Busting ADHD myths: Helping parents better understand what ADHD can look like — and how it can be managed

Back on Track is the book for every parent who has worried about their child and wants to create change. It provides an action plan for parents to help their child thrive at school, at home, and at play from Dr. Rebecca Jackson, a professional who develops and implements brain-based wellness programs.

In an exclusive article for Mayo Clinic Press, Dr. Jackson helps parents better understand what ADHD is and how it can be effectively managed.

When many people hear the term “attention-deficit/hyperactivity disorder” (ADHD), they picture an 8-year-old boy bouncing off the walls and falling out of his chair in class. They may envision loud, boisterous behaviors that require frequent redirection to stay on task, a struggle to keep hands and feet to themselves, and disruptive behaviors both in the classroom and at home.

While this description can be accurate for some kids with ADHD, there is so much more to this condition than the disruptive behaviors that have become stereotypical symptoms. This general lack of understanding regarding the depth and breadth of the impact of ADHD has led to challenges — and individuals with ADHD are hurt the most by this misunderstanding. It’s fascinating to think that while ADHD is one of the most well-researched topics of childhood, there’s still a lack of widespread understanding and support options to help.

Pre-pandemic data on kids with ADHD indicate that nearly 10% of kids in the U.S. have been diagnosed, and a staggering 17% of additional kids are thought to have subthreshold ADHD. Subthreshold means that these kids are facing similar challenges to those diagnosed with ADHD, but to a lesser degree, and falling just shy of the criteria to meet the diagnosis. The data shows that during the pandemic, there was an increase in ADHD symptoms.

Some recommendations for treating kids with ADHD primarily focus on managing behavior. While this focus on behavior can be a starting point for many, ADHD impacts so much more than merely behaviors.

To help parents and professionals gain a deeper understanding of ADHD, here are some common myths and misconceptions:

Myth: ADHD is loud and boisterous

While challenging and disruptive behaviors can exist with ADHD, it can also manifest in a plethora of quiet and subtle concerns.

In fact, there are three subtypes of ADHD:

• Predominantly inattentive. The majority of symptoms fall under inattention, such as being easily distracted or having trouble staying focused in tasks or play.
• Predominantly hyperactive-impulsive. The majority of symptoms are hyperactive and impulsive, such as fidgeting, squirming or being in constant motion.
• Combined. This is a mix of inattentive symptoms and hyperactive-impulsive symptoms.

Individuals with ADHD have been shown to struggle with organization and prioritizing, face feelings of shame and inadequacy, and struggle with procrastination and perfectionism. Many of the symptoms and challenges are quiet, and disruptive only to the individual struggling. Whether someone is struggling to pay attention and keep up in class, to remember to complete assignments and turn them in, or to manage mood and emotions, many of these symptoms are subtle.

ADHD is not just behaviors, nor is it laziness or a lack of trying. Oftentimes the person with ADHD is like a duck in the water: calm on the surface and paddling like crazy below the water trying to hold it all together. But the continual effort to keep up and keep it together takes a toll. Emotions can run high when frustrations or upsets occur.

Myth: Kids will outgrow ADHD

ADHD used to be referred to as a childhood disorder. But the research and terminology has evolved. ADHD is now considered a life span disorder. The ADHD challenges of an 8-year-old will differ from that of a 38-year-old, but challenges do persist. Individuals can become better at implementing strategies for success to manage the day to day. But brain scans indicate that many of the structural differences in the brain remain, creating an uphill battle for managing time, emotions, focus and productivity.

This requires the individual with ADHD to work harder to accomplish some of the same tasks as their peers, and to implement additional strategies to help with time management, mood and emotional regulation, attention to detail, and hitting deadlines. These individuals also may be more susceptible to the impacts of acute or chronic stress, as stress fatigues the brain, depleting the resources that help to support sustained attention and inhibition control.

Myth: Medication is a quick fix for ADHD

Medication certainly can help some aspects of ADHD. But medication alone can’t impact all areas of ADHD. Nor is the effect of medication universal. Some individuals respond to medication better than others, both in terms of the positive effects and negative side effects. While studies have indicated an increase in sustained attention and an increase in seated work time in the classroom with fewer disruptions, the jury is out on whether medication impacts long-term learning outcomes.

Medication is not always the silver bullet that parents are hoping for — and it may take months or even years to find the best dosage or combination of medications. Each family needs to work directly with their healthcare team to determine if medication is the right next step for them and to monitor the outcomes. Families also need to have additional science-backed approaches and options to help.

Myth: ADHD is always a standalone issue

It’s important to note that while ADHD can be a standalone diagnosis, an individual with ADHD may qualify for additional diagnoses, both as a kid and as an adult. Anxiety, depression, oppositional defiant disorder, learning disabilities and autism are some of the most common additional conditions that occur with ADHD. Beyond diagnosed conditions, people with ADHD have been shown to have a higher incidence of challenges ranging from addiction to bullying or being bullied. The effects of ADHD touch nearly every aspect of life, including learning, stress and anger management, relationships, and careers.

Myth: ADHD can’t be improved

This is the best myth of all to bust, and it’s all based on neuroscience! Neuroplasticity means the brain can change. Through specific activities and repetition over a period of time, structural and symptomatic changes can occur.

Attention is one of our most fragile resources. It is one of the last areas to reach maturity in development and one of the first areas to decline in aging. Attentional abilities are also highly susceptible to daily experiences. When a person is tired, hungry, stressed or emotional, one of the first regions to be impacted is sustained attention and impulse control. It’s why people are more negative, impulsive and less focused during times of fatigue, stress or high emotion.

If you are a parent raising a child with ADHD or have ADHD yourself, know that the challenges of ADHD are significant and go beyond behavior and mood. In fact, ADHD expert Dr. Russell Barkley’s work on this topic has indicated that regions of the brain involved in executive functions, such as sustained focus, emotional control and organization, are up to 30% more immature in people with ADHD compared to peers, contributing to challenges with executive functions. Some developmental aspects of a 10-year-old child with ADHD may be more in line with that of a 7-year-old. This can impact attention, learning in the classroom, as well as managing behavior and upsets. This is not an indication of intelligence, aptitude or effort, but of real challenges due to ADHD.

Increasing your awareness, understanding and knowledge that ADHD can be improved will only set your child and family up for greater success going forward.

To learn more about development and how to support the development of optimal attention, check out Dr. Jackson’s book, Back on Track, available now at bookstores everywhere.

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