ADHD Made Simple

 

Due to structural and neurochemical differences in the brain, children with ADHD do not develop their ability to regulate their thoughts, words, actions and emotions at the same time as their peers. They also struggle to perceive and sense time and to regulate their attention and behaviour across time.

For this reason, children with ADHD often find it hard to sit still, to focus and concentrate, to stay on track and to transition between tasks. They can be messy and disorganised as well as forgetful. They may also struggle emotionally, socially and academically and display behaviour that is not considered socially appropriate.

The concept that these behaviours are not wilful or a choice, that they are instead the manifestation of a child’s ADHD symptoms, can be very hard for individuals with good executive control to grasp. To them it can seem pretty simple – when faced with something that you have to do but really don’t want to, you simply press your imaginary “just get it done” button and ta-da! You make it happen.

However, the belief that everyone has a well-functioning “just get it done” button is false. Along with the fact children with ADHD’s vary in their ability to regulate their behaviour depending upon the situation they are in and the demands placed upon them, this false belief often leads individuals to conclude that if children with ADHD are not doing as they are told it’s because they are wilfully refusing to do so and are therefore being naughty or disobedient.

However, the real reason children with ADHD cannot regulate their thoughts, words, actions and behaviour in line with their peers is because they lag behind in the development of their executive functions by approximately 30% and when they do eventually develop these abilities, they tend to be less efficient than those of their neurotypical peers.

 

Executive functions

Executive functions is the name given to the mental processes that people rely on to control themselves and get things done, even when they find the required task to be boring or tedious, and the reward for effort is delayed.

According to Russell Barkley (2015) there are 6 executive functions (or self-directed actions):

• Self-awareness which comes from wilfully directing one’s attention inwardly to become aware of one’s thoughts, feeling, motivators and behaviour.
• Inhibition or self-restraint. This complex process involves:
  
  • delaying one’s initial reactionary response to a stimulus
  • redirecting one’s attention inwardly and paying selective attention to the process of contemplating the future, whilst inhibiting intrusive external or internal stimulus
  • choosing an appropriate self-determine response (words and behaviours).
• Non-Verbal Working Memory which is the ability to recall visual imagery or pictures, as well as sound, taste, touch, smell, and to use this information to sense the hypothetical future.
• Verbal Working Memory which is the ability to use internal speech for self-instruction, self-reflection, self-soothing and problem solving, and to invent personal rules that govern one’s own behaviour.
• Self-motivation or self-directed control which is the ability to weigh-up the outcome benefits of possible options in order to choose one which maximises goal attainment, even when there is no immediate consequence.
• Planning or problem solving which is the ability to flexibly manipulate and analyse information, to generate new ideas and to play with these ideas in order to find new approaches or solutions to problems/obstacles, and to plan interventions in order to obtain goals.

By understanding the reason behind a child with ADHD’s challenging behaviour, parents and teacher are better able to put in place the supportive scaffolding children with ADHD require in order to develop in a healthy manner and to negotiate life successfully.