Need to know: What is ADHD and how does it affect your child
ADHD is a neurodevelopmental condition categorised by impairments to the brain’s executive system. It is not due to bad parenting and it is not because children are being purposefully naughty or lazy.
The symptoms your child displays are thought to be due to deficiencies in neurotransmitters including norepinephrine (noradrenaline) and dopamine. Both are responsible for focus, attention, sustaining effort, they help regulate movement, learning, emotional responses, as well as controlling the reward system and motivation.
Why it’s important
Demystifying ADHD helps to remove any associated stigma. Dr Russell Barkley, a clinical psychologist and clinical professor of psychiatry from the US, has paved the way in understanding the role of the executive system and how ADHD impairs its functions.
The executive system assists us in anticipating the future, as well as using hindsight and foresight to identify consequences of future actions and adjust our behaviour accordingly. Children with ADHD have an impaired executive system, meaning they might have difficulties with these skills and struggle to modify their behaviour in certain settings.
Executive functions manage the following processes so that we can reach our goals and improve our future welfare. *ADHD can delay these by 25% to 40%. The following list outlines the main functions in our executive system and how these influence our behaviour:
1. Self-awareness. Stop and assess what I’m doing. Look in the “mind’s mirror” and be conscious of how my body is moving or what my mouth is saying – I can monitor myself
2. Inhibition. I’m able to monitor what I am doing and I can use self restraint to stop doing something that is not going to contribute to a positive outcome. I can use self restraint rather than act on impulse
3. Non-verbal working memory. I’m able to visualise something that has happened in the past to guide my present actions so that I can change the outcome. I can use hindsight to inform foresight.
4. Verbal working memory. I talk to myself about the memories I am watching in my mind. Children do this out loud around the ages 3-5, but around the ages of 8-10 that voice becomes internal and private. I can evaluate consequences.
5. Emotional regulation. I can manage my emotions internally. As we grow older we develop the ability to moderate strong emotions so they are acceptable to the outward environment and are in line with the goals we are trying to achieve. I can control my emotions.
6. Self-motivation. I find ways to push myself in order to achieve a goal. A future reward linked to a positive emotion can be the automatic driver for motivation. A future harm has the power to suppress an action because we have thought about the consequences. I am motivated by future rewards, not just immediate consequences.
7. Mental play. I can manipulate objects or ideas in my mind and I can consider their impact simply by playing with relevant information. In young children this is done in play using physical objects, but in time this play can be transferred to the mind. Planning and problem solving require the ability to manipulate objects or ideas in our mind. I can visualise and rearrange the environment in my mind to plan ahead.
Tips and strategies
ADHD is a lifelong condition that is best managed using a multimodal approach. Depending on your child’s challenges, they might benefit from a combination of some or all of the below.
Occupational therapy focuses on developing skills a child needs to function independently in daily life. Occupational therapists can help children with everything from fine motor skills such as handwriting to improving their executive function.
A psychologist is a mental health professional who can help your child with strategies for recognising and managing emotions and improving social connections. Depending on your child’s age, sessions are used to train and equip parents with strategies that they can use every day to help their child thrive.
Speech and language development can be delayed in some children with ADHD. A speech pathologist can help your child learn to communicate more effectively in social situations. They might also help your child develop better planning, organisation, and study skills. In some cases they can work with your child’s teacher to help your child thrive at school.
As a parent, you are the most influential person in your child’s life. Learning about ADHD empowers you with the knowledge to make the right accommodations for your child. Raising a child with ADHD requires patience, empathy and the use of a range of positive parenting and effective disciplinary strategies.
In order to treat ADHD, paediatricians and psychiatrists often prescribe medication to change the production or absorbance or neurotransmitters in the brain. Stimulant medications have proven to be the most effective treatment, but not everyone does well on these medications and instead your paediatrician may suggest a non-stimulant option. It can take a while to find the right balance of medication, because all brains and bodies are different, but when the brain has the right levels of neurotransmitters to function well, symptoms such as hyperactivity, inattentiveness and impulsivity will be significantly reduced.