Further Reading

Young children with attentional difficulty may struggle with managing their activity level, regulating emotions, consistently responding to directives, or transitioning between activities. Following adult commands can be a challenge due to trouble listening and remembering commands as well as greater difficulty accepting influence from authority figures like parents or teachers.  As many as 50% of young children with attentional difficulty present with clinically significant levels of defiant behavior, and while strength of will can be a true asset in adulthood, the trait puts a real strain on caregivers during childhood.  Applying the metaphorical “brakes” (not calling out, hitting when emotionally triggered, or otherwise acting impulsively) can be more challenging for these children. 

• In school, your child may present as a “space cadet,” or alternately may get overly excited, making impulsive choices, and struggling to refrain from talking, wiggling, fidgeting, calling out, or making sounds.  On the playground they may get hurt easily due to poor impulse control or coordination. They may also struggle interpersonally, missing social cues, getting too rough, or having trouble accepting when they haven’t won.  Learning in the classroom may be complicated by distractibility, variable attention (difficulty sustaining attention, particularly for topics they do not find very interesting), and spaciness.  Routines like putting materials away or getting started for morning work are more challenging to adhere to.  Multi-step commands are difficult to follow through with, as is initiating tasks that are not of interest, and your child may require more individualized attention, structure, or prompting to transition or carry out individual work than their peers. 

• At home, routines and transitions between activities may be hard.  Children may be unresponsive or overtly combative to parental requests. Homework time may require hand-holding.  Materials may be lost, assignments forgotten, projects or more attention-heavy work avoided.  Some children find independent work or tasks so challenging they may go to extremes to get out of doing it. Routines, chores, keeping one’s room tidy (or tidying it)… the list goes on.

• Parents often wonder how to support their children.  Why won’t they listen better? Are they being defiant on purpose? How do I get them to follow through without shouting?  What can I do to improve behavior at school or with peers?  What about aggressive behavior?  How do I support them with homework without hovering over them to do it?

• Emotionally, your child may be the happiest kid on the block; alternately, they may struggle with worries, sadness, or self-esteem.  Low tolerance for frustration and difficulty with self-regulation can lead to strong and sometimes explosive feelings.  Additionally, children with attentional difficulty are usually acutely aware that they are different, and they draw more negative feedback from those in their orbit, leading to poorer self-esteem.  These sad or anxious feelings tend to worsen with time as they continue to struggle.

• Strengths: Your child may be passionately engaged in topics of interest, loving a certain project or area of study.  They may be unstoppable on the basketball court at recess time, or remarkable in their artistic talents.  Other children may be drawn to their sense of humor, their spontaneity, or their friendliness.  Teachers may note their creative thinking. 

While adolescence is often marked by less overt activity/hyperactivity, your child may report feeling restless or request to get up to use the bathroom or move around frequently, or may be more fidgety than their peers while sitting in their seat.  Difficulties with attention and executive functioning may also become more prominent. According to research, adolescents with attentional challenges may lag by a couple of years in the development of key parts of the brain, including those associated with attention, executive functioning, and higher-order judgment.  As their lives introduce new opportunities (and demands) for independence, you may notice more difficulty with new things.

• In school, your child may struggle to get through readings that are denser or less of interest.  It may become difficult for them to plan, pace themselves, and initiate tasks with longer-term deadlines list projects or tests, leading to last-minute scrambles or late nights.  They may be less effective studiers, underperforming on exams that they thought they were prepared for.  Materials may get lost, assignments forgotten, and keeping track of online platforms for assignments, messaging, and submissions may feel daunting. Teachers may perceive them as less motivated or interested.  Your child may feel confused about why it is so difficult to do their work, as may you.  When adolescents internalize this, they may close off, feeling anxious, ashamed, or demoralized.  Other times they may externalize, lashing out and blaming others for their struggles. 

• At home, your child’s room may be a mess. They may struggle to remember and complete chores around the house, or find them to be daunting (e.g., cleaning their room may feel too overwhelming to approach).  If they have a phone, it is likely difficult for them to manage their screen time, and it may interfere with homework and other obligations.  Heightened conflict in the home is common.  Poor sleep habits often develop during this time, with late time-to-bed due to procrastination of homework or difficulty winding down from preferred tasks (screens, friends, or other leisure activities). 

• College age adolescents often find themselves ill-equipped for the adulting skills required to manage a healthy lifestyle and keep up with the unstructured environment of higher education.  This can take a major toll on families, who have dedicated considerable resources to tuition, only to find they are being squandered. 

• Emotionally, your adolescent is far more prone to anxiety, depression, and self-esteem issues than their peers.  They are more likely to revert to avoidant coping, further jeopardizing chances at success by shutting off to people or resources that can help them.  Rather than advocate for themselves, they may withdraw, relying on hope and luck that they will emerge from predicaments, unsure of how to do so or waving a metaphorical flag of resignation.

• Parents often feel confused about how to help in adolescence.  To be firm or compassionate.  To get involved or to leave them to their own [literal or figurative] devices.  If they want to get involved, how to do so in a way that is fruitful, that the adolescent is receptive to, and that leads to greater independence in the adolescent rather than fostering dependence upon the parent.   High school and college test parents’ appetite for risk and present a conundrum: to get involved or risk failure (and subsequent college prospects, loss of college of tuition, etc.).  And where safety and judgment is concerned (e.g., alcohol or drug usage, sex, driving, and the like), parents are, well, concerned.

• Strengths of adolescents with ADHD can include creative or divergent thinking (thinking outside the box), strong empathy or social savviness, and/or passion for or skill honed in a particular area.

The transitional period between adolescence and adulthood is often referred to as “Emerging Adulthood.”  Throughout young adulthood, individuals gradually launch themselves toward greater independence, securing gainful employment, providing for oneself to some degree, managing a home, handling activities of daily living (hygiene, meals, bill payment), keeping up with a social support system, and the like. 

These “adulting” skills may come more naturally to some than others, and often require refinement. Job applications, day-to-day demands of an entry-level and/or office job, project management, self-advocacy skills, and the like, often need to be learned. This can be a confusing and frightening time. Taking chances, exploring new job roles, and selecting careers that are a good fit for one’s strengths are part of this process as well.

When these skills are lagging considerably beyond one’s peers, emerging adults may rely heavily on parents or other adults, resulting in a “failure to launch” scenario.  These young adults are best supported through a combination of skills (for executive functioning and for managing distressing emotions and related patterns of behavioral avoidance) and parenting help (helping parents to reduce their participation in dependent patterns).

• At work, adults with ADHD may struggle more with managing time, overseeing projects, and initiating and completing tasks that are not of interest.  Menial, monotonous activities may feel aversive if not impossible to complete.  Work product may be inconsistent.  They may have received negative reviews by bosses, or lost jobs.  Alternately, they may become bored with jobs and undergo more job or career changes than their peers.

• At home, these individuals are more prone to messes, worse at completing bill payment or taxes, and struggle with menial tasks like keeping up with mail, watering the plants, or cleaning the bathroom.  Relationship partners may find themselves frustrated with unpredictable follow-through, inconsistent attendance to household duties, messiness, poor planning or accounting for time, and forgetfulness.  Impulsive and novelty-seeking behavior can also affect families. 

• Certain Life Stages can be particularly tricky.  Parenting comes with a host of difficulties for most individuals, and you may find that these feel magnified.  Among women, fluctuating hormone levels around pregnancy, post-partum, and later, in menopause, come with their own challenges, as attentional and executive functioning resources are impacted by estrogen levels and the many other changes that occur during these phases of life.   

• Strengths. While simple tasks may seem insurmountable, more challenging ones may feel more engaging.  These individuals are often valued for their ability to creatively problem-solve, connect with or mobilize others, or to address systemic challenges in organizations and find solutions.  They are engaged and highly effective when (literally or figuratively) on their feet, stimulated with a job that ensures novelty and is not too repetitive or rote.  They are often entrepreneurs or leaders, seeing opportunities and perhaps willing to tolerate more risk than their less disinhibited peers.  They can make excellent coworkers, spontaneous partners, and fun parents.