Some commonly observed challenges with children who have ADHD are Oppositional Defiance Disorder, Rejection Sensitivity, Hyperfocus, Emotional Dysregulation and Masking. A brief overview on each of these challenges is provided below.
Oppositional Defiance Disorder
Oppositional defiant disorder (ODD) is a childhood behavior disorder defined by a persistent pattern of hostile, vindictive, and defiant behaviors towards authority figures. ODD may be diagnosed if this behavior lasts 6 months or longer.
- An oppositional, defiant child will often lose his temper, argue with adults, actively defy requests or rules set by adults, deliberately annoy people, and blame others for misbehavior.
- The child will engage in angry, violent, and disruptive conduct directed at the adults in his life which include parents, teachers, physicians, and other authority figures.
- Additionally the child may also seem to feel most comfortable in the midst of a conflict, which is upsetting and exhausting for everyone involved — even the child himself.
- The symptoms of ODD may look different for girls and boys, in whom the condition is more common. Boys with ODD tend to be more physically aggressive and have explosions of anger while girls often lie, refuse to cooperate, and otherwise express symptoms in indirect ways. ODD is usually diagnosed in early childhood; some patients outgrow the condition by the age of eight or nine.
- ODD impacts between 1 and 16 percent of children and adolescents in the general population, but is far more common among patients with attention deficit hyperactivity disorder (ADHD). In fact, 4 out of every 10 children with ADHD also show signs of ODD.
- Some experts suggest that ODD may be tied to ADHD-related impulsivity. “Many kids with ADHD who are diagnosed with ODD are showing oppositional characteristics by default,” says Houston-based child psychologist Carol Brady, Ph.D. “They misbehave not because they’re intentionally oppositional, but because they can’t control their impulses.” Other experts suggest that ODD is a way for kids to cope with the frustration and emotional pain associated with having ADHD.
Source: https://www.additudemag.com/what-is-oppositional-defiant-disorder/
Rejection Sensitivity
Rejection sensitive dysphoria (RSD) is an intense vulnerability to the perception – not necessarily the reality – of being rejected, teased, or criticized by important people in one’s life. RSD causes extreme emotional pain that may also be triggered by a sense of failure, or failing to meet either your own high standards or others’ expectations.
- Rejection can be especially hard for kids with ADHD (also known as ADD). They often experience its effects more intensely and take longer to recover from it.
- Many kids with ADHD struggle with managing emotions . Being rejected can bring up very strong and long-lasting feelings. These might include feelings of disappointment, sadness, shame, and regret.
- Most kids have ways of making themselves feel better if they’re rejected. Handling rejection requires executive skills that most kids with ADHD lack. These include cognitive flexibility and self-control.
- Executive skills allow kids to come up with explanations for what happened and develop a plan to move on. This kind of thinking helps kids put things in perspective. But kids with ADHD can get stuck. They find it hard to shift their thinking and move on. So, they may become hyper focused on the rejection, talking about it constantly.
- Kids with ADHD often already feel like they’re on the outside. They’re more likely to struggle in school and have social issues which can lead to poor self-esteem.
In extreme cases, rejection triggers such painful feelings that kids go to great lengths to avoid it. They might spend a lot of energy pleasing other people, so they won’t be rejected. Or they may withdraw from situations that might lead to rejection, like joining games at recess. This only makes them feel more isolated. And it can contribute to mental health issues like anxiety and depression , which are common in kids with ADHD.
Source: https://www.additudemag.com/symptoms-of-add-hyperarousal-rejection-sensitivity/
Hyperfocus
Hyperfocus refers to an intense fixation on an interest or activity for an extended period of time. People who experience hyperfocus often become so engrossed that they block out the world around them. Children and adults with ADHD often exhibit hyperfocus when working intently on things that interest them.
- For children, the object of hyperfocus might be playing a video game or watching TV. Adults might hyperfocus on social media or shopping. But whatever holds the attention, the result is the same: Unless something or someone interrupts, hours drift by as important tasks and relationships fall by the wayside.
- Like distractibility, hyperfocus is thought to result from abnormally low levels of dopamine, a neurotransmitter that is particularly active in the brain’s frontal lobes. This dopamine deficiency makes it hard to “shift gears” to take up boring-but-necessary tasks.
- “Children and adults with ADHD have difficulty shifting attention from one thing to another,” says ADHD expert Russell Barkley, Ph.D. “If they’re doing something they enjoy or find psychologically rewarding, they’ll tend to persist in this behavior after others would normally move on to other things. The brains of people with ADHD are drawn to activities that give instant feedback.”
- There’s nothing inherently harmful about hyperfocus. In fact, it can be an asset. Some people with ADD or ADHD, for example, are able to channel their focus on something productive, such as a school- or work-related activity. Others allow themselves to hyperfocus on something as a reward for completing a dull but important task. Many scientists, writers, and artists with ADHD have had very successful careers, in large part because of their ability to focus on what they’re doing for hours on end.
Source:
https://www.understood.org/articles/en/adhd-and-coping-with-rejection-what-you-need-to-know
https://www.additudemag.com/understanding-adhd-hyperfocus/
Emotional Regulation
Children with ADHD experience the same emotions as other children, but their feelings are more frequent, intense, and longer-lasting. Because the underlying brain mechanisms that help manage emotions are affected by ADHD, emotional regulation development is delayed. Emotions hit them more quickly and they are easily overwhelmed by them. This may result in exaggerated overreactions. A child with ADHD may:
- Be quick to get frustrated by minor annoyances.
- Worry too much or too long about even small things.
- Have trouble calming down when they’re annoyed or angry.
- Feel hurt or take offense at even gentle criticism.
- Feel excessive urgency to get something they want now.
Parents find that managing their kids’ outbursts and intense mood swings can be very challenging.
Emotional dysregulation affects well-being, family life, academic achievement, and vocational success. It contributes to low self-esteem and social difficulties more than any other symptom of ADHD. Emotional dysregulation can also persist into adulthood and usually worsens with age, so early intervention is essential.
Source:
https://www.additudemag.com/emotional-regulation-adhd-kids-strategies/
https://adhdfoundation.org.au/wp-content/uploads/2020/05/The-Key-to-ADHD-Emotional-Regulation.pdf
https://www.understood.org/articles/en/adhd-and-emotions-what-you-need-to-know
Masking
ADHD masking is when someone with ADHD presents in a way that makes them seem like they are not living with the disorder. ADHD masking may also be called “camouflaging.” This is when someone with ADHD tries to cover up their symptoms by copying the behaviors of people who don’t have it. ADHD masking may be a way for some people with ADHD to fit in socially, avoid being stigmatized, or feel more accepted.
Types of ADHD masking seen in children include:
- Staying too quiet and being overly careful about what they say to avoid talking too much or interrupting people.
- Obsessively checking their belongings to make sure that they don’t lose things.
- Reacting as they are expected to during class instead of how they feel inside.
- Hiding hyperactivity through calmness, so people think everything is fine.
- Listening carefully and focusing too hard when someone is talking to not miss anything they say.
- Excessively writing everything down so they don’t forget it later because of memory issues with ADHD.
- Bottling up intense emotions until they feel sick inside without knowing why (this can sometimes also lead to depression).
- Being irritable when they are forced to concentrate on something that doesn’t interest them for an extended period of time.
ADHD masking can be used as a coping mechanism and sometimes may help people get by when they are young and trying to make sense of the world around them. But eventually, this behavior becomes difficult to manage on its own.
ADHD masking can hide symptoms, which may lead to a delay in diagnosis. People who engage in ADHD masking might be unaware that they have undiagnosed ADHD, which may lead them to develop depression and anxiety.
Source: https://www.verywellmind.com/what-is-adhd-masking-5200863