June 7, 2021

ADHD uncovered- a short overview & guide

Written by Hedie Lahijani, psychologist at hedielahijani.dk

A learned behavior

Attention Deficit Hyperactive Disorder is a relatively common developmental impairment that effects 4-12% of children. The impairment is seen in the self-managing system of our brains, also called the executive function, which is directed by the prefrontal cortex. The executive function of our brains allows us to plan, handle several tasks, prioritize, pay attention, remember instructions, and resist impulses. Some children somewhat grow out of the impairment as their brains mature, while others deal with the impairment throughout adulthood. The disorder can develop from a combination of genetic factors and environmental factors, such as certain stressful experiences in childhood.

Many parents to children with ADHD symptoms experienced same challenges in their own childhood and may lack executive function skills as adults, which becomes more evident when under stress. We may not have learned how to plan well, juggle tasks, prioritize, pay attention, remember instructions, and control impulses while growing up (age 1-5 years) or we may have learned it later in life, making it more difficult for us to be a good role model to our kids when we are under pressure. If stress causes a parent to frequently interact with their children without being present in the moment, lack the ability to prioritize contents of thought, lack ability to manage multiple tasks, and act out impulsively in anger, unintentionally responding to their children with hostility, it can be damaging to the children’s development of self-managing skills.

The intensity of parenting stress increases if or when the child develops symptoms related to ADHD, creating a viscous cycle. It tends to put a strain on families and have a negative influence on the quality of the relationships within families as well. The environmental factors or process in which a child develops ADHD symptoms can affect the expression of genes, alter brain chemicals, and change the brain itself, which in turn helps to sustain the impairment. An important point to take away from this article is that children are not born with self-managing skills, they must learn it, and the earlier the better. As parents, we feel overwhelmed with guilt and shame for not always being able to act maturely in front of and with our kids. It is common for parents to feel alone with the given challenges and thus it can be relieving to be reminded of the fact that problems related ADHD are common. More importantly, there are things we can do to improve, and I will get to it later in the article.

ADHD symptoms

Everyone can experience challenges with executive functioning skills, especially in the absence of adequate sleep. If the impairment in executive functioning is significant, long-lasting, present at school and at home, and not due to poor sleep, other medical or psychological conditions, or to giftedness it may be ADHD. Though, ADHD often co-occurs with other psychological disorders as well. Not all people show clear signs in childhood. Please consult a professional in the field for more adequate guidance. Nonetheless, here are some signs that can be related to ADHD in children that you can keep in mind as a parent or caretaker.

· Inattention:

o Short attention span for age (difficulty sustaining attention)

o Difficulty listening to others

o Difficulty attending to details

o Easily distracted

o Forgetfulness

o Poor organizational skills for age

o Poor study skills for age

· Impulsivity:

o Often interrupts others

o Has difficulty waiting for his or her turn in school and/or social games

o Tends to blurt out answers instead of waiting to be called upon

o Takes frequent risks, and often without thinking before acting

· Hyperactivity:

o Seems to be in constant motion; runs or climbs, at times with no apparent goal except motion

o Has difficulty remaining in his/her seat even when it is expected

o Fidgets with hands or squirms when in his or her seat; fidgeting excessively

o Talks excessively

o Has difficulty engaging in quiet activities

o Loses or forgets things repeatedly and often

o Inability to stay on task; shifts from one task to another without bringing any to completion

(Attention-Deficit/Hyperactive Disorder ADHD in Children)

Poor sleep can disrupt all children’s executive functioning skills, whether they have ADHD or not but children with ADHD tend to have poor sleep. In other words, ADHD can cause problems with sleep regulation and awakening by making it difficult for kids with ADHD to sleep at an adequate time or to wake up and be alert enough throughout the day. Alertness can diminish with lack of opportunity to talk or walk.

Treatment for ADHD symptoms

The knowledge we have about a child's development of ADHD should not stigmatize parents. It should create solutions. ADHD symptoms in children and adults is not localized to parents or a small group of individuals but it is rather a collective and societal problem. Therefore, the solutions should also be at collective and societal level as well. Children can learn self-management skills from parents at home, from teachers in daycare or at school, and in other daily settings. Whether you are a parent or teacher who experiences the mentioned challenges above, I urge you to consult a professional to gain guidance and support in your parent or teacher role, if not simply to gain information about the options available to you in your home country. There are support groups, and parent and teacher training series out there that I would ask about or investigate. To reduce severity of ADHD symptoms, to enhance normal development, and to improve quality of life for children and adults with ADHD, early detection and intervention is beneficial.

Attention-Deficit/Hyperactive Disorder (ADHD) in Children. John Hopkins Medicine.

<https://www.hopkinsmedicine.org/health/conditions-and-diseases/adhdadd>

Executive Function and Self-Regulation. Center on the developing child. Harvard University.

<https://developingchild.harvard.edu/science/key-concepts/executive-function/>

Harold, Gordon T. et al. (2013) Biological and rearing mother influences on child ADHD-symptoms: revisiting the developmental interface between nature and nurture

Wermter, Anne-Kathrin et al. (2010) From nature versus nurture, via nature and nurture, to gene x environment interaction in mental disorders. European child & adolescent psychiatry. 19, 199-210.

Wiener, Craig. (2007) A.D.H.D. as a Learned Behavioral Pattern: A Less Medicinal More Self-Reliant/Collaborative Intervention.

Hedie Lahijani at hedielahijani.dk