Dr. Shazia Savul treats adults whose lives are significantly affected by symptoms of attention deficit hyperactivity disorder.
These patients, whom Savul sees as the lead psychiatrist of clinical services for adult ADHD at University of Pennsylvania's Perelman School of Medicine, frequently experience challenges with focus and time management that consistently impact their work, school, relationships, and mental health. This can include losing track of time, falling behind on tasks, and becoming so focused on a specific activity that other obligations fall to the wayside.
Savul has a list of evidence-based treatments that she recommends to patients with ADHD. Prescribing a technological device like a smartwatch is not among them.
This may surprise some consumers with ADHD, who may have seen products like smartwatches advertised to help improve their time management skills. Even retailers like Amazon and Walmart have category pages devoted to ADHD watches, despite the fact that experts like Savul don't rely on or prescribe them for treating patients.
"There's no specific device or gadget or watch or any instrument that we specifically recommend for ADHD to improve executive skills — not yet," Savul says, noting that research on such devices is very limited.
That doesn't mean ruling out tech devices altogether as an intervention for ADHD. Indeed, there are testimonials on TikTok and elsewhere online describing the potential benefits of using a watch or timer for managing symptoms. Savul says that if a tool or gadget helps with organization or forgetfulness, a patient should "by all means" use it.
But before you splurge on an expensive watch billed as the solution to your ADHD-related time management problems, here's what you should know:
ADHD is a neurodevelopmental condition that is believed to affect the part of the brain responsible for executive functioning. Typically, people develop a related set of skills to execute tasks and goals, like sorting through competing demands and making deliberate choices about what to prioritize.
But for people with ADHD, the brain's executive functioning can be impaired, perhaps because that area of the brain is less active or has difficulty suppressing various incoming stimuli and signals. In turn, Savul says this can affect time perception, orientation, and management. Time blindness, a popular term to describe the phenomenon of losing an awareness of time, can happen to anyone, but it is often pronounced in people with ADHD.
While not everyone with ADHD struggles with time equally, those who do often find it hard to subjectively gauge time as it passes, meaning minutes can evaporate into hours with diminished awareness of what's happening.
In children, this frequently shows up as distractibility, being unable to stick with a task, and taking much longer to do routine tasks than their peers, even if they have an established routine, says Dr. William Benson, a psychologist in the ADHD and Behavior Disorders Center at the Child Mind Institute. Typically, ADHD emerges in elementary-school age children as classwork expectations grow.
Still, the condition isn't always identified in childhood. Savul often treats patients who are being diagnosed for the first time as adults. Sometimes, these patients had a degree of structure and support that effectively reduced their symptoms. But when they reached adulthood and their environment changed, their symptoms became unmanageable. In other cases, patients may have been treated for depression or anxiety, but also had ADHD that went undetected.
Both Savul and Benson told Mashable that children and adults should seek professional help when symptoms interfere with daily functioning.
"These things can happen in almost every person some of the time, but if it's consistent, it's a pattern, it's repetitive, it's getting in the way of doing things, moving forward, then that's when it's important to have it evaluated," says Savul.
While some watch products are described as being designed for ADHD, there is little high-quality research on whether smartwatches reduce symptoms for people with the condition.
Instead, features like timers, vibrations, and alarms are marketed as ways to help the user keep track of time and stay on task.
In one six-week pilot study conducted during the early stage of the COVID pandemic, 10 children with ADHD between the ages of 10 and 15 received an Apple Watch and iPhone in order to evaluate whether timed reminders helped their organizational skills. The reminders popped up on participants' watches five minutes before they needed to attend virtual class.
The results, which were published in PLOS ONE in October 2021, found that some parents noticed improved self-awareness and self-motivation for their children. One participant's parent, however, said the watch distracted their child because they'd never worn a device on their wrist and experienced "tactile sensitivity."
Additionally, the children generally wore their watches during the first three weeks of the study, after which use decreased by half.
The study authors noted that far more research is needed to better understand how a smartwatch can support children with ADHD.
Stimulant medication, which promotes focus, is typically the first choice for treatment, given how effective it is, says Savul. Still, some patients don't see improvements in their time management or organizational skills.
That's when cognitive behavioral therapy specifically designed for ADHD can be useful, specifically for adults. That type of psychotherapy can address "cognitive distortions," or unhelpful thought patterns, that surface in ADHD, often in tandem with depression or anxiety. A patient may have a negative view of themselves based on years of coping with ADHD, a dynamic that can interfere with their problem-solving skills.
In Savul's clinic, patients can also receive ADHD coaching, which offers training in organizational skills and time management. The goal is to help patients become more productive and have more control over accomplishing their daily tasks.
But instead of fancy gadgets, Savul says patients may work with digital and paper planners, scheduling tools, and other time-assistive devices, like a basic timer.
For kids with ADHD, Benson says that it's important to help them understand how much time is passing in simple ways. A 15-minute block, for example, is half the length of their favorite cartoon. An hourglass or visual timer can also be helpful, as are posted schedules and calendars with a detailed breakdown of their day.
While learning to track time is key, kids also need to develop the ability to accurately estimate how long a certain task will take. They might think a homework assignment will require just 10 minutes but forget the time that elapses when they're booting up a computer or sorting through different class projects.
Benson says that a watch might be helpful if it provides visual or physical reminders (like a vibration), but insight is just as important. In other words, it's key to understand how and when a specific tool, like a watch, is effective.
If, for example, a child feels the buzz of a reminder but is so overwhelmed by a messy workstation that they can't transition to the next task, the watch may not yield positive benefits. There's also the risk that a watch's novelty will wear off; it's not so useful when the alarms just get snoozed or when kids stop wearing the watch altogether.
Savul says that each patient's treatment needs to reflect what works best for them. One patient may find success with a digital task organizer, while another thrives when using sticky notes.
They key is finding strategies that become routine, says Savul: "It's important to recognize, 'What is it that I can do which I can maintain consistently?'"
Savul cautions people against spending a lot of money on unproven strategies or products for ADHD. She says that, in fact, many strategies for time management aren't costly, like using a planner. She also reiterates that there's no specific items that she recommends to patients with ADHD at this point.
Though treatment for ADHD can be expensive, even with insurance coverage, Benson says that products making unsupported claims can also be pricey.
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In general, he notes that there's no evidence for expensive interventions that use high-tech equipment. He also urges families to be wary of blood testing or scans that purport to determine what "type" of ADHD a child has in order to customize their treatment.
"That's not accepted by the scientific community," he says.
Similarly, certain products that use games and activities to train working memory as a way to treat ADHD don't seem to be effective, says Benson. Some products may even say they are "cleared" by the Food and Drug Administration, but that doesn't mean they're effective, and it's not the same as receiving approval from the federal agency, he adds.
If you see an ad or product that looks interesting, even if it's in a publication that you otherwise trust, Benson recommends looking at its claims and how they're backed.
"Be a skeptical consumer," he says.
