ADHD Dictionary

With school (kind of) starting again, I offer this dictionary of important terms regarding ADHD.   It is not inclusive but hopefully a good primer in helping to better understand and deal with ADHD.

ADHD core symptoms:  Inattentive, disorganized, impulsive and/or hyperactive.  In addition, (for some), poor emotional and behavioral control.  The diagnosis is given as Attention Deficit/Hyperactivity Disorder, “primarily inattentive presentation”, “primarily hyperactive/impulsive presentation”, or “combined presentation”.

Boredom Anxiety:  People with ADHD can tend to get bored easily.  When faced with a boring task, lecture, social gathering, they may feel anxious about how to handle that.  Boredom turns into an anxious feeling and this can cause irritation and avoidance.  When kids anticipate a boring event, it can cause oppositional behavior or shut-down.

Cognitive Behavioral Therapy: A form of talk therapy and writing therapy that helps a person become aware of irrational or inaccurate thinking.  It helps in managing challenging situations and can decrease strong emotions such as panic, anger, fear, and sadness.

Coping Skills: Ways for parents and kids to handle the challenges of ADHD in positive ways.  Fredrikson and Joiner in 2002 reported that those with a wide range of coping skills tend to interpret their experiences as positive.  This suggests that coaching for coping skills is essential in successful management of ADHD.  Typical skills worked on include time management, organization, and executive functioning.  Other skills include mindfulness, taking space, cognitive behavioral therapy (CBT), and deep breathing.  CBT and mindfulness “have been shown to improve regulatory processing (Lewis et al., 2008).”

Effortful control:  Forcing oneself to do that which one does not want to do or inhibiting actions which one is tempted to do (Wiersema & Roeyers, 2009).

Emotional Repair: The ability to shift emotional and mental states from heightened or aroused to neutral. (This is especially a challenge in some people with ADHD).   Poor emotional repair leads to staying in bad moods and struggling with communication, especially regarding feelings.

Escape/avoidant coping strategies:  Often used by those with ADHD when faced with a challenge.  This can lead to a downward spiral of depression, anxiety/panic, low confidence, and low resilience.

Executive functioning: The cognitive set of skills that facilitate a successful day.  The skills include working memory (defined below), selective attention, inhibition, alertness, flexibility, planning and executing a series of actions, acting in novel situations, and handling complex tasks.

Focus regulation problems: This might be the best way to conceptualize ADHD.   People with ADHD can focus, sometimes too much on one stimulus.  The challenge for many with ADHD is shifting focus and putting it where it needs to be.

Frustration threshold: The line between productive and unproductive stress.   In 1957 Broadhurst reported on the relations between performance and stress; too much stress reduces performance but no stress causes inaction.  Stress is helpful to a point, but it is important to have skills to manage it so that it will lead to motivation.

If-Then:   This is the ability to understand and observe cause and effect.   Gawrilow et al 2011 showed that if-then planning in kids with ADHD decreased perseverative errors, improved executive functioning, and promoted managing distractions.  Help kids with skills such as “If I feel like yelling, then I will squeeze my stress ball instead.”

Immature:  Kids with ADHD are often behind in social and emotional development.   It is important to understand that kids with ADHD, when stressed or having other strong emotions, should be viewed at their developmental age, not chronological age.  This helps with patience and empathy and problem solving.

Maladaptive coping:  Ineffective or destructive ways to handle tasks, situations, or emotions.  This often involves escape and avoidance behavior (exacerbated by social and academic failures).

Maladaptive behaviors: Stem from maladaptive coping.  For kids with untreated ADHD, these are dysfunctional behaviors.  They are learned because maladaptive coping can yield immediate relief of strong emotions.   Maladaptive behaviors include denial and avoiding, lying, and oppositional behavior; when older, this can include a tendency for drug or alcohol abuse.

Mindfulness: Being present and aware of the self.   It is the ability to and accept the now without judgment or criticism.  This has been shown to help manage ADHD (see the work of Lidia Zylowska.)

Negative intrusive thoughts: “Unbidden memories or invading thoughts of self-deprecation that bring with them a heightened level of emotional duress” (Norton et al, 2012; Salkoviskis & Campbell, 1994).  Many people with ADHD have intrusive negative self-narratives.

Observational learning: Learning new normative behaviors and social cues.   Kids with inattention may miss out on 10 seconds of this every sixty seconds.   That is one out of every six chances to learn social skills.   This can lead to a lag in development and social struggles (Chen & Bullock, 2004; Murray-Close et al., 2010).

One Touch Rule:  When you see it or are reminded of it do it.   People with ADHD often use reminders with the best of intentions but do not do what the reminder says right away.  Then they get distracted and not do what the reminder says.  It is important to get in the habit of doing the reminder now, while you are “touching it”.

Panic: Sudden uncontrollable fear or anxiety, often causing inhibition of positive problem solving. Common in kids with ADHD.  This is part of why teaching coping skills is important.

Praise versus failure ratio:  Most students need between three and five affirmations to counteract one negative in the classroom (Knoster, 2008).   Students with ADHD generally experience more failure than neuro-typical peers.  They therefore tend to need more positive reinforcement but tend to encounter negativity because of the challenges of focus regulation problems.

Reactive control:  The ability to regulate initial emotional reactions and behaviors.  This lags in kids with ADHD.  For parenting, it imperative to be patient and empathic.  This helps you and your child handle the negative intrusive thoughts that come with ADHD.

Rejection Sensitivity Dysphoria: Being overly sensitive to rejection; not handling rejection well.   Quite common in those with ADHD.  This is a feeling of being shunned or criticized even when that is not actually happening.  This may lead to social anxiety and avoidance.  Also, can lead to being overly agreeable and not having good boundaries.

Resilience:  Persistence in handling strong emotions and difficult situations.  It is crucial to help kids with ADHD build resilience.  (See “coping skills”, among other entries).

Reward response: The dopamine pathway in the brain is responsible for feeling reward.  This tends to be reduced in individuals with ADHD and leads to less effort and to burnout regarding academics.  This is especially challenging in delayed rewards which are the cornerstone of most classroom management systems – Covington, 2000. Frequent intermittent rewards work very well in ADHD.   Always and loudly recognize positives, quietly redirect.

Self-efficacy: “The mental evaluation a person does to determine how likely he/she is to be successful at a given task” (Van Derek Fiji & Shortridge-Badggett, 2002).    Kids with ADHD tend to have poor or negative self-efficacy.

Self-regulation:  Exerting a will against impulses.   Keeping routines such as regular sleep/wake times and eating schedules.

Social failure: Less friendships, social misinterpretations, and bullying due to gaps in social skills.  This may include difficulty in reading facial expressions, reading social cues and situations.  Also, for kids with ADHD, they may lag in age appropriate behaviors and with inhibition and management of impulses.

Social Skills- (See “observational learning”).  Kids with ADHD lose chances to learn social skills because they miss social cues.  The lag in social skills can escalate to larger social ineptitudes.  Chen & Bullock, 2004.  Many kids with ADHD are immature and behind in social and emotional development.

Stereotype threat: Those with negative stereotypes about how they will do in certain situations or tasks will, at times, perform worse than others despite being equally capable (Marx, Monroe, Cole, & Gilbert, 2013; Steele, Spencer, & Abramson, 2002).  Common stereotypes in ADHD include, “I’m just lazy”, and “I’m too stupid”.

Stimulants: Medications that increase Dopamine availability to the brain.  This is a chemical that the body produces.  It is important to activate the frontal lobe to help with focus regulation.  Stimulants have been shown in research to one of, if not the most, effective intervention to help treat ADHD and all the challenges that come with it.

Working memory:  The capacity to access or retain information and perform mental operations on that information.   It is an ability to hold and manipulate information in real time.  This helps in reasoning, understanding, and learning.  Treating ADHD has been shown to help improve working memory.

Reference:  ADHD Report, Russell A Barkley & Associates, Volume 27, No 7, November 2019

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