ADHD Symptom Spotlight: Object Permanence

Object permanence refers to the ability to understand that objects still exist even when they are out of sight. Technically, that ability is not impaired in people with ADHD. What is impaired is the ability to remember things without some kind of sensory cue, like seeing it right in front of you or hearing a verbal reminder.

Essentially, it's 'out of sight, out of mind.' While the term object permanence is often used to describe this tendency in ADHD, it's important to remember that it's not actually what people are experiencing. They don't forget that things exist just because they can't see them. Object constancy might be a better term to describe this forgetfulness and the need for reminders.

What Object Permanence Issues Look Like in ADHD

Object permanence is a developmental milestone. It's the ability to understand that things exist, even when they can't be seen. It typically emerges around the ages of 6 to 9 months. People with ADHD don't actually have problems with object permanence. They know objects continue to exist, but they may not actively remember them without some reminder.

I’ll put a pot of water on the stove to boil for pasta. Then, I’ll leave the kitchen to do something else while I wait for it to boil. Almost immediately, I’ll completely forget that there’s a pot of water boiling on the stove—until I happen to walk into the kitchen a few hours later and find an empty pot sitting on a hot burner.

It’s not that I don’t understand that objects keep existing. It’s just that I need constant visual or audio cues to prevent myself from forgetting them.

The same forgetfulness happens with people, too. I’m really good at maintaining contact with people who live in the same house as me. But it takes an elaborate system of social “cues” and planning to make sure I keep in touch with people I don’t see every day—because my brain is simply too distracted by whatever present activity or environment it’s in to remember.

This puts a lot of strain on friendships because forgetting to visit and check in on people looks a lot like simply not valuing that person enough to remember them. Even I still wrestle with the worry that maybe I am just a cold and callous person—right up until I meet up with a friend in person and all the love and fun memories come flooding back at the sight of them.  

The Science Behind Object Permanence

The underlying process creating these object permanence problems in ADHD likely has more to do with poor working memory than with any lack of understanding that objects and people keep existing even when we can’t see them.

If you’re driving to the post office, for example, that memory of how to get there moves into your working memory along with a list of what you need to bring with you and the reason you’re going there.

Because of the attentional difficulties at the root of ADHD, though, the brain has a hard time filtering out irrelevant information and focusing only on relevant details. In your external environment, it doesn’t know which sensory input to focus on. When recalling information, it struggles to pick which specific long-term memories to pull out of storage.

When it comes to object permanence, a cluttered working memory makes it hard to recall specific objects or people from the depths of that clutter. It also means that the contents of your working memory are constantly being replaced with whatever input happens to be present at that moment.

It’s easy to remember the pot of boiling water when you’re staring at it, but not when you leave the room. Your attention is redirected toward the laundry on the couch you still haven’t folded, the snacks you left on the coffee table, or the latest posts on the Instagram feed you thought you’d scroll through while you waited for the water to boil.

Coping with Object Permanence Issues

For people with ADHD, using an elaborate system of sensory cues is really one of the most reliable ways to overcome object constancy issues.

Use Visual Cues Whenever Possible

In my experience, visual cues are the most effective. An alarm on my phone reminding me to take my medication can be dismissed before I’ve actually taken them. But today’s pill sitting out on my desk is a clear and constant reminder that I have not taken my meds yet.

Remind yourself of the date by picking out your outfit and hanging it on a door. Decorate your walls with photos of friends and family to act as reminders to reach out to people if you struggle to maintain relationships.

Create a Space Where Visual Cues Stand Out

As powerful as visual cues are, too many of them can create so much clutter that no single cue stands out as a reminder anymore. If your desk is always cluttered with papers, adding that bill you need to pay to the pile will cause it to just blend into the pack.

Likewise, an already messy space makes it difficult for your brain to pick out the cues you left for yourself. Make sure you’re clearing out older visual cues regularly and putting stuff you don’t need to remember right away out of sight.

When your ADHD symptoms make it too hard to actually clean, just toss stuff into the most appropriate bin. That way, the clutter is now at least contained to a few containers instead of all over your home. Meanwhile, if you need to find something, the labels will help you narrow down which bin you most likely put the thing in. Whenever you get a burst of motivation, you can take a container and put the things wherever they’re actually supposed to go.

Create Reminders and Alarms for Absolutely Everything

For things you can’t easily create visual cues for, use audio cues like alarms and reminders on your phone. Just make sure they have these three traits:

• Automatic. For things you need to do regularly, set up recurring reminders: a medication reminder that goes off at the same time each morning, a monthly reminder to pay rent, and a weekly reminder to call your mom.
• Clear labels. If your medication reminder isn’t labeled something like "take meds," there’s a good chance it’ll go off tomorrow morning, and you’ll have to strain to remember what that alarm was for.
• Realistic timing. Set the reminder to alert you at a time when you’ll likely be able to do that thing right away. A morning reminder to call your mom won’t help if you cannot make the call until after work. Instead, set it to go off when you usually get home from work.

Tie "Social Cues" to Established Routines

Unfortunately, it isn’t really practical to have everyone you care about live in the same house as you so that they’re always present as visual reminders to visit them.

While I’ve tried creating a social calendar, complete with automatic reminders, to get me in the habit of checking in regularly, I found that too many alarms diluted their impact the way too much clutter in your environment can drown out visual cues.

I'm still working on convincing my brain to make this an automatic habit, so I still forget to add the social piece about half the time. But that half of the time that I call or text someone during those activities has already helped me keep in touch with people on a much more regular basis than I used to.

Takeaways

Problems with object permanence (aka object constancy) can make life a lot more challenging for people with ADHD. It's why you immediately forget something once you start working on a different task. Medication may help you improve your ability to focus and remember, but you can also use many strategies to enhance your ability to remember. Visual and verbal cues are often the most helpful approach.