Issue 17, Page 12: ADHD and transition

A bit about me

I come from a very colourful, neurodiverse family and it was no surprise when I was diagnosed with ADHD in 2004. I always knew I was different; I just didn’t know ‘how’, ‘why’ or ‘what’ to do about it. Diagnosis answered some of my questions, but I still needed to understand what a diagnosis of ADHD meant for me, for my child, and what it meant for the children I work with.

Through my studies as a SaLT TI, I have learned that effective support and improved outcomes are achieved through reflection of what we ‘know’ about ADHD and by enabling adults and children to develop a better understanding of what having a diagnosis of ADHD means to them. I wrote ‘ADHD and Me’, a guide for children and young people to help them understand what ADHD means to them as a unique individual.

A bit about ADHD

ADHD (Attention Deficit Hyperactivity Disorder) is a neurodevelopmental disorder that can cause above-normal levels of hyperactive and impulsive behaviours.

An under recognised strength of ADHD is the ability to find creative, unique solutions to problems. ADHD brains do not think in a linear way, so they might come up with what seem to be bizarre suggestions. It is incredibly empowering for a child however, when adults recognise and utilise their unique ideas and, with some gentle guidance, it is likely they’ll come up with an idea which may not have been considered before!

An area which is often of most concern to adults, is behaviour difficulties. However, ADHD isn’t a ‘behaviour problem’ and many children with ADHD do not exhibit any behavioural difficulties at all. Children with ADHD experience emotions to a much greater degree and are unable regulate them. They might be thought of as ‘over-reacting’ or ‘too sensitive’ but this isn’t a choice they make; it is a difference in their brain’s functioning. Emotional dysregulation can be crippling – it batters self-esteem and fuels the internal negative dialogue: ‘Everyone else can do it, why can’t I?’

Children (and adults!) with ADHD struggle with the most basic of everyday tasks due to core difficulties with executive functioning and we are often much harder on ourselves than people realise. This means we often don’t trust ourselves, but having someone else trust us can really help. Finding creative ways to show that you trust and believe in individuals with ADHD will really help boost their self-esteem, especially during a transition where they might struggle to visualise themselves being successful.

Please challenge what you ‘know’ about ADHD. For example, inattentiveness and hyperactivity are core features of ADHD, but the ways in which they present and impact a person can manifest in countless ways. No two children are alike just as no two children with ADHD are.

Tips for transition

It is common for children with ADHD to have more than one diagnosis and trying to unpick strategies for each diagnosis is not always possible, nor the best place to start. Children with ADHD can become very distressed during transitions, and skills, such as switching and maintaining attention, organisation, planning, reflection and prediction can be difficult to get back on track after a change to routine.

• Assess core executive functioning skills in a variety of situations including working memory (for example the ability to read a text, hold onto the information and use it to answer questions), flexible thinking (finding relationships between two different concepts) and self-control (the ability to ignore distractions and resist temptation e.g. not blurting out an answer in class).Try using countdowns, visuals, reassurance and let them know if expectations will remain the same or change.
• If the child struggles with the transition, try switching from a rules/consequences approach, to a positive, solution-focused approach using motivation, reward and understanding.
• Try analysing situations in which the child succeeded, and those in which they struggled. Gather information on when and why they needed support as well as when and why they were able to achieve unaided, as it is this information which will provide you with a starting point for your planning.
• Ensure that expectations are achievable and individualised, rather than setting ‘typical’ expectations. One example might be to break the transition down into small, achievable chunks rather than talking about it as a single, large, complete event. This can really help lower anxiety, improve understanding and help them to feel as if it is something they can manage.

A bit about ChatterPack

ChatterPack creates accessible, effective, practical information, and resources to support children with special educational needs. We share these via our free monthly SEND newsletter and store them on our website for future use. We have also written a book, ‘ADHD and Me’, a guide to help children figure out what ADHD means to them as a unique individual. Find out more at ChatterPack.net

Finally, ADHD is underdiagnosed and under medicated in the UK (REF: https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(17)30167-0.pdf & NICE Guidance) Early identification and the right support can help to avoid significant mental health problems which can improve long term outcomes. So, please, please seek assessment if you are ever in doubt.