In the article “Your Child’s ADHD is and Iceberg,” author Penny Williams compares Attention Deficit Hyperactivity Disorder (ADHD) to an iceberg. In detail, an iceberg has many layers that are not visible to the human eye. Correspondingly, just like an iceberg, one that has ADHD do not have visible symptoms that are easily recognizable. Symptoms such as inattention, impulsivity, and hyperactivity are very important to take notice of. Williams notes that “these traits are too often mistaken for character flaws, personality defects, or moral or ethical deficits. They’re not any of those things.” In this case, it is necessary for parents to pay close attention to their child and be consciously aware of their symptoms. 

Within each layer of ADHD there are the following:

1. Poor Self-Esteem and Self-Confidence Kids who struggle with ADHD may experience poor self-esteem. It is the parent’s job to help their child regain their self-confidence by creating opportunities such as calm environments and activities where your child can excel in.

2. Developmental Delays Williams states that “children with ADHD develop 2-3 years more slowly than their peers.” This can impact their maturity, social skills, executive functioning, emotional dysregulation, and self-regulation. 

3. Inflexibility It is seen that kids with ADHD may be more stubborn than willing. Inflexibility prevents children from being able to manage their emotions: they do not have the skills to notice that their emotions can be changed rather than one way. 

4. Intensity When children's emotional awareness, self-regulation, frustration tolerance increase, it can lead to hypersensitivity that can make them have extreme emotions. When this happens, instead of trying to resolve this intensity and get to the bottom of it, ask your child, “How can I help you?” This will help your child understand that you are there for them and are trying to help them.

5. Emotional Dysregulation Children with ADHD may have a hard time regulating their emotions that’s appropriate for given situation and/or their age. They may have a difficult time with expressing and regulating their emotions at home, to the family, at school, and in social interactions with peers.

6. Co-Existing Conditions According to Penny Williams, “it’s estimated that 50 to 60 percent of individuals with ADHD also have one or more coexisting conditions.” These conditions include mood disorders, anxiety, autism, learning disabilities, functioning deficits, and more. As a parent, it is important to keep and eye out for signs of distress in order to fully understand and help your child effectively. 

7. Skill Deficits Skill deficits are very common for those who have ADHD. Because ADHD is a developmental disorder, kids with ADHD may not have fully developed skills on how to manage and regulate their time, frustrations, plans, emotions, problems, etc. However, these skills can be taught improved over time with a little bit of practice and help from the parents.

8. Executive Functioning Deficits Executive functioning skills such as learning how to manage one’s day, organizing, starting tasks, regulating one’s emotions, and managing one’s time may fall apart if one exhibits executive functioning deficits. As a parent it is dire to identify your child’s level of executive functioning and continue to be flexible when it comes to adapting for areas of weakness in the classroom and at home.

9. Time Blindness People with ADHD may have trouble with the concept of time. For example, 30 min. may feel like forever or just a quick second. People with ADHD may not have an innate sense of what it feels like. William notes that you can tell a child that ”you have until the end of class,” or, “You have one hour,” but that will mean virtually nothing to someone with time blindness. 

10. Meltdowns In order to get what they want, children may throw temper tantrums to get their parents attention. Generally, to get what they want, children may have a meltdown or a tantrum. However, a meltdown is different than a tantrum. In detail, during a meltdown your child is no longer in control of what they are saying or doing. Similarly, a meltdown can be triggered by a tantrum, which usually comes first, along with sensory overload, feeling misunderstood nor heard. During this time your child can not go through their actions and rationalize what they have done. At this time, it is important for you as parents to not give in to what they originally wanted: why they through the temper tantrum and had a meltdown in the person. If you give in, then your child will associate meltdowns as a way to achieve what they want every time, essentially reinforcing the tantrums and meltdowns.

11. School Incompatibility Students with ADHD may have a harder time in school because all assignments are not subjected for their needs. Furthermore, Williams states that in school “students must sit still, be quiet, and remain attentive for long periods of time.” However, kids with ADHD may not handle staying still for long periods of time nor does the teacher realize that it is very difficult for these students. These weaknesses and challenges are rarely considered by teachers and parents.  Your child may not be able to make all of your expectations and that is okay, this is when one needs to be flexible. 

12. Pills Don’t Teach Skills There is not one medication that solves everything: there is no magic pill.  Certain medications may affect one physically on the outside (hyper focus or hyperactivity), but on the contrary, the layers beneath one are yet to be cured with one pop of a pill. In order to get past this, as parents, it is essential to pay attention to your child’s self-esteem and work on building it up with them. To do that, you must focus on your child’s inflexibility, intensity, emotional dysregulation, skill deficits, time blindness, etc.

Focus on looking below the surface and deeper into your child’s everyday actions and emotions. This will not only contribute to the growth of you and your child’s relationship, but their well-being and mental health as well. Williams describes that “these hidden layers are all part of ADHD. Together, they form that beautiful but dangerous iceberg. Others might not see them; you must.” 

For more information on ADHD and its symptoms, please contact us. To learn how we can help you or your child who may be struggling with being successful with ADHD, contact us or visit our website. For more information on therapy, visit Hilber Psychological Services. 

To learn how Neurofeedback can help with the “white-knuckling” experience of ADHD, visit San Diego Center for Neurofeedback, APPC or contact us for for more information.

- Written by Lily Schmitt and Tanya L. Hilber, PsyD

References 

Williams, Penny. “Your Child’s ADHD is an Iceberg.” ADHD Symptoms in Children. ADDitude. Web. 28 Jan. 2019. https://www.additudemag.com/what-is-adhd-symptoms-hidden-parents-educators/