Navigating your child’s ADHD diagnosis

They may not seem to listen and may not sit still. It may appear as though they would rather do anything than talk to you. They can make promise after promise without following through. As a parent, it’s difficult getting the phone calls from teachers, devastating when you find out that your child was the only one not invited to a birthday party and frustrating when you’re trying your best but it still doesn’t seem to be enough.

Whether it’s a child, a sibling or a spouse, it can be challenging to live with someone with Attention Deficit Hyperactivity Disorder, or ADHD.

After finding out that your child has ADHD, you may feel lost and even move through the five stages of grief. But it’s important to accept the diagnosis, for the benefit of yourself and your child. And that starts with learning everything you can about it.

Nobody really knows what causes ADHD, although current research tells us that there is a strong genetic component to this disorder. Theoretical causes include environmental exposures to certain pesticides, and exposure to high levels of lead and food additives, such as artificial colours.

But there’s no doubt that it is a real disorder: the latest studies have shown that there is a neurobiological difference in the structure of a brain affected by ADHD. The cerebral cortex, or outer area of the brain, is broken up into four regions, or lobes. Repeated magnetic resonance imaging (MRI) studies have shown that the right frontal lobe appears smaller in children with ADHD. This area of the brain is involved mainly with executive functions such as problem solving, attention, reasoning and planning. Not surprisingly, sufferers of ADHD usually have deficits in these functions.

ADHD is often present with other learning disabilities and can appear in many different forms, making it more difficult to diagnose. According to the National Institute of Mental Health, ADHD is divided into three subtypes:

• predominantly hyperactive-impulsive, in which most symptoms will display as high levels of energy, such as fidgeting, impatience and non-stop talking.
• predominantly inattentive (often referred to as ADD, without the ‘H’), in which symptoms are quieter, often appearing as an inability to focus and follow  instructions, daydreaming and becoming bored easily.
• combined, where an individual shows signs of both types.

Lazy, scattered and slow?

There are many misconceptions when it comes to ADHD. The person with ADHD has heard them all, and often times has taken the labels personally, affecting their self-esteem and sense of self-worth.

In most cases, these labels could not be further from the truth.

“Sometimes with ADHD, it’s not that they’re not paying attention, it’s that they’re paying attention to absolutely everything,” says Rhondda Lymburner, a disability services counsellor at Conestoga College in Kitchener, Ont.; the spinning of the fans, the buzz of fluorescent lights and the squeak of chairs can easily overwhelm a person with ADHD and muffle a lecture at the front of the room. Similarly, when they’re bouncing their leg, drumming their fingers on the desk or scanning the room, it’s not that they’re not paying attention. They may be doing these actions to use up their excess energy, stimulating their brain enough to pay attention to just one thing.

So what’s it like having ADHD?

Sandra Roberts is an executive member of the Kitchener-Waterloo ADHD Parents Support Group, a certified ADHD Life Coach and the mother of a child with ADHD. Her son, Christopher Cusimano, is now 21.

“I remember a psychiatrist, years ago when Christopher was getting diagnosed, saying it’s like he has six TVs going on in his head at all times, and they’re all on six different channels and he’s trying to watch all six different shows,” says Sandra. It was an eye-opening concept.

Christopher’s biggest challenge with having ADHD is that he doesn’t notice it. He’s only reminded of it when other people express frustration with him. He’s not currently taking medication, but didn’t notice a change in his behaviour when he was, yet everyone else did.

Another aspect of ADHD is hyperfocusing — the ability to completely focus on, and lose yourself in, an activity that you thoroughly enjoy. While the ADHD person may have difficulty focusing on day-to-day tasks, they will zero in on something they thoroughly enjoy, ignoring everything else around them, even the need to eat or use the washroom. While ignoring food and washroom breaks can be detrimental to their health, the benefit is that they’re able to zero in on one subject, often becoming masters of their chosen activity.

“What’s really important to understand about ADHD is that it’s context driven,” says Dr. Tim Bilkey, a psychiatrist specializing in ADHD and co-author of Fast Minds: How to Thrive If You Have ADHD (Or Think You Might). They may be criminal lawyers, EMS personnel, or emergency room doctors, and if you saw these people doing something that they were passionate about, such as caring for a patient or representing a client in court, you wouldn’t catch the distractibility trait. “It’s more the tedious, repetitive, boring activities that people really struggle (with),” things like chores, paying bills and sometimes, parenting. The fact that they can hyperfocus on things of interest — and will often do so at work – makes it difficult for people to recognize that they have ADHD, as they are very successful in certain parts of their lives, but can’t keep up in others.

Another complication of hyperfocusing is when the individual needs to transition out of the activity and move on to something else; a necessity when it comes to the modern educational system.

Sandra fought for years to get accommodations in place for her son. She worked with teachers to create Individual Education Plans (IEPs), listing what his needs were and how the teachers could best accommodate them. She patiently explained ADHD and how it manifested in her son. But the plans weren’t always followed, and Sandra’s experience wasn’t unique.

“That is a big part of our support group meetings every month … first and foremost are the issues that somebody has had at school with their child. And teachers not understanding, not wanting to understand, not wanting to follow the IEP,” says Sandra.

The paradox of ADHD is that the child will sit still in their seat on Tuesday, but stand on the desk on Wednesday. The behaviour is not always consistent or visible.

By post-secondary school, it may not be so obvious to teachers that the student is struggling. “In the classroom, just staying focused on the topic is hard,” says Rhondda. The student often drifts into other thoughts, such as what to do after school or what was on television the night before.

Recognizing ADHD

Although each person is different, there are some main signs and symptoms in children, which usually start to appear by Grade 2 (or persist long after). These traits are present in most children, but it’s the frequency and intensity of them that sets the ADHD child apart.

Social and emotional immaturity.
“ADHD kids are a good two to three years behind socially and emotionally; so, you have a kid who’s seven or eight years old and really, they’re only four or five,” Sandra says. This is a concept that is sometimes difficult for teachers to grasp. While their schoolmates are now able to sit still and are developing the social skills required to make friends, children with ADHD lag in these areas.

Gender differences.
Often, the girls are missed because they don’t tend to display the hyperactivity that the boys do. “And those are the nice little girls that sit in the back of the class and never ask a question or do anything, so those are the ones that the teacher really likes because they don’t cause problems in the classroom. But they’re just as unfocussed as little Johnny up at the front, who’s running in circles,” says Sandra. And little Johnny’s symptoms will change over time, too. “As boys get older, that hyperactivity just goes into their mind, where it’s racing.” They become tactile, pickers, or they play with something.

Difficulty with transitions.
The child may be watching television, unaware that their parent is calling them for supper. When the parent starts to yell, he will look up with a blank, puzzled stare. And he won’t be able to pull himself off the couch and bring himself to the table.

On the bright side
The disorder comes with many hidden benefits. “These are the Bill Gates of the world. These are the Albert Einsteins of the world. These are the people who are willing to take the chances and go out and do things and not be restrained by society,” Sandra says.

People with ADHD are often artistic, intuitive and driven individuals who live in the moment, which can make them enchanting to others. But it can also be a detriment because the bills aren’t getting paid. The key is to find the balance.

“A lot of these people are above average intelligence, and you don’t know it because it’s hard to come out in the way that we think,” says Sandra. “I think the biggest thing is to educate yourself about ADHD, educate yourself about what parts of ADHD affect your child.”

Although you might find medication works well for your child, it’s no longer looked at as the sole solution for treating ADHD. There’s a strong emphasis on teaching children (and parents) coping strategies and life skills. Some parents flat out refuse to use any medication at all, as there are side effects they aren’t willing to tolerate, such as sleep disturbances, headaches and lack of appetite.

At the parenting support groups, Sandra tells parents to look at the quality of their children’s life and ask themselves if medication is going to improve or hinder it. But she reminds parents to keep in mind whose life they’re talking about. “As a parent, it’s not improving the quality of my life, it’s their life, because he’s the one living with this, not me.”

9 facts about ADHD

1. Roughly four percent of adults have ADHD.
2. There is not much difference between the frequency of ADHD in developed and lesser-developed regions of the world.
3. People with untreated ADHD are four times more likely to have a car accident.
4. It’s believed that ADHD is more common in males than females.
5. Young girls with ADHD are less hyperactive; as such, they are not often diagnosed. They are often daydreamers and more outwardly chatty than others.
6. Female teenagers with undiagnosed ADHD are more likely to suffer from bulimia-nervosa and mood disorders, such as anxiety, and sometimes, addictions.
7. Women don’t often have the hyperactivity trait, so they may be diagnosed with depression before discovering they have ADHD.
8. ADHD is 80 percent genetic, which means it’s as heritable as height. Many parents find out that they have ADHD after their child has been diagnosed.
9. Brain scans in children have shown that those with ADHD have a stronger emotional reaction to stimuli than those without. This means that it
   may be more difficult for adults with ADHD to get out of a bad mood.

– From Fast Minds: How to Thrive if you have ADHD (Or Think You Might) by Dr. Craig Surman and Dr. Tim Bilkey

Tips and tricks for parents of a young child with ADHD

When it comes to transitions, use a countdown: let them know what’s going to come next. Use something visual, such as a timer, or use what’s already available, such as the timing of television shows. “When this show is done, we’re going to have supper,” Sandra used to tell her son, Christopher Cusimano. She would then explain what’s going to be served. The key is to keep two steps ahead of the child.

• Don’t let ADHD rule your child. ADHD is a part of your child, not the
  whole of your child.
• Get support by attending parent support groups. Others may think ADHD is just a phase, or they don’t understand. It’s important to be around people who understand the frustrations, without judgment.
• Don’t try to fit your child into a mold. “You cannot jeopardize your relationship with your child over spelling homework,” Sandra says.
• Set up routines and consistency.
• Get the proper diagnosis, so you know what it is you’re dealing with. There are disorders that look a lot like ADHD, and the wrong diagnosis leads to the wrong treatment. And once an ADHD diagnosis is made, “try to take a step back, and relax. Enjoy your child for who they are. School, yes, is important, but we make it
  the be all and end all. Does it really matter what your marks were in Grade 4?” Sandra says.

Lisa Olsen is a freelance writer with a background in human services, where she has worked closely with individuals diagnosed with ADHD. Her work has appeared in numerous publications. Originally published in 2013.