Common challenges
Anxiety
Whilst anxiety is very common in young people and adults with ADHD and is often treated ahead of the underlying disorder, it can also be evident in the early years and at a point where children find it difficult to express how they are feeling.
This can result in very challenging and oppositional behaviour (for example, in not wanting to go to school or on family outings).
The causes of anxiety are varied and complex, but can relate to sensory sensitivities (e.g. the fear of loud noises, smells, busy places), worries about social failure, a feeling of not belonging, academic insecurity, and a pervading sense of failure at home and at school.
This is why it is important to boost self-esteem and to put in place scaffolding’ to support, rather than punish, young people through their formative years.
Relationships
Ask most children with ADHD what they really want to change and their answers will involve improved friendships.
They will tend to blame themselves for social failure and have shown by research to have a weak understanding of how they present to others.
Some can appear over-confident because they believe others value them for their friendship rather then just being entertained by their ‘acting-out’ behaviours, but this ‘positive illusory bias’ tends to diminish in the teenage years with a consequent loss of social identity.
Parents and teachers can help. Promoting friendship through organised activities and clubs or teams can mitigate the impact of ADHD on development throughout the life span.
Anger and Frustration
Anger and frustration are natural responses that are common in all young people, but tend to be more severe in those with ADHD.
The first thing to do as a parent is to identify, if possible, what the triggers are by looking for patterns (time of day, place, context) so that these can be avoided or at least reduced or managed better.
Children do not want to be angry. When a child has a ‘melt-down’ they are already being ‘punished’, so don’t double that pain by inflicting yet more hardship on them.
Talk them through how they felt and how better to channel their feelings. Learn the difference between ‘tantrums’ and ‘melt-downs’ and understand how to respond when they occur.
As well as the linked video, have a look at the SPD guidance (link) for how to manage tantrums and meltdowns.
Low mood and depression
A continual diet of social failure and academic under-achievement can, in many circumstances, lead to serious consequences. A withdrawal from situations in which those ‘failures’ are likely to recur, and a loss of self-esteem and belief.
Chase the positives as a class teacher or a parent. Makes sure that success is first identified (many positives are ‘invisible’; if a child is attending to a task, or prevents an impulsive response, it will tend not to be seen) and then reinforce it.
Be extremely careful about criticising the child themselves. Separate their behaviour from who they are and ensure that they feel loved and valued, even if their behaviour is causing difficulties.
We tend to function and develop best in nurturing rather than hostile environments, so don’t let ADHD become a barrier to family warmth and affection.
Lack of internal structure
Children with ADHD tend to have poor executive functions and struggle to cope with the organisational demands we place upon them. This is particularly true as they transition from primary to secondary school.
The developmental delays associated with ADHD mean that we should make demands that are ‘stage’ rather than ‘age’ appropriate, and to put in place the ‘scaffolding’ that will allow a child to perform to the best of their ability.
ADHD causes huge difficulties with short-term memory, so use lists, routines and prompts to reduce organisational failures, and apprecite that the ‘internal clock’ that many of us take for granted may not function well in children with the disorder.
Set boundaries where possible and have clear expectations, but do not over-punish organisational failure because this can have a very corrosive impact on development in general.
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