A child sits at the table with their homework in front of them. They know it needs doing. They know what happens if it is not done. They have been told three times. And they still do not start.
The word that usually gets attached to this is careless. Maysoon Al Nashash argues that it is the wrong word, and that using it makes everything worse.
She is an occupational therapy specialist at the Zayed Authority for People of Determination in Abu Dhabi, holds the ADHD-RSP credential, and was herself diagnosed with ADHD as an adult. We hosted her for a live webinar with The Butterfly, and what follows is drawn from that session, with her quotes lightly edited for clarity. She has also published a companion piece on LinkedIn, nine things about ADHD that parents, teachers and therapists get wrong.
Your child is not being careless
Al Nashash starts by widening the definition. Most people hear ADHD and think of two things: cannot sit still, cannot pay attention. She lists nine difficulties instead, and the list is worth keeping somewhere you can find it:
- Sustaining attention
- Impulse control
- Activity level
- Starting a task
- Organising
- Remembering instructions
- Managing time
- Shifting between activities
- Emotional regulation
These cluster under what psychologists call executive function, the set of self-management processes that let a person hold a goal in mind and act on it. Russell Barkley's influential 1997 model placed behavioural inhibition at the centre of ADHD, arguing that when inhibition is impaired, working memory, self-regulation of motivation and the internalisation of speech are all affected downstream. It is a technical way of saying what Al Nashash says plainly:
Her objection to the careless label is not sentimental. It is that the label points the adult in the wrong direction. If you decide the problem is attitude, your response is pressure, and pressure is the one thing that reliably makes it worse.
The two headline symptoms, in her framing, are not the problem. They are what the problem looks like from outside. Narrow your attention to those and you end up writing rules to suppress the visible behaviour while the thing driving it goes untouched.
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The clearest thing in the session was her explanation of task initiation, and she used herself as the example rather than a client.
Her phone charger is in the car. She needs it. She does not go and get it. Asked why, the answer is not laziness, it is a stack:
She would need to change into outdoor clothes. Then find the house key. Then find the car key. Then remember where in the car she left the charger. Then she might meet someone in the building and have to talk to them. Then she will be tired when she gets back.
None of those steps is hard. There are just six of them, and they arrive simultaneously rather than in sequence.
That last part is the piece most adults miss. The child is not consciously running the list. They have run it so many times that only the conclusion surfaces. From the outside, all that is visible is a child not starting their homework.
Run the same analysis on the homework and you get the child's version. Where is the bag? Is the pencil sharpened? Is the eraser the one that smudges? Which book was it? Three of those went fine yesterday and today one of them did not, which is why a child can manage the same task on Monday and stall on Tuesday.
Her own solution is environmental rather than motivational. She reorganised her home so that the clothes she needs to go outside hang in one place by the door.
What actually helps a child start
Four things she uses, in the order she would try them.
1. Remove steps before you add motivation
Ask what the child has to do before they can do the thing, then delete as much of that as possible. Sharpened pencils in a pot on the table. The bag in one fixed place. Books out before you ask. You are not making the task easier, you are shortening the runway. This is the single highest-yield change available to most families, and it requires nothing from the child.
2. Short, clear tasks with a timer
Long open-ended tasks are the worst possible shape. Al Nashash cuts them small, states them plainly, and puts a visible timer on them. Her reasoning is about suspense rather than discipline, which leads to the best story in the session.
She gave a boy a puzzle and a one-minute timer. He could finish it in thirty seconds. Instead he placed every piece but one, then held the last piece and waited.
She cut the timer to twenty seconds and framed it as a challenge between them. He would abandon whatever he was doing, chips included, to start immediately. The timer was not there to hurry him. It was there to make starting interesting.
3. Reverse the reward order
This one is counterintuitive enough that it is worth stating carefully, because it inverts standard advice.
The usual arrangement is homework first, then the video game as a reward. Al Nashash argues this is why the homework gets rushed: the child is not doing the work, they are getting through the work, in a hurry, with the fun thing pulling at them the whole time.
Do the desirable thing first and it stops competing for attention. What remains is a child doing homework rather than a child escaping homework. It is worth trialling for a fortnight before judging it, and it will not suit every household.
4. Be careful about over-quieting the room
Sending a child to a silent bedroom to concentrate is standard advice. Al Nashash finds it often backfires, because an under-occupied brain fills the space with its own material. She describes studying maths through a film as a teenager and doing well at both. Some of her students work better with music on; some focus best while explaining the work to somebody else.
Treat this as something to test rather than a rule. The point is not that noise helps, but that silence is not automatically the answer, and it is cheap to find out which way your child runs.
Short, timed, feedback-rich activity is also what camera-based games are good at, which is why they sit naturally alongside this kind of work:
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Do not stop the movement
On fidgeting, foot-tapping and pacing, her position is unambiguous.
Her qualifier matters: this is not an argument for no boundaries. It is an argument against issuing verbal stop commands to a child who is moving in order to regulate. Give a solution instead of an instruction, she says, because these children do not respond well to being stopped but will accept an alternative. She teaches breathing and squeeze-and-release exercises, which she frames as ways to relax without anyone being told to relax.
The research adds a useful wrinkle here. A 2023 meta-analysis of 24 studies covering 914 children and adolescents with ADHD found that physical activity improved inhibitory control and working memory, with a moderate effect. But the benefit is strongly moderated by the type of activity: exercise that demands thinking, such as ball games and sports that require tracking other players, consistently outperforms plain aerobic exertion like running laps.
So movement helps, and movement with a demand attached helps more. A trampoline on its own is weaker than a trampoline plus catching a ball.
Where screens actually fit
Al Nashash is not a screen-time abolitionist, and was direct that she plays Roblox and Minecraft with her own children partly to understand the space her clients live in.
Her concern is not the screen, it is the schedule. The pattern she warns about is unpredictable access: a long stretch of tablet one day because the family is staying in, none the next, an extra hour when a parent is tired.
Intermittent reward is the most habit-forming schedule there is, which is why this matters. A dull fixed routine is harder to negotiate with and easier for a child to stop fighting, and tools like Google Family Link make the limit a property of the device rather than an argument with a person. She also cautions against the sudden total ban after heavy use, which tends to produce exactly the dynamic you were trying to escape.
Three presentations, and when to get help
The DSM-5-TR recognises three presentations of ADHD: predominantly inattentive, predominantly hyperactive-impulsive, and combined. Several symptoms must have been present before age twelve, appear in more than one setting, and interfere with functioning.
The inattentive presentation is the one that gets missed: that child is quiet and calm, and is frequently assessed for a learning difficulty instead. Al Nashash is emphatic that none of this is a home diagnosis, and that proper screening runs to more than a hundred questions. She suggests seeing an occupational therapist or physician when a child cannot regulate themselves, when school performance sits below what they are capable of, when conflict with other children is persistent, or when sleeping, showering and eating are consistently difficult.
Her closing answer, when asked what one thing she wishes parents understood, was about acceptance rather than technique. She also pushed back on the framing of ADHD as purely deficit:
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Frequently asked questions
Why can't my child with ADHD start their homework?
Task initiation is one of the executive functions most affected by ADHD. Before the task itself there is usually a stack of small preparatory steps, and they arrive all at once rather than in order. The child is rarely aware of running that list, so what surfaces is simply a reluctance to begin. Removing steps in advance helps more than increasing pressure.
Should homework come before or after screen time?
Al Nashash suggests reversing the usual order and allowing the game or activity first. Her reasoning is that a pending reward makes a child rush the work to reach it, so removing the pull leaves them able to focus on the task itself. It contradicts conventional advice, so trial it for a couple of weeks and judge by what actually happens in your home.
Should I stop my child fidgeting while they work?
Generally no. Movement is often how the child is regulating in order to stay engaged, and a verbal stop command removes the strategy without replacing it. Offer an alternative rather than an instruction. Research also suggests physical activity benefits attention and working memory in ADHD, with the largest effects from activities that require thinking, such as ball games, rather than plain aerobic exercise.
How much screen time is right for a child with ADHD?
Al Nashash is less concerned with the number of minutes than with predictability. Access that varies with the day, the weather or a parent's mood is the pattern most likely to create attachment to the device, because unpredictable reward is powerfully habit-forming. A fixed, dull routine, enforced by a tool such as Google Family Link rather than by argument, is easier for a child to stop negotiating with.
When should I see a professional about ADHD?
Consider an assessment when a child cannot regulate themselves, when school results sit well below their evident ability, when conflict with other children is persistent and they cannot calm down afterwards, or when daily routines like sleeping, eating and showering are consistently difficult. Diagnosis requires proper screening by a qualified professional and cannot be done from an article or a checklist.
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Last medically reviewed on September 21, 2026
How we reviewed this article:
- (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD Psychological Bulletin, 121(1), 65-94. https://pubmed.ncbi.nlm.nih.gov/9000892/
- (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text revision) American Psychiatric Association Publishing. https://www.psychiatry.org/psychiatrists/practice/dsm
- (2023). Meta-analysis of the effects of physical activity on executive function in children and adolescents with attention deficit hyperactivity disorder PLOS ONE, 18(8), e0289732. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0289732
- (2024). Attention-Deficit / Hyperactivity Disorder (ADHD): Diagnosis and treatment Centers for Disease Control and Prevention. https://www.cdc.gov/adhd/diagnosis/index.html
September 21, 2026
