If you are a parent or caregiver, then you don’t need us to tell you that raising a child is hard work. This already daunting task can become even more challenging if your child suffers from a disorder like attention deficit hyperactivity disorder, or ADHD.
Speaking broadly, ADHD is a disorder characterized by inattentiveness, hyperactivity, and impulsivity. Individuals who have ADHD might struggle to concentrate on tasks for extended periods of time or inhibit their own thoughts and actions. They might have trouble adhering to strict rules and schedules, and they could have a tendency to say or do things at socially inappropriate times.
Because ADHD usually develops during childhood, parents and caregivers often find themselves in charge of managing their child’s disorder. They might have special difficulty helping their child navigate the highly structured environment of the school classroom. On their worst days, they might find themselves frustrated, exhausted, and struggling to know how best to help their child with this challenging disorder.
Raising a child with ADHD isn’t easy, but fortunately, help is out there. Thanks to modern psychiatry, ADHD is very treatable, and many individuals with ADHD go on to live full, normal lives. They just might need a little help learning to manage and cope with their disorder.
To learn more about ADHD, we spoke with Dr. Tammie Dones, who is one of our three staff psychologists at Cummins. In today’s blog post, Dr. Dones explains the basics of ADHD and how individuals can overcome its challenges to lead happy lives.
What Is ADHD and Who Does It Affect?
ADHD is what’s known as a neurodevelopmental disorder. In less scientific terms, this means that ADHD is the result of abnormal development of the nervous system.
“When ADHD is studied in a lab setting, there are brain differences in the frontal lobe, which relates to what we call ‘executive function,’ “ Dr. Dones explains. “Executive function is kind of like our mental secretary or our mental organizer. Executive functions in the frontal lobe also help us inhibit responses. For example, if I thought right now, ‘I’m thirsty, I’d like to get a soda,’ my brain can tell me, ‘Don’t do that, you’re in the middle of an interview.’ But some people with ADHD don’t inhibit that well.”
ADHD can be broken into three distinct types with slightly different symptoms:
- Hyperactive Type: individuals have difficulty paying attention and controlling their behavior, and they tend to be highly active
- Inattentive Type: individuals have difficulty paying attention and frequently experience procrastination, hesitation, and forgetfulness
- Combined Type: individuals experience hyperactivity/impulsivity as well as inattentiveness
Dr. Dones provides some examples of what these symptoms might look like in action:
“The combined and hyperactive types are characterized by over-activity. This could be restlessness or fidgeting. One of the criteria is being ‘on the go’, or feeling as if driven by a motor. With the inattentive type, there’s difficulty sustaining attention and focus, difficulty harnessing attention and focus, and difficulty often with emotional regulation. And then the other cluster is impulsivity, which of course affects your attention span as well, because if you’re trying to do, say, a math worksheet, but another thought crosses your mind, your mind drifts away from the math worksheet.
Impulsivity has other social and life management aspects, too. There tends to be about a 25% to 30% delay in general maturity in somebody accurately diagnosed with combined type ADHD. This means reaching life milestones later. For example, an 18- or 19-year-old with ADHD is going to have a harder time managing their debit card, driving without impulsivity, and things like that.”
Approximately 5% of children are diagnosed with ADHD, making it a fairly common mental disorder. Males are about twice as likely to be diagnosed with ADHD as females. The typical age of onset is 4 years old, although the inattentive type is often harder to detect and might not be diagnosed until closer to age 9 or 10.
How Can ADHD be Treated or Managed?
If your child has been diagnosed with ADHD by a psychiatric professional, there are several different treatments they can receive to help manage their symptoms.
To begin, prescription medications tend to be highly effective at reducing symptoms of ADHD. The specific medications used to treat ADHD, known as stimulants, help to regulate impulsive behavior and improve attention span by increasing the levels of certain naturally-occurring chemicals in the brain. According to the Cleveland Clinic, these medications improve ADHD symptoms in 70% of adults and 70–80% of children.
Dr. Dones adds, “At Cummins, we have a strong psychiatry staff. They’re very experienced, and they stay on top of the research in terms of side effects and things like that. So medication treatment is fairly common.”
Whether or not medication is used in treatment, it’s also important for individuals to learn strategies for managing their ADHD symptoms. For example, Dr. Dones emphasizes the importance of using visual cues and “thinking out loud.” She says, “You want to do things that draw that mental organizer or mental secretary out into the open. This could involve visual prompts and cues or the adult thinking out loud to help the child.”
Dr. Dones gives an example of what this might look like from her own life experience: “When I was teaching my daughter to look both ways before she crossed the street, I’d say, ‘Now, we’re going to look both ways before we cross the street.’ I wonder how many times I said that? Probably 9,000 or 10,000 times. Because we want that deeply trained in their brain, right? So for someone with ADHD, that type of thinking aloud, with their parents verbally mediating things using prompts and cues, is really important.”
At Cummins, most people who enter treatment for ADHD can also benefit from our life skills services. These services are specially designed to help individuals learn and implement skills for managing their disorder in the real world—not just in therapy settings. “ADHD is kind of a point-in-time disorder,” Dr. Dones explains. “Oftentimes, the problem isn’t a lack of knowledge; it’s that we don’t perform the right behavior at the right point in time. It’s like, ‘Oh, I knew that, but I didn’t do it right now.’ The skills training matches well to what people need when their symptoms happen in the real moment. So that’s one thing that I’m proud that Cummins has.”
Many individuals who have ADHD continue using the self-mediating skills they learn in treatment throughout the rest of their lives. “Adults diagnosed with ADHD continue to use a lot of prompts, cues, and calendar reminders,” Dr. Dones says. “Post-it notes are a typical thing I’ve heard about from clients. They would say, ‘I knew I didn’t want to forget this appointment; look, here’s my post-it!’ People with ADHD, whether it’s inattentive or hyperactive, also tend to have a rough time with sense of time. So time either feels like it takes forever, or it passes without them noticing. So they might use timers like how some people do with social media now. They have those timers on their phones that say, ‘After 45 minutes, I have to get off this social media device.’ Those are the kinds of things that a person with ADHD might have to do just for normal tasks.”
The Role of Family Support in Recovery
As we mentioned in the previous section, parents, caregivers, and other family members play an important role for children diagnosed with ADHD. The younger the child, the more likely it is that they’ll need help learning how to manage the symptoms of their disorder. Family members can be instrumental in modeling and guiding new coping behaviors.
However, the experience can be challenging for everyone involved. “I think it’s important to meet the situation with as much grace, compassion and nurturance as you can, because ADHD is a chronic problem,” Dr. Dones says. “It can wear parents down. It can frustrate parents. Some of the things that are inherent to the disorder make it hard for children or teenagers to profit from experience. So you’re like, ‘I told you that yesterday.’ But it’s kind of lost on them. So you need to be patient, consider each day its own day, and reteach the best you can.”
Children who have ADHD may face frequent punishments and sanctions for their behavior outside of the home environment. It’s important that caregivers deliver praise for good qualities and productive behaviors whenever possible. “These kids are going to hear, ‘You messed up. Did you forget? What are you doing? Stop it!’ They’re going to get yelled at. So somebody has to counteract that self-esteem damage,” Dr. Dones says.
Having a young child with ADHD can be emotionally challenging for parents and caregivers. On top of the difficulties in managing their behavior, parents might also worry about their child’s future. They might wonder if their symptoms will ever improve or if they will ever be able to fit harmoniously into society. The good news is that many people live full and successful lives despite an ADHD diagnosis. For example, actress Emma Watson, gymnast Simone Biles, and musician Justin Timberlake are just a few people who have had great success in their lives despite living with ADHD.
Dr. Dones says, “When we say ADHD is chronic or lifelong, that can be discouraging. But people do improve. There are developmental lags, but a developmental lag eventually catches up. It’s an additional challenge for that person to meet each day, and a responsibility to manage things that come naturally to the next person, but many people do manage successfully.”