About the mind of a child with ADHD
Why ADHD causes emotional outbursts
How to handle outbursts
Long-term strategies for managing ADHD
In this module, you will learn:
About the mind of a child with ADHD
Why ADHD causes emotional outbursts
How to handle outbursts
Long-term strategies for managing ADHD
ADHD in Childhood – 5m13s
4.1 Inside the Mind of a Child with ADHD
From the point of view of a child with ADHD, their emotions are very much amplified
compared to those of other children.
Intense feelings and heightened sensitivity are common for children with ADHD, as are mood swings
and irritability. Children with ADHD are also prone to angry or emotional outbursts which seem
disproportionate to the situation which triggered them. This experience of emotional dysregulation
can be extremely difficult for children, and it’s important to understand that they have little control
over it.
Sadly, due to a lack of understanding, the child often runs up against negative tags such as
'troublemaker' or the 'naughty kid', etc. Dispelling this misunderstanding is key to helping them
move forward positively.
Children with ADHD often suffer negative feelings due to their emotional lability. These
could include:
Feelings of frustration and disorientation
Impatience and isolation
Disconnection with others and confusion
Restlessness and lack of control over oneself
In this module, we begin to look more closely at what is really going on inside the mind of a child
with ADHD, to help you to understand their symptoms better and explore ways to alleviate them.
First, it’s necessary to touch on some findings regarding the ADHD brain itself.
Brain imaging has shown that there are some differences in the brains of those with ADHD as
compared to their neurotypical peers and, in theory, this could play a role in aspects of the
condition.
For example, it has been noted in several studies that the prefrontal cortex is underdeveloped in
children diagnosed with ADHD when compared to other children the same age. This is potentially
important, as that is the area of the brain responsible for things such as impulse control,
concentration, judgement and executive functioning.
Other studies have observed a link between a part of the brain called the corpus striatum and ADHD
medications, leading to a theory that an issue with this brain area contributes to ADHD. It was found
that one of the medications used to treat ADHD (methylphenidate) always goes directly to the corpus
striatum, which is part of the brain that decides which thoughts or feelings to send to the prefrontal
cortex for processing. Normally it only sends one thing at a time, but the theory is that in ADHD
brains, the corpus striatum sends several things to the prefrontal cortex at the same time. This
would explain why people with ADHD often feel that they have too much going on in their minds. It
is thought that methylphenidate helps the corpus striatum to function properly, which is why it helps
with ADHD symptoms.
There are numerous other observations and theories regarding irregularities in the brains of those
with ADHD. Some are related to specific regions of the brain, while others focus on the chemical
messengers (neurotransmitters) which carry information between the various regions. Suffice it to
say, there are thought to be several significant differences, and these are likely to cause the
symptoms associated with the condition.
So, what does this actually mean for a child with ADHD? What is their experience of their ADHD
symptoms?
There are a number of key terms or words that children tend to use when describing the
impact of ADHD on their minds:
It's uncontrollable
The first thing that they will often mention is that it really is out of their control. They may very well
wish to stop hyperactive activities or control their impulsive behaviour, but it is something that is
beyond their capabilities. The same is true of inattention symptoms – they try really hard to focus
but simply can’t do it.
There is too much going on in their mind
Another common complaint is that there is simply too much going on in their mind all the time - like
they are trying to process several thoughts all at the same time. This makes it harder for them to
focus on anything, and leads to them failing to get things done, no matter how hard they try. This in
turn leads to frustration and negative self-talk.
They feel bad about themselves
This may be surprising to many, but children that have ADHD are aware of what they are doing, but
because they can’t control it, they feel bad about their actions. They are also aware, for example,
that other children sometimes don’t want to play with them, or that their teachers and other adults
can get annoyed with them. They are prone to blaming themselves for the situation when, of course,
it’s not their fault at all.
They often feel frustrated, angry or anxious
Perhaps not surprisingly, a child with ADHD is liable to feel both frustrated and angry at times.
Anxiety is also common, as children with ADHD often worry about getting into trouble or not
knowing what they’re supposed to be doing.
As you can see, these are all extremely negative feelings that the child experiences, and you can now
begin to understand how this makes life so difficult for them.
Children with ADHD require support from patient, sympathetic and understanding people as they
make their way in the world.
This is especially true of the times when it all gets too much for the child, and their emotions become
overwhelming, triggering an outburst. We will now move on look at those kinds of situations and
how they come about.
4.2 Why ADHD Causes Emotional Outbursts
Many children with ADHD will have emotional outbursts at times, and often the flare-ups
will seem completely out of proportion with what triggered them.
Why is this? Why are the reactions of children with ADHD sometimes so intense? To answer these
questions, we need to delve further into the impact of ADHD on the child’s daily life.
It’s crucial for parents and caregivers to understand ADHD outbursts, and how to handle them. If we
can offer a better explanation of why these outbursts happen, then they can face them with an
approach that will help to defuse and calm the situation, rather than exacerbate it.
Emotional dysregulation
One major contributing factor to outbursts is something we touched on earlier – emotional
dysregulation. To reiterate, this is extremely common in children (and adults) with ADHD and means
that people with ADHD struggle to manage their emotional responses. Typically, emotional
dysregulation presents as persistent irritability, mood swings, overreactions to events or situations,
and emotional outbursts or anger.
Hyperactivity
Physical and/or verbal hyperactivity, and the restlessness that goes along with it, can sometimes be
too much for a child to handle. In this situation, an angry outburst can occur simply to allow the
child to release the tension which has been building up.
Impulsivity
Being impulsive means that the children are more likely to express anger or annoyance because they
find it difficult to control their emotions or their reactions to trying situations.
This is not easy to control - even for the parent watching their reaction - and it illustrates how
challenging this condition can be.
Frustration
Children with ADHD generally have a low tolerance to frustration, meaning that they get frustrated
easily. Furthermore, their daily life is filled with more challenges and frustrations than their
neurotypical peers, and their emotional experience is more intense. Because of this, their frustration
can easily turn into angry outbursts.
Low self-esteem
Low self-esteem is common among children with ADHD. Criticism from others for not understanding
their condition, difficulties with academic achievement, and problems making and keeping friends
can all contribute to feelings of low self-worth. In many cases, this can lead to anger.
Medication rebound
Finally, it’s also worth mentioning the phenomenon known as ‘medication rebound’. This happens
when the effects of the ADHD medication start to wear off, with the result that intense ADHD
symptoms occur. This is difficult for children to manage, and can manifest as highly emotional
outbursts.
There are many reasons why children with ADHD experience outbursts, and it’s important to note
that they’re all outwith the control of the child.
However, if you pay close attention, you can begin to understand and identify the situations in which
those emotions and outbursts can suddenly emerge. Identifying triggers can be very useful, and
when this is followed up with the right support, it’s possible for children with ADHD (and their
parents) to learn some strategies to help cope with their intense emotions.
4.3 How to Handle Outbursts
Even though we are using the term 'outbursts' it is important not to perceive this as a form
of temper tantrum.
Remember that the child has no control over the outburst and that it stems from their ADHD
symptoms rather than a desire to get their own way. How you deal with those outbursts is going to
have a profound impact on not only the child but also the family situation in general.
The key is to accept that outbursts will happen and to be prepared.
Understanding on the part of parents, siblings, caregivers, teachers, and significant others can
empower the child. Parents and teachers can work together to develop coping strategies and help
the child build upon their core strengths.
A child with ADHD will improve when they receive support, understanding and recognition, and this
in turn will help to foster that all-important self-esteem.
There are a number of simple steps that parents can take to help to reduce the frequency and
severity of outbursts:
Identify triggers: You might notice that outbursts are most common at certain times, for
example after school, when the child is mentally drained. In this case, ensure you don’t
schedule too many after-school activities – rather, allow them some quiet time to relax once
they get home, or if possible, spend some time playing outside to release some tension.
Follow a schedule: Children with ADHD need structure, and can get anxious when they don’t
know what to expect. Set a schedule and stick to it, so that there is no uncertainty. For
example, have a set time every day for homework or chores.
Be empathetic: React with empathy when the child is angry, and instead of threatening
punishment, ask them what’s wrong. Allow them to explain, and be supportive.
Stay calm: There is no benefit to reacting angrily to a child’s outburst. It is better to talk to
the child quietly and calmly or even to temporarily remove yourself from the situation if
necessary.
Encourage self-regulation: Some children will respond very well to simple methods of self-
regulation such as taking deep breaths, or journalling their feelings. They should be
encouraged to find which ways work best for them – this exercise will have long-term benefits.
There are other things which can help, such as ensuring the child eats a healthy, balanced diet, and
that they get sufficient sleep. Try to make time for play, and remove as much stress as possible from
their lives.
Later in the course, we will dedicate an entire module to the art of dealing with intense emotions
and how to calm things down. However, at this moment, it is enough to just make you aware that
there are things you can do that will make a huge difference to not only the situation at the time but
also the way in which a child will react to a similar situation in the future.
FACT
According to a European Lifetime Impairment Study, parents/carers of children with ADHD report a
negative impact on the lives of their children at school, socially, and when doing daily activities.
Source: ADHD-Institute.com
4.4 Long-Term Strategies for Managing ADHD
Finally, we take a look at some general goals and long-term strategies for managing ADHD
in childhood.
There is no fixed template or rulebook to follow, as what works for one family might not work for
another. However, the following are some general guidelines for how to approach life with a child
with ADHD, and this advice can be tailored to fit any family.
Determine key triggers
As time progresses, you will get to know the key triggers or antecedents that will lead to a potential
issue for the child - and it will make a major difference if you can take the time to observe the
triggers and try to think of ways to avoid them or lessen their effect. Essentially, it’s best if you can
spot problems before they strike, and try to avoid them where possible.
Stick to treatment plans
When a child is diagnosed with ADHD, you need to make sure that the treatment plan is followed to
the letter. This means ensuring regular attendance at approved therapy sessions, and that
medication is taken as directed. Any side effects or other issues should be discussed with a doctor as
early as possible. Finally, it also means that any approved diet and lifestyle approach is adhered to
consistently.
Listen to others
By listening to others, we mean spending time talking to and reading about other adults who are in
the same position as you, no matter the relationship that you have with the child in question. For
example, if you are a parent, try and learn what other parents are doing in this situation. If you are a
teacher, read up about how other teachers work with children who have ADHD. The idea here is that
you can learn from others’ experiences and then improve your own approach. This will ensure you’re
in a better position to help the child.
Inform others
It’s useful to let other significant people in your child’s life know that they have ADHD, and share
some information about what this means. This is especially important for anyone who regularly looks
after your child or has them around for play dates. This will help them to understand how to look
after the child, and it will ensure a consistent approach from all caregivers.
Look after your own wellbeing
This is really important but can easily be overlooked. ADHD can be draining for parents and other
caregivers, and it’s essential that they find ways to relax and look after their own mental health. It
can be something as simple as having a long hot bath or a walk in nature, while the other parent or
another caregiver takes over. If time isn’t made for this essential self-care, parents run the risk of
burnout - and they will find it more difficult to be patient and calm with their child as a result.
Careful planning, consistency, and clear communication with medical professionals, teachers and
other caregivers are all really important aspects of an effective approach to ADHD. Also, keep
learning about the condition – be it through books and online resources, from your doctor, or from
carefully observing the child with ADHD. It can be tough, but with effort, the right treatment and
strategies can be found to help.
SUMMARY
In this module, we have sought to try to provide you with a better idea of what is going on inside the
mind of a child with ADHD.
We examined some of the negative feelings commonly experienced by children with ADHD, and
linked those feelings to the emotional outbursts that occur when it all gets too much.
We looked at some ways in which parents and other carers can react to the child’s emotional state,
and touched on some general guidelines for a baseline approach to ADHD.
One of the key takeaways is that this is a condition – it is not the child misbehaving. They have little
control over their symptoms initially. The way in which you identify their danger signs and then take
the appropriate action will make a huge difference.
In the next module, we will move on to adolescence and how ADHD affects this stage of life.
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