Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD) are common problems that many children or teens may experience. ADHD is classified into different subtypes including an Inattentive type, a Hyperactive – Impulsive type, and a Combined type. ADHD affects both boys and girls, though boys typically display more hyperactive and impulsive symptoms than girls. ADHD will often affect school performance and can typically affect home life as well as social interactions. In fact, one of the more common complaints of parents of children with ADHD is that their child or teen experiences social difficulties that may result in peer problems or difficulties in establishing and maintaining friendships. This is also frequently the reason why children with ADHD will sometimes exhibit symptoms of depression or sadness.
Another difficult adjustment issue for children with ADHD may revolve around school performance and school interactions. A child with ADHD may get in more trouble with his or her teacher and be seen as noncompliant or intentionally defiant. Often children with ADHD do not wish to cause problems in school or at home, but have increased difficulty managing their impulsive behaviors. Difficulty with organization and following directions are also common problems with ADHD often resulting in deficits in academic functioning. Children may also display increased challenges with flexibility in thinking and have a difficult time seeing others’ perspectives or changing gears. These types of symptoms can be especially frustrating for the child with ADHD as they may result in punishment from teachers or adults. Medication is a common treatment for ADHD though it is not the only method to address problems associated with this disorder. Counseling, social skills groups, and psychological assessment are commonly used in addition to or on their own in treating Attention Deficit Disorders.
Signs and symptoms of an Attention Deficit Disorder in children or adolescents may include:
History of poor achievement in school despite high intelligence
Difficulty and resistance to completing homework, boring tasks, and studying
Challenges with organization and initiating projects or assignments
Low frustration tolerance for boredom or difficult activities
Difficulty following directions
Difficulties in social functioning or problems with peers
Difficulty focusing and paying attention
Forgetfulness and a tendency to lose things
Hyperactive behaviors including difficulty sitting still
Speaking without thinking
Blurting things out or interrupting others
Counseling and Therapy
Individual, family, and group therapy can be helpful for the child with ADHD and for the family and parents wishing to support their child or teen. Individual therapy can help a child work through adjustment issues and frustrations that come with symptoms of ADHD. Individual counseling can help a child become more aware of their triggers, become more mindful of their choices and actions, increase their frustration tolerance, and help the child or teen make better decisions. Behavioral management strategies through individual and family therapy can be helpful in providing both the child and the parents with more effective strategies to help with organization, compliance, decision-making, and frustration management. It can also be beneficial for children and families to have a greater understanding of the disorder as well as to be able to identify and address other behavioral or emotional problems associated with ADHD.
Many children can benefit from group therapy that will address some of the social skills deficits associated with ADHD and ADD. Therapy can also address coping strategies that may help the child deal with frustration tolerance and management of boredom. Since children with ADD or ADHD may have difficulty staying focused in an individual therapy session, group therapy can provide a more action oriented format that will engage them in a more effective and productive manner. Therapy can help children with ADHD feel that they are not the only ones that are experiencing some of these problems. Group counseling can also allow for children to hear effective strategies from other children or teens that may help them in coping with their own individual problems. School social workers, psychologists, therapists, and psychiatrists often refer children and adolescents diagnosed with ADHD/ADD to the Activity Counseling Groups for Boys and Journeys Groups for Girls programs at Pathways Psychology Services to address social skills deficits.
While medication is a common treatment for Attention Deficit Disorder, counseling can help address adjustment difficulties associated with ADHD, strategies to work with ADD, and support parents in effective behavioral interventions.
Goals for counseling typically include:
Improve academic performance by assisting parents in developing schedules, organizational systems, and behavior plans in the home
Help the child and teen improve decision making through education into the nature of ADHD and the development of cognitive coping skills to think through situations more effectively
Improve social skills by increasing the ability to understand the perspective of others, identifying and correcting negative social behaviors, and learning more effective socialization strategies
Reduce defiance in the home through effective parent management and behavior planning
Identify and change thinking that leads or poor decision making, impulsive behaviors, and low motivation
Work through feelings of low self-esteem and feelings of inadequacy frequently associated with ADHD
Stop making poor choices with harmful or potentially harmful consequences
ADHD Testing and Psychological Assessment
Testing and assessment can also provide additional information besides whether the child does or does not have an Attention Deficit Disorder.
This type of information can include:
Specific areas of weakness
Specific recommendations to address deficits
Rule out Learning Disabilities
Provide schools with information to best accommodate the needs of the child
Provide parents with direction to address particular areas of weakness
In many cases, symptoms initially presenting as ADHD can be more accurately explained by anxiety, motivational challenges, learning deficits, vision or hearing impairments, processing deficits, or other areas of difficulty. One of the problems with relying solely on an ADHD diagnosis from an interview or questionnaire is that other difficulties or challenges may incorrectly lead one to assume that ADHD is present when it is not. On the other end, children with strong intelligence can fly under the radar and their condition may not be correctly noticed.
Assessments that incorporate performance tests which measure a child or teen’s actual performance in the areas of attention and concentration can:
Increase accuracy of making a diagnosis of ADHD and help avoid misdiagnosis
Comprehensive testing that includes measures of intellectual potential and academic achievement levels creates a more complete picture of the child’s functioning in the areas of attention and concentration in comparison
Avoid under-diagnosis common in highly intelligent or gifted children
Accurately specify the nature of the attention disturbance among the subtypes of ADHD
Allow for school accommodations children diagnosed with ADHD/ADD are entitled to receive
ADHD/ADD can present in many different ways in children and adolescents. Comprehensive psychological assessment allows for a more holistic picture of the child and specific recommendations to address individual needs.