David and Isabelle explore the myriad injuries and ponder the links between clumsiness and ADHD--is it because we're clumsy (which there are some fascinating links) or do we try and do too much? And speaking of doing things we don't want to do, but we care about doing, how does chunking help? All this, plus how we try to win by getting all the groceries in the house in one trip.
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Isabelle recounts a series of minor injuries, a bum knee, menstruating, and funny bone elbow stuff, and as she was sitting down she hit bone on bone throughout the day and sit down and had no self-regulation and was crying and then taking a ice pack that she is rotating to every injury. Is this clumsiness/injury-prone-ness ADHD? Or is this just her life? David names that there is a real thing about ADHD and clumsiness, and also some times you just have a bad night. Way more common to injure yourself with ADHD. Both clumsy and not clumsy exist in ADHD; there is some data around balance and your cerebellum and ADHD.  David taking in all his groceries in one trip is maybe the dumbest thing in the world. He has a bag of cat litter on his head, bags up and down his arm and they’re both in front of him and then facing the obstacle of the door, he is trying to get the key in the door, but then the door explodes open, and he lands on cat litter—and that’s just taking in the groceries. You have to elbow pinch, and using your whole body to align the key with the keyhole, it's a whole thing. But this whole thing is not clumsy—he’s doing way too much in a moment.  But is it really clumsiness, or going for the win, or the lack of response cost—it would’ve been shorter to take two trips, but it was about winning and he had to do it in one.  Isabelle witnesses this in her kids—neurotypical, neurodivergent, all kids—the way you do the task is the way you decided it needed to be done to get the win, rather than what would actually be simplest. And sometimes you step in, and sometimes you just let it fly. While she was just in the doctor’s office where she was getting her knee checked out, and she brings her foot up to tie her shoe, the time it takes it takes for you to do this, just take two trips—and that’s what her kid does, too, and of course, because she does it, too. Six years ago, David said, fuck laces. No more laces, too much time, can’t do velcro professionally, but professional shoes you can’t just step in because you'll ruin the heels, so now he's doing this sequence of kicking up his heel to try to jack the shoe in while standing without ruining the heel...and now he is resisting the urge to jump up and show that he does this. Makes David think of chunking, taking two unlike or like items and smashing them together. So every time David takes out the garbage, he cleans the litter box—pairing two things together, he won’t forget to take out the garbage. When you can put multiple things together, it makes you feel more effective with your time, why not take care of future you a little bit and make a transition more effective?  Isabelle tries to take an object from one room to another, like anything that you need to rehouse to that room you take with. David names we all do this in our morning routine and going to bed routine — we have "hitting alarm, stretching, brushing teeth, getting dressed, get coffee" and it becomes “wake up routine;” we have "take shower, brush teeth, put on pj's, read a book" and becomes "going to bed routine," all those steps into one chunk.  Isabelle tried this with a client during packing, and actually physically chunking to make a bunch of things just one category of thing, so you don’t have to remember all of it, you just have to remember the category (like here is your bag of toiletries). David would chunk together his sequence of actions upon arriving home after travel—initially it was hard, but now it’s a reflex—he immediately takes all his clothes and puts it in the laundry, and puts his suitcase away (all right away). Isabelle thinks of the game “my name is Joe and I like to Jump” (she was Isabelle who ice skates and she hates ice skating for the record)—it’s like a memorization technique. You’re trying to outsource the working memory, so you’re building a habit so you don’t have to think about it so much any more. Takes six weeks of consistency to build a neurological habit. It’s a long long time, but not a long time. But once you’ve built the connection, any time you justify not doing the thing, everything is broken. When you’ve been on vacation, and then you return, and then everything’s awful for two weeks. Working memory is hard for all of us, but anytime you can outsource it you can. Isabelle hates changing the sheets on beds, especially her kids’ low loft bed. The feeling of a clean sheet, maybe top five sensations, after you’ve freshly showered or bathed, and you have clean sheets—and she takes the thing where she cleans already every week, she adds in changing the sheets. Is it also giving a bigger norepinephrine something, or momentum, or a sense of productivity (and David is furiously thumbs upping it). David affirms: we have to find a way to do the things we care about. When we’re able to do the things that make us feel better, even when we don’t want to do them, that’s norepinephrine— “look at you, you made the bed, stripped the bed, changed the sheets, etc." check mark for the day!

Here is just one of many articles on clumsiness and ADHD - essentially, the cerebellum, which is the part of the brain we understand is responsible for learning to move your body in a sequence, etc. is also structurally different and may be connected to the executive functioning and motor sequencing differences in neurodivergent folx (Source: NIH article)

You can continue down a whole long rabbit hole ADHD/cerebellum rabbit hole:

 Cerebellum hypothetically tied to impulsivity and compulsivity (Frontiers in Behavioral Neuroscience, 2019)

Also, (from 2011 article) children with ADHD are more likely to have dyspraxia, or differences in performing motor skills like writing, playing sports and games, tying shoelaces, and eating with a knife and fork. 

Chunking: taking two unlike or like items and smashing them together. We all do it a ton in wake up and go to bed routines—all those things get chunked together into one thing “night time routine” (eg. Brushing teeth, putting on pjs, getting into bed, etc.)

Proprioception (from ScienceDirect’s Encyclopedia of Neuroscience): “Proprioception, or kinesthesia, is the sense that lets us perceive the location, movement, and action of parts of the body. It encompasses a complex of sensations, including perception of joint position and movement, muscle force, and effort.”

Response Cost: a neurological skill that helps you know the consequences of your actions later on down the road. This is a forebrain skill that is often harder for folx with ADHD.

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