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Living with ADD

“To understand life with ADHD it is first important to know its developmental course. For many, ADHD is a lifelong problem, but one which changes from childhood to life as an adult.”

Preventive measures to reduce the incidence of ADHD in children are not known at this time. However, early detection and intervention can reduce the severity of symptoms, decrease the interference of behavioral symptoms on school functioning, enhance the child’s normal growth and developmental process, and improve the quality of life experienced by children or adolescents with ADHD.

Important to the view of the development of person with ADHD, is the description given by Hutchins (1994), in which he describes the symptoms of persons with and without hyperactivity-impulsivity:

Main Symptoms        Impulsivity                                Inattention
Behavior                     Overactive                                      Sluggish
Model                          Impulse Inhibition                          Organization
Occurrence                 Boys more than Girls                    Boys more or equal to                                                                                                 Girls

Language                    Language Disorder                       Subtle Deficits
Peers                           Peer Rejection                                Social Withdrawal
Comorbidity                Aggression,                                    Anxiety, Depression
                                     Conduct Disorder

Presentation               Behavior, early referral                   Learning, late referral
Family Type                Discord/Anger                                Stress/Frustration
Outcome                     Persistence                                     Adjustment

And by Zgonc's Study (as cited in Price, 1999)

Trait ADHD                Impulsivity/ADHD                           Inattention
Decision Making         Impulsive                                     Sluggish
Boundaries                 Intrusive, Rebellious                    Honors Boundaries, Polite, Obedient
Assertion                    Bossy, Irritating                                     Underassertive,                                                                                                                                Docile, Overly Polite
Attention Seeking       Show-off, Egotistical,                 Modest, Shy, Socially                                                                                                   Withdrawn                                        Popularity                   Attracts but doesn't Bond               Bonds but doesn't Attract


Research shows that there are three major aspects of physical development that are affected in the child with ADHD. These are the processing of input through the five sensations, proprioception (spatial knowledge of ones body) and establishment of dominance. A child who has not developed tactility (touch) fully, may be more interactive with their environment to gain needed physical stimuli. Decreased auditory and visual processing may result in difficulty with short-term memory, difficulty following through on instructions, ease of distraction, and rapidly shifting attention. Proprioception that has not fully developed can lead to a child who may bump into objects and have decreased coordination. Additionally, they may engage in activities that are physically dangerous, as the development of exactly what the body is capable of is not yet clear. The establishment of dominance is important in the acts of reception, processing, storage and utilization of information. If the child has not yet established a dominant side, then the child may not utilize their brain in the most effective manner in the processing of outside stimuli. There is more information on this topic on this website under the heading of Sensory Integration. 

Sensory Integration

Auditory Processing

There is a massive amount of research as to how stages of development and gender correspond with ADD. In the younger child, there is an increased chance of hyperactivity-impulsivity type of ADHD. Teens are often diagnosed as having predominately inattentive-type. (This may be due to a trend in late diagnosis of this type of ADD- It may not mean that there are more inattentives than hyperactives during adolescence.) Males are generally perceived to be at a higher risk for ADHD, although the ratio of male to female (3:1) did not vary by diagnosis type. It is reported otherwise that females who are afflicted appear to be at greater risk for going undetected due to the belief that girls generally have a higher incidence of the inattentive type of ADHD, which does not show overt signs (behavior), and may be less obvious to parents and educators. It is more likely that females are less likely to be represented due to the view that ADHD is viewed as a "male" problem, as it was shown that the females who were referred were more severely impaired. All subtypes of ADHD showed correlation with Generalized Anxiety Disorder, though ADHD-C had the highest severity.

Psychological Development

When adopting our daughter, we knew the genetic tendency toward this condition and started seeing differences between her and other children as early as infancy. As an infant, the task of learning to calm and regulate themselves is complicated by their overflow and sensitivity to environmental. They may be unable to organize sensations properly, reacting adversely to stimuli that would be calming to other infants. This is often treated as a sensory disorder by an occupational therapist.

As a toddler, they have difficulty in learning to tolerate frustration and to overcome stress of disappointments. These children are described as being emotionally over-reactive, and having a tendency to fall apart easily.

As the pre-school years approach, the child faces the tasks of individuation and self-concept. These children may become fearful, confused, manipulative, and avoidant because of the mixed message they receive to their behavior, which is, without their control, chaotic. These early problems are strong contributors to later emergence of anxiety disorders in children with ADHD. My daughter had a great preschool that adapted to her needs. Although they handled things differently with her, she never had what I referred to as “mixed messages”, came out of her preschool years with a great self-concept, and was successful at individuation.

In elementary school, the child should be learning social interactions. However, they often demonstrate social deficits, particularly in processing social information and cues. They are often very sensitive to the feedback from others, and the shunning by peers, criticism from teachers and parents, lead the child to begin developing a negative self-image, low self-esteem and feelings of depression and anger. (Again, a parent can choose the environment carefully to minimize the social stress: always keeping in mind that your child’s self esteem touches every aspect of their life.)  

For info on family games that develop cooperation & social skills Click Here

Gresham (1988) notes that ability to successfully interact socially is one of the most important aspects of a child's development. Those social deficiencies have been "consistently linked to higher incidences of school maladjustment, suspensions/expulsions, delinquency and childhood psychopathology”.

As adolescence approaches, there may be a change in the symptoms of ADHD. There does not seem to be much research as to why some experts believe this. There are statistics that show a higher level of the inattentives in adolescence than in childhood. However, most inattentives are not diagnosed until the puberty years. All adolescence with attentive difficulties, whether they be hyperactive or inattentives, may start manifesting oppositional or antisocial behaviors that result in frustration and feelings of inadequacies. Guervemont and Dumas (1994), report that their ratings of social competence by themselves, parents, and peers have lower scores than those of normal peers. Their research reporting that the adolescent felt they were not liked, loners with no friends, or were involved in frequent fighting. At this stage of life, the social rejection and incompetence may be felt most heavily, when acceptance is so crucial.

This is as a result, the factor contributing most heavily to continued depressed moods, decreased self-esteem, and the emergence or worsening of antisocial behavior. The teens continued to have problems with school, home, and community. One of the major academic hardships reported by teens was the task of listening to an instructor and attempting to take notes at the same time. They find that their attention, when divided in that manner allows them to gain very little from a class. This does take a toll on the self-image, and only serves to accentuate their differences.

Both individual and group therapy can assist in what may be that one of the major milestones to be accomplished, which often occurs during these years: "Probably the hardest part of having ADHD is accepting the diagnosis… The disorder is part of who you are and, yes, you have to control it, but it does not define you. It's okay to have attention deficit disorder, as long as you know what to do about it." (Farley, 1997) This acceptance may be the key to overcoming many of the perceived failings, and resultant psychosocial issues such as lowered self-esteem and depression.

Social Skills

When social skills were defined as cognitive and overt behaviors a person uses in interpersonal interactions, children with learning disabilities, including ADHD, were found to be behind their peers. This does not imply that they engage in less social interactions overall, but instead focuses on the quality of those interactions. However, they engage in organized, extracurricular and sport activities that require complex social activities less often. They also tend to jump to a solution in social situations, rather than using problem solving behaviors, and use fewer nonverbal and verbal social skills than same-age peers. 

There are four domains in which children of ADHD have social difficulty:
High-rate intrusive behavior
Excessive talking, Interruptions, Noisy interactions, Dominating activities Monopolizing discussions, Obnoxious behavior

Deficient communication skills
Limited turn-taking during conversations, Less responsive to others' initiations, Likely to ignore peers' questions, Problems shifting roles between giving and receiving information, Inappropriate or disagreeable verbal exchange, Difficulty remaining on topic, Poor eye contact and motor regulation

Biased and deficient social cognitive skills
Decreased self-awareness, Less knowledgeable about appropriate behavior, Deficient social problem-solving skills, Biased attributions of others' intentions, Inattentive to social cues

Poor emotional regulation
Aggressive behavior, Temper outbursts, Overreaction to minor events, Excitability, Poor transitioning from one activity to another The generalization of social skills from a taught singular situation to larger settings is also decreased. As a result of these lack of skills, the tendency to is to act in an antisocial as opposed to prosocial manner.

School Performance Issues

Generally, ADHD will affect the student in one or more of the following performance areas:
Starting tasks
Staying on task
Completing tasks
Making transitions
Interacting with others
Following through on directions
Producing work at consistently normal levels
Organizing multi-step tasks                                                                                                                        Low metacognition and motivation (Munoz, Smeal, David, & Wittig, 1999)

 Studies show up to 50% of ADHD children have reading difficulties, nearly 40% have mathematical difficulties, and 30% are presented with both mathematical and reading difficulties. Speech and expressive difficulties were found to be present in children with ADHD at a higher rate than normal children. Because of lowered academic and standardized test scores, a high number of ADHD children are placed in special education settings.

Cognitive Symptoms

Seay (1999) notes many of the cognitive symptoms that are prevalent among children (as well as adolescents and adults), which contribute to the more widespread problems. These include "blinking", "scanning", "multi-tracking", "flooding", "radial thinking" and "hyper-focus".

"Blinking" is the quick loss of focus and then refocuses on a discussion or task. If this occurs during a conversation, or in school, the child will have missed content. They are faced with the task of asking for the person to repeat themselves, or not understanding the person or lesson.

"Scanning" is when the mind does not filter environmental stimuli. The child may be overwhelmed with input from a teacher, the fly in the room, another child talking, and the sound of the chalk. They may be unable to pick out a single item to give their attention to. This can lead to being perceived as not paying attention, to not being interested in a person or subject.

"Multi-tracking" is similar to "scanning", in that multiple stimuli are affecting the child. The difference lies in that the child is able to follow one of the stimuli instead of being overwhelmed, but jumps back and forth between them. This results in disjointed conversation with others, and loss of continuity in work.

"Flooding", can be described as "The porous system of the ADDer instantly absorbed all that is in his environment, in such an intense and pervasive way that it floods the person, causing them to overreact when compared to most people" (Seay, 1999). This results in the person pushing away from a situation that is painful or too stimulating, whether it is perceived as such by others.

"Radial thinking" is where the person with ADHD connects topics laterally rather than in a sequential fashion. They may begin new topics unannounced based on a thought that was generated by a single word in a conversation. When attempting to communicate ideas to others, this makes understanding difficult, and raises frustrations among both the person with ADHD and their listener.

Finally, "hyper-focus" is the reverse of what ADHD is normally perceived as. When a person with ADHD is able to focus on a topic, they may become so immersed in it that they have no time for any other pursuits, sometimes not even sleep. As a result, family and friends, other projects, are all pushed aside in the singular pursuit of one project.

The coexistence of cognitive problems with ADD is just starting to get more attention from the media.  We are one of the few centers that offer programs in cognitive training as part of a comprehensive treatment plan for ADD.

Incredible Horizons strives to offer cutting edge technologies to provide solutions to improve the life of individuals with attentional difficulties. Please look at the coaching programs and home services that we provide on our homepage.

Progression of ADD into adulthood

  Attention Coaching

Incredible Horizons ADD/ADHD Articles Loop

 References for research cited

Farley, D. (1997). On the teen scene: Attention disorder overcoming the deficit. FDA Consumer, 31(5), 32-36.

Gresham, F. M. (1988). Social skills: Conceptual and applied aspects of assessment, training and social validation. In J. C. Witt, S. N. Elliott, & F. M. Gresham (Eds.), Handbook of behavior therapy in education (pp. 523-546). NewYork: Plenum.

Guevremont, D. C., & Dumas, M. C. (1994). Peer relationship problems and disruptive behavior disorders. Journal of Emotional and Behavioral Disorders, 2(3), 164-173.
Hutchins, P. (1994). Learning, language and attention problems in adolescence. Available online: http://www.web-tv.co.uk/paul2.html [December 3, 1999].

Munoz, C., Smeal, D., & Witting, C. (1999) Problems of persons with ADD/ADHD. In Lazurus, B. (1999). Teach students with AD(H)D. Available online: http://www.soe.umd.umich.edu/belinda/teachadd.htm [December 11, 1999].

Price, B.K. (1999). Research results showing comparisons of characteristics exhibited from ADD/WO and ADD/H. Available online: http://members.aol.com/bevkprice/html/web03.html [December 3, 1999].

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