I will be discussing how to assist children with ADHD manage themselves over the next 3 months.
Part 1: The deficits that affect children with ADHD outlined.
ADHD is an inherited neurodevelopmental disorder where there is a delay of about a third in the development of the brain responsible for self-control. A delay in this ability results in them battling to control how they respond to the world around them, leaving them reacting impulsively to it. Without self-control they are victims to the circumstance and become solely dependent on interest or urgency to get a task done.
The area responsible for self-control is found in the prefrontal cortex and comprises 5 main executive functions, which is the name of the ability we use to get something done. They consist of: Inhibition, the ability to plan and prioritise, working memory, emotional control and time perception.
Lack of inhibition is seen in 3 ways. Firstly they battle to stop doing something interesting like lego or video games. Secondly, they battle to inhibit their response to irrelevant distraction. Finally, the hyperactive child battles to inhibit movement and reacts impulsively.
The lack of planning and prioritising is seen in their inability to prioritise a task and develop or keep to a schedule. They also battle to organise their world around them so live in chaos, often not knowing where they put their things or when their tests are due.
Working memory is your train of thought. It’s what you use to tell yourself what it is you are doing. A deficit here results in them being easily sidetracked when distracted as they forget what they were doing. It affects their ability to remember what was said so often don’t follow through on instructions. It can also affect their comprehension ability as they often can’t remember what they’ve just heard or read.
A delay in their ability to control their emotions will result in them being more sensitive to criticism than others and predispose them to temper outbursts when asked to do homework. They are unable to self-motivate when things are no longer interesting, resulting in distraction and can experience episodes of sadness.
All children with ADHD have a lack of time perception so are unable to pace themselves, taking too long to do somethings while rushing to do others. Without the confines of time, they have no urgency to complete a task until the last minute. This affects their ability to prioritise it and is seen in their procrastination as well as their slowness in getting ready to leave in the morning or to start or complete homework at night. This lack of sense of time also makes any consequence only relevant if it is immediate. They live in the now.
These 5 executive functions allow the child to take hold of how they respond to a task by being able to stop, prioritise, plan and keep in mind what they are doing, while keeping self motivated so they can do it on time without distraction for their own long-term benefit. Understanding this process is imperative if you are to parent them effectively and explains the need for routine, immediate consequences and timers which will be discussed in part 2 and 3.
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