Areas of Expertise

ADHD

NEW VIEWS ON ADHD

It is well known that children are more active, distractible, and impulsive than adults. Therefore, it is not surprising that they experience more difficulties than adults when required to follow through on directions or complete chores with little supervision. So when parents or teachers complain that a child behaves impulsively and cannot seem to focus on the task at hand, others may be quick to dismiss these problems as part of normal development. Yet the fact remains that the older children become, the more we expect them to do things independently that may be boring or effortful. For a child with a short attention span and limited impulse control, it is not only ill-advised but potentially detrimental to his or her psychological and social well-being to downplay these problems or to chalk them up to immaturity. Doing so could cause enduring problems with the child’s academic, social, and emotional development. Children facing significant problems with inattention, over activity, and lack of inhibition may reach a degree of severity that can best be explained by a developmental disability known as Attention Deficit/Hyperactivity Disorder (ADHD). ADHD is largely a biological disorder with a large genetic/hereditary basis; at least two genes for the disorder have been reliably identified (Barkley, 2000). The genetic basis of this disorder is exemplified further by the fact that there is at least a 50% chance of an ADHD child having a biological parent with ADHD.

Recent research (and accompanying theories) has come to reflect the disorder as a disturbance in impulse control and to delay immediate gratification (Barkley, 2000). Whereas impulse control challenges may manifest as over-activity early on in life, the symptoms often appear more as distractibility and challenges in activities that are longer than usual, especially those that are boring, repetitious, or monotonous (e.g., math worksheets). These children lose interest in their work much faster and are drawn to more rewarding, fun, or fulfilling aspects of a situation. Children with ADHD tend to opt for doing less work now for a small but immediate reward, rather than doing more work now for a much larger reward available later. Difficulties controlling impulses are evidenced in behaviours such as blurting out answers before the question has been completed (e.g., without raising his hand in school), difficulties waiting for things (e.g., taking turns, standing in lines, etc.), interrupting or intruding on others’ conversations, and becoming sidetracked while completing schoolwork. Over-activity may be most evidenced in appearing squirmy, difficulties sitting still, acting as if driven by a motor, and frequently humming or making odd noises. Additionally, these children often present as more accident prone than their peers, and engage in greater risk-taking behaviours.

A variety of intervention approaches are now recognized to help manage and cope with these behaviours. These methods include increasing the novelty, excitement, or fun involved in learning experiences, breaking larger activities into smaller segments, and providing more immediate rewards and consequences for particular behaviours. Treatment also includes designing manageable home and school programs to facilitate an increase in academic and chore completion, enhancing listening skills, and promoting more positive social behaviours.

Consultation with a psychologist will help determine whether your child’s (or your own!) patterns resemble that of ADHD, or whether these difficulties are secondary to others such as language, memory, or anxiety. If you are concerned (or would like to rule-out) that your child faces symptoms of ADHD, the first step is a thorough assessment. Our assessments include intellectual testing to help determine learning style, academic testing to pinpoint the cause of academic issues, subjective measure of observed behaviours, and objective tools designed to assess impulse control and ability to sustain focus. It may be of benefit to observe your child in his or her natural environments, such as the school classroom.

References:
Barkley, R. (2000). Taking Charge of ADHD. The Complete, Authoritative Guide for Parents. New York: The Guilford Press.