Although many people have heard of ADHD before, they do not necessarily know what it is or how to manage it. ADHD is the abbreviation for Attention Deficit Hyperactivity Disorder. It’s often assumed that ADHD is just a behavior problem most often seen in young boys, but that’s not entirely true. Recent research has revealed that ADHD is a developmental impairment of the brain’s self management system, which often manifests itself differently in boys and girls. ADHD is a brain-based disorder involving a wide range of self-regulation and executive dysfunctions, meaning people who struggle with ADHD struggle with one or a combination of inattention, hyperactivity, and impulsivity. Compared to a neurotypical brain, the brain of a person with ADHD will have differences in the central nervous system – both structurally and neurochemically (Rief, 2016).

People who struggle with ADHD will also face other challenges related to executive function and self regulation, like, social and emotional control, organization and time management, and academic challenges. Dr. Thomas Brown summarizes ADHD into six categories on episode 132 of the Learn Smarter Podcast (Brown, 2020):

  1. First, there’s the issue of organization and getting started on one’s work. When there are a lot of things to do, people with ADHD will have a hard time getting organized and figuring out what items to do first. Often this will lead to irregular sleep patterns, where they stay up all hours of the night rushing to complete an assignment and have a hard time waking up the next morning to get ready for school. 
  2. Second, is focus and sustaining attention to a task. People who struggle with ADHD will struggle with using their working memory, focusing on a task, and then shifting focus as necessary. In the classroom, such focus and shifting focus can be problematic for a student. For example, if they’re paying more attention to how they’re taking notes than the actual information being delivered by the teacher, then the student may miss the entire point of the lecture because their focus was on formatting and color coordinating. 
  3. Third, is regulating alertness, keeping up effort, finishing a task, and processing speed. Many people with ADHD have trouble being awake when they have to be awake and asleep when they have to be asleep. This is where long term projects can become overwhelming because completing a task piece by piece each day is going to require more long term effort than a task that can be completed quickly and all in one go. 
  4. Fourth, is managing frustration and modulating emotions. Sometimes a person with ADHD will get extremely angry about something seemingly trivial, which usually doesn’t last that long; and, then, other times their feelings will get hurt and they will have a hard time letting go of it. By getting caught up in the feeling of something they want to do or want to buy, they will hyper fixate on that thing and will relentlessly push everyone to do it until they, either, get it or hit a brick wall. Other people worry so much that they have all these “what ifs” and the problem, then, is that the thinking about the “what ifs” leads to living those fears. It becomes very difficult for people with ADHD to manage their frustrations and emotions. 
  5. Fifth, is a difficulty with memory. While they might remember specific events from a long time ago or know all of the lyrics and music to hundreds of songs, they will still struggle to remember what happened just a couple of minutes ago or even yesterday. The problem with memory and ADHD is the short term working memory, not the long-term memory. Working memory is what we depend on when we have to hold one thing in our heads while doing something else. For example, reading can be challenging because they might understand the content while they’re reading, but struggle to summarize what they just read as soon as they’re done reading that section. 
  6. Sixth, is monitoring and self-regulating action. Being able to slow down when you need to slow down and speed up when you need to speed up is a challenge for people with ADHD. For example, it can be challenging to maintain a conversation because they have to organize what they want to say while also keeping track of how people are reacting to what they’re saying.  This isn’t just an issue of hyperactivity, although, it is common to see students with ADHD struggle to sit for long periods of time. 

In order to better understand ADHD, it’s important to reiterate that this is a developmental impairment that can be managed with various strategies (2020). Not everyone with ADHD has the same exact challenges; so not all strategies will magically work for everyone struggling with ADHD. All of these challenges can manifest into a negative self image, anxiety, and the fear of being perceived as lazy or willfully disregarding others expectations (Rief, 2016).

When supporting someone who has ADHD, pay particular attention to their high sensitivities. Although they might appear to be the class clown and/or flighty, they do in fact struggle to manage their emotions and can be moody or easily have hurt feelings. Starting with empathy can help. One way to show empathy is to note that everyone has problems with executive functioning and self regulation sometimes. Practice active listening and provide time and space for them to feel their feelings. Validate their experience and ask if they want help finding a solution or managing the problem. After they’ve had adequate time to express their feelings, explain that it’s time to distract from those negative feelings, resolve the problem, or reframe the issue. 

Also, noticing a child’s social interactions with peers and their interest in school could be a good starting point for determining whether they are struggling with self-esteem. Are they making self-deprecating claims about their intelligence and their abilities? Are they reluctant to go to school or to partake in new or challenging activities? These kinds of questions can help get to the root of what’s going on for a student. Approaching them with curiosity instead of judgement is going to be a crucial tact for understanding their struggle. 

If you do notice that your child or student is struggling to manage their emotions related to ADHD and self image, then an Educational Therapist (ET) can help. An ET can boost a child’s self-esteem by incorporating the “growth” mindset into various treatment plans (Dweck, 2014). ET’s can identify and highlight a student’s strengths and play into those strengths when a client starts to get down on themselves. Also, an ET has been thoroughly trained on the brain and how learning happens; so, they can help to demystify a student’s experience by teaching them about the brain, the learning process, and coping mechanisms. 

Mindfulness is a multi-faceted tool that allows people to pay close attention to their senses. This practice can support students who experience anxiety and low self-esteem because mindfulness promotes awareness. Some studies have identified that the gray matter of the brain increases during and after mindfulness activities, which “represent enduring changes in brain structure that could support improved mental functioning” (Hölzel et al., 2011). While continued research on mindfulness in teens is being conducted, it’s safe to say that incorporating mindfulness techniques at a young age could promote a lifelong practice and a greater sense of emotional balance in adulthood.

Furthermore, an ET can help the client manage stress and uncertainty by teaching them mindfulness and how to pay attention to bodily responses to stress. “When I start to get sweaty and antsy while completing my math test, I know that that’s my body’s way of preparing me for this challenge.” Positive self talk, like this, can support a child with severe low self esteem. Providing them with sentence starters and various reminders for when and how they can talk to themselves would be a great way for them to develop a positive self image. Additionally, incorporating journaling activities that utilize prompts for enumerating the students’ strengths and reflecting on a time they felt confident and self assured would help to restore faith in their abilities. These journal entries could be taken a step further and can be used to practice visualizing strategies, whereby students are encouraged to close their eyes and visualize themselves as confident, proactive, and effective learners. This particular visualization strategy could be utilized again during times of stress or anxiety at school. 

As with any strategy for ADHD, it not only requires commitment from the student but also from their entire support network of parents, teachers, tutors, and aides to be successful. By being aware of these strategies, everyone can encourage the student to use them as necessary. This allows the student to feel supported as they get similar messaging from all of the adults in their life, and this encourages a flow of positivity. When the professionals in a student’s life practice these strategies for positive self talk, mindfulness, visualization, and journaling, it encourages the students to practice these strategies, too, and vice versa. ADHD is manageable and does not need to be viewed as an eternal detriment. Students, neurotypical or not, deserve a learning environment that will foster their interests, creativity, and opinions. By understanding their diagnoses and finding and utilizing strategies to support their learning, students with ADHD will feel more self-aware and in turn develop a greater sense of confidence. 

Citations

Brown, T. (guest). (2020, December 1). ADHD Expert Dr. Thomas Brown [Audio podcast]. Retrieved from https://learnsmarterpodcast.com/132-adhd-
expert-dr-thomas-brown-author-series/.

Dweck, C. (2014, November). The Power of Believing that You Can Improve. Lecture presented at TedX in Sweden, Norrkoping. Retrieved 2019, from https://www.ted.com/talks/carol_dweck_the_power_of_believing_that_you_can_improve?language=en

Hölzel, B. K., Carmody, J., Vangel, M., Congleton, C., Yerramsetti, S. M., Gard, T., & Lazar, S. W. (2011). Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Research: Neuroimaging, 191(1), 36–43. https://doi.org/10.1016/j.pscychresns.2010.08.006

Rief, S. F. (2016). 1.1 Understanding ADHD. In How to reach & teach children & teens with ADD/ADHD (3rd ed., pp. 3-20). San Francisco, CA: Jossey-Bass, a Wiley Brand.