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Developmental Demands of AD/HD Written by Judith M. Glasser, Ph.D.,
ADHD can take a toll on a family especially due to the genetic nature of this disorder. Oftentimes several members of a family have different forms of ADHD; while the disorder is genetically linked, the specific type of ADHD can vary from person to person. One person might have more symptoms of hyperactivity, while another person might be quite forgetful and disorganized. In any case, there can be a great deal of stress and conflict in a family when one or more members have ADHD. In addition, the specific type of stress that is associated with ADHD varies over time. Often, although certainly not always, a child with ADHD is difficult from infancy. It is not uncommon to find a history of colic and ear infections in a child who is later diagnosed with ADHD. Difficulty establishing regular sleeping and eating habits are also common. There is a wide range of abilities present with children who receive this diagnosis; some are late in developing motor milestones such as crawling and walking, while some are very early. Some are so hyperactive they are climbing out of their cribs very early and able to lock and unlock doors, causing enormous worry for their parents. Of course many children later diagnosed with ADHD are delightful and fun. They also span the range in intelligence and can certainly be bright and creative. Once the child enters day care or pre-school, another set of problems can occur. The child may be impulsive and get into all kinds of difficulties with their class mates. All pre-school age children are impulsive. However, children who are later diagnosed with ADHD often stand out even at these young ages for their difficulty with sitting still during circle time, difficulty keeping their hands to themselves, and difficulty following directions or listening. A minority of children with ADHD behaves aggressively in an impulsive way, and can get kicked out of pre-school due to their behavioral difficulties.
Elementary school age children enter a new world of challenges. For many of the children with ADHD the school age years are a real struggle as they try to meet classroom demands. One of the hallmark challenges for people with ADHD is difficulty focusing on tasks that require sustained mental effort. School work frequently requires sustained mental effort, often on topics in which children are not terribly interested. Society requires that children learn specific information, some of which is interesting to them and some of which is not. While everyone can focus better when interested, for these children, requirements to focus for extended periods of time on material which is uninteresting to them, becomes an extreme source of difficulty. Not only must the child sit in a classroom with 20-30 other children and concentrate for 6 &1/2 hours a day, but then he is given more work to do at home. Homework struggles can be taxing for all families, but especially so for those with a child who has difficulty with focusing, concentrating, and organizing, and who tends to lose and forget things. I often hear of a child who completes homework with a parent and then forgets to turn it in, causing the parent to be extremely frustrated. Children with ADHD also often have social difficulties, as they try to get along with teachers and peers. They don’t understand non-verbal cues as well as others do and they can often misunderstand the impact of their behavior on others. They may not get their work completed, and may lose recess time which is often an important time for developing social skills in this age group. They may struggle in after school activities as well; religious school activities, scouting, and sports all occur in a group context and place demands on these children to listen and follow directions, often after a full day in the classroom. Middle school can be a blessing or a curse for the ADHD child. For some children, changing classrooms and teachers for every class represents a relief; at least they get to move around and change scenery. If they don’t get along with a teacher or student, at least there is a chance in the next class. However there is more to keep track of and there is more independence expected at this age. Often, there are 7 different classes, with 7 teachers, and 7 books and sets of homework to organize. If the child has not learned how to use an assignment book and organize their materials, they can really have difficulty coping. In addition, the social stress increases in this age group as hormones kick in. Children with ADHD are often slower to mature emotionally than their peers; some people in the field believe that children with this diagnosis are one-third less mature in terms of their social/emotional development than their same age peers. This situation can cause major struggles and can lead to the child being the victim of teasing and bullying (see article by Eric Rossen, Ph. D. on Bullying). By high school, lack of good study habits has often become an issue for the teenager with ADHD. Struggles with parents can become quite intense at this point in a child’s life. By the time a child reaches high school, parents begin to look for signs that the child is moving towards independence. Every parent’s goal is to raise a child who will be able to function independently by the age of 25 to 30. Because a college education is often an important factor in achieving financial independence, the tension between parent and child may grow. This is because; high school grades begin to count towards the goal of getting into college. For the previously diagnosed child, impulsivity and distractibility combine with hormones and increased social pressure make this time an even greater challenge. If ADHD has gone undiagnosed, a decline in grades in this age group can signal a problem for a child that has struggled silently up till now. They must make choices daily between the excitement of new found freedoms and the demands of parents and schools. Driving presents new challenges for the distractible and impulsive person, and raises new worries for parents. The big three concerns for parents of children this age are usually sex, drugs and alcohol, and all can be especially tempting for the ADHD teen. Because ADHD rarely occurs in isolation, often by adolescence there is also some difficulty with depression or anxiety. This is due in part to the fact that life with ADHD can be such a struggle, and these kinds of emotional problems can arise out of the struggle. In addition, the same biological problems that cause ADHD can also cause problems with depression and/or anxiety. No matter what the developmental age of the child, there is help for the problems associated with ADHD. First there must be appropriate diagnosis, with education provided for the family. If medication is used as part of the treatment plan, it is important to monitor the child’s response closely. Environmental intervention is also often important; parents and therapists need to be involved with the child’s school and need to intervene when necessary. Other helpful approaches to reducing the challenges of ADHD may involve technological aids as well as coaches and tutors. While treatments don’t “fix” the underlying neurological problem, they can greatly minimize its impact and improve the child’s ability to learn, to relate well to others, and to better manage his or her daily life. |
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