When we look at the whole story of children diagnosed with ADHD, we find that hindsight reveals deeper challenges that have not received attention. While the average age of presentation is between 3 to 6 years of age with the average age of diagnosis coming at 7 years of age, developmentally, other pictures emerge. In taking history we learn of symptoms and challenges that were present from an early age. Eventually, those children diagnosed (and undiagnosed) have endured labels very different from the ones many parents do not want (ADHD, ODD, etc.). Most of these other identifiers come within relationships with peers, with family, with parents and teachers—and, most importantly, with one self.
Unfortunately, in these early stages children do not have the self-confidence, cognitive or coping skills to manage the negative attention they often receive. The feelings and interactions are concrete and can set in stone less than positive ideas about oneself. So, when we consider parenting children with ADHD, it’s important to look beyond actions, executive functions, and what they are doing. It is deeply important to discover, uncover, and support who they are and who they are becoming.
Here are some ideas to help this process:
More Than Skills
The common mantra is that ADHD children know what to do, but fail to execute at the point of performance. It is at this point of performance that children get noticed for what they are not doing. Unfortunately, what the child internalizes is not the lack of execution (skills) but a sense of failure (identity).
By the time children are 7 or 8 years of age, their self-esteem has huge holes and their identity is often centered on not being smart or good enough. It is no wonder that girls often present with depression before the underlying ADHD is diagnosed.
While lack of ability to attend and execute center on the skills of managing, organizing, and monitoring, the overall context must include the child’s unique personality and sense of self. Otherwise, the child identifies with what they cannot do or be, rather than who they are beyond skill development.
While inattention or attention to everything prevails in ADHD, how a child receives and perceives attention is still paramount. Parents’ attention is gold. Often parent-child relationships get hung up and off track on patterns and routines. Getting ready for school, bedtime, dinnertime, homework, clean-up, and transitions become relationship minefields.
In all parenting, the quality of the parent-child relationship is foundational. Rituals and time spent nurturing and developing the relationship are more important than the management and redirection that often dominates how we notice the child in time and space.
As a practitioner, I hear a common fear of parents expressed as “I don’t want my child to be labelled.” This is understandable as the label of ADHD has a cultural stigma, but the label does little to clarify the diversity of its presentation as well as the child’s individual experience.
Yet the labels that often cut the deepest are the ones experienced in relationships, as well as the world of assessment. Often the chronology of school assessments are littered with grades not representative of the child’s ability and potential. Zeros for homework still in the backpack or points lost for a missing rubric or not having sufficient time to complete a test…
In considering the roots of ADHD, it can be understood as a delay in the development of self-regulation. This finding is substantiated in both testing and brain imaging. The question then is: Why is this neurodevelopmental delay considered different because of its presenting behaviors? This question becomes more poignant when we consider that children with speech, motor or cognitive delays are not labelled with personality flaws or punished for what is beyond their present developmental ability. While it is difficult to address this issue institutionally, it can be considered one child at a time — your child.
What you can do:
- Discover and nurture your child’s interests. This is vital to a sense of competence, self-esteem, and motivation.
- Coach and teach missing skills. Remember that this is not a one-shot effort and takes lots of repetition and practice. Pick only one or two skills to practice at a time.
- Work on the nervous system’s “braking system” with mindfulness, meditation or martial arts. Learning how to slow down, stop, and be present is fundamental to relationships, executing tasks, and developing competence.
- Schedule regular one-on-one time. This is a “just because” time to be with them to affirm and build relationships.
- Create systems and routines to help monitor and manage specific points of performance (these times are often noticed as being off task or as a lack of follow-through).
- Make exercise a central family value. Get outside and move as much as possible.
- Limit screens. These are often a preference of children with ADHD because of the immediate feedback, novelty, and enjoyment. Unfortunately, screens are not typically helpful for developing focus, attention, and the “braking system.”
- Getting restful sleep is vital to the day-to-day plan. Lack of sleep can exacerbate symptoms of inattention and impulsivity — in all of us!
Berger, I., Slobodin, O., Aboud, M., Melamed, J., & Cassuto, H. (2013). Maturational delay in ADHD: evidence from CPT. Frontiers in human neuroscience, 7, 691. doi:10.3389/fnhum.2013.00691
Shaw, P., Gilliam, M., Liverpool, M., Weddle, C., Malek, M., Sharp, W., Greenstein, D., Evans, A., Rapoport, J., … Giedd, J. (2010). Cortical development in typically developing children with symptoms of hyperactivity and impulsivity: support for a dimensional view of attention deficit hyperactivity disorder. The American journal of psychiatry, 168(2), 143-51.