Presenting with ADHD: Losing the Thread and Nerves

The slide is open and the first two sentences are in place. In the middle of the third sentence a very good example comes to mind. I tell the example, and another detail comes out of inside the example. A minute later I look at the faces of the listeners and I do not remember where I came from.

I know the subject. What I have lost is the road.

In this article I describe why that road breaks, how nerves add themselves to the picture, and how I have tried to set up preparation in a way that suits ADHD.

Why the thread breaks

From the outside, speaking looks like a single job. On the inside several jobs run at the same time: building the sentence you are saying, preparing the next sentence, holding the overall plan in mind, and pushing aside the unrelated ideas that arrive in that moment.

The last part matters. Russell Barkley's model puts behavioral inhibition at the center of ADHD: the ability to stop a response, an impulse or an interrupting stimulus (Barkley, 1997). The bright side idea that occurs to you during a presentation is exactly such a stimulus. When inhibition is strained, you cannot stop yourself from saying that idea, and the idea takes you off the main road.

There is also a study that looks directly at language production on this. Participants were given two pictures and a verb and asked to build a sentence; the combined-presentation ADHD group produced more repair-type disfluencies as the task got harder, that is, they stopped a sentence they had begun and corrected it (Engelhardt et al., 2010). A study done in a laboratory with short sentences is not the same thing as a twenty-minute presentation on a stage. But it did me good to see that the feeling of "going back in the middle of a sentence and correcting" has a counterpart.

Knowing the subject and being able to tell it along a line are two separate skills.

Working memory is involved too. When I go into a side idea, the place that holds where the main plan stood is emptied. When I want to go back, the address to go back to has been erased. For me the sentence "just a moment, where was I" looks less like forgetfulness and more like a lost address.

Nerves are a separate layer

At the moment of presenting, the body comes into play as well. The heart speeds up, the voice changes, the mind works either faster than usual or emptier than usual.

A systematic review of forty-one studies that examined the relationship between ADHD and social anxiety reports that the two conditions are often seen together, and that when they are together the social difficulties and anxiety symptoms run a heavier course. Social anxiety was linked especially often with the inattentive presentation (Støre et al., 2024). It has to be added that the rates vary across a very wide range between studies; giving a single figure would be misleading.

What this finding means for me is this: as someone who grew up with the quiet, inattentive presentation, for years I carried the fear of "I am going to say something wrong." Part of the nerves in a presentation are the nerves of that moment, and part are the voice of an accumulated past. Separating the two helps me. I dealt with the general picture of anxiety in the article ADHD and anxiety.

Renaming instead of calming down

The advice I hear most before a presentation is "calm down." My body has never listened to that advice.

The work of Alison Wood Brooks suggests another route. In karaoke, public speaking and math tasks, some of the participants relabeled their anxiety as excitement; for example, they said "I am excited" out loud. Compared with those who tried to calm down, they felt more excited and performed better (Brooks, 2014). The explanation goes like this: anxiety and excitement are both states of high arousal. Turning high arousal into low arousal is hard; turning it into another feeling at the same height is easier.

These studies were not done with participants who have ADHD, and I cannot say that the effect will be the same size in everyone. Still, trying it is free. Saying "I am excited" to myself instead of "calm down" before I walk through the door at least reduces my fighting with my body.

A skeleton instead of memorizing

When preparing for a presentation, for years I swung between two extremes: either memorizing word for word, or saying "I know the subject" and not preparing at all. Both worked badly for me. Memorizing collapses entirely when a single word is missed. Not preparing opens an endless number of doors to side roads.

What I find worth trying is a skeleton:

Three stops. Reducing the presentation to three main points at most. Let each stop have a one-sentence core, and memorize only that sentence.

Making the slide title a sentence. Instead of "Data," "Most users leave at the second step." When I look at the slide after I get lost, what I need to say is written there.

A return sentence. At the end of each stop, a ready sentence that connects to the next one. When I veer onto a side road, this is the sentence I use to come back to the main road.

A box for side ideas. Writing the good but unnecessary examples that come up during preparation on a separate sheet of paper. Being able to say "that was in the box" when one comes to mind in the presentation reduces the urge to say it. It can also be useful in the Q&A part.

Rehearsing on your feet and out loud. Rehearsing in the head is misleading; the mind fills the gaps by itself. An out-loud rehearsal shows where you really get stuck. Measuring the time with a visible timer also catches, from the start, the five-minute section that takes fifteen because of time blindness.

Choose in advance the sentence you will say when you get lost. Use a single sentence like "Let me return to the main point from here" in the rehearsal too. When you really do get lost in the presentation, this sentence comes out of your mouth without your having to think, and it buys you a few seconds.

The day of the presentation

Most of the preparation is done in the earlier days, but the morning of the presentation has its own small traps too.

Not going into last-minute corrections. When I open the slides "one last time" an hour before the presentation, I always find something to change. The more I change, the more the skeleton from the rehearsal falls apart. The rule I set for myself is this: on the morning of the presentation, only read, do not correct.

Memorizing the opening sentence. The rest of the skeleton can stay flexible, but the first thirty seconds should be memorized. The moment when the nerves are highest is the start, and when the start and the first sentence are in place, the body slows down a little too.

Moving before going in. Walking in the corridor for a few minutes, climbing stairs, or just standing and loosening the shoulders. Part of the accumulated restlessness disperses before you reach the lectern.

Putting the time in a visible place. When I pick up the phone to look at the time, there is a chance I will slide into something else. A small clock placed on the table or a timer on the presentation screen is safer.

The sheet of paper in front of you. A single sheet on which I write, in capital letters, the one-sentence cores of the three stops and the return sentences. When I get lost I look not at the screen but at the sheet; the eye movement is shorter and the return is faster.

In online presentations a few more things are added. Turning off notifications, closing all the tabs other than the presentation, and putting the notes right next to the camera. When what is in front of me is not faces but small squares, reading the listeners' reaction becomes harder; so stopping at the end of each stop to ask "is there a question so far" both lets me take a breath and shows that the other side is still there.

When I notice in the middle of the presentation that I have really skipped something, I do not go back and tell it from the beginning. I say "I would like to add one point," say it in a short sentence, and return to where I was. Most of the listeners have not even noticed the skipped part.

The Q&A part

For me this is the riskiest part of the presentation. Before the question is finished I feel as if I already know the answer, and I want to take over the talk.

I have a small rule I have tried: repeating the question in my own sentences. "So what you are asking is..." This sentence both makes me really listen to the question and gives me a few seconds to build the answer. I described the general side of the tendency to talk too much in the article why people with ADHD talk so much.

When a question comes that I do not know, saying "Let me check that and get back to you" is also a complete answer. Stretching out an unprepared answer often opens a new side road.

Afterward

After the presentation ends, my mind replays it for hours. The sentence I missed, the moment my voice shook, the expression on someone's face.

Stopping this replay is not easy. What makes sense for me is to write three lines right after the presentation: one thing that went well, one thing I will change next time, and "done." The third line looks odd, but it tells the mind that the closing has been made.

Losing the thread in a presentation does not make me a bad speaker. It only reminds me that I need to keep the map of the road not in my head but in front of me.