- Kids with ADHD may seem unruly at times, but the behavior is not necessarily intentional, nor simple for them to control.
- How adults respond to kids' ADHD can shape their self-view and dictate whether conduct disturbances develop.
- Telling an ADHD child to "behave" or that they need "to just focus" doesn't consider their internal experience and can engender defensiveness.
Attention-deficit/hyperactivity disorder (ADHD) needs little introduction. Restless, impulsive, inattentive, and distractible children with low frustration tolerance are believed to account for 4-5 percent of people aged 6-18 (e.g., Sayal et al., 2018; Mohammadi et al., 2019). Further (i.e., Sayal et al., 2018), it is believed another 5 percent exhibit symptoms considered sub-threshold of the full diagnosis.
With these numbers, chances are you have crossed paths with people with ADHD, especially if you work in healthcare or schools, and it might be frustrating at times. Even people who are prescribed ADHD medication do not have symptom remission. Prescriptions can help, but intensity can remain.
If you find being in the presence of someone who’s distractible and in constant motion challenging, imagine that experience from the inside out, with no reprieve. Now, imagine trying to get through your day as such, only to be barraged with messages that instill a sense of being flawed and/or “bad.”
How Adult Responses to ADHD Can Fuel Conduct Complications
It’s no secret that kids (and even adults) with ADHD are inundated with reactions from others, well-meaning and otherwise, that instill a sense of marginalization and deprecation that only serves to deepen their conflicts. On the more innocuous end of the spectrum, children with ADHD often feel depressed because it is such a struggle to keep up with peers, and they don’t feel like they fit in. On the more toxic end of the spectrum, conduct disorder is not an unusual co-occurrence when ADHD kids are treated as “bad.”
To understand the latter, consider that kids with ADHD are often told to behave and are meted out reprimands or reacted to negatively at school, home, or both for something they have no control over (e.g., Bjornebekk et al., 2015). Feeling little control over their internal or external environment and unfairly aggressed, they may gain a sense of control by becoming the aggressor. Then, they are no longer the victim in their mind, and being an aggressor also punishes those who they perceived as wronging them.
Having never felt empathized with, as noted by famed personality expert Stuart Yudofsky (2005), they may reason, “I’m not going to give what I never got.” This, of course, makes it easier to remain offensive and maintain that sense of omnipotent control. Add to this that, at baseline, they are likely impulsive, stimulation-seeking, and risk-takers, making it hard to control their frustrated reactions, and it is easy to see how they may react with conduct disturbances like fighting, running, and theft.
It has been established that the way others respond to children with ADHD can have a big impact on whether they develop other behavioral complications (e.g., Bjornebekk et al., 2015; Nelson et al., 2019). This is important not only for the child but for society because the trajectory of children with Conduct Disorder is correlated to adult sociopathy (e.g., Storebo et al., 2016; NICE, 2017; APA, 2022).
Avoid These 2 Phrases for ADHD Children
People who encounter kids with ADHD are frequently guilty of two phrases that ultimately add to their frustration and contribute to a negative self-perception and possibly conduct issues. If you know someone with ADHD, or you encounter such individuals on the job and aren’t sure what to say, avoiding the following two phrases will likely up your game, especially if replaced with the suggested alternatives.
1. “Will you behave?”
Often muttered by frustrated caretakers as their ADHD child fidgets off the Richter Scale, touching everything they were told not to, this utterance implies that the kid is being intentionally oppositional and mischievous, and thus “bad.” It must be remembered, though, that it is in the nature of ADHD for children not to have fully heard what you said, to have quickly forgotten what was asked of them, and, perhaps even harder, to control their penchant for simply gravitating towards anything that looks interesting to play with.
Instead, practice recognizing that what appears as opposition is not personal nor necessarily intentional. There’s a good chance that being accusatory will only escalate the matter as the kid tries to stick up for themselves, which is perceived by the frustrated adult as further opposition, fueling an unproductive cycle. Approaching the child with a more understanding offering, perhaps firmly if need be for emphasis, such as, “I know there’s a lot going on all around, and it’s hard to keep contained in situations like this, but I’ve seen you do it before. We’re almost done.”
This statement sends a more supportive message, letting them know you recognize their struggle but reminding them they have the ability to keep it together and that the overstimulating situation is not forever. While this approach may not be a perfect antidote, it at least spares the child from feeling embarrassed and deviant and likely from escalating the situation into an argument.
2. “I just need you to stop and focus.”
If it were that easy, they’d “just” do it. The child doesn’t want to be distracted any more than a teacher or parent wants them to be. Adding insult to injury, it tends to be delivered in an authoritarian or patronizing manner with an implied finger wag. Imagine being on the receiving end of that when you’re doing the best you can despite your mind being a pinball machine.
“I just need you to stop and focus” can send a message that if only the kid wanted to, if they weren’t being so devious, they could reign it in and be as attentive as a surgeon. Naturally, the kid’s attention may continue shifting, only frustrating the requester, who becomes more commanding. This is the equivalent of speaking louder and slower in your native tongue to someone foreign in the hopes they’ll finally understand you.
Instead of seeing them as uncooperative, it is more productive if we can learn to cooperate with them. I recently evaluated a young teen who was literally under the table, on the windowsill, and sitting in all the different chairs in the room as I interviewed them. Ideally, they would’ve remained seated for a more linear discussion, but allowing them to engage their need for stimulation actually kept them better focused for the discussion. It was as if the whole room was their fidget spinner. Trying to control their impulse to move and pay attention to the conversation would’ve proven too burdensome, and they’d naturally err to the physical need.
If you are a parent, teacher, or helping professional and encounter children whose ADHD is particularly challenging, and you find yourself reactive to it, parent retraining (one doesn’t have to be a parent to attend) could prove a useful endeavor (e.g., Rapaselli, 2018; Hornstra et al., 2021).
Disclaimer: The material provided in this post is for informational purposes only and is not intended to diagnose, treat, or prevent any illness in readers or people they know. The information should not replace personalized care from an individual’s provider or formal supervision if you’re a practitioner or student.
Facebook/LinkedIn image: Rawpixel.com/Shutterstock
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
Antisocial behaviour and conduct disorders in children and young people: recognition and management. (2017). National Institute for Health and Care Excellence (NICE).
Bjørnebekk G., Kjøbli J., & Ogden, T. (2015). Children with conduct problems and co-occurring ADHD: Behavioral improvements following parent management training. Child and Family Behavioral Therapy, 37(1), 1-19. doi: 10.1080/07317107.2015.1000227. Epub 2015 Mar 9. PMID: 25892844; PMCID: PMC4396403.
Hornstra, R., van der Oord, S., Staff, A.I., Hoekstra, P.J., Oosterlaan, J., van der Veen-Mulders, L., Luman, M., & van den Hoofdakker, B.J. (2021) Which techniques work in behavioral parent training for children with ADHD? A randomized controlled microtrial. Journal of Clinical Child & Adolescent Psychology, 50(6), 888-903, DOI: 10.1080/15374416.2021.1955368
Mohammadi, M.-R., Zarafshan, H., Khaleghi, A., Ahmadi, N., Hooshyari, Z., Mostafavi, S.-A., Ahmadi, A., Alavi, S.-S., Shakiba, A., & Salmanian, M. (2021). Prevalence of ADHD and Its Comorbidities in a Population-Based Sample. Journal of Attention Disorders, 25(8), 1058–1067. https://doi.org/10.1177/1087054719886372
Nelson, T., East, P., Delva, J., Lozoff, B., & Gahagan, S. (2019). Children's inattention and hyperactivity, mother's parenting, and risk behaviors in adolescence: A 10-year longitudinal study of Chilean children. Journal of Developmental and Behavioral Pediatrics, 40(4), 249–256. https://doi.org/10.1097/DBP.0000000000000661
Rapaselli, D. (2018, March 28). Parent training for children with ADHD. Psychiatric Times. https://www.psychiatrictimes.com/view/parent-training-children-adhd
Sayal, K., Prasad, V., Daley, D., Ford, T., & Coghill, D. (2018). ADHD in children and young people: Prevalence, care pathways, and service provision. The Lancet Psychiatry, 5 (2), 175-186,
Storebø, O. J., & Simonsen, E. (2016). The Association Between ADHD and Antisocial Personality Disorder (ASPD): A Review. Journal of Attention Disorders, 20(10), 815–824. https://doi.org/10.1177/1087054713512150
Yudofsky, S. (2005). Fatal flaws: Navigating destructive relationships with people with disorders of personality and character. American Psychiatric Publishing.