How can GTD help a teenager who's had multiple strokes?

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Hi,

My name is Robert and I have some dear friends whose son has had 11 strokes.

They have to make a decision within the next couple of years whether he can go to college or not. The boy is smart, but has memory problems.

According to his mom, he seems to have problems choosing which things are most important to do. However, after talking with her, I've determined that (yes I am a doctor) part of that is the boy does not have a set system for knowing when things are due and has to relearn how to prioritize based off of a process sheet I'm trying to create with the aid of his parents (both professionals).

Already the boy has a habit of writing down everything that he considers important on paper. He has to do that or he'll completely forget about it.

When I asked the mother a few minutes ago about his skills in planning, she said they aren't so good. The example she provided was simply this: he has the opportunity to go to either one of two speech/debate camps this summer or a classical reading camp. His mom told him to decide which one and tell her. When she asked today, he said, "I thought you already had signed me up for a camp."

Obviously I believe if I could help him learn this system that it could make a tremendous difference in his productivity in life. He's a great kid, and I really need the following from readers of this group:

1. Are there any other questions I should be asking to determine his "capability" to use the system?

2. Has anyone out there ever done this before using Getting Things Done?

3. If I somehow with the help of everyone get this going, Would Mr. Allen mind me posting the "case" to a brain study/support group website?

4. Any and all suggestions, as I have an appointment next week with the parents.

5. Obviously, the boy definitely needs to know when loops are open or closed, so any other hints besides what's in the book?

Thank you all for your help, because if you're like me, you probably realizee that helping someone else with this means you learn the skills better too!

Sincerely,

Robert
 
Some thoughts

Dear Robert,

I'm impressed at the task you seem to be taking on.

Before I say anything else, please let me add some caveats:

1) I'm not a doctor
2) I cannot know for sure what aspects of his thinking might be affected by the strokes.
3) I've never had to work intimately with someone who might not be able to handle parts of the system.
4) I'm not a productivity coach so these observations are based largely on my own experiences.
5) I don't work for DA and cannot address any questions related to DA Company

Now that I've said that...

I doubt you will be able to tell before hand whether or not GTD will help him. GTD is essentially a way to let the mind forget things unrelated to the current task while guaranteeing that those same things will be remembered when they should be. Thus, I wouldn't be surprised if it could help him to compensate for his memory. My feeling, however, is that people get out of GTD what they put into it, and he is the one who will need to be motivated to make it work. The fact that he already writes lots of things down is a positive sign on that score. Even if he is motivated though, it may be difficult to get him to the point where he understands enough to make it work. Just browse around this forum for a while and you will see that even motivated people can find it difficult.

Some specific suggestions that you might want to consider:

1) Get him the GTD book, let him read it, and see if it makes sense to him. David Allen does a great job of explaining and motivating.

2) Tutor him in the basic system for a while (a month or even more) before starting to modify it. GTD is an integrated system, so you need to understand what you are changing and why you are changing it before you actually change it.

3) Take great care that his workspaces (home, school, etc.) and reference systems are completely set up. Any hole in the system, can be a major energy sink.

4) The Weekly Review is the key that makes it all work. If he takes up the system, an adult may need to help him through the process weekly until he really has it down. It would also be a good opportunity to look for holes in his system so you can encourage him to find a good way to plug them.

5) If he has trouble getting through everything at the Weekly Review because he doesn't remember enough about items in his in-box (physical, email, etc.), he may want to process parts of the system on a daily basis instead of weekly. Some daily processing (inbox, emails, Next Action lists) may also make the Weekly Review more relaxed and fun because it will be less onerous.

6) Use checklists freely. They are one of the more advanced (read simple to use, but hard to train yourself to actually use them) parts of GTD. Simple informal or formal checklists are a terrific way to be sure that something is covered without needing to remember it specifically, and the physical act of checking something off it is a good small reward.

7) As much as possible, let him decide how to implement the system. If he works well on paper, let him use paper, and if he works well on a computer, let him use a computer. In the end, he is the one who will have to make the system work.

8) Never forget that GTD requires thinking when processing something. The best system is useless without quality thinking. Getting him to actually think and make decisions when he needs to may be one of the hardest parts.

9) To really understand everything, whoever works with him will probably need to implement the GTD system too. Otherwise, the chances are low they will understand it well enough to help him. Using one of the David Allen Company personal coachs may help if this a problem. (and no, I don't work for DA)

10) A PDA might be a big help if he needs alarms to remind him when to be somewhere, or that some deadline is coming up.

and lastly,

11) Be patient. Most of the people who come to this forum seem to take months or years to completely understand it and fully implement it.

Best Wishes,

David
 
>part of that is the boy does not have a set system for knowing when things are due and has to relearn how to prioritize based off of a process sheet

I have a neurological condition and have been using/trying to use GTD on and off for several years now.

GTD's "hard landscape" might be helpful if the boy knows when theings are due. But then, any calendar system would probably help. A Palm with an alarm I've found helpful. However having "lists" of things using David's "intuitive, decide-in-the-moment based on context, energy, priority, etc" has not worked very well for me. Requires too much processing power in the moment, which I rarely have. Similarly, all the "processing at the front end instead of the back end" I've not been very successful at either.
 
It seems to me that the strict GTD system really emphasizes the future (what needs to be done) and de-emphasizes the present (use your intuition in the moment) and the past (it's already happened, so don't waste your mental energy tracking it).

For someone with memory problems, wouldn't an old fashion daily task list be helpful? I wonder if the Franklin planner approach overall woudn't work best: a calendar and daily task list for what needs to be done (and to track what has already been done and when), plus a daily record of events to write down all those thoughts, ideas, and reminders in a single location. And it can all be done on paper or PDA.

C
 
GTD for disabled

Yes GTD can be made to work, adapted to work for anyone in my opinion. Palm--check on the dexterity first. Consult with either a speech and language pathologist who specializes in "cognitive rehab" or a really competant l.d. teacher or a psychologist who can tell you what functions are preserved and what are not. some may even be remediable.
 
Re: How can GTD help a teenager who's had multiple strokes?

Hi Robert,

What a courageous young man to persevere in spite of having had all those strokes. Fortunately, that has not happened to me but I do have LD and have had to deal with similar issues this kid is facing although I am sure his problems are alot worse than mine.

I would agree with the advice to seek the assistance of a professional specializing in cognitive rehabilitation. I just feel his problems may be very complex that I worry that I wouldn't be doing him justice with my advice. But let me offer a some comments about GTD and people with cognitive problems

I have personally benefited from GTD but you need to keep in mind that this system is geared towards people who don't have cognitive problems. Ok, I understand that people with ADHD find it very beneficial but my difficulties and obviously this kids problems are more widespread..

Now before anyone responds and says this is a copout excuse, I am not saying that people with cognitive difficulties shouldn't stop trying to learn how to be organized. But it is a very tough process. and is more than just having discipline.

First of all, while I am not a doctor like you are, it sounds like this kid's difficulties with planning are related to executive function difficulties which is what I have. Here is a brief definition so you know what I am talking about:

"functions including, but perhaps not limited to, decision making, planning, initiative, assigning priority, sequencing, motor control, emotional regulation, inhibition, problem solving, planning, impulse control, establishing goals, monitoring results of action, self-correcting""

To digress, if the kid sees a cognitive rehab professional, there is a software program that can be run on a computer and pocket pc that replicates the executive function. The name escapes me but you might want to ask about it.

Hopefully, you understand what I am reluctant to say that GTD is the answer. It may be or it may not be. Let me comment on the rest of what you said though. You go on to say:

<<According to his mom, he seems to have problems choosing which things are most important to do. However, after talking with her, I've determined that (yes I am a doctor) part of that is the boy does not have a set system for knowing when things are due and has to relearn how to prioritize based off of a process sheet I'm trying to create with the aid of his parents (both professionals).>>

Having a set system is an excellent idea whether it is GTD or another system. However, you say you're teaching him how to prioritize of a process sheet. But does he literally know how to prioritize tasks?
For example, if he had three tasks such as a) pay bills that are due tomorrow, research an item on the internet, and purchase an item that isn't time sensitive, would he know what to do first?

One thing you have to keep in mind Robert is that people like me and possibly this kid need more explicit instructions than the average person, depending on the area. This might not be applicable to him but I wanted to throw that out there for your consideration..

An positive of the GTD system is that the only tasks that should be dated are the ones that absolutely have to be done that day. As a result, I have been able to do away with the 1-5 priority system that drove me crazy. The problem is that I worry if I don't make something mandatory, it will slip through the cracks .

What concerns me about the young man adopting this system is there are too many gray areas when it sounds like he would do better with some explicit guidelines. But perhaps you can adapt it so it is beneficial to him

<<Already the boy has a habit of writing down everything that he considers important on paper. He has to do that or he'll completely forget about it.>>

In a way, that is GTD because David Allen's philosophy is that you should do a complete mind dump and write everything down. His theory is if it's in your head, you won't accomplish anything. But obviously, folks without his problems would usually know how to prioritize. Again, I would make sure he truly understands the process of how to decide which task should get done first.

<<When I asked the mother a few minutes ago about his skills in planning, she said they aren't so good. The example she provided was simply this: he has the opportunity to go to either one of two speech/debate camps this summer or a classical reading camp. His mom told him to decide which one and tell her. When she asked today, he said, "I thought you already had signed me up for a camp." >>

I see two issues. The deficit in planning which may be related to executive function difficulties. Personally, I have found outlining to be helpful but of course, your mileage may vary.

Regarding his comment about being signed up for camp, that could relate to his deficiencies in planning. But could he have also misunderstood what his mother said? Obviously, you know the situation better than I do but I am sure you know as a doctor that sometimes what seems to be a case of something ends up being another issue.

<< Obviously, the boy definitely needs to know when loops are open or closed, so any other hints besides what's in the book?>>

I need to do this myself but people like this boy and I would probably do better with short daily reviews because of our memory issues. Personally, I think the weekly review is overwhelming.

Robert, you might find for this boy that GTD is helpful in some areas but in other places, it won't work. For example, because of my visual perceptual problems, using all manila file folders would be disaster for me. Again, your mileage may vary but it is important not to abandon a system just because you may have to deviate from some areas to make it work for this kid.

Sorry, I don't have a straight answer. But since I could relate to what that kid was experiencing, I thought I would take a shot at responding. I don't know if GTD is the right answer for this kid or not.
As a result, I wanted to give you the pros and cons.

Good luck

CAB
 
Re: How can GTD help a teenager who's had multiple strokes?

Anonymous said:
Hi,

My name is Robert and I have some dear friends whose son has had 11 strokes.

They have to make a decision within the next couple of years whether he can go to college or not. The boy is smart, but has memory problems.

According to his mom, he seems to have problems choosing which things are most important to do. However, after talking with her, I've determined that (yes I am a doctor) part of that is the boy does not have a set system for knowing when things are due and has to relearn how to prioritize based off of a process sheet I'm trying to create with the aid of his parents (both professionals).

Sincerely,

Robert
Click to expand...

Don't know how this compares to GTD, but perhaps GoBinder http://www.gobinder.com/gobinder2005.aspx with or without Planplus for Windows XP. Maybe a Tablet PC - can be had for under $1500.
 
You could also seek out the state resources available through vocational rehabilitation services. Often they will pay for assistive technology necessary to achieve a vocational goal. They can even fund services for a tutor to help prioritize school work.
 
Re: How can GTD help a teenager who's had multiple strokes?

Anonymous said:
When I asked the mother a few minutes ago about his skills in planning, she said they aren't so good. The example she provided was simply this: he has the opportunity to go to either one of two speech/debate camps this summer or a classical reading camp. His mom told him to decide which one and tell her. When she asked today, he said, "I thought you already had signed me up for a camp."
Click to expand...

I feel like any system would benefit from personalizing it in fun ways. Stickers, colored markers, post-its in odd shapes, whatever works to keep him enthusiased about doing his reviews and continuing to write. There's nothing wrong with changing these as he grows used to seeing them either!

I want to mention another source in line with my suggestion above.
It's a book called Organizing for the Creative Person
by Dorothy Lehmkuhl & Dolores Coter Lamping, C. S. W.

They have written good directions in how to prioritize (A,B,C), and how to prioritize (4 quadrant) method.
They also talk about why some people are resistant to putting things away, or decluttering them. Why they resist using a calendar, or filing. It may give you and him and his mother some insight.

From your quote, it sounds like his mother could be brought in to the system as well, providing her with a way to follow up with him in time to make successful decisions.

Thank you for sharing and good luck. Since it's been almost 3 months since your original post, please let us know how it's going.

Elena in Texas, USA
 
Robert,

What an interesting situation. I hope you'll continue to give us updates.

I was wondering about a few details:
How long ago did the strokes happen?
Is the young man likely to suffer from more strokes in the future?
How is he handling his current schooling arrangement?
Have his parents read GTD? (They are probably in the best position to see if GTD or certain GTD "tricks" might work for him, and they will certainly need to understand the system in order to support him if he tries it.)

I heard an interview on NPR within the past few days with a woman who had worked to rehabilitate her father after a stroke to the point that he was able to fly airplanes again. The family worked VERY HARD, using flashcards and essentially recapitulating the man's entire education, starting with the very basics of recognizing letters. She wrote a book about the experience, including their difficulties in dealing with the low expectations of the medical establishment for stroke patients.

Here is a link that I found:

http://www.susanedsall.com/index.html

The human mind is truly an amazingly complex organ.
 
You should look at the following book:

The Organized Student by Donna Goldberg. ISBN-13: 978-0-7432-7020-5

Ms Goldberg is the founder of a NYC company called the Organized Student and works with parents and students in setting up "student systems" both at home and school. Well worth a read with lots of check list etc.
 
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