How undiagnosed ADHD can manifest in children

Narbis

Daydreamers. Chatterboxes. Manipulators. Plenty of kids go through phases that drive their parents and teachers crazy, but when is the time to start thinking that there might be something atypical about their behavior? One important step is to listen to what your child’s teachers are saying since their experience at school is wildly different than home.

According to Candida Fink, MD, a child and adolescent psychiatrist, who has worked in the field for 30 years, kids who haven’t been diagnosed with ADHD are often described with phrases like: “He’s so smart, but he doesn’t pay attention in class” or, “She talks too much,” or “She’s making careless mistakes,” or “He daydreams a lot.” When ADHD is left undiagnosed, it usually manifests itself as a child who just gets by in school: they work hard to succeed yet only get B grades despite the amount of effort put in.

Also, kids with ADHD are often the last kid standing when there is a scrum or a fight; The other kids see the adults coming and shift gears and get out of sight. Kids with ADHD are left standing, and often the ones to get in trouble, notes Fink.

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Gender bias and ADHD

Parents of daughters should also be aware that gender can play a role in the diagnosis of ADHD in kids. Girls with ADHD are more inattentive and tend to daydream more frequently, while boys are often more hyperactive. If girls are performing satisfactorily academically — despite their ADHD — schools can miss a diagnosis. Girls with ADHD frequently have fewer behavior problems at home and in school because they are less likely to present with impulsivity and hyperactivity. In these instances, they will often quietly sit with their classwork but be unable to finish it.

“Teachers are more likely to assume the problem is with their ability level or intelligence, rather than a focus problem,” says Whitney Rancourt, a literacy specialist, mom of three kids, and the founder of mamamanages.com, a blog that helps parents and teachers navigate public schools.

Since these female ADHD students often require less attention from the teacher, they may be undiagnosed and struggle for years to come.

Teachers see behaviors at school that aren’t present at home

One major challenge teachers have is convincing parents to address their child’s focus problems in school by visiting a medical professional. Many parents believe it’s simply the teacher’s failure, (‘they’re not like that at home!’) However, they fail to realize that the home environment is radically different from school. For one, home is far less stimulating, for another, parents don’t frequently require their children to sit with a single task and complete it.

If your child’s teacher believes a visit to a medical professional is warranted because of their inability to tend to a task, keep hands to themselves, or remain seated, it would be wise to follow their advice. While no one knows your child better than you; no one knows what is ‘normal’ for an age group more than a teacher.

Even if they ‘don’t act like that at home,’ if your child’s teacher says that his or her behavior falls outside the expected range for any age-appropriate skills, it’s worth getting a doctor’s opinion. Doctors will frequently send the child’s teachers a questionnaire to complete and return, to help make the diagnosis.

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ADHD and Dyslexia

Science hasn’t yet explained why, but ADHD and dyslexia frequently co-occur, although one doesn’t cause the other. A child with dyslexia is more likely to have ADHD, and a child with ADHD is also more likely to have dyslexia. Schools will frequently catch one or the other, but not often both.

“If behavioral concerns are causing lots of classroom problems, ADHD will often be addressed, and parents may assume their child struggled to read because they were unable to focus in kindergarten and first grade, during those first critical years in school,” says Rancourt. “Conversely, if a teacher makes the assumption that a struggling reader would focus better if they could just read, the ADHD diagnosis may be missed as a student tests into a dyslexia support program. In fact, both challenges need to be explored and addressed independently.”

Non-Drug Tools to help manage ADHD

Once diagnosed with ADHD, your child might be prescribed medication for his or her symptoms, but many parents want other, non-drug options in their back pockets to try as well. We asked experts for their suggestions for unconventional, but effective tools or applications on the market that people might be surprised to learn can help their children maintain focus/overcome ADHD symptoms:

  • Have a three-pronged plan when giving instructions

Child psychiatrist Candida Fink’s top tips for helping kids with ADHD follow instructions are: 1) Give instructions one at a time, 2) Employ a multi-sensory approach to make sure they are attending to you when you speak, and 3) Ask the child to repeat the instruction back.

“Overall, it’s helpful to remember that repetition and reminders will be needed much more for kids with ADHD – and it’s not their fault – it’s just a part of how we need to work with,” says Fink.

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  • Gentle approaches work better than firm discipline

It is an unconventional approach to work with kids with ADHD in gentle ways rather than ramping up consequences and “firmness.” The troubles that kids with ADHD have in meeting expectations that other kids their age are meeting are because of differently developing self-regulation circuits. They can’t just fix the problems because we tell them to.

They aren’t planful, “behavioral’ or manipulative – they are neurodevelopmental. Kids with ADHD will have plenty of negative consequences in life due to having ADHD – we don’t have to add more to get the point across, says Fink.

  • Sensory and movement strategies can improve attention

Movement helps a child regulate. Sensory input including deep pressure and linear swinging can also be beneficial for sustained attention, suggests Tanya Peterson, a Pediatric Occupational Therapist and former College Instructor of Developmental Pediatrics. Rotating between preferred tasks and non-preferred tasks, visual schedules, and verbal prompts can also help, she says.

  • Holistic practices for ADHD

According to a holistic clinic, the Thrive Group, children with ADHD often experience anxiety due to the chasm between what they’re capable of and what is expected of them. It’s effective to treat the anxiety symptoms first since the anxiety only exacerbates their struggle in focusing. Some approaches to consider from a holistic point of view include:

  • Breathing: Encourage long soft exhales to bring your body to a more relaxed state rather than the shallow, short inhales that cause more anxiety.
  • Trigeminal Nerve Tapping: Tap lightly with small jumps of two fingers towards the center of the forehead and then back to the temples. Use the same motion from the temple along the cheekbone to the bridge of the nose and back to the temple. Then from the temple, below the eye bone, to under the nose and back to the temple. Then from the temple, on top of the jawline, to the cleft of the chin and back to the temple and then around the ears. Repeat 5-7 times.
  • Acupressure: Very gently press with your fingers on the top of the eyebrows in the middle, then on the two sides of the eyes, and then under the eyes.
  • Hands and rhythm: Activities using bilateral integration-using both hands and rhythm and timing such as the Learning Breakthough Program can be an effective treatment for ADHD symptoms.
  • Balance: Improving one’s balance, both static and dynamic, has a positive effect on one’s ability to focus and attend, so balancing activities would be an effective treatment for ADHD symptoms.
  • Decreasing sensory sensitivity: Sometimes the distractibility is caused by sensory sensitivities, in that case, sensitivity integration would be an effective treatment for the ADHD symptoms. Once the sensitivities have decreased, the person can have better focus as they are no longer focusing on their sensory discomfort.
  • Neurofeedback: A 2019 study concluded that neurofeedback based on standard protocols in ADHD should be considered as a viable treatment alternative to medication. The authors suggest that further research is needed to understand how specific neurofeedback protocols work. There are a number of at-home neurofeedback devices on the market today including Narbis neurofeedback smartglasses (affiliate link).

Parting thoughts

Without question, parenting a child with ADHD comes with a new set of rules and responsibilities, as well as expectations. The good news is, there are tried and tested ways to help make communication and parenting easier once you have a diagnosis.

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Narbis writes about a wide array of topics focused on health, technology, and attention disorder issues including Neurofeedback, ADHD, Kids' Attention, Parenting Tips, Mindfulness, Workplace Culture, Peak Performance, and Video Gaming.

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