ADHD
Attention Deficit Hyperactivity Disorder (ADHD) is a lifelong neurological difference traditionally characterised by persistent patterns of inattention, hyperactivity and impulsivity that can affect daily functioning and development. Current diagnosis distinguishes between two types: hyperactive and inattentive, recognising a presentation common in girls and women and which may previously have been missed or misunderstood. People with the inattentive type may experience ‘internal hyperactivity’, with a mind that is constantly busy. This may present as daydreaming or inertia.
Once again, the word ‘disorder’ implies a flaw in willpower, character or even parenting, focusing on behaviour and, in school, often an inability to comply with the demands of the system and the curriculum, with its long periods of sitting and regular transitions between subjects that offer varying levels of interest to the young person.
For more information, go to https://adhduk.co.uk or https://www.nhs.uk/conditions/adhd-children-teenagers
Alex Partridge hosts a podcast on ADHD and other neurodivergent conditions with discussions with clinicians and lived-experience advocates. It’s available on Spotify.
More recently, the understanding of ADHD has focused on the role of dopamine, rather than a simple inability to pay attention. ADHD is understood to be characterised by a low-dopamine brain state, or dysregulated transport of dopamine, affecting motivation, the processing of rewards and executive function. Because of this, ADHD brains struggle to motivate actions for long-term rewards and crave immediate dopamine stimulation to function normally.
When dopamine is low, the young person is driven to seek stimulation by seeking instant gratification (impulsivity), focusing intensely only on things that interest them, present novelty or are driven by adrenaline (hyperfocus) or pursuing easy dopamine hits through procrastination or endless scrolling (inertia).
ADHD hyperfocus reinforces the idea that this is a regulation issue rather than truly an attention deficit issue. While ADHDers can’t maintain attention on boring, repetitive or low-stimulation tasks, they can focus for long periods on activities they find interesting, and can even find it hard to detach their attention in that case.
By the time a young person receives an ADHD diagnosis, they may already have received the message that they are ‘bad’, ‘stupid’, ‘lazy’ or been given other negative labels. This can make it even harder for them to engage with expectations when they continually appear to fail.
Stimulant medication can be prescribed to increase dopamine levels but this alone may not undo the damage already done to the young person’s self-perception.
People with ADHD, when appropriately supported, are often highly creative thinkers. They can find innovative ways of doing things that other people don’t think of. ATTACH-Manchester aim to create an environment in which these young people can access these skills, develop their talents and create alternative adult pathways to employment.
Exercise and physical movement are important for management of ADHD. They boost dopamine, norephinephrine and serotonin. As well as making the young person feel good physically, this can help with task inititiation. Making tasks more interesting or urgent also creates a dopamine boost that can help overcome inertia. Though structure can support those with ADHD, rigidity may be unhelpful. Our provision need not involve predetermined and ultimately unnecessary transitions from one activity or subject to another, instead allowing hyperfocus and adapting curriculum delivery to fit with this through music, competition and real-world learning that is likely to have inherent validity for the ADHDer.