Bi-lingual Clinical Psychologist Providing ADHD Treatment in Hong Kong

HOW DO I KNOW IF I OR MY CHILD HAS ADHD?

“The hallmark of the ADHD nervous system is not attention deficit, but inconsistent attention…ADHD is not a damaged or defective nervous system. It is a nervous system that works well using its own set of rules.”

–WILLIAM DODSON, M.D. Read more.

This page addresses common questions asked around ADHD:

What is child ADHD?
What is adult ADHD?
What problems can ADHD create for my child/me and how is therapy useful?
Is ADHD an executive problem or emotional problem, or both?
What is rejection sensitive dysphoria?
How to know if its ADHD or something else?
What can parents do to help?
What are ADHD management tips?

Child ADHD at a Glance

Time-Blindness: Kids, and adults, with ADHD have a very weak concept of time. It is either “now” or “not now.” That’s why planning and time management are such a struggle for them. It is called “time-blindness.”

Zoning Out and Hyper-focusing: They are also very drawn to stimulation-rich environments. It is not that they can’t focus, it is more that a non-stimulating environment (e.g., a typical classroom, a one-on-one conversation) gets drowned out by the, metaphorically speaking, multiple channels that are simultaneously playing in their mind. So it can look like they are off in their own world. But if you put them in front of their favorite computer game, they often “hyper-focus.”

Emotional Dysregulation: Because emotional regulation can be challenging for them, if you tell them no, try to impose limits and structure, or redirect them, at times it can feel like you are fighting a losing battle. Their emotional dysregulation can manifest as tantrums, defiance, or withdrawal.

Emotional Sensitivity: They are also very sensitive creatures. Because they feel a lot, they can come across as emotionally intense. People often find them very touchy.

Impulsivity: An ADHD brain is not very skilled at inhibition. As children, they might speak out of turns, jump the gun, and at times engage in socially inappropriate behavior such as pushing and hitting. They don’t intend to hurt their peers, but they are not yet very in control of the brake that says “Stop! Not a good idea.”

Creativity: But their hyperactive brain is also a wonderful goldmine for new solutions, novel ideas, creative insights, and things that people with a typical brain can never imagine in a million years!

Procrastination: Procrastination is an emotional regulation problem, not a time management problem. A lot of parents say, “If my child starts work early she/he doesn’t need to be so stressed.” True, but if they could start work early, they would. It’s no fun for them to get so stressed out either, but something gets in their way. What I tend to find is that procrastination is an avoidance strategy: not about the work itself, but how the work is making them feel (e.g., anxiety, fear, worries). In other words, what we see as “procrastination” is in fact an emotional paralysis.

A poem by ADHD expert Dr Ed. Hallowell

Take my hand and come with me,
I want to teach you about ADHD.
I need you to know, I want to explain,
I have a very different brain.
Sights, sounds, and thoughts collide.
What to do first? I can’t decide.
Please understand I’m not to blame,
I just can’t process things the same

Learn more.

*Visit our Test Kit to access child and adult ADHD screeners, and/or other mental health screeners.

*For ADHD parenting support groups, please visit the Hallowell Center. They also have other ADHD classes and workshops. (We are not affiliated with the Hallowell Center in any way.)

Adult ADHD at a Glance

Adults who have ADHD often struggle with time management, organization and prioritization of tasks, following through and completing projects, and managing distractions. They might go through cycles where they swing between feeling like a bundle of endless energy and then burning out. They can be late more often than they would like, and find it stressful to meet deadlines on an on-going basis. They might also struggle to stay on tasks that they don’t find interesting.

Their weak time management and organization can also create difficulties for their interpersonal relationships. Spouses often get frustrated by their forgetfulness and unpredictability, and feel like they have to shoulder more than their fair share. This can lead to resentment in the relationship. Learn more about how to manage relationship challenges.

What It’s Like To Have ADHD (PDF)

*ADHD: Not Just for Kids.

In behavioral terms ADHD Symptoms in children can show up as:

difficulties with sitting still and waiting turns
spacing out
poor time management
forgetfulness and disorganization
impulsive speech, extremely talkative
difficulties with following set rules and multi-step instructions
difficulties with playing with others in structured environments
difficulties with completing assignments (this gets worse as assignments get more advanced)

The Challenges of ADHD and the Importance of Treatment

The way the learning environment is currently structured can prove challenging for children with ADHD: one or two teachers with many students to supervise and so it is important for children to work well within that set structure, and to stay on task so the class as a whole can move forward. Society also has a way of rewarding cooperative children because, realistically speaking, they don’t interfere as much with the group agenda. So, when a child who shows up that requires more attention and patience than others, and at times shows behavior that challenges authority figures, these children can quickly attract negative attention: blame, criticism, judgment, punishment. Children can internalize the negative experiences and the negative labels that are used on them, and then conclude that they are, in fact, bad, dumb, lazy, troublesome, inadequate, defective, etc.; and without therapeutic interventions, these labels can fossilized as part of their adult identity. As adults, they might have compromised confidence, motivation, and skills to succeed at work and in interpersonal relationships. An inherent feeling that something is wrong with them, or that they are somehow inadequate and defective follows them around like a shadow.

William Dodson, M.D.: “We consider ourselves doing spectacularly well if we get a kid all the way through high school without him being damaged by the system: being called lazy, stupid, defiant…”

ADHD, Executive Function and Emotional Regulation

ADHD, traditionally, is considered a condition of atypical executive function. Executive function helps us stay focused, manage time, plan and organize, control our impulses, and regulate our emotions. Recent investigations start to lend more weight to how emotional hypersensitivity and dysregulation complicate ADHD. Gabor Mate talks about how ADHD can be understood as a coping response to emotional trauma. These features of ADHD are not listed in the DSM (The Diagnostic and Statistical Manual of Mental Disorders).

Find out if you have Rejection Sensitive Dysphoria, and how it relates to ADHD.

ADHD Fact Sheet and Management Tips

Download, or browse other parenting printables.

Why should psychological treatment be considered for ADHD? Learn more about child therapy.

Is it ADHD, or something else?

Can my or my child’s ADHD-like behavior be caused by other factors such as anxiety, depression, low motivation or lack of confidence, or a mis-matched learning/work environment?

Sometimes it might feel hard to tease out what is what. Talking to a psychologist/therapist is one way to start. Another way is to talk to teachers who know your child well. Getting more information from the internet and books is also a great way to equip yourself with more knowledge. ADHD (and ASD) tends to run in the family, which could provide another clue. However, if the condition your child has is interfering significantly with their functioning, it is a good idea to talk to a psychologist/therapist about therapy to address what is going on in your child.

Poor academic performance might be caused by other factors such as low motivation and confidence. Find out how to boost your child’s resilience here.

If you are concerned that other factors such as anxiety or emotional distress might be creating difficulties for your child (kids are not good at dealing with big feelings, so they “act out”!), contact us for a consultation.

To gain a better understanding of your child’s condition, some of these Self-Help Checklists might help.

Navigating a Diagnosis

Most children will show some of these “symptoms” at some point in their lives, and so it will be important to find out what the symptoms mean (for example, is it anxiety, depression, ADHD, or something else?). Currently, there are no tests that can confirm a diagnosis of ADHD with 100% accuracy. An assessment typically involves a checklist about your child’s behavior, a developmental history interview with caretakers, interviews with people in your child’s life, and interviewing and observing your child in person. Learn more about misconceptions in diagnosis.

Undiagnosed ADHD children could be misunderstood and mislabeled as stupid, lazy, troublesome, even willful and disobedient. Imagine being described that way as a child over and over again and the child starts to believe it! When as adults they discover that what they have is actually ADHD, a mental health condition–instead of all these negative qualities that they were told they had–it can feel like a long overdue vindication and relief. They finally have a way of understanding and labelling correctly what has been happening with them, and it is something that a lot of other people have!

However, because children often don’t understand what the label ADHD entails, it can feel stigmatizing to them. Parents would worry that diagnosed children will see themselves as different, crazy or stupid, that something is wrong with or abnormal about them, and they are less than or not good enough. Parental interventions will be important to instill the correct understanding of this condition for children (“More on ADHD” at the end of this page provides some pointers). Remember, ADHD is just a label; your child, with their other amazing potentials and qualities, is definitely a lot more all-rounded than these 4 little letters.

What helps ADHD?

Therapy and coaching for child
Parenting support and education
Medications such as stimulants (the majority of people report positive results after being put on medication; some, however, find the side effects outweigh the benefits)
Regular Exercise & Meditation
TCM (increasingly TCM is being used to treat mental health conditions)
School accommodations
Supplements such as omega 3 (prescription-strength omega-3 approved by the FDA as a “medical food”)

ADHD School-Management Tips

The idea is to teach them skills and awareness to minimize how their ADHD traits might affect their ability to motivate themselves, stay on track, and finish tasks. It is not so much what grades they are getting now that matter in the long run. (Honestly, who looks at a 10-year-old’s grade report card?) It is how they learn to work around and overcome their ADHD tendencies that will help them cope with academic and life challenges over the long haul. This is what determines long-term life success.

I see a lot of adults with ADHD who are successful, but they understand and find ways to manage their ADHD so it doesn’t completely paralyze their efforts to succeed.

What helps the ADHD brains?

ADHD management tips include:

Externalize planning and time management by using lots of visual aids (kids with ADHD don’t see time, and so we need to turn abstract time into concrete visual forms for them)
Put reminders where your child can see them (help them remember tasks)
Break down complicated tasks into a sequence of smaller units (you need them to learn sequencing)
Help them assign time to each individual task (you are teaching time management)
Minimize distraction at their desk, and experiment with them how they work best (do they like listening to background music, or need to move around as they remember the times tables, or work best with a study buddy, or sit close to you while you prepare dinner?)
Allow them breaks in between tasks
Encourage them to move around during study breaks
Stay hydrated
Limit the use of electronic devices during study breaks (devices are highly addictive for the ADHD brain)
Monitor and optimize the use of ADHD medication to when it is most needed (for school and homework time)

Positive Traits of ADHD

Though often overlooked, children with ADHD come with its own golden bag of goodies. They are usually

sensitive and kind (they have a heart of gold!)
conscientious and intuitive
creative, artistic, and sophisticated problem solvers
full of exciting energy
bundles of fun and (quirky) humor
super-focused when they find an activity engaging!