologist.


Donae Cannon 26:39

Awesome. Well, thank you so much Michael. Thank you for sharing all about internal language with us. I'm sure people will want to know what you're doing, work with you, get in touch with you. How can they do that?


Michael McLeod 26:52

Sure. Yeah, so my website is GrowNOWTherapy.com. GrowNOW ADHD is also my facebook page. You type right in, GrowNOW ADHD. One word, GrowNOW. Also on Instagram, GrowNOW ADHD. Follow me on Instagram.


Go to my website. My email is Mike@GrowNOWTherapy.com. We provide one on one executive functioning coaching, parent coaching, and I also train school districts and schools. I trained public schools, private schools, charter schools, in the GrowNOW model for executive functions. I helped the staff to become certified in the GrowNOW executive functioning model.


I've trained schools, school districts, and educators all across the country and internationally. We provide virtual services and in-person sessions to students and families. Definitely reach out if you're interested, and want to learn more about executive functions. Going off of this research, I'll be happy to chat with you.


Donae Cannon 27:49

Thank you so much. I appreciate it. You definitely will have all those links in the show notes, so you didn't have to keep that in your head if you were listening. I'll have that so you can easily see what what Michael is doing. Thank you so much. Appreciate your time.


Michael McLeod 28:01

Thanks so much for having me. This is awesome.


 

How to reach Michael:

Instagram: @grownowadhd

Facebook: GrowNOW ADHD

Email: Mike@GrowNOWTherapy.com


Books Mentioned in Podcast:

Declarative Language Handbook (by Linda Murphy)


 

Interested in learning more about my group coaching program, Embrace Your Brain? Considering 1:1 coaching or have other questions for me? Please feel free to contact me here.




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