ADHD is perhaps one of the most misunderstood diagnoses we have. It is a developmental disorder that involves a different way of using the brain, and which gives rise to many strengths and many challenges. In this post, you will read about five main challenges in the ADHD brain, and how we as parents, professionals and teachers can understand - and help - children and young people with ADHD.

 


Image: Dreamstime (with licence)

This is some of what comes out in an excellent blog post from The ADHD Supervisor, by Cecilie Jahreie, which we reproduce here with permission from the author.

Are you one of those people who frustrated sugar "Why can he not just?". "Then it can not be so difficult to just pick up that sweater?" and "why can't he just do what I ask him to do?". "He never hears!" Do you really understand the ADHD brain of your son or daughter?

Instead of frustratingly asking yourself why he can not, I would challenge you to be wondering and curious why he does not listen to you. 

Why is Johan running out of the gymnasium crying? Why doesn't Noah stop talking in class when the teacher asks him to, and even get angry? Why did your reward system suddenly stop working on Jenny when it has worked so well before and works for the sister? Why can't Cathrine just do those homework instead of spending half an hour trying to drop it?

Is it really just because they want to be difficult, or is it more complex than that?

If you ask with that in mind, you will gather information and understand the neurological explanation of why they can not just just. 

 

The nervous system with its own set of rules

ADHD is perhaps one of the most misunderstood diagnoses. I think this is both due to the fact that it is an invisible disability and that one focuses almost exclusively on the behavior. I have heard more mothers than me who have sometimes been ashamed to wish that the child had been in a wheelchair instead. It is visible.

"Do I have anger problems mom?" The question came from my daughter. "No, you do not have that!" I answer (and I feel the soreness of the little girl come creeping). "Then I do not have ADHD, because everyone with ADHD has anger problems". I feel irritated and angry again. This is what she hears from other children and teachers. Those who have ADHD have behavioral and anger problems. 

ADHD is a confusing, contradictory, inconsistent and frustrating condition. Sometimes the child acts completely adequately, but suddenly he has a behavior that you do not understand anything of. No wonder people turn around and stumble upon the not entirely age-appropriate behavior or wonder a little about the mother who looks somewhat insecure and desperate where she stands.

Most children with ADHD know that they are different. Although they may not want to admit it, they know, and feel it, deep down. They sense, and hear from everyone around that they do not quite fit. They have been told that they must "sharpen up" and behave like everyone else.

The main challenge in understanding ADHD has been, and is, a perception that they can and should be like the rest of us. The question of why they do as they do are rarely asked.

  

A different nervous system

The short answer is that ADHD is a neurological developmental disorder. This does not mean that it is an injury to the brain, instead it is a different nervous system. 

My starting point is that it is a nervous system that works well with its own set of rules. This means that it is up to us outsiders to put on the ADHD glasses. Something we rarely do. 

As you read this article, I would like to invite you to put on the glasses of the person in your life who has ADHD, whether it is your child, your grandchild, your student or someone you are dealing with. ADHD is not a "one-size fits-all" diagnosis. It is a complicated, sometimes very complicated. 

The key to understanding the ADHD brain is to understand and accept that not all ADHD degenerates in the same way. ADHD is expressed in different ways for each individual, which makes it difficult to both diagnose and accept!

 

5 main challenges for the ADHD brain

The difficulties appear in five main areas. As you will see, these challenges overlap. Most children have challenges in several, if not all areas, but they can be expressed in different ways. There can also be large variations in one and the same child from day to day.

 

1. ATTENTION

It is a common belief that people with ADHD do not have the opportunity to hold their attention. This is not entirely true.

It is not attention deficit disorder that is the challenge neurologically, but the ability to regulate or manage attention. 

The challenges are related to knowing what is important to focus on, being able to focus on what is important in the relevant time period, being able to shift attention from one thing to another, and being able to stop focusing on something when the situation requires it. 

The brain of someone with ADHD has many things going on at the same time, apparently for no reason at all. For the person themselves, it can feel like five people are talking to them at once. Nothing gets sustained, undivided attention. Nothing is done well. It is therefore difficult to follow the teacher, because it is just as interesting to follow the rain out there, and the student next door who fiddles with the pencil. 

 

2. HYPERACTIVE AND HYPERFOCUSED

Hyperactivity is perhaps what we primarily associate with ADHD.

The world is experienced more intensely for these children. It is the children who want to take part in everything that is interesting and challenging. It is the children who are seldom concentrated; it is the children who have the brain that is always in high gear - constantly busy with inner chores. When we think of a child with ADHD, we often imagine the boy hanging in the curtain, standing at the desk in the classroom screaming, which only gets worse when the teacher asks him to keep quiet. 

However, what is less known, (and perhaps less accepted?), Is the inner hyperactivity. It is all the thousand thoughts that swirl around in your head at once, without being able to filter out what is not important.

The inner hyperactivity manifests itself, among other things, in the difficulties of getting involved in the moment, listening to other people or being able to read a book or watch a TV program. This is also a reason why many people with ADHD have major sleep problems. They are constantly disturbed by sensory impressions that are unconscious to us. It can be difficult to relax enough to fall asleep, and the slightest noise in the house can be so annoying and prevent you from falling asleep.

 

THE HYPERFOCUSED ADHD BRAIN

However, people with ADHD are not only hyperactive, they are also the opposite; hyperfocused.

Any person with ADHD can enter the hyperfocused zone at least four to five times each day. When they are in the zone, it seems as if they have no disabilities, and the executive disabilities that were so obvious just before they became so hyperfocused are blown away.

When they are in the zone, they have no problem completing a task within a time limit or producing a lot of work in a short time. There are two things that can make those hyperfocused:

 

  1. They capture interest and are motivated. 
  2. They are challenged or see it as competition

These were two great tricks for the teacher who is struggling with his ADHD students! Try to angle the task to a topic that they are interested in or use your imagination and create a glossary competition. Maybe out? Then the students get to jump off too! 

A new assignment can get a lot of attention from the ADHD student. However, the interest in the news is short. Children with ADHD can therefore often handle crises easily, because it is exciting! The problem, however, is that everything falls apart when it becomes routine. Living a life from crisis to crisis is also a rather tiring way of living. 

The fact that ADHD symptoms and disabilities can come and go throughout the day is probably the main problem for the outside world, and perhaps also for the person himself. It makes it difficult to relate to the person and can also make ADHD something mysterious and frustrating.

 

3. IMPULSIVITY

Impulsive children are often seen as rude and disrespectful, and perhaps even aggressive. In reality, these children face much greater challenges than just trying to be decent. The way their brains are screwed together makes it difficult, or impossible, for them to control themselves at the moment. For neurotypical people, the world is linear, with a past, present and future. People with ADHD fail to distinguish this. 

"Acting without thinking" is the definition of impulsivity, and is the reason why people with ADHD have difficulty learning from experience.

They are in a way locked into the present without the opportunity to think ahead. In other words, they have a challenge in dealing with time. Either it's going to happen right now or it's not happening at all. Without an understanding of time, they live in the here and now and have difficulty learning from the past and understanding the consequences of their actions. 

Without taking into account future events and consequences and without the ability to learn from past mistakes, they miss out on social codes, it leads to constant interruptions, and of course they get into fights and quarrels more often. 

 

4. ORGANIZATION

Impulsivity also makes it demanding for children with ADHD to organize, plan and do a task step by step. Organization requires conscious self-management and some planning. This is not easy for children who are easily distracted, hyperactive and who lack impulse control! 

This also has consequences for tasks to be done. For neurotypical people, every task has an introduction, a main part and an end.

In the same way that the child with ADHD is unable to distinguish between past and present, the different steps in a task slide into each other. This becomes clear in school assignments. They do not know where and how to start the task, since they can not find the beginning. They may jump right into the main part of the task and work in all directions at once.

Organization becomes an impossible task because it requires a system of linearity, importance and time aspect. 

 

"I THOUGHT WE HAD STOPPED WITH SOAP LONG AGO?"

When you do not know how to plan, prioritize or sequence what to do, it is difficult to handle things and take responsibility. This affects all areas of life. In some children and young people with ADHD, it can be expressed in that they have difficulty following up on basic hygiene and eating and drinking.

The hygiene challenges are easily surprising because they can seem so uplifting otherwise. An example is a teenage girl with ADHD. The family had established good, regular shower routines, so it was something that the mother needed to follow up little. One day, however, the mother became unsure if the girl had used soap when she showered, and randomly asked: "did you remember to use soap when you showered now?". Of which the girl looked overwhelmingly at her mother and said "I thought we had stopped doing that a long time ago?" When we talked about this, the mother came to the conclusion that when the shower routine was incorporated, they had focused on every step that was to be done in the activity "to shower". Once this had been incorporated, however, only the mother gave the message "go to the shower" or "take care of yourself." Using soap was a natural part of showering for the mother, but not for the daughter.

 

5. EMOTIONS

The connection between ADHD and emotional intensity is a fairly new development in the understanding of ADHD.

Today we know that dealing with emotions is a critical part of our executive functions, a function that is developmentally delayed in children with ADHD. 

Dealing with mood swings is necessary to deal with life's disappointments with some degree of decency, and these hares have greater difficulty than others in dealing with disappointments. And in addition, they experience disappointments to a greater extent than other children. With all their impulsivity, inattention, hyperactivity and disorganization, they are also reprimanded much more often than other children. Over time, this will have a major impact on their self-esteem and relationship with other people.

 

Executive features such as the umbrella

We have been through five main challenges for people with ADHD, which fall under an umbrella of difficulties in the executive functions.

Executive functions represent all the cognitive skills we use to manage our lives, plan and regulate ourselves.

We all receive around two million pieces of information all the time. However, we have a brain that does a fantastic sorting job for us. Unknowingly, the brain filters out most of these impressions, and we are consciously left with only seven pieces of information. However, people with ADHD do not have this filter. 

Without the ability to sort information, ADHD becomes the brain in a way like a large, disorganized library. A library with lots of information, many parts with information, but no whole. The information exists in many forms, such as articles, video, audio, internet, but there is no index card, no structure. 

Everyone with ADHD has their own way of storing this huge amount of information. The challenge, however, is that when they are unable to sort the information, they are unable to distinguish important from unimportant. The brain is then full of trifles (for us!), So there is little room for what we consider important.

 

How can we expect...

We have been through a good, neurological explanation of why our children "can not just ..." An even better question than why the children can not, is how we as adults can expect what we do from children we know have neurological challenges?

 

  1. How can we expect Cathrine to be able to keep up with the other girls when her brain has not been able to shift focus quickly enough so that she can see where they are going?

  2. How can we expect Jenny to write the Norwegian style when she does not know how and where to start and does not have a linear view that a story requires?

  3. How can we expect Noah to be able to be out the door to go to school, when he does not have a relationship with time (despite the fact that he is 13 and "should" have it)?

  4. How can we get angry at Johan who consistently interrupts, destroys toys and teases his sister, when his brain makes it impossible for him to control himself at the moment?

 

Which user manual do you use?

Have you ever felt that you have tried "everything" and "nothing" works?

Many of the tools and techniques that we are encouraged to use are intended for neurotypical children, and will not work for children who have a completely different set of challenges.

Then no one would say to a lame person "The reason you can not go up that stairs is because you do not sharpen and try enough ?!"

It is a neurological developmental disorder that is the reason why:

 

  1. Regular child rearing does not work on children with ADHD

  2. Many children do not fit into the traditional school system which is based on what someone else thinks and thinks is important and relevant

  3. People with ADHD do not thrive in regular workplaces where the people's job is based on what others (read the boss) think is important

  4. People with ADHD are disorganized. Every organizational system is built on two things: prioritization and time management, two things that people with ADHD do NOT handle. ADHDers have struggles to choose between alternatives, because everything is equally important.

The parents and teachers of Johan, Noa, Jenny and Cathrine use a neurotypical user manual in their handling of the children. It is just fine for other children, but not for those four with ADHD. 

Until we adults around children with ADHD, whether we are parents, grandparents, teachers or the football coach, begin to see and understand their behavior based on an understanding of how their brain works and based on their conditions, the oppositional behavior will increase, and can in the worst case result in a depression or anxiety. 

 

Conclusion

It is not surprising that ADHD is an often misunderstood diagnosis. It is a complex condition, and it differs from person to person. One of the things that makes it most difficult for outsiders to understand is that in one moment they work very well to suddenly work poorly. Apparently for no reason.

The main cause is a neurobiological developmental disorder in the executive functions, which makes them have difficulty with attention, hyperactivity, concentration, impulsivity and emotions.

The answer to the introductory question; "Why can't they just get along?" is simple. They have no prerequisite. There and then the neurological connections make it impossible. Had the child been able to, he would have wanted to get along.

The implications of this are extensive. First, it means that professionals, teachers and parents must stop trying to make people with ADHD neurotypical. The goal should be to intervene as early as possible, before the child has become so frustrated by struggling and trying to deal with a world they do not fit, and will never fit into. 

Medication will make a child with ADHD calmer and more concentrated. However, a child can take the right medicine and the right dose, but nothing will change if we expect him to approach the tasks with neurotypical strategies.

- From the blog to ADHD counselors

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Written by

ove heradstveit

Ove Heradstveit

Psychologist, specialist in clinical community psychology. PhD.
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