Understanding object permanence and ADHD

Do you remember when peek-a-boo stopped being fun for you? Maybe not, as you were likely very young. But the game probably lost its luster after you developed object permanence, the awareness that objects continue to exist even when you can’t sense them. Swiss psychologist Jean Piaget first described the concept of object permanence in the 1950s, after observing how infants react when their toys are hidden from view.

To be clear, “object permanence” is not a condition or a symptom of one. But in recent years, some people found the term a useful shorthand for describing concentration issues faced by people with ADHD (attention-deficit/hyperactivity disorder) particularly when an object isn’t right in front of them and seems to have disappeared from their minds. Maybe you took your daily medication in the morning, only to forget hours later whether you had or not. Or maybe you’ve found yourself unable to locate a favorite shirt, only to discover that you put a load of laundry on last night and forgot about it.  

What you’re experiencing is a difficulty in remembering things without a sensory cue—you didn’t hear the washing machine ding, for example. And if you experience these memory lapses frequently, they may signal a mental health condition or underlying neurological condition. Forgetfulness in daily activities is a symptom of ADHD, which is usually characterized by an ongoing pattern of inattention and/or hyperactivity and impulsivity that, together, interfere with functioning or development.

Again, these memory events aren’t technically linked to problems with object permanence problems, but people with ADHD often find it helpful to informally describe them this way.

Whether you have ADHD, or suspect that your forgetfulness might come from an undiagnosed mental health condition, keep reading to learn more about the relationship between object permanence and ADHD, tips for improving attention and working memory, and additional treatment options.

What is object permanence?

Say you’re playing catch with a friend and accidentally throw the ball into a bush. Object permanence is how you know that the ball hasn’t ceased to exist, even though you’ve lost sight of it. Infants reach this developmental milestone in their first year of life, alongside motor skills, and master it over time.  

When babies learn to see and touch objects from different angles, this can trigger cognitive changes that help them understand that objects in their environment will stay the same no matter what angle they’re observed from. There’s still some mystery around how this actually works, but gains in attention capacity and visual memory ultimately help infants to understand that objects continue to exist even when they can’t see them from any angle.

Object permanence is also essential to working memory, which is the form of memory that allows you to retain and alter task-specific information related to particular goals over relatively short periods of time. Let’s return to our ball-in-the-bush scenario. If your goal is to retrieve the ball, you need to remember where it disappeared and create a plan for locating it. You also need to focus attention on your goal for long enough to complete it. To do any of that, you have to know that the ball still exists.

Do people with ADHD struggle with object permanence?

To reiterate, disruptions to object permanence are not recognized by clinicians as a symptom of ADHD. But people with ADHD understandably use “object permanence” to describe issues related to inattention and working memory—both of which are symptoms of ADHD that affect their daily lives.

Say you’re mailing a gift to someone special. You wrap it up, add a bow and a card, and set it aside to take to the post office later. At some point, you drape a coat over it. That afternoon, you get in your car to run errands. Everything seems fine until you return home, move your coat, and see the gift you forgot to mail. You didn’t forget that objects continue to exist when you’re not looking at them (in other words, you didn’t experience a problem with or lack of object permanence), but you did lose track of a particular object and its related goal, which can feel about the same. This is a frustrating turn of events, and now the gift might not get to its destination in time.  

For people with ADHD, these sorts of “out of sight, out of mind” issues can complicate relationships with family, friends, and work. You might start responding to a text message or email only to become distracted, forget what you were doing, and move on with your day, unaware that someone expecting a message from you hasn’t received it. These drop-offs in communication can create friction in your social and work life. Though you didn’t mean any harm, others may feel neglected. That’s why it’s crucial to engage in open discussions with family members and loved ones regarding object permanence and working memory, as they may perceive these "out of sight, out of mind" issues as a lack of concern on your part.

Adults with ADHD might also forget to keep dates, pay bills, or turn in work without a constant stream of reminders, all of which can have an impact on their wellbeing. That means the expectations and responsibilities that are part of adulthood in general can be difficult to manage.

Related article: What to know about ADHD spouse burnout and how to overcome it

Children with ADHD

For children with ADHD, issues stemming from inattention and working memory lapses may include the following, among others:    

• Forgetting to complete homework assignments: If they aren’t looking at an assignment or a related reminder, children with ADHD may not remember when it’s due or that it has even been assigned.  
• Careless errors or neglected details in school-related tasks: Even when children with ADHD are able to stay on task, they may lose track of the details that would enable them to properly execute a given task.
• Issues with problem solving: Children with ADHD may miss or forget information crucial to effectively solving academic problems and navigating complex social situations.
• Difficulties staying on top of their responsibilities at home: What we informally refer to as “object permanence” issues can make completing chores difficult for kids with ADHD, as important information leaves working memory and their attention is drawn away from the task at hand.
• Strained relationships with peers: Children with ADHD may experience a lack of acceptance from their peers and/or have difficulty forming close friendships. Inattention and working memory lapses may trigger behaviors that other children without ADHD find inappropriate, and/or they may have trouble returning text messages and other communications.

It’s important to remember that the effects you personally experience related to object permanence may differ from those outlined above. They could also stem from a condition other than ADHD. Whatever your object permanence-related experiences are, speaking with a psychiatrist might help. They can provide clarity, management strategies, and help diagnosis whether you have a mental health condition. Complete Talkiatry’s short assessment to get the ball rolling.

Treating “object permanence” issues in ADHD

Thankfully, there are several ways to treat what people with ADHD informally describe as “object permanence” issues.  

Some people find that medication helps them alleviate ADHD symptoms related to inattention and working memory. ADHD medications can include stimulants (psychostimulants) and nonstimulants.

A number of therapies are also available. In consulting with your psychiatrist, the two of you may decide that medication, therapy, or a combination of the two is the best fit for you. Therapeutic options include:  

• Cognitive behavioral therapy (CBT): CBT is a process-based, goal-oriented therapy that focuses on rewriting thought and behavior patterns that may contribute to ADHD’s effects while also teaching you techniques for managing core symptoms, including inattention and working memory issues.
• Occupation therapy (OT): In OT, you’ll focus on learning skills that’ll help you meet the goals and accomplish the tasks you regularly encounter in life. Occupational therapists can help children and adults break down tasks into simple parts and create cues and other reminders to guide them from one part to another.
• Executive skills coaching: This can be a valuable intervention to help you optimize your functioning, organization, and working memory. By working closely with a trained professional, you'll learn practical strategies to manage tasks, create routines, and enhance your self-awareness.  

Issues with inattention and working memory and executive functioning is one of the symptoms of ADHD. But, symptoms can vary from person to person and may overlap with other mental health conditions. In addition to what are informally called “object permanence” issues, you might easily become distracted, fidget, or avoid tasks that require planning and prolonged mental effort.  

If you think you may have ADHD, you should consult a clinician to learn more. Fill out our quick assessment, to get connected with a Talkiatry psychiatrist suited to your needs. They can help diagnose a mental health condition, if you have one, and help advise a treatment plan.  

If you’re not ready to see a psychiatrist yet, you can answer a few questions  about what you’re feeling to find out if they line up with ADHD symptoms.

7 Tips for improving ADHD “object permanence”

ADHD-related “object permanence” issues can impact your daily life. That’s why having access to strategies for coping with and mitigating object permanence issues is important. Here are seven strategies that can help.

Create visual cues

Visual reminders can be especially helpful to stay on top of things. Consider keeping a white board or notice board in a prominent location at your house with information about responsibilities and tasks. You might also try leaving your wallet and keys in a designated, easy-to-see location when not in use. If you’re having trouble remembering to take medications, it might be helpful to get a weekly pill organizer. Leave it in a prominent, frequently visited area of your home to make sure you see it.  

Keep structured routines

Having a set schedule, even on weekends, can help you stay on task and accomplish goals. If you know in advance what you’re supposed to be doing at any given point in the day, you can create reminders for yourself, which brings us to our next tip…

Set reminders for yourself

Use calendar and alarm apps to set reminders for as many tasks as possible, and make sure you include labels that clearly state what you’re meant to do when those alarms go off. You can also make accompanying to-do lists, with each item on the lists corresponding to your alarm reminders. Cross items out when you finish their associated tasks.  

Explore multisensory learning  

Studies have shown that working memory and attention in children with ADHD improve when more than one sense is engaged. The combination of visual, auditory, kinesthetic, and tactile learning styles that works best varies from person to person, so experimenting with different pairings may help you determine what’s right for you or your child.  

For visual learning, you can use charts and diagrams to make information more understandable. If they respond well to hearing things, try explaining concepts out loud or using recorded explanations. To get them actively involved, kinesthetic learning through movement and hands-on activities can be helpful. And don't forget about tactile learning, which means using textured objects or materials to provide a physical connection.

Talk to loved ones

Being honest about your experiences can help family and friends sympathize with what you’re going through. Once your loved ones know that you have issues related to inattention and working memory, they can be more accommodating and help you stay on track when necessary. Consider having regular check-ins to strengthen your support network.

Try mindfulness exercises

Recent research suggests that mindfulness training, which comes from mindfulness meditation, can improve attention and help adults and adolescents with ADHD better regulate their behavior. This practice involves focusing your attention on the present, in particular on breathing and body sensations, and observing your own thoughts without judgment.

Consult a professional

Working with a psychiatrist and/or a therapist can help you manage inattention and working memory issues whether you’ve already received an ADHD diagnosis or believe that such a diagnosis may be appropriate for you.  Remember that personal experiences of ADHD can vary so getting professional guidance, you can learn more strategies and get a treatment plan tailored to your specific needs. Not sure where to start? Try taking Talkiatry’s free online assessment. We have a team of board-certified psychiatrists who treat adults and children.  

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.