“My autism is extremely invisible,” Lehmann says. “Society has more tolerance for a child having a meltdown but when an adult male who doesn’t look disabled does it, it comes across as very threatening.”

Recently on a work trip, Lehmann’s flight was delayed, causing his “Jenga tower of functioning” to come tumbling down. He kicked a trash can in frustration, attracting the attention of a heavily-armed police officer. Lehmann’s mother stepped in, explaining, “My son has autism. I’ve got this.” The officer took a step back, ready but waiting, as Lehmann calmed down.

Lehmann has had enough negative encounters with law enforcement — cornering him, cursing at him, shaming him — to know this was a best-case scenario. He’s terrified about what could have happened if he hadn’t had a traveling companion, or if the officer was more forceful. He wonders what the outcome might have been if he’d been Black.

The duty of law enforcement is to protect and serve, but when they encounter people with disabilities, too often the result is harm instead of help. Adults and teens with autism, ADHD, and other neurodevelopmental disorders appear to be at a heightened risk for negative outcomes every step of the way in the criminal justice system, from first police contact to questioning and detainment, to jail, trial, and beyond. Mishandled interactions can result in everything from distress and humiliation to jail time, or even death.

[Read: What the Americans with Disabilities Act Means For You]

While no comprehensive data exists on the collective outcomes when people with disabilities encounter police, we do know that neurodivergent individuals are over-represented in the carceral system. Rates of ADHD are six times higher among inmates than in the general public,¹  and rates of intellectual and developmental disabilities (including autism) are four times higher.²

Law Enforcement and the Neurodivergent: Unique Risks

Neurodivergent people face challenges with law enforcement as victims, witnesses, and especially as suspects. For individuals with autism, common behaviors like stimming, avoiding contact, or meltdowns arouse suspicion, which can lead officers to shout commands or make physical contact. This, in turn, intensifies sensory overwhelm and anxiety, making compliance less likely, not more.

Similarly, people with ADHD may have trouble following commands, because of impulsivity or distractibility, and this behavior can be viewed by police as uncooperative or disrespectful. An individual’s hyperactivity and restlessness, exacerbated by confinement to a chair in a small room, might be perceived as a sign of guilt. Working memory problems, time blindness, and memory distrust syndrome may cause a person with ADHD to have difficulty accurately answering questions or to reply, “I don’t know” to even simple questions such as: “Is this the road you live on?” Police may misinterpret this as evasiveness, another possible sign of guilt.

[Read About the Mom Spearheading Police Training on Autism]

In all these cases, what might have begun as a harmless situation can escalate quickly. “Officers that can’t identify the signs of disability may over-utilize force, may make an arrest for a situation that doesn’t call for one,” explains Texas Police Sergeant James Turner, who spent nearly a decade heading the Crisis Intervention Team (CIT) training in Austin, Texas.

Heightened Threats for People of Color

For neurodivergent people of color, the perils of an interaction with police are even greater. Black Americans are killed by police at twice the rate of White Americans, according to the Fatal Force Database, which has been tracking deadly police shootings since 2015.

Stephon Watts, a Black 15-year-old with autism in Illinois, was one of these victims. Watts’ parents called 911 to help respond to their son’s meltdown, but the arrival of the police only escalated Watts’ distress. Police fired two shots, killing Watts in his own home. In 2021, Illinois passed the Stephon Watts Act, also called the Community Emergency Services and Support Act (CESSA), which requires emergency responders to send mental health professionals to respond to mental or behavioral health calls.

Devastating stories like these keep Evelyn Polk Green, M.S., Ed., up at night. Past president of ADDA (Attention Deficit Disorder Association) and CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder), Green says that as a mother to Black sons with ADHD, she worries about all the things that any mother of a person with ADHD worries about in a police encounter. “It’s just multiplied exponentially by all the other things that we already have to worry about on top of it,” she explains. “Unfortunately, so often law enforcement is ready to jump to the absolute worst conclusion and with Black and brown kids, it’s even worse, because they often automatically assume they’re up to something.”

Disability Awareness Training on De-escalation Techniques

Experts agree: training is the essential first step in ensuring better outcomes. “Most people call 911 when they don’t know what to do. We have to be properly equipped in that moment to handle that crisis,” says Sergeant Turner. “We are problem solvers but we have to have the tools.”

Those tools are exactly what David Whalen, project director for Niagara University First Responder Disability Awareness Training (DAT), aims to provide. The DAT is an eight-hour comprehensive training that covers victimization, Americans with Disabilities Act (ADA) compliance, interface with CIT, interaction skills, proper language and specific information on identifying and understanding a dozen disabilities including ADHD, autism, Tourette’s syndrome, dementia, and epilepsy.

Sergeant Turner’s disability awareness training was received during a 40-hour CIT training, required for all cadets in Texas. CIT training addresses how to support people experiencing a mental health crisis, and Turner hastens to clarify: “People with disabilities are not mentally ill, though they can have that issue as well.” Because some of the techniques (including de-escalation) overlap, disability awareness is often folded into CIT training.

Key topics include:

• Recognition of Disability: Officers learn common signs and symptoms of disabilities. Not all individuals can self-identify, and some choose not to. Proper identification of disability prevents officers from jumping to erroneous conclusions, including that the person is intoxicated, and allows for ADA accommodations.
• De-escalation Techniques, including:
  • Giving the individual space and time to respond. Many encounters with disabled individuals take a tragic turn simply because of the speed at which they unfold, creating unmanageable (and often unnecessary) distress. “You don’t always need to rush up on them,” says Turner. “You need to ask yourself, what are the risks vs. benefits of delaying action?”
  • Appropriate communication is essential. If someone with autism is distressed or experiencing sensory overwhelm, for example, a loud, commanding voice may cause further overwhelm. Adjusting tone and pace of speech, or using a pad and pen or hand signals, might be appropriate. Sometimes, Turner says, the key might be to call a family member to ask for specific guidance about support.
  • When force is unavoidable, using less lethal tools like tasers and pepper spray can save lives.
• Connect with Community Resources: Often, Whalen says, it is invaluable for officers to help individuals pursue longer-term support. Turner agrees: “We are not the experts. We just need to know who the experts are.”

“Fighting for Crumbs of Funding”

It’s clear that training works to improve outcomes. Yet there’s enormous variability in how much, if any, disability awareness training police officers receive, since it’s largely determined on a local level.  Too often, Whalen says, training only happens as a term of a settlement after a person with disability, or their family, sues the police for wrongdoing.

This was the case in Maryland; the bill that now requires disability awareness training for all police officers — through the Ethan Saylor Alliance — was created only after a 26-year-old man with Down Syndrome was killed when sheriff deputies tried to forcibly eject him from a movie theater where he neglected to buy a ticket.

“It would be beneficial to have something mandated at the national level but you have got to have the funding to support implementation,” says Leigh Anne McKingsley, senior director of Criminal Justice Initiatives at The Arc. “This issue of disability justice has been bumped down the priority list, and we’re fighting for crumbs of funding to bring about the exposure and education we need.”

Beyond Training: Community Resources

Training is crucial, but McKingsley says: “You can’t just expect training to take care of everything,” This is why, as part of its training, The Arc’s Pathway to Justice program assembles Disability Response Teams (DRT). These are multidisciplinary planning teams that bring together law enforcement, people with disabilities, attorneys, victim advocates, and disability advocates to collaborate in an open dialogue.

“The mandate is, on the day of training, the DRT starts making a plan of action moving forward,” McKingsley says. That includes brainstorming how to address the most glaring gaps in support and services both short and long term, and figuring out how to expand disability training in the community.

Sergeant Turner, who served on a DRT in 2019, agrees that bringing together police officers and people with disabilities leads to better policing. “Anytime someone calls 911, well, it’s probably not the best day of that person’s life,” Turner says. “Showing what a person with a disability looks like when they’re not in crisis is important.” Lehmann agrees: “Get-togethers with fun activities allow police officers to see the human side of disability, and they give that context.”

On the flip side, Lehmann points out, these community events help people with disabilities familiarize themselves with police officers in a calm environment, alleviating anxiety and setting the stage for better outcomes.

To truly tackle the problem though, McKingsley says, we have to understand its contours more fully, and this requires research, which is currently scarce. “Data would help us better evaluate the training, to know what strategies work and why,” he says. “The more we can show how often these encounters are happening, the more we can bolster our ability to go to local and state entities for action.”

Detained by Police? Keep This in Mind

If law enforcement stops you with questions, remember these three key pieces of advice from Rosemary Hollinger, J.D., founder of Partner Up, LLC:

1. First, pause. It’s important to not say the first thought that goes through your mind.
2. Tell the officer you have ADHD. Under the ADA, you’re entitled to reasonable accommodations, including modified questioning, fidgets, frequent breaks, and access to your medication.
3. Before you answer questions, make sure to have someone you trust, such as a lawyer or family member, with you to figure out exactly what happened. You must be truthful and accurate with police, so if you are forgetful and have time blindness, it’s essential to have a lawyer or trusted person with you to support you.

ADHD and the Risk of False Confession

Susan Young, Ph.D., a clinical psychologist in London, has conducted extensive research about people with ADHD in the criminal justice system. One study in which she was involved found that people with ADHD were at an increased risk of making a false confession, and the more severe the person’s ADHD, the greater the risk.³

If police don’t recognize that an individual’s difficulty following commands, sitting still, and answering questions is a result of ADHD, they may misinterpret these behaviors as evasive and guilty, explains Young. This may cause police to detain the person for even longer, which in turn exacerbates symptoms — particularly if the person’s ADHD medication has worn off. It’s a vicious, dangerous cycle which creates desperation.

“There’s all this anxiety; they want to get out,” says Young, who adds that sometimes, people with ADHD will choose to proceed without an attorney present, because they can’t bear to extend the process at all.

“They just want to leave,” Young concludes. “And they’ll say anything.”

The study concluded that safeguards for people with ADHD must be “put in place to prevent miscarriages of justice.”

Law Enforcement and Neurodivergent Justice: Next Steps

• Read: Crime, Punishment, and Redemption for My Son with ADHD
• Q&A: Recently Diagnosed, ADA Information
• Read: ADHD Clinicians Must Consider Racial Bias in Evaluation and Treatment of Black Children
• Upcoming Webinar: AuDHD Guidance – Why Autism Is So Difficult to Diagnose in Women and Girls with ADHD

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹ Young S, Moss D, Sedgwick O, Fridman M, Hodgkins P. A meta-analysis of the prevalence of attention deficit hyperactivity disorder in incarcerated populations. Psychol Med. 2015 Jan;45(2):247–58. https://doi.org/10.1017/S0033291714000762

²   Bureau of Justice Statistics, Disabilities Among Prison and Jail Inmates, 2011-2012 (U.S. Department of Justice, 2015), tables 4 and 5, http://www.bjs.gov/content/pub/pdf/dpji1112.pdf.

³ Gudjonsson, G. H., Gonzalez, R. A., & Young, S. (2021). The Risk of Making False Confessions: The Role of Developmental Disorders, Conduct Disorder, Psychiatric Symptoms, and Compliance. Journal of Attention Disorders, 25(5), 715-723. https://doi.org/10.1177/1087054719833169

New research proposes that ADHD may increase the risk of gaming disorder (GD) in college students, hindering academic success and sleep. ¹

The study, published in the journal PLOS ONE, reported that 35.7% of college students with GD display ADHD symptoms compared to 23.3% of students without gaming disorder.

Gaming disorder is a mental health condition marked by excessive and compulsive engagement in Internet games, which can significantly disrupt relationships, school, and work. The behavior must be present for at least 12 months (or shorter in severe cases) to receive a GD diagnosis.

After surveying 383 university students in Lebanon, the researchers determined that ADHD symptoms directly affect academic performance and indirectly increase the risk of GD. Among students classified as high academic performers with GPAs of 3.2 and above, only one met the criteria for symptoms of GD or ADHD.

“The absence of GD and ADHD symptoms among high academic performers suggests that academic engagement and success may be protective factors against these conditions,” the study’s authors wrote. “Alternatively, it may be that the symptoms of these disorders disrupt academic performance, which would be consistent with the negative correlation observed between disorder prevalence and academic excellence.”

Gaming behaviors may distract college students from academics as they prioritize playing video games over studying. The study reported that students with a gaming disorder spend more time gaming on weekdays and weekends than do those without the disorder. “The correlation between GD and gaming hours, particularly on non-school days, suggests that free time may exacerbate gaming behaviors, potentially leading to disorder,” the study’s authors wrote. “This finding has practical implications for the management of GD, as it highlights the importance of structured time and alternative leisure activities as part of the therapeutic approach.” ²

Gaming Disorder Affects College Students’ Sleep Habits

According to the researchers, GD also impacts students’ sleep quality and duration. On average, students with GD sleep 6.1 hours; 64.3% wake up in the middle of the night to game. In comparison, those without GD sleep between 6.8 to 7.2 hours, with negligible nocturnal awakenings for males and none for females.

“The high incidence of nocturnal awakenings in the disordered gaming group (DGG) to continue gaming is a concerning trend that warrants attention due to the critical role of sleep in cognitive function, emotional regulation, and overall health,” the study’s authors wrote. ³

Findings also indicate that ADHD is more predictive of GD in females than in males, though other factors beyond ADHD may contribute to the development of GD, especially in females. These results echo a study published in June 2023 in the Journal of Attention Disorders. That study found a staggering 82% of individuals with GD had ADHD; more than half of the participants with ADHD (57%) had GD. ⁴

Why Gaming Appeals to College Students with ADHD

Why are students with ADHD symptoms more susceptible to gaming and, consequently, gaming disorder?

“From escapism and socialization to competition, video games are highly engaging, reinforcing, and stimulating by design,” said Jeremy Edge, LPC, IGDC, during the 2023 ADDitude webinar, “Addictive Technology and Its Impact on Teen Brains.” “Prolonged, excessive exposure to immediate rewards and dopamine hits in gaming may diminish the number of dopamine receptors in the brain over time, which can lead to tolerance and further stimulation seeking. ⁵ Gamers who are motivated by both escapism and achievement and who consider gaming part of their identity, are most at risk for problematic or disordered gaming.”

While the PLOS ONE study suggests a strong link between ADHD symptoms and GD, the study’s design does not establish causality and relies on self-reported data, which may introduce bias. In addition, the prevalence of ADHD in the sample is also higher than typical epidemiological estimates.

“More longitudinal studies are needed to clarify the causal relationships between ADHD and GD and to track how these relationships evolve,” the study’s authors wrote.

Edge emphasized that anyone showing signs of gaming disorder should talk to a doctor or mental health professional. “While still a growing field, help for technology addiction is available and ranges from psychotherapy and inpatient treatment clinics to recovery programs, support groups, and even medication,” he said.

Sources

¹ Hawai, N., Samaha, M. (2024). Relationships of Gaming Disorder, ADHD, and Academic Performance in University Students: A Mediation Analysis. PLOS ONE. https://doi.org/10.1371/journal.pone.0300680

² Buono, F.D., et al. (2020). Gaming and Gaming Disorder: A Mediation Model Gender, Salience, Age of Gaming Onset, and Time Spent Gaming. Cyberpsychology, Behavior, and Social Networking, 23(9): p. 647–651. https://doi.org/10.1089/cyber.2019.0445

³ Bourchtein, E., Langberg, J.M., Cusick, C.N., Breaux, R.P., Smith, Z.R., Becker, S.P. (2019). Technology Use and Sleep in Adolescents With and Without Attention-Deficit/Hyperactivity Disorder. J Pediatr Psychol. https://doi.org/10.1093/jpepsy/jsy101

⁴ Hong, J. S., Bae, S., Starcervic, V., & Han, D. H. (2023). Correlation Between Attention Deficit Hyperactivity Disorder, Internet Gaming Disorder or Gaming Disorder. Journal of Attention Disorders, 0(0). https://doi.org/10.1177/10870547231176861

⁵ Sussman, C. J., Harper, J. M., Stahl, J. L., & Weigle, P. (2018). Internet and Video Game Addictions: Diagnosis, Epidemiology, and Neurobiology. Child and Adolescent Psychiatric Clinics of North America,27(2), 307–326. https://doi.org/10.1016/j.chc.2017.11.015

Use the tips below to guide you in putting this behavioral strategy into action. Remember that active ignoring takes time and practice to perfect. Some caregivers also work with a professional trained in effectively utilizing active ignoring.

How to Use Active Ignoring for Attention-Seeking Behaviors

1. Use active ignoring only for minor misbehaviors that are reinforced through attention. This can include:

• whining
• arguing
• interrupting
• yelling
• being purposefully annoying

2. Do not ignore or tolerate dangerous, destructive, or unsafe behavior. Intervene to stop those behaviors immediately and implement appropriate consequences.

3. Do not use active ignoring for non-attention-seeking behaviors. If your child is dragging their feet about brushing their teeth in the morning, for example, they’re probably not doing it to get your attention. You shouldn’t let your child avoid the task, even if they’re whining about it. (In this case, you should think about strategies to encourage your child to brush their teeth, like setting a tooth-brushing alarm, establishing specific rewards for dental hygiene, or maybe changing their toothpaste flavor.)

[Get This Free Download: Your Guide to Ending Confrontations and Defiance]

4. Ignore minor misbehavior, but don’t ignore your child outright. While actively ignoring, you’re also waiting for the opportunity to give attention to the behavior you want to see. Meet the desired behavior with positive attention as soon as you see it. Say something like, “Thank you for waiting so calmly as I finish up dinner.”

5. Watch your non-verbal communication. There are plenty of ways you can inadvertently give attention to problematic behaviors. Be mindful of facial expressions, eye rolls, huffs and puffs, crossed arms, stances, and other forms of attention. (This takes lots of practice!)

6. Should you explain to your child why you’re ignoring them? It’s not necessary, but this approach can be effective, provided you are mindful of your tone. Consider using “when-then” statements to encourage the behavior you want to see. Don’t say, “I’m not responding to you because you’re whining. That’s not how we talk to each other.” Say, “When you ask me nicely, then I will answer your question.”

7. Expect the behavior to get worse before it improves. When you withdraw your attention from a behavior that used to get your attention, the problem behavior will often get worse before it gets better. (We call this phenomenon an “extinction burst.”) Everyone at home should be prepared for these behaviors to escalate and to continue to actively ignore them — provided they are not dangerous.

[Read: How to Leverage Video Game Psychology to Improve Your Child’s Behavior]

8. Be consistent. It is important to make sure that all of a child’s caregivers can clearly define the problem behavior and are on board with the plan to actively ignore it. Consistently ignoring the problem behavior, while praising the positive behavior that you want to see, will yield the best results.

Attention-Seeking Behaviors and ADHD: Next Steps

• Download: 50 Discipline Tips for Kids with ADHD
• Read: Your Child Is Sending You Signals. Are You Ignoring Them?
• Read: How to Manage Your Child’s Toughest Behavioral Problems

The content for this article was derived from the ADDitude webinar titled, “Parenting Styles That Work for Neurodivergent Children” [Video Replay & Podcast #481] with Caroline Mendel, PsyD, which was broadcast on November 29, 2023.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

• arts & crafts
• digital prizes
• events and experiences
• friend and family time
• “free passes”
• screen-free games and toys
• and more!

A behavior chart and/or points system may help encourage consistency and gamify the process. Remember: Rewards should come after your child demonstrates desired behaviors.

Many parents today are raising their children differently than they themselves were raised. In a recent ADDitude poll, about 70% of respondents said they were using a “very different” or “somewhat different” parenting style from the one their parents used with them.

The generational divide is deepened by our evolving understanding of neurodivergence — brain-based differences that affect how someone behaves, thinks, and learns. ADHD, autism, learning differences, and other conditions that tend to be identified in childhood all fall under the umbrella of neurodivergence. Many of these now-commonplace diagnoses were not always recognized and effectively treated in prior generations.

Neurodivergence: Then and Now

Like parenting, societal views of differently wired individuals have also changed significantly. Historically, people whose brains work differently were not celebrated for their neurodivergence; instead, educators and caregivers focused solely on remediating their apparent deficits. Today, we know that our families and communities are made richer by our individual differences. And we understand that leveraging strengths — while also providing constructive support — is critical for neurodivergent children.

Today, we know a lot more about the science of various brain-based conditions. We know that these conditions are not characterological, meaning an aspect of one’s personality, or caused by “bad” parenting. Advocacy from organizations and individuals has helped reduce stigma around neurodivergence and encouraged more schools and institutions to adopt diversity, equity, and inclusion initiatives. Meanwhile, technological advances — like autocorrect or text-to-speech capabilities — have helped reduce the strain of day-to-day functioning for neurodivergent individuals, who can sometimes feel like a square peg in a round hole. And we can’t overlook the role of social media, which has allowed many neurodivergent people and their families to find community and belonging.

[Get This Free ADHD Parenting Guide — Strategies for Kids, Tweens & Teens]

The Best Parenting Style for Your Neurodivergent Child

Parenting styles of the past emphasized obedience through harsh discipline and strict enforcement of the rules. This style of parenting is generally known as authoritarian parenting and its techniques, we now know, can cause distress and are linked to maladaptive behaviors. Children, especially neurodivergent children, do not respond well to this form of parenting.

On the other hand, permissive parenting, characterized by high levels of warmth and little to no limit setting, isn’t what our children need either, as this can also lead to negative outcomes. The parenting style with the greatest benefit is in the middle; authoritative parenting combines warmth and limit setting. It’s a dynamic that fosters the parent-child relationship while also providing children with the structure they need for positive development.

From establishing routines to reinforcing positive behaviors and providing appropriate consequences for misbehavior, authoritative parenting offers various strategies to meet your child’s unique needs. Use this parenting guide to look up the most effective strategies for neurodivergent children. You may need to apply these strategies more frequently, over longer periods, and with the help of a mental health professional to best meet your child’s needs.

Neurodivergent Parents of Neurodivergent Children: You’re Doing an Excellent Job

As an adult who was only recently diagnosed with ADHD, how can I help my child when they’re emotional and overstimulated if I also feel the same way?

How do I get my child to follow a regular routine when I myself have ADHD and cannot follow a regular routine?

How do we implement these parenting strategies when they are so unfamiliar to us? It feels incredibly overwhelming when we have ADHD that was never properly addressed in our own childhoods.

[Read: “The Best Neurodivergent Parenting Tips I’ve Ever Received Are…”]

I don’t need to tell you that parenting is hard, especially if you are a neurodivergent parent raising a neurodivergent child and using different approaches than your parents used on you. As a psychologist who helps parents manage ADHD in their children, please hear me when I say that you are not alone, and that you are doing a wonderful job. Acknowledge the progress that you’ve made and are making. Set small goals for yourself and celebrate the small wins. Build and rely upon your support network and take care of yourself — one of the most important behaviors you can model for your child.

Parenting Styles: Next Steps

• Sign Up: Behavioral and Emotional Skills Training from the Child Mind Institute
• Join: ADDitude’s ADHD Support Group for Parents
• Read: Brick Wall, Jellyfish, or Backbone — What Type of Parent Are You?
• Learn: Moms and Dads — Lets Turn All Those Can’ts Into Can-Dos

Additional Resources

• Taking Charge of ADHD: The Complete, Authoritative Guide for Parents by Russell A. Barkley, Ph.D.
• Your Defiant Teen: 10 Steps to Resolve Conflict and Rebuild Your Relationship by Russell A. Barkley, Ph.D., Arthur L. Robin, Ph.D., and Christine M. Benton
• The Kazdin Method for Parenting the Defiant Child by Alan E. Kazdin, Ph.D
• The Everyday Parenting Toolkit: The Kazdin Method for Easy, Step-by-Step, Lasting Change for You and Your Child by Alan E. Kazdin, Ph.D.

The content for this article was derived from the ADDitude webinar titled, “Parenting Styles That Work for Neurodivergent Children” [Video Replay & Podcast #481] with Caroline Mendel, PsyD, which was broadcast on November 29, 2023.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

With patience and a few tried-and-true strategies, you can help your student harness their enthusiasm and energy in the classroom while minimizing blurting. Use these ideas to spark your next brilliant behavior plan or classroom-management strategy.

1. Try planned ignoring. During a classroom activity, acknowledge students who raise their hands and wait to be called on. (Be sure to repeat this expectation prior to and during the lesson.) When a student who was previously blurting is now raising their hand, call on that student right away, and praise their enthusiastic efforts to contribute while following classroom expectations.

[Get This Free Download: The Daily Report Card for Better Classroom Behavior]

2. Three nods and a deep breath. For students who struggle with waiting their turn to contribute to a conversation (especially when it’s an exciting one that relates to their interests), encourage them to work and refine their patience muscles with a quick exercise: When the urge to blurt comes up before a friend has finished their statement, slowly and slightly nod three times and then take a deep breath before jumping in. Even if the student does end up blurting, it’s the practice of mindfully waiting that counts. This exercise also teaches students to be active listeners.

3. Use self-monitoring tools. Sometimes, students are unaware that they are blurting and how often they engage in the behavior. Self-monitoring tools can raise their awareness (without causing shame) and help control its frequency. My favorite way to use self-monitoring in the classroom is for both student and teacher to track the student’s blurt count for a lesson/period and compare results.

If the blurt tally is the same, then the student gets to pick from the big prize box for recognizing the number of times they blurted. (If the tally is off, you should reward the student anyway for making progress, perhaps by allowing them to pick a smaller prize.)

Over time, once the student’s baseline number of blurts is established, you can set clear goals around limiting those interruptions. If five is the average for a lesson, then aim for the student to blurt no more than three times a lesson. Praise and reward the student, perhaps with additional time for recess for the whole class.

[Read: Impulse Control Strategies for School and Home]

4. Do an environmental check. Thinking critically about the environment in which our students learn is essential to maximize their learning and make sure everyone is on the same page with respect to the classroom rules.

• Review classroom expectations frequently with your students. Make sure that the rules are clear and easy to understand, and write them on the board or keep them on a poster hanging up for all to see. Ensure that students understand when it is okay to talk softly to friends in their desk pod and when it’s time to be absolutely quiet, like during tests.
• Consider seating. Put a student who blurts near your desk or away from other students who also blurt. Consider creating a designated space in your classroom that students can go to if they need to self-regulate to control blurting and other impulsive behaviors.
• Don’t overlook the importance of a clutter-free space. Where is my notebook? Pencil? Last week’s homework assignment? A cleaner environment can reduce these questions, which may come out as blurting. During transition times, have your students take a few minutes to do individualized environmental check to keep organized.
• Check noise levels. Soft music may calm some students, which helps with impulsivity, while others need absolute silence to avoid being “activated.” Think of what works for your students and consider using noise cancelling headphones for students who need quiet.

How to Stop Blurting: Next Steps

• Free Download: Solving Behavior Problems Rooted in Executive Function Deficits
• Read: Disruptive Behavior — Solutions for the Classroom and at Home
• Read: Behavior Problems at School —  A Complete Problem-Solving Guide for Parents

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

As a chatty kid, I saw myself (I’m embarrassed to say) in Donkey, the talkative motor-mouth and sometimes annoying character from Shrek who could not and would not shut up. I suppose the rest of my family and friends, to my chagrin, also saw the uncanny similarities between myself and that hyperactive little sidekick.

“Donkey, You Have the Right to Remain Silent. What You Lack Is the Capacity.”

Though I excelled in classes that relied heavily on participation and creative thinking, my enthusiasm – in the form of constant hand-raising and oversharing – wasn’t always appreciated. I still remember being absolutely mortified when a teacher I loved politely shushed me in front of the class and said, “Alright, too many side comments.”

Some of my classmates thought I talked and talked for attention. What they didn’t understand was that my oversharing and chattiness – symptoms of an overactive ADHD brain – felt compulsive more than anything. How else was I to release the overwhelming tsunami of thoughts that flooded my mind? I was brimming with ideas, stories, rants, and opinions about everything.

[Read: “If You’re Happy and You Know It, Talk Without Taking a Breath for Three Hours Straight”]

I did have one fan, my mom, who listened patiently and enthusiastically to whatever came out of my mouth. Or at least she tried to listen to it all. (At some point, she did need a bit of me-time.) She had the brilliant idea of buying me a tape recorder into which I could pour my stories, rants, and thoughts. Before I knew it, I had completely filled six tapes with audio. It was a gift that changed the course of my life.

An Outlet for Never-Ending Thoughts

Talking into a recorder absolutely served as a healthy outlet for my active mind, as my mom intended, but it became much more than that for me. It led to my next creative avenue: writing.

Recording my thoughts helped me organize, remember, and build upon them enough to put them down on paper. Those thoughts racing through my head became first place prizes in school writing competitions and, today, an average of 300 pages a year of journaling (no kidding!), published short stories, poems, articles, and even skits and scripts for stand-up comedy.

Turns out that there was nothing wrong with having a wild sea of thoughts raging inside of me. I wasn’t doomed to be annoying or overbearing, as I had feared. Through the right lens and care, I could make like an alchemist and turn each drop of the raging ocean into gold.

[Read: “I Never Shut Up. Exercise and Therapy Helped with That.”]

When my boyfriend recently asked me, “Where do you get all your ideas? Aren’t you worried that you’re going to run out?” I shrugged. “No, actually, I’m not worried about running out of thoughts,” I said, borrowing a line from Shrek. “It’s getting ‘em to shut up that’s the trick!”

Excessive Talking in Children with ADHD: Next Steps

• Free Download: Your Child’s Unique “ADHDisms”
• Self-Test: Does My Child Have Hyperactive Impulsive ADHD?
• Q&A: Should I Tell My Son That He Has A Motor Mouth?

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• Car accidents and moving violations
• Unwanted teen pregnancy and STIs
• Substance and alcohol use disorder
• Self-harm

A slew of recent research, however, has revealed that treating diagnosed ADHD may dramatically reduce the incidence of these negative outcomes in teens. In response to this data, many clinicians are urging teens and their parents to see the benefits of medication, not just for school, but for the life that presents itself through the day (and night).

The Developing Teenage Brain

Adolescents navigate thrilling new freedoms and significant new responsibilities at a time when their prefrontal cortex, responsible for decision making and risk analysis, is still developing (a process not completed until the late 20s). Brain-imaging studies show that this maturation process takes, on average, two years longer for teens with ADHD than it does for their neurotypical peers.

“In the teenage years, the prefrontal cortex matures later than the limbic system, putting teens at risk of having emotional decision-making, addictive decision-making, and impulsive decision-making that isn’t modulated by the prefrontal cortex. This affects the ability to pause and think through a thought before it becomes an emotion or an action,” explained Greg Mattingly, M.D., in the APSARD webinar “ADHD Treatment in the Primary Care Setting: The Teenage Years.” “Individuals with ADHD have an even further maturation gap, so concentration, impulse control, working memory — they get there, but it takes about two more years. We want to be mindful of this as we talk to our teenagers. How does this impact things like substance use, and sexual behavior?”

[Read: ADHD Symptoms in Teens – Your Guide to Warning Signs & Treatments]

Understanding that your teen has an increased likelihood of engaging in risky behaviors may provoke anxiety, but Mattingly suggested that awareness helps parents make more informed and collaborative decisions about their teens’ treatment plans. While ADHD medication is often considered a tool for improving school performance, studies show its benefits extend to protecting against everything from car accidents to substance abuse. Said Mattingly: “This data demonstrates the importance of holistic treatment, treatment that lasts as long as possible, into the evening.”

ADHD Medication Lowers Serious Risks

1. Car Accidents and Moving Violations

Getting a driver’s license is a rite of passage for teens, and with it comes the exhilarating promise of freedom. But new drivers with ADHD face special risks that need to be taken into consideration. “From traffic citations to serious crashes, drivers with ADHD are more likely than drivers without ADHD to experience adverse driving outcomes,”¹ explained Joseph Biederman, M.D., in his 2022 ADDitude article “Driving with ADHD: Pumping the Brakes on Vehicle Safety Risks.”

“Driving is a multidimensional activity involving many cognitive abilities and executive functions,” Biederman said. “The underlying impairments inherent to ADHD are thought to interfere with driving.” Impulsivity can lead to speeding, passing, weaving through traffic, as well as driving under the influence of alcohol and other substances. Inattention can make sustained focus difficult, especially in low-stimulus, monotonous environments. The result?  Moving violations, license suspensions, and car crashes.

The incidence of risky driving and car accidents is especially high among teenage drivers with ADHD. According to a study published in Pediatrics,² over the first four years of having a license, drivers with ADHD are:

• Twice as likely as their non-ADHD peers to drive while intoxicated
• 37% more likely to get into a crash
• 150% more likely to receive an alcohol, drug, or moving violation

While these are sobering statistics, new research offers hope about the potential of ADHD medication to significantly reduce driving risks.

[Free Driving Contract Template: Safety Rules for Teen Drivers with ADHD]

In a study conducted by Biederman with other researchers at Massachusetts General Hospital (MGH) and Massachusetts Institute of Technology (MIT), teens with ADHD were separated into two groups, then tasked with driving through a virtual roadway featuring surprise events, including oncoming traffic.³ The teens in the first group received stimulant medication (lisdexamfetamine: brand name Vyvanse) while the teens in the second group did not. Compared with the group of non-medicated ADHD teens, the medicated group:

• Were 67% less likely to have a collision during these events
• Reacted 9.1% faster to these events

While a 9% faster reaction time may not seem like much, Biederman explained that for drivers moving at 65 mph, that translates to a car traveling an additional eleven feet before reacting to a sudden obstacle. Eleven feet can have serious — even deadly — consequences.

“For families that stop ADHD treatment on weekends and during ‘downtime,’ I emphasize the importance of driving only while medication is active,” Biederman said. “A short-acting medication taken about half an hour before hitting the road may just be life-saving.”

2. Unwanted Teen Pregnancy and STIs

When you combine impulsivity with surging hormones and burgeoning sexuality, the result is often risky sexual behavior. Of the many studies that have explored the ramifications of this behavior in teenagers with ADHD, one of the most comprehensive is the Milwaukee Longitudinal Study by Russell Barkley, Ph.D.

Barkley and his fellow researchers followed a large group of children with combined type ADHD, as well as a control group of neurotypical children, through childhood into young adulthood, assessing them at four points in development.⁴ They found that, compared with non-ADHD peers, teens with ADHD had the following:

• More sexual partners (19 vs. 7)
• More teen pregnancies (38% vs. 4%)
• More sexually transmitted diseases (17% vs. 4%)

It’s a data set, Mattingly said, that builds a compelling case for making sure teens are medicated for ADHD beyond school hours. “It’s important to consider as you’re thinking about what days of the week you’d like your child to take their medicine,” Mattingly explained.

ADHD medication can prove indispensable at protecting against these unwelcome outcomes by decreasing levels of impulsivity — both physical and mental. In “How Does ADHD Medication Work?” Laurie Dupar, PMHNP, RN, PCC, explained that, when ADHD medication is working effectively, “You’ll notice that your thoughts are less impulsive. Instead of jumping from one thought to the next, you’ll follow a train of thought more effectively.” Medication can help teens create a space between the urge to do something and actually doing it. This space gives their good judgment more of a fighting chance.

3. Substance Use Disorder

Stimulants are classified as controlled substances because of their risk for abuse, leading many parents to worry that taking these medications may lead to addiction. So it may come as a surprise to learn that the risk of developing a substance use disorder drops dramatically when a person with ADHD receives treatment.

While people with childhood ADHD are almost twice as likely to develop a substance use disorder as people without childhood ADHD, those who receive treatment are 60% less likely to have a substance use disorder, compared with people whose ADHD is left untreated.

The research is clear: receiving ADHD treatment protects teens against substance abuse.

“Considerable evidence suggests that children taking ADHD medication commonly experience improvements to academic and social functioning, which translates to improved self-esteem, and lower rates of self-medication with drugs or alcohol,” said Timothy Wilens, M.D., in the ADDitude article “ADHD Medication Diminishes Risk of Substance Abuse.”

The protective effect of ADHD medication against drug and alcohol use is evidenced in the research that shows medication can help those who abuse substances maintain sobriety. “Treating ADHD with medication tripled people’s rates of staying in substance use treatment,” Mattingly said. “When we treat ADHD. we find dramatic improvement, not just in ADHD symptoms, but in staying in substance use treatment and maintaining sobriety.”⁵

4. Self-Harm

One of the most frightening behaviors associated with ADHD in adolescence is the increased likelihood of self-harm. This correlation was a focus of investigation for UCSF psychologist Stephen Hinshaw, Ph.D., who wrote about his research in the ADDitude article “ADHD and Self-Harm: How to Help the Girls Who Suffer Most.” “Our findings of extremely high rates of cutting and other forms of self-injury, along with suicide attempts, show us that the long-term consequences of ADHD in females can be profound,” Hinshaw said.

Specifically, Hinshaw’s study uncovered the following:

• More than 50% of teen girls with a history of inattention and impulsivity engaged in moderate to severe self-harm vs. 19% of neurotypical peers
• More than 20% of teen girls with ADHD attempted suicide vs. 6% of teen girls without ADHD⁶

A new study published in Child and Adolescent Mental Health confirmed that ADHD increased likelihood for self-harm and recommend screening all self-injuring teens for ADHD.⁷ The connection between ADHD and self-harm is not fully known, but it is thought to be related to both impulsivity and emotional dysregulation, as well as the high incidence of comorbid conditions such as depression and anxiety.

“Impulsivity, a key trait of ADHD, is frequently implicated as a possible risk factor for self-harm (in conjunction with other risk factors such as affective disorders),” wrote the authors of the study. “It has been shown that young people who self-harm struggle to express emotions verbally: it is plausible that emotional dysregulation would lead to expression of strong feelings through impulsive acts of self-harm.”

Medication can play an important role in reducing emotional dysregulation and impulsivity in people with ADHD,⁸ leading the authors of the study to conclude that “this may suggest a potential pharmacological therapy for self-harm.”

Teens, Drunk Driving & Unplanned Pregnancies: Next Steps

• Read: ADHD and Addiction – The Truth About Substance Abuse
• Watch: The Teen Years with ADHD – a Practical, Proactive Parent’s Guide
• Read: How Can I Help a Teen Patient with ADHD Who Needs But Resists Medication?
• Watch: ADHD and Substance Use Disorders – How to Recognize and Manage Addiction

Joseph Biederman, M.D., co-founder of APSARD, groundbreaking ADHD researcher, psychiatrist, and mentor to many in the field, passed away in January of 2023.

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Sources

¹ Curry, A. E., Metzger, K. B., Pfeiffer, M. R., Elliott, M. R., Winston, F. K., & Power, T. J. (2017). Motor Vehicle Crash Risk Among Adolescents and Young Adults With Attention-Deficit/Hyperactivity Disorder. JAMA Pediatrics, 171(8), 756–763. https://doi.org/10.1001/jamapediatrics.2017.0910.

² Curry, A. E., Yerys, B. E., Metzger, K. B., Carey, M. E., & Power, T. J. (2019). Traffic Crashes, Violations, and Suspensions Among Young Drivers With ADHD. Pediatrics, 143(6), e20182305. https://doi.org/10.1542/peds.2018-2305

³ Biederman, J., Fried, R., Hammerness, P., Surman, C., Mehler, B., Petty, C. R., Faraone, S. V., Miller, C., Bourgeois, M., Meller, B., Godfrey, K. M., & Reimer, B. (2012). The effects of lisdexamfetamine dimesylate on the driving performance of young adults with ADHD: a randomized, double-blind, placebo-controlled study using a validated driving simulator paradigm. Journal of Psychiatric Research, 46(4), 484–491. https://doi.org/10.1016/j.jpsychires.2012.01.007

⁴ Barkley, R. Gordon, M. Research on Comorbidity, Adaptive Functioning, and Cognitive Impairments in Adults with ADHD: Implications for a Clinical Practice, In: Goldstein, S. Ellison, A.T. (eds) Clinician’s Guide to Adult ADHD, San Diego, CA: Academic Press; 2002; 43-69. https://doi.org/10.1016/B978-012287049-1/50005-0.

⁵ Kast KA, Rao V, Wilens TE. Pharmacotherapy for Attention-Deficit/Hyperactivity Disorder and Retention in Outpatient Substance Use Disorder Treatment: A Retrospective Cohort Study. J Clin Psychiatry. 2021 Feb 23;82(2):20m13598. doi: 10.4088/JCP.20m13598. PMID: 33988929; PMCID: PMC8351325.

⁶ Hinshaw, S. P., Owens, E. B., Zalecki, C., Huggins, S. P., Montenegro-Nevado, A. J., Schrodek, E., & Swanson, E. N. (2012). Prospective follow-up of girls with attention-deficit/hyperactivity disorder into early adulthood: Continuing impairment includes elevated risk for suicide attempts and self-injury. Journal of Consulting and Clinical Psychology, 80(6), 1041–1051. https://doi.org/10.1037/a0029451

⁷ Ward, J.H. and Curran, S. (2021), Self-harm as the first presentation of attention deficit hyperactivity disorder in adolescents. Child Adolesc Ment Health, 26: 303-309. https://doi.org/10.1111/camh.12471

⁸ Kutlu A, Akyol Ardic U, Ercan ES. Effect of Methylphenidate on Emotional Dysregulation in Children With Attention-Deficit/Hyperactivity Disorder + Oppositional Defiant Disorder/Conduct Disorder. J Clin Psychopharmacol. 2017 Apr;37(2):220-225. doi: 10.1097/JCP.0000000000000668.

Hi WhitBe:

I completely understand your concerns. As a student coach for high school and college students with ADHD, I see this behavior frequently. It’s not uncommon for high school seniors to experience this kind of inner turmoil when facing the transition to college. It’s as if the impending change triggers a sense of fear or anxiety, leading them to act out or disengage from their current responsibilities. Although it’s a pretty typical “senioritis” issue, it seems to be happening early in the school year for your son.

The good news is you do not need to carry this burden alone.

First, your son’s therapist’s “Are you adulting vs. studenting?” approach is a valuable framework. Hopefully, it will help him identify the contrast between his current student responsibilities and the more independent adult life he’s approaching. This can open a non-judgmental conversation about his feelings, concerns, and uncertainty about the future.

[Free Download: Transform Your Teen’s Apathy Into Engagement]

Graduating from high school is a major life change. If he is an overthinker or worrier, he could be overwhelmed and scared, as you say. His actions may be telling you what he can’t express in words.

Senioritis Cures

You mention that he’s unsure of college. Remind him gently that he doesn’t have to decide about college for many more months. Introduce other options for him, such as taking a gap year or attending a local community college in your area.

I’m also a firm believer in natural consequences. This means that just because he was accepted to several colleges doesn’t mean he automatically gets to go. As his parent, you have the right to set clear and fair expectations for him regarding academic performance. So, make sure he is fully aware that his unwillingness to do any schoolwork will not only affect his college acceptances but also your willingness to allow him to attend.

Second, it’s time to enlist the help of your son’s school’s guidance counselor and his teachers. You mention that his teachers have noticed his lack of motivation. Have they spoken with him about the natural consequences of his actions or, in this case, his inactions?

[Self-Test: What Are Your Teen’s Weakest Executive Functions?]

They can help him see what he needs to do to graduate in terms of schoolwork, and the importance of mid-year grades to keep those college acceptances.

Have you visited the colleges that have accepted your son? It has been my experience that college visits, specifically being on the campuses of the schools that my students wanted to attend, made them more comfortable with the transition and motivated them to keep working towards the goal of attending. It’s as if they could feel it. And by feeling it, it became more real.

My sense is that, if he has gotten this far in school successfully and has already been accepted to four colleges, he will make it to the finish line. This may be a slight detour. The transition to college is a complex and challenging process for everyone and particularly overwhelming for students with ADHD. Be supportive but fair. I hope that, with the support of his therapist and school team, he can find his way forward and embrace the opportunities that lay ahead.

Good luck.

ADHD Senioritis Cures: Next Steps

• Read: “Q: My Son Doesn’t Care About Anything! What’s Going On?”
• Read: How to Motivate a Teenager with ADHD
• Watch: “The College Application Guide for Neurodivergent Students”

ADHD Family Coach Leslie Josel, of Order Out of Chaos, will answer questions from ADDitude readers about everything from paper clutter to disaster-zone bedrooms and from mastering to-do lists to arriving on time every time.

Submit your questions to the ADHD Family Coach here!

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Dear ConcernedParent:

Knowing how to respond effectively and connect with a child who is overwhelmed and emotional can be tricky. It’s common for children with ADHD and executive functioning challenges to experience intense emotions and struggle with emotional dysregulation, leading to mood swings, impulsivity, and difficulty regulating their behavior.

Let me offer some techniques that may help you to establish a stronger connection with your daughter during those moments.

Active Listening

Sometimes, the hardest thing for parents to do (and yet the most important) is to actively listen. When your daughter gets overwhelmed, find a quiet, comfortable space to sit together and let her express herself without interruption. If you feel the urge to speak, remember the acronym WAIT, which stands for “Why Am I Talking?” It will help you be more aware of interrupting or offering your opinion.

While actively listening, show genuine interest and empathy by nodding, making eye contact, holding her hand, and providing verbal affirmations like, “I’m listening,” or “I understand this is tough for you.”

[Free Download: Emotional Regulation & Anger Management Scripts]

Be sure to validate her emotions by acknowledging that it’s okay to feel like she does. You can say, “It’s completely normal to feel overwhelmed sometimes.” This will help her feel understood and less alone in her struggles.

As parents, we often want to be our child’s best problem solver. We may think that benign statements like “It’s not so bad” or “You can do it” are supportive, but they can be interpreted as opinions or advice and make our children feel worse. We need to validate their feelings first and actively listen before offering sage advice.

Stay Calm

Maintaining emotional composure during your child’s moments of emotional dysregulation is essential. Otherwise, the situation can escalate if you become agitated, frustrated, or even raise your voice. Instead, take a few deep breaths and speak in a very low voice. From my experience, bringing your voice down helps a child modify their own. When my children were younger and experiencing emotional outbursts, I would ask, “Are you able to match me tone for tone?” This helped them immediately modulate their voice.

Offer Choices

It’s so important that your daughter believes she is in control of her situation, as that will help her with emotional regulation. You can support her by letting her lead. Once she is in a more composed emotional place, please do not launch into a litany of questions. Instead, ask her, “Would you like some alone time, or prefer we sit together and talk?” Options give her authority and allow her to process her emotions at her own pace.

[Free Download: Easy Mindfulness Exercises for Kids with ADHD]

Normalize Mistakes

As a parenting coach, I’ve seen many parents overfocus on “fixing the problem” and leapfrog over “normalizing tough moments.” However, our children must hear that everyone makes mistakes and experiences hard times. It’s how we learn and grow. Feel free to share with your daughter some examples from your life. Just remember to keep your language neutral.

Seek Professional Help

If your daughter’s emotional struggles persist and significantly impact her daily life, consider seeking support from a mental health professional specializing in children with ADHD. They can work with your daughter to develop coping strategies for when she is dysregulated.

Remember that building a strong connection with your daughter takes time. Consistently demonstrating empathy and support will help her feel safe (when her world doesn’t) and understood during moments of emotional overwhelm.

Good luck.

Active Listening 101: Next Steps

• Self-Test: Could Your Child Have an Executive Function Deficit?
• Download: Evaluate Your Teen’s Emotional Control
• Read: 5 Ways to Be a Better Listener
• Learn:  “Stop Trying to Fix Everything!” Scripts for Reflective Listening

ADHD Family Coach Leslie Josel, of Order Out of Chaos, will answer questions from ADDitude readers about everything from paper clutter to disaster-zone bedrooms and from mastering to-do lists to arriving on time every time.

Submit your questions to the ADHD Family Coach here!

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

by William Dodson, M.D., LF-APA

“Most people, clinicians included, have only a vague understanding of what ADHD means. They assume it equates to hyperactivity and poor focus, mostly in children. But when we step back and ask, What does everyone with ADHD have in common, that people without ADHD don’t experience? a different set of symptoms take shape. From this perspective, three defining features of ADHD emerge: an interest-based nervous system, emotional hyperarousal, and rejection sensitivity.”

• Continue reading 3 Defining Features of ADHD That Everyone Overlooks

2. 5 Overlooked Signs of ADHD – the Inattentive Type

by Sharon Saline, Psy.D.

“People with inattentive ADHD are not lazy, stupid, unwilling, or oppositional. They are creative, outside-the-box thinkers whose minds stray from uninteresting tasks. They have a biologically based challenge with attending to an uninteresting task, maintaining their focus, and sticking with it until finished. All too often, their brains tire more quickly.”

• Continue reading 5 Overlooked Signs of ADHD – the Inattentive Type

3. The 5 Things Every Doctor (and Parent) Should Know About Girls and ADHD

by Ellen Littman, Ph.D.

“The tendency of girls with ADHD to mask their inattentive traits and internalize their feelings make their symptoms harder to recognize. As a result, they are often diagnosed later in life, after comorbidities have begun to interfere with healthy behaviors, when unhealthy coping skills start to undermine their sense of self. When in treatment, girls tend to censor themselves. They hesitate to articulate their feelings to a doctor without encouragement. They may respond to questions by saying ‘fine,’ when what they mean is ‘there’s no way I’m telling you these pills aren’t working.’”

• Continue reading 5 Things Every Doctor (and Parent) Should Know about Girls and ADHD

4. Intention Deficit Disorder: Why ADHD Minds Struggle to Meet Goals with Action

by Russell Barkley, Ph.D.

“Think of ADHD as a performance disorder. People with ADHD know what they need to do, but they struggle – greatly, at times – to transform intention into action, whether that’s preparing for a test or finalizing an important project at work. It’s an issue directly tied to the executive function difficulties inherent in ADHD. And yet, this very real challenge of ADHD is often mistaken for laziness and lack of motivation, which many breed low self-esteem and even depression.”

• Continue reading Intention Deficit Disorder

5. Carrots vs. Sticks: The Science of Reward and Punishment for Children with ADHD

by Gail Tripp, Ph.D.

“Science suggests that children with ADHD differ from their neurotypical peers in their responses to positive reinforcement and punishment. The central differences: Children with ADHD are not effectively motivated by promises (of privileges to be earned or lost); and positive reinforcement is particularly powerful, but also ephemeral, in ADHD brains. In most scenarios, positive reinforcement is a more effective motivator than is punishment, which may carry serious long-term consequences if the child’s emotion regulation skills are weak.”

• Continue reading The Science of Reward and Punishment for Children with ADHD

6. How Can We Improve Outcomes for College Students with ADHD?

by Kevin Antshel, Ph.D.; Anne Stevens, Ph.D.; Michael Meinzer, Ph.D.; and Will Canu, Ph.D.

“The population of college students with ADHD has increased substantially in the past 20 years — from roughly 2 percent of the student body to about 11.6 percent. ADHD in college is also associated with a range of challenges. According to clinical psychologist Arthur Anastopoulos, college freshmen with ADHD encounter a ‘perfect storm’ of increased interpersonal and cognitive demands alongside decreased parental involvement and support, all with lingering executive function challenges and symptoms of inattention and impulsivity/hyperactivity.”

• Continue reading How Can We Improve Outcomes for College Students with ADHD?

7. ADHD Minds Are Trapped in Now (& Other Time-Management Truths)

by Ari Tuckman, Psy.D.

“Life brings a constant barrage of stimuli competing for our attention and goals needing our efforts. It is hard to disconnect from the distractions and temptations of the moment to create the space where we can mull over our options and make the best decision. Individuals with ADHD are more absorbed than others by what is happening now. It’s harder to create that space to give the future its due until the future becomes the present and the scramble begins.”

• Continue reading ADHD Minds Are Trapped in Now

8. Face It — People with ADHD Are Wired Differently

by Oren Mason, M.D., Tamara Rosier, Ph.D.

“For decades, we weren’t sure how ADHD brains worked, and this led to many misunderstandings about the syndrome. Many doctors, therapists, social workers, and coaches tried to teach children with ADHD to slow down using the self-control methods that neurotypical children use. ‘Take a deep breath and press the following buttons on your activity thermostat’ makes sense if the wiring is standard, but not if the wires are connected differently, as they are in children and adults with ADHD. The most current research on brain imaging is starting to let us trace the wiring, so we can untangle the misconceptions that experts, as well as those with ADHD, have about the disorder and the brain.”

• Continue reading Face It — People with ADHD Are Wired Differently.

9. Don’t Mistake Your Child’s ADHD Symptoms for Bad Behavior

by James M. Greenblatt, M.D.

“Bottom line: Your child is not a bad child. You are not a bad parent. Nobody is to blame for ADHD. Therefore, assigning blame for your child’s bad behavior — and trying to correct it with criticism — is useless. But how do you stop yourself from being ‘overly critical?’ How do you show your child respect rather than subjecting him to a barrage of negativity? How do you change your behavior to help your child’s behavior? The strategy I’ve used with many parents is called SAIL.”

• Continue reading Don’t Mistake Your Child’s ADHD Symptoms for Bad Behavior

10. How Autism in Women Is Different: Unique ASD Symptoms, Risks

by Theresa Regan, Ph.D.

“A woman with autism may show a larger range of emotion in her face and voice. She might be able to adopt social standards fairly well but find it exhausting and stressful. The drama of female peer relationships can feel really overwhelming and not enjoyable. Autism in women can also present with an eating disorder. In fact, research shows that around 23% of females with eating disorders are on the autism spectrum.”

• Continue reading How Autism in Women Is Different

11. Fight, Flight, Freeze … or Fib?

by Monica Hassall, R.N., and Barbara Hunter, M.Ed.

“Faced with a threat, the human brain must react in a split second; deciding how to best protect itself. This is widely referred to as the ‘Fight, flight or freeze’ response.Today, psychologists are beginning to observe and document a fourth ‘F’ that manifests in times of real or perceived danger for children, adolescents, and even adults with ADHD: ‘fib.’ Often, a ‘fib’ or ‘fabrication’ does allow an individual to escape from fear, embarrassment, judgment, guilt, or shame — at least for the time being.”

• Continue reading Fight, Flight, Freeze … or Fib?

12. New Insights Into Rejection Sensitive Dysphoria

by William Dodson, M.D., LF-APA

“Rejection sensitive dysphoria (RSD) is one of the most common and disruptive manifestations of emotional dysregulation — an under-researched and oft-misunderstood symptom of ADHD, particularly in adults. Dysphoria is the Greek word meaning unbearable; its use emphasizes the severe physical and emotional pain suffered by people with RSD when they encounter real or perceived rejection, criticism, or teasing. The emotional intensity of RSD is described by my patients as a wound. The response is well beyond all proportion to the nature of the event that triggered it.”

• Continue reading New Insights Into Rejection Sensitive Dysphoria

13. Why the ADHD Brain Chooses the Less Important Task — and How CBT Improves Prioritization Skills

by J. Russell Ramsay, Ph.D.

“A combination of ‘procrastinate’ and ‘activity,’ the term ‘procrastivity’ aptly describes a tussle common among adults with ADHD who are always busy but never seem to make headway on life’s important goals. At its root is an implementation problem: the individual knows what they need to do, but they won’t or can’t do it, so they keep occupied with more palatable but less critical tasks.”

• Continue reading Why the ADHD Brain Chooses the Less Important Task

14. The Social Executive Function Skills That Elude Kids with ADHD

by Ryan Wexelblatt, LCSW

“Dominating conversations. Not showing interest in others. Telling cringey jokes. Struggling in unstructured social situations. Children and teens with ADHD know these social struggles and misunderstandings too well. Navigating social interactions requires various mental processes, or executive function skills. Deficits and delays in these skills – which I refer to as social executive function skills – are common in ADHD, and they explain many of our kids’ problems in the social realm.”

• Continue reading The Social Executive Function Skills That Elude Kids with ADHD

15. ADHD and Eating Disorders: Research, Diagnosis & Treatment Guidelines

by Roberto Olivardia, Ph.D.

“Numerous studies show that individuals with ADHD are at three to six times greater risk for developing eating disorders compared to non-ADHD individuals. In a study of patients being treated for bulimia, a quarter of subjects had ADHD. What’s more, eating disorders appear to grow in severity alongside ADHD symptoms. Several factors – biological, cognitive, behavioral, and emotional – may explain why ADHD predisposes individuals to eating disorders and challenges. Understanding these factors is essential when devising an appropriate and effective treatment plan.”

• Continue reading ADHD and Eating Disorders: Research, Diagnosis & Treatment Guidelines

16. 7 Surprising Ways ADHD Shows Up in the Classroom

by Mark Bertin, M.D.

“A student who doesn’t seem to have a learning disability isn’t progressing in reading. A student seems to be disliked by her peers, is socially isolated, and eats alone. A teacher gives a two-minute warning to the class that independent reading time is about to end, and a student does not stop reading. These are all less-recognized ways ADHD symptoms show up at school — and here are productive ways to address each one.”

• Continue reading 7 Surprising Ways ADHD Shows Up in the Classroom

17. The Dyslexia-ADHD Overlap: Why Evaluators Confuse the Conditions

by Cheryl Chase, Ph.D.

“Considerable overlap exists between dyslexia and ADHD – from reading challenges to heritability – and both conditions frequently co-occur. ADHD and dyslexia are both linked to problems in school and with learning, but for different reasons. Ultimately, these overlapping traits complicate evaluations for ADHD and dyslexia, especially when both conditions are present. A thorough evaluation that carefully considers each symptom cluster is critical to receive appropriate support.”

• Continue reading The Dyslexia-ADHD Overlap: Why Evaluators Confuse the Conditions

18. ADHD Needs a Better Name. We Have One.

by Edward Hallowell, M.D., and John Ratey, M.D.

“ADHD is an inaccurate — and potentially corrosive — name. The term ‘deficit disorder’ places ADHD in the realm of pathology, or disease. Individuals with ADHD do not have a disease, nor do they have a deficit of attention; in fact, what they have is an abundance of attention. The challenge is controlling it. Therefore, we argue that a more accurate descriptive term is needed — and we have it.”

• Continue reading ADHD Needs a Better Name. We Have One

19. ADHD and Trauma: Untangling Causes, Symptoms & Treatments

by Kerry J. Heckman, LICSW

“Imagine the intricate complexities of a spider’s web — one thread attaches to dozens of others; pull just one silky strand and the entire web collapses. Living with ADHD and trauma can feel similar — the symptoms are so intertwined a single tug may cause the whole thing to cave in.”

• Continue reading ADHD and Trauma: Untangling Causes, Symptoms & Treatments

20. The Educator’s Guide to Executive Functions: How to Understand and Support Students in Need

by Karen Hubert, M.Ed., and Maureen Bechard, M.S.

“Executive functioning refers to the mental processes that allow us to concentrate, plan, organize, complete tasks, and more. They often unlock — or preclude — success in the classroom. Executive dysfunction is ubiquitous in children with ADHD, which helps to explain why so many students with attention deficit are reprimanded for forgotten homework, disorganized projects, running out of time on tests, and more. But students with ADHD aren’t the only ones who struggle with EF skills. Educators should teach executive functioning language to all classroom learners, not just those who show deficits. When educators assist students with identifying their executive functioning strengths and areas of need, they also teach them how to advocate for their own needs in the classroom and beyond.”

• Continue reading The Educator’s Guide to Executive Functions

21. Secrets of Your ADHD Brain

by William Dodson, M.D., LF-APA

“Attention deficit hyperactivity disorder is a confusing, contradictory, inconsistent, and frustrating condition. My work for the last decade suggests that we have been missing something important about the fundamental nature of the ADHD brain — the feature that everyone with ADHD has, and that neurotypical people don’t have. That feature is the ADHD nervous system, a unique and special creation that regulates attention and emotions in different ways than the nervous system in those without the condition.”

• Continue reading Secrets of Your ADHD Brain

22. The Damaging Effects of Cannabis on the ADHD Brain

by Roberto Olivardia, Ph.D.

“The risk of developing cannabis use disorder (CUD), a problematic pattern of cannabis use linked to clinically significant impairment, is twice as high in people with ADHD. Contrary to popular belief, individuals can be mentally and chemically dependent on and addicted to cannabis. Contemporary marijuana has concentrations of THC higher than historically reported, which exacerbates this. What’s more, the adverse effects of cannabis are especially amplified in people with ADHD.”

• Continue reading The Damaging Effects of Cannabis on the ADHD Brain

23. Everything You Never Knew About the ADHD Brain

by Alison Kravit, Psy.D.

“The prefrontal cortex (PFC) is the intersection through which attention, behavior, judgment, and emotional responses run (I think of them as cars). A person with ADHD will likely react to whatever is in his focus at that moment — in other words, the faster car. For people with ADHD, the PFC is unregulated; there are no traffic lights or stop signs controlling which message (car) gets through first. You could be the smartest, most motivated student ever, but if the teacher says ‘This species of dog…’ and your thought switches to ‘I wonder what my dog is doing right now?’ you get distracted.”

• Continue reading Everything You Never Knew About the ADHD Brain.

24. What Is Auditory Processing Disorder? Symptoms, Comorbidities, and Exercises

by Beverley Holden Johns

“Auditory processing disorder (APD) throws a child’s ears and brain out of sync. This misalignment can cause a range of challenges – struggles with auditory discrimination, with listening in noisy environments, with remembering what you’ve heard, and with recalling the sequence of words spoken. APD may cause communication difficulties, but it does not show up in traditional auditory tests for hearing loss. It is a misunderstood and largely overlooked condition that may appear in 3% to 5% of all children.”

• Continue reading What Is Auditory Processing Disorder?

25. The ADHD Medication Stopped Working! How to Troubleshoot Treatment

by Thomas E. Brown, Ph.D.

“Studies show that ADHD medication safely and effectively improves communication between neurons in the ADHD brain. Amphetamine has been around since 1937, and methylphenidate since 1956. There are more research studies done on these types of medicines than on any other medicine you will ever take. Most of the work of ADHD prescribers involves adjusting the titration, especially in the early weeks. In the process, we hear these questions most frequently from patients.”

• Continue reading The ADHD Medication Stopped Working!

Honorable Mention: What is Sensory Processing Sensitivity? Traits, Insights, and ADHD Links

by Bianca Acevedo, Ph.D.

“Recent research suggests that there may be three groups of sensitive people. About 40 percent of people fall into a moderately sensitive group (tulips). Low-sensitive individuals (dandelions) make up about 30 percent of individuals, and highly-sensitive individuals (orchids) make up another 30 percent. Some markers of highly sensitive people include needing privacy from stimulation, being easily overwhelmed by bright lights, strong smells, loud noises, clothing materials, and other stimuli, being affected by other people’s moods and feeling overwhelmed when asked to do too many things at one time.”

• Continue reading What is Sensory Processing Sensitivity?

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Disrespectful behavior from your child is a signal, says Sharon Saline, Psy.D. Getting curious about what’s triggering that warning signal is Step One in dealing with lying, pushback, and rudeness.

• Look underneath your child’s words and behaviors. Oppositional behavior often masks other emotions such as anxiety, depression, poor self-esteem, confusion, boredom, fear, and frustration. Many kids with ADHD will resort to lying as a form of coping; impulsivity and poor self-regulation skills sometimes make them do things they regret, and rather than dealing with those things directly, they’ll deny their actions. Avoid addressing these surface behaviors in the moment — expect that your child will act out at times. Opt to come back to the topic later when emotions have cooled.
• Establish doable routines. How can your child’s routines change to increase their confidence and decrease frustrations that cause problematic behaviors?

[Get This Free Download: A 2-Week Guide to Ending Defiant Behavior]

• Manage your own feelings. Provocative behaviors from your child can trigger reactivity on your part and escalate the situation. To manage reactivity and avoid saying things you don’t mean, ask yourself, “Why am I talking now?” There are times when it makes more sense to stay silent and listen rather than get into it.
• Set up a “take-back-of-the-day” system where everyone in the family has a chance for a redo. This practice helps address impulsivity, and it also gives your family the opportunity to practice forgiveness.
• Rely on natural and logical consequences. When you stand in the rain, you get wet. When you begin a huge school project the night before it’s due, you may get a poor grade. Your punishments and threats won’t do much to change your child’s behaviors, but natural and logical consequences will because they empower your child.
• Set clear and appropriate expectations. Expectations should fit the child you have, what they can do, and what they can almost do. Avoid focusing on goals that are barely reachable for your child.

Watch Dr. Saline’s ADHD Experts webinar, “Motivating the Unmotivated: Strategies for Middle and High School Students with ADHD,” for more insights on teen behavior challenges.

Rude and Disrespectful Behavior in Teens: Next Steps

• Free Download: How to End Confrontations and Defiance
• Read: Should I Punish (or Ignore) My Teen’s Disrespectful, Snarky Behavior?
• Read: Don’t Freak Out! And 13 More Rules for Navigating Teen Behavior Challenges

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.