ADHD: It’s more than “he just can’t sit still”

ADHDers have an abundance of attention, the challenge is controlling it. It is not a disorder of KNOWING, it’s a disorder of DOING.

When I think of the ‘experts’ in realm of ADHD, I think of Russell Barkley and Thomas Greene. In this week’s weekly win, I’ll define ADHD and also explain the experts differing frameworks on ADHD.

When people are asked about their ADHD symptoms, sometimes they are asked “can you pay attention?” and often people will say “well, it depends on the topic!” Can you relate? Maybe we should be asking “have you been able to get engaged and stay engaged in a topic?” And then dive a little deeper into the types of activities / topics people can and can’t engage in based on the experts explanation of ADHD below…

Attention Deficit Hyperactivity Disorder (ADHD) is a complex neurodevelopmental condition that affects individuals of all ages. Two experts in the field, Dr Russell Barkley and Dr Thomas Brown, have made significant contributions to our understanding of ADHD.

Russell Barkley's Framework:

Russell Barkley is a clinical psychologist who has extensively researched and contributed to the understanding of ADHD. His framework revolves around the concept of self-regulation and executive functions.

1. Self-Regulation Challenges:

Barkley sees ADHD as a disorder of self-regulation, emphasising difficulties in managing attention, impulses, and activity levels.

Individuals with ADHD may struggle with sustaining attention, making careless mistakes, and exhibiting impulsive behaviour.

2. Executive Functioning Deficits:

Barkley emphasises the role of executive functions, describing them as the brain's managerial system responsible for planning, organising, and regulating behaviour.

ADHD is associated with deficits in working memory, inhibitory control, and cognitive flexibility, impacting various aspects of daily life.

3. Developmental Course and Persistence:

Barkley's work highlights the chronic and lifelong nature of ADHD, noting that symptoms often persist into adulthood.

While hyperactivity may decrease with age, inattention tends to endure, affecting academic, occupational, and social functioning.

4. Neurobiological Basis:

Barkley's research delves into the neurobiological foundations of ADHD, emphasising genetic factors, neurotransmitter imbalances (particularly involving dopamine), and structural differences in relevant brain regions.

5. Multimodal Treatment Approach:

Barkley advocates for a comprehensive treatment approach, incorporating behavioural interventions, education, and, when appropriate, medication.

Education for individuals and their families is crucial, fostering understanding of the disorder and empowering the development of effective coping strategies.

Thomas Greene's Contribution:

Dr Thomas Green is a clinical psychologist and leading expert on ADHD, and has a focused on understanding the cognitive and motivational aspects of the disorder. His work complements Barkley's framework by exploring the lived experience of individuals with ADHD.

1. Executive Functions and ADHD:

Greene emphasises the impact of ADHD on executive functions, describing it as an impairment of the cognitive management system.

Difficulties in organisation, time management, and planning are central aspects of executive dysfunction in ADHD.

2. Working Memory Challenges:

Greene's work highlights the role of working memory deficits in ADHD, affecting the ability to hold and manipulate information.

Individuals with ADHD may struggle to follow through on tasks, complete assignments, or remember instructions.

3. Motivational Impairment:

Greene explores the motivational aspect of ADHD, noting that individuals may struggle with initiating tasks, sustaining effort, and managing emotions related to task completion.

This perspective sheds light on the challenges faced by individuals with ADHD in achieving long-term goals.

4. Positive Traits:

Greene acknowledges that individuals with ADHD often possess unique strengths, such as creativity, resilience, and a capacity for out-of-the-box thinking.

He emphasises the importance of recognising and leveraging these positive traits in treatment and support strategies.

The positive traits associated with ADHD offer a unique set of strengths that, if properly nurtured multi-modally, can contribute significantly to an individual's personal and professional success. Recognising and accommodating these traits in educational/work settings is very important in helping individuals with ADHD. By fostering environments that celebrate creativity, resilience, and non-linear thinking, we can create a society that empowers all learners, including those with ADHD!

Collectively both Dr Barkely and Dr Green, contribute to a more comprehensive and empathetic approach to ADHD. I especially love the multimodal and strengths based approach towards a more personalised and effective way of people managing their own unique set of ADHD symptoms.