ADHD can be an often misunderstood label. According to the Centers for Disease Control and Prevention, there were 6 million children diagnosed with ADHD from 2016-19.1 Despite how common ADHD diagnoses are in the United States, many parents, educators, and even the children diagnosed don’t truly understand the breadth or depth of what it means for a child to live with ADHD or how to support them.
What is ADHD?
Attention-deficit hyperactivity disorder (ADHD) is classified as one of the most common childhood neurodevelopmental disorders. It can begin in childhood and last into adulthood. Many know this.
What they don’t know is that while the name includes the words “hyperactivity” and “attention deficit,” those are not the only ways that ADHD can present itself in children. In fact, ADHD presents in many ways and children who live with it can have a variety of struggles as well as exceptional aptitudes. Symptoms can also present differently in boys than they do for girls.
Safa Sherza, a mother of two, first learned that her children had ADHD when they were four and seven years old.
“Sometimes the acronym ADHD is inaccurate, because not everyone displays hyperactivity, especially girls,” said Sherza.
Because of the different ways that ADHD can present, some parents may not realize their child even has ADHD until they are much older. Naglaa Rizk, MD, Gynecologist, and CEO of Crescent Care Women’s Health, has three children with ADHD, two girls and a boy. However, she did not learn that her oldest daughter had ADHD until she was in college because of how different the symptoms can present between the sexes.
“Girls learn to mask and mimic while they are young so that they are able to manage [their ADHD symptoms] for longer,” said Rizk.
How can ADHD present?
According to the American Psychiatric Association, ADHD tends to present in one of three ways:
- predominantly inattentive
- predominantly hyperactive/ impulsive
- a combination of the above
While this may sound simple and clear-cut, specific symptoms can manifest in hugely different ways and can involve anything from difficulties sitting still/being fidgety, struggles with cleanliness and organization, frequent forgetfulness, difficulty maintaining focus or sustained mental effort, blurting out, frequent bouts of interrupting others, engaging in aggressive or risky play, disregarding rules and authority, lack of attention to detail, and even the inability to prioritize or break down larger tasks.
At first glance, many of these symptoms sound like run-of-the-mill childhood behavior. But for the ADHD child, what makes the difference is that symptoms tend to be pervasive, lasting throughout childhood, can worsen over time, and they impact the child in multiple areas including learning, home life, social-emotional regulation, and personal relationships.
The ADHD Brain
According to the Child Mind Institute, an independent nonprofit that provides evidence-based care and education on children’s mental health, many of the symptoms of ADHD fall under the broader umbrella of executive functioning:
“a set of mental skills that include working memory, emotional control, and complex problem-solving. Essentially, executive functions are the skills we all use to manage day-to-day tasks, such as time management, staying organized, and planning. While there are several different parts of the brain that contribute to executive functioning, the prefrontal cortex is especially important in regulating these skills. Research has shown that in children with ADHD, the prefrontal cortex matures more slowly than typically developing kids. It is also slightly smaller in size.”
Brain imaging in ADHD children has also revealed:
- irregular activity in areas of the brain at involve motor control, cognitive and emotional regulation
- higher than typical amounts of brain activity while trying to focus on a task, leading to struggles with focus
- higher than typical levels of functional brain connectivity, causing them to take notice/ get distracted by things that many others might not
- disrupted dopamine pathways which can impact internal motivation and rewards
Not understanding the legitimate brain differences in children with ADHD can lead people to make negative assumptions and wrongly associate ADHD behaviors with problems in parenting, character development, or even intelligence.
“People often think ADHD children are lazy because they are smart but don’t seem to live up to their potential which can be disheartening to hear,” says Sherza.
In trying to dispel common myths about ADHD, Child Mind Institute says that the attention deficit part of ADHD is not really that attention is not present or cannot ever be sustained, but that attention is usually sustained only on the things that interest the child and make them feel rewarded.
In her experience, Sherza says it’s this “hyper-focus on topics of their own interest which causes them to not pay attention to other things around them.”
Child Mind also teaches that when children present with inattentive ADHD, it can lead others to believe that ADHD is not present at all when in fact, the inattentive presentation often comes with lots of challenges in forgetfulness, organizational skills, or sustained mental effort.
In Rizk’s family, some of the biggest struggles for her children include frequently starting tasks or projects but not finishing them, trying to manage many different ideas at the same time, setting grandiose goals and then feeling incompetent when they cannot see them through, and “time blindness,” the feeling of either never having enough time or overestimating how much time they actually have.
“When they cannot get anything done, especially on time, it results in a perpetual feeling of incompetence or failure,” shares Rizk.
Strategies That Help ADHD Learners
Since ADHD is a chronic condition, living with it comes down to finding systems and strategies that help children effectively manage their symptoms. With regard to learning, strategies are often needed to aid in motivation and productivity so the child can work toward their goals.
According to the American Academy of Pediatrics, treatment for ADHD usually involves a combination of parental training, behavior therapy, medication, and classroom interventions. Since presentations and symptoms can vary from child to child, so will strategies, but Child Mind recommends a general combination of modeling behavior and providing positive reinforcement.
In Rizk’s experience, one of the best strategies for ADHD learners is finding alternative ways for them to learn. Her recommendations include:
- learning on the playground or while the child is physically active
- frequently changing routines and systems to make subjects more exciting
- including child-led initiatives throughout all learning processes
- being comfortable as a parent to allow your child to lead and be flexible as long as they are safe
- providing alternative learning manipulatives for every subject (embrace the dollar store)
Sherza recommends strategies that involve using checkpoints and visible reminders such as:
- having a checklist that includes tangible steps instead of general instructions like “clean your room”
- alarms and reminders, making use of technology to remind them of appointments, online classes, taking meds etc.
- visual timers, one that clearly shows the passage of time helps to keep them focused and finish their work faster
- having designated spots for everything – don’t assume they will be able to keep a space tidy unless there are specific places to keep items.
Supporting Your ADHD Child However They Learn
While professionals still have a long way to go to fully understand ADHD, there are many ways that parents can help support their ADHD learner, whether they’re attending school or involved with homeschool classes or cooperatives.
“Advocate for them,” advises Sherza. “Especially if they need aides or extra time for tests or assignments. Reduce the steps required for them to be successful. For example, submitting an assignment online instead of via papers that need to be taken home, completed, then handed back to the teacher… If you have not experienced ADHD yourself, learn about it, and try to distinguish bad behavior which is deliberate from that which is out of their control.”
“Constantly showing them their successes (big and small) fuels them to expand their horizons,” suggests Rizk. “Promoting their creativity and stream of consciousness in any subject allows them to produce things beyond our imagination. Reminding them not to compare themselves to anyone (and not comparing them to anyone) encourages them to accept themselves as differently-minded, not faulty… Allah blessed you with this amazing child knowing full well that you are the perfect person to parent him. Be humble enough to bask in this glory and open enough to see the beauty that your child will produce, inshaAllah.”
If you would like to learn more about ADHD, try one of the resources below: