ADHD in Children: Dispelling Common Myths and Getting to the Real Deal

A father helps his little daughter to do her homework for the school.

Following on the heels of some virtual schooling most of the time, when parents get a front row seat to what their child looks like in class, parent referrals for testing and support are coming in fast. I have seen a major increase in the number of families reaching out to the team here at Kids BRAIN wondering whether their child may have ADHD. Well, often the question is whether their child is struggling with ADD, but technically, this diagnosis was eliminated in the 90’s when psychologists changed the diagnosis. We are really good at that as a field. Psychologists love to talk about labels and to clarify them over time. So, briefly ADHD includes what we used to call ADD. Attention-Deficit/Hyperactivity Disorder is the spelled out version. Notice the slash mark in the middle. This means that the front part pertains to the inattention part of the ADHD profile. The back part includes the behavioral control struggles observed in ADHD. This means that a child (or adult) could have the Inattentive Presentation of ADHD (where attention control is a problem but there aren’t significant issues with behavioral control), the Hyperactive-Impulsive Presentation of ADHD (where the person is hyperactive and impulse but actually pays attention pretty well), and the Combined Presentation, which is when a person is inattentive, hyperactive, and impulsive in a way that makes daily functioning harder. If there is this much confusion regarding the name for this diagnosis, I figured it might be helpful to also discuss some common beliefs about ADHD and to sort fact from fiction.

ADHD Is Not Intentional Misbehavior or Manipulation

Many people assume that children and adolescents with ADHD are able to control their behavior — but choose not to. This is simply not true. It is my experience that if a child truly COULD do better that they WOULD do better. It makes no sense to intentionally generate that much stress and conflict for yourself on purpose. Hyperactivity and impulsivity happen without thinking and is because of differences in neurological wiring and communication. You may see excessive talking, talking over others, getting up and moving fast when having a thought, asking a great number of questions, and falling off of the seat. These manifestations of ADHD do not reflect willful intent or the desire to make a situation or lesson difficult. These are children who don’t have a functional “braking” system. If you are a fan of Looney Toons, they are a classic Wylie Coyote. They are way past the edge of the cliff before they have time to stop and respond, forever falling into the valley below even though they cognitive know better.

ADHD Is Not Due to Permissive or Lax Parenting

Sadly, parents are often blamed for their child’s hyperactive or impulsive behaviors, limited social judgment, or academic struggles. But ADHD is not caused by parenting. However, it can be worsened by mismatched parenting strategies. Often times, parents attempt to accommodate their child’s weaknesses by creating supports in their home and school to help their son or daughter function at their best. Other parents and teachers may think or even say that they are ‘coddling’ their child or not being ‘strict’ enough. Well, tough love doesn’t teach any skills; it only causes more frustration and possible feelings of anxiety. These are children who truly lack functional skills in multiple areas. Most people pick these skills up naturally, so they are mystified regarding why their ADHD child does not, even with lots of repetition and support. It’s a brain thing. Parents of children with ADHD benefit significantly from direct parent training to foster better success with less conflict. It takes a different approach.

ADHD Is Not Low Intelligence

ADHD is not associated with low intelligence. Children and adolescents with ADHD have a great number of strengths. Many have well-developed visual spatial learning skills; they think in pictures and videos rather than words. They may be able to see the big picture first and then learn the details, which are rarely as important in the long term but sometimes matter to parents and teachers in the short term. Intelligence, or lack of it, is not a correlate with ADHD. In fact, a large majority of children with ADHD are average to above average in their ability to think, make connections, generate creative ideas, and to talk with others about what they observe.

ADHD Is a Neurological Disorder

ADHD impacts attention, physical and emotional regulation, social skills, learning and behavior. ADHD is diagnosed based on manifestations of different behaviors, such as difficulty focusing, sustaining concentration, sitting still, and inhibiting thoughts or actions. These struggles are real, not fictitious. ADHD is as real as diabetes. Nobody has ever doubted or questioned if a person truly has high blood sugar levels. Thorough and direct assessment of these functional domains is important, not just to ensure that your child has ADHD, but also to determine where the holes are so that intervention planning can be as specific and tailored as possible.

ADHD Is Connected to Anxiety

Many children, adolescents and young adults diagnosed with ADHD also experience anxiety. Often, anxiety results from an awareness that class assignments, homework, projects, studying and daily life tasks will take a long time and a worry that they will be too difficult or draining to complete. Many people with ADHD are aware that they struggle to concentrate or focus even when the desire and motivation is there. Children with ADHD are more likely to require adult input, guidance, and redirection. They are more likely to have negative or critical interactions with others, with can increase levels of stress and anxiety, as they often don’t have full control over what would need to be changed to reduce this kind of correction in the future. This is where Executive Functioning Coaching comes in to play — to build systems and plans that will improve follow-through as well as self-confidence. Parents are a part of the process in helping to create the routines and consistency that will also make it possible to complete daily routines and tasks. The team at Kids BRAIN offers this type of service individually and through a parent training course focused on academic organization, management of materials, and academic planning (https://kidsbrainllc.teachable.com/p/organizing-your-child/ ).

ADHD Is Manageable

Parents of children with ADHD often feel like they have tried everything. They come to my office hopeless, frustrated, and sad about the way that their household runs and the relationship they have with their child. ADHD is manageable with the right support at home and school. This includes learning about areas of strength and weaknesses (which comes from high quality assessment), and using those strengths to compensate for weaknesses. Parents can seek support plans such as a Section 504 Accommodation Plan or an Individualized Education Plan (IEP) in school (depending on the child and their needs). At home, with the help of a therapist/counselor/parent trainer, parents can begin to understand their child’s profile, which can help with managing behaviors, emotions, friendships and academics. Talk therapy is often ineffective in addressing ADHD symptoms in children with ADHD. If only talking about it were going to fix it, all the parent conversations would work better. They do benefit from direct executive function coaching, counseling support to manage anxiety and emotional difficulties, and time to speak with someone regarding what have ADHD really means and what they can do to help themselves function better.

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