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Same Child, Same Behaviour, Different Lens

Attention Deficit Hyperactivity Disorder (ADHD); most people have heard of it. The portrayal in the media is usually of a naughty, loud, and defiant child. A child who is nothing more than a bully who can’t sit still, interrupts all the time, and is down-right aggravating to be around. Think: Bart Simpson!

ADHD used to be viewed as a behavioural disorder and it’s not hard to see why. We see the outward workings of the ADHD brain manifesting in “bad” behaviour, so we try to fix the behavioural problems, with little or no success. For example, we might see a child suspended for punching a peer in the playground, or losing their screen privileges because they haven’t cleaned their room in a month. However, these responses to such behaviours reflect an underlying flaw in our fundamental mindset.

In trying to fix the symptoms of ADHD without understanding and managing the underlying disorder, we are doing a major disservice to these children, not to mention our efforts being essentially futile. Imagine trying to treat the flu by blowing your nose. Of course, you’ll likely see some changes in how runny your nose is, but it will be short lived, and will not address the underlying cause of the runny nose; that is, the flu. Similarly, by trying to treat or fix the outward behaviours of ADHD, we are not actually addressing the reason for the behaviour: the underlying disorder.

Don’t get me wrong. The child with ADHD can be extremely “naughty,” “defiant,” “obnoxious” and push you beyond what you once thought your limits were. I have been there more times than I care to count. Times when I have literally left my screaming children at home with my husband, because I didn’t think I could do it anymore. Times when I wanted to run away and never return because it was all too hard and I couldn’t tolerate one more outburst about what a horrible mother I am because I asked my child to pick up a dirty sock.

However, I understand that these children aren’t trying to be naughty, and they are not behaving this way on purpose. They are not trying to push your buttons or be manipulative. They are not running in and interrupting you every two seconds, or jumping on lounges in a furniture shop while disapproving customers look on, as retribution. They aren’t pretending to ignore you, or walk away from a conversation while you’re mid-sentence, or forget to do their homework just to be defiant. They don’t want to get into trouble. They aren’t trying to make your mornings stressful. These are the symptoms of an underlying disorder, and I am passionate to have people understand this: These children are not trying to be naughty.

To move past the behavioural symptoms and really help children with ADHD, we need to understand why these kids are behaving like this. In other words, we need to understand what ADHD actually is. In its 5th edition, the DSM (Diagnostic and Statistical Manual of Mental Disorders, DSM-51) has reclassified ADHD as a neurodevelopmental disorder. It’s no longer classified as a Disruptive behavioural disorder. Because although we see disruptive behaviour. Those behaviours are due to a neurodevelopmental disorder.

ADHD has been extensively researched over the past few decades. What the science showing us is that ADHD is a neurodevelopmental disorder, primarily of genetic origin. There are differences in the structure, function, and connections in the brains of children with ADHD compared with their neurotypical counterparts. This means there are differences in the size, volume, blood flow, electrical impulses, and neurotransmitters (particularly dopamine and norepinephrine) between the brains of children with ADHD compared to children without ADHD.

If you’re interested in reading further about the intricacies of the ADHD brain, I would highly recommend reading the work of Dr Russell Barkley (Ph.D.). Dr Barkley is an internationally renowned expert in the field of ADHD research and advocacy. His book, Taking Charge of ADHD: The Complete, Authoritative Guide for Parents, outlines the brain differences in ADHD, as well as further extensive information on how to truly understand these children. This book is a reference that I constantly refer to, both as a mum and a speech pathologist, and I highly recommend it.

Research now indicates ADHD is a specific developmental disorder of executive function and self-control. These mental processes are involved with motivation, as well as allowing us to plan, focus our attention, remember instructions, prioritise important tasks, and set and achieve goals. Further, they allow us to ignore distractions, and control impulses and emotions that are not appropriate for the context or environment we find ourselves in. These mental processes also include working memory (holding and using information) and mental flexibility (sustaining and shifting attention when needed). For more information on executive functions, see additional resources below.

We’re all affected by shortfalls in these mental processes sometimes. Most of us have difficulties at some time or another controlling our behaviour to achieve goals (like sneaking a delicious piece of chocolate cake while trying to lose weight), sustaining our attention (think of old Aunty Mavis recounting her bus trip in agonising detail), and resisting distractions (or is it just me who watches Netflix instead of scrubbing the bathroom?). The difference is, however, for people with ADHD, these difficulties have a significant and persistent impact on a child’s life. It’s not that they won’t filter out distractions to pay attention to you; it’s that they can’t.

A child with ADHD might take an hour to get dressed in the morning, even though they’ve had to do it every school day for the past seven years. A child with ADHD might climb on the roof of the family car or home (yes, experience talking here!). A child with ADHD might completely dissemble a brand-new DVD player and leave the pieces all over the floor (experience here too!). If we think of these outward characteristics of ADHD through a ‘behaviour lens’ we will see a defiant child who is lazy, rude, and destructive. I can see why children with ADHD are viewed as delinquents in need of a good dose of punishment, when they’re purely being viewed through that lens.

But, let’s shift our focus. Let’s remove the “behaviour lens” and start looking through the “deficit of executive function lens”. Doing this allows us to bring so much more empathy and understanding to the table. It allows us to see a child who is “defiant” and “unwilling to follow instructions” as the child who is not able to sustain their attention long enough to listen to their classroom teacher’s instructions, hold that information their working memory, and then perform the action that was requested. We can now view the “rude” child who constantly interrupts conversations as the child who does not have the self-control to inhibit the piece of information they feel compelled to share with you, even though you might think it never needed to be said, let alone in the middle of another conversation you’re having. There are so many countless other examples.

Now, let’s get this straight: I am not of the belief that having ADHD excuses bad behaviour. ADHD is not a Get Out of Gaol Free card, and we should not just allow these children to run wild. These children still need discipline and training, and the research indicates that children with ADHD require more frequent and immediate consequences. However, simply telling these kids to “Just behave!” is never going to work. They need support and help to learn to inhibit their behaviours. We are not going to change the behaviour of an ADHD child by trying to shame them into behaving normally.

Did you know that most children with ADHD are very aware of what they can’t do? In general, people with ADHD feel such a sense of shame and disappoint in themselves from repeated failure to meet others’ expectations. They view themselves as different, naughty, and inherently flawed. It is estimated that children with ADHD receive 20,000 more negative messages by the age of 12 than children without ADHD. (William Dodson, M.D – link to ADDitude article below) Stop, pause, and reflect on that. These children are receiving negative messages about themselves multiple times every single day, and if they don’t have the skills to control their symptoms of ADHD, what they’re hearing is You’re too noisy, You are not good enough, There is something wrong with you, You can’t learn: You are a failure.

This week, I really want you to start viewing the child with ADHD differently. Take off those behavioural lenses, and let’s put on the lenses of truth. The lenses that show us that these children significantly struggle to regulate their executive function skills, and who are unable to use self-control in the same way that their neurotypical counterparts can, without a significant amount of love, support, patience and intervention. How does that make you feel about them now?

Please let me know how you go! I want to hear from you.  How are you viewing the children with ADHD, in your home, classroom, office, on the street, in the supermarket differently? Are you viewing them with more empathy? With more understanding? Share with me! I am passionate about helping our kids with ADHD flourish!  

Additional Resources and links

DSM-5 criteria for ADHD

Executive Function

Fact Sheet – ADHD

Executive Function & Self-Regulation in ADHD

ADDitude: ADHD and the Epidemic of Shame

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