others
I would like to spend a little time discussing a few characteristics that are common among ADHD sufferers.
Impulsivity
In my opinion the impulsivity associated with ADHD is not adequately emphasised in the DSM-5 criteria.
I often hear very amusing stories about these children’s impulsivity. I chuckle quietly to myself when I hear how their spontaneous honesty blows the lid off our pretensions. They’ll comment on the braai that was supposed to be lunch, but will clearly not be ready before sunset. Everyone is hungry, irritable and ever so decently quiet about it all. But when James feels the first hunger pang, he says so. He doesn’t mean to insult Uncle Robert’s honour – even though he let the fire go out five times. He has no idea that the women have been trying to pretend no-one’s hungry for hours. And in the deathly silence that follows the child’s faux pas (when all he’s done is to tell it like it is), he will often just say: “Oops!”
They speak without thinking. They don’t mean to tread on anyone’s toes. They are not being difficult. They aren’t the kind of children who scheme underhandedly and create difficulties for others – they’re not like that at all. They say and do things straight. A thought has scarcely popped into their head, and it’s slipped out their mouth. Needless to say, they are hopeless at keeping secrets.
Honesty, in a sense, almost goes naturally with impulsivity. I’ll discuss the attractive characteristics of these children and adults more seriously in chapter 12. Right now, for the sake of comprehensiveness and structure we are focusing on the other behavioural characteristics that are often associated with ADHD.
Disorganisation
Everyone is continually making copies for ADHD children of the copies they lost. Finding out what they are actually writing a test about, and getting that information together in the same place as the child, is no easy task. When you’ve finally phoned and emailed everyone you can think of, used the pharmacy’s fax machine and the nearest photocopier to get everything lined up and ready – then, oh no! – the child has disappeared.
When the adult ADHD sufferer has to compile a shopping list, make three telephone calls and attend to someone who arrives unexpectedly, chaos erupts in his head. He will then usually focus intensely on one of those activities (or perhaps something completely different) and, when it is too late, realise that there are negative consequences to be borne. And then the blame is usually laid on the neighbour who turned up unexpectedly, or on anyone or anything else.
If we didn’t see the humour in situations like this, then we – mom, dad, teacher, therapist – would soon be exhausted. The image that comes to mind here is of a Tom and Jerry cartoon. Old Tom’s tongue is hanging out, his shoulders droop, his hair stands on end as if he’s been electrocuted – and Jerry’s darting off over the hill to his next adventure, accompanied by staccato music.
Literal or concrete mindedness
On the whole these children (and even adult ADHD sufferers) are unbelievably literal in their thinking. A consequence of this literal mindedness is that they really struggle to make summaries. When next you and your child are floundering about with their school work, make a summary of part of the relevant learning area yourself. You will notice how many abstract thought processes are involved. So help your child with this and if necessary do the summary for them. “But he needs to take responsibility for his own work,” Miss C and Granny may say. But you only have so much energy and time, and other more important issues may need your attention.
By now you have probably also noticed that your child sometimes just doesn’t get a joke. At other times she will surprise everyone with her sense of humour. It would appear that children and adults with ADHD simply do not get jokes of a more abstract nature. Because their minds work so concretely they often interpret things completely literally.
Sometimes I ask children to use a different coloured pencil for some activity or another. Working with a nine-year-old boy, Philip, one day, I told him to choose a red pencil for the next pattern. He rummaged through the ice-cream box filled with colouring pencils, fishing out a very small red one, only about two centimetres long. I said something like: “I see you’ve chosen the longest one.” And Philip replied very earnestly: “That’s not true – look,” and he immediately laid about twenty long red pencils on the table.
Children with ADHD are often humiliated or teased because they take things so literally. With an older brother or sister, he will even be embarrassed in front of friends, with remarks like: “Excuse my brother, he’s a moron.”
Another consequence of this literal mindedness is that they struggle with certain aspects of mathematics – word sums in particular, although they usually have no problems with other sections. Some of the children I see in therapy are in fact brilliant at mathematics. Children with ADHD also tend to struggle with comprehension tests. Although they are able to answer the factual questions correctly, they have a problem with the insight.
Rigidity
Children with ADHD are often rigid and do not like disruptions. Unexpected changes or unforeseeable events easily unsettle them and make them anxious.
One little eight-year-old’s entire day was disrupted because his grandfather had to collect him from school. Granny usually picked him up at a specific gate. But on this particular occasion Grandpa had to collect Greg, and from another gate because it was the only one he knew. Grandpa was also unable to be there before two o’clock. Careful arrangements were made, but Greg struggled to focus the entire day. When his teacher walked Greg to the pick-up point where he was supposed to wait for fifteen minutes, he started crying uncontrollably. He was confused and anxious. When there was no-one to fetch him at the gate, he ran to the usual gate, sat down and refused to listen to reason. He was afraid that Grandpa would come looking for him at the usual place and would drive off without him if he wasn’t there.
Another extreme case was that of ten-year-old Josh, a brilliant rugby player and cricketer who regularly went on sports camps. His parents would have to obtain the entire schedule from the organisers in advance so that they could take Josh to all the restaurants they would eat at. This would enable him to study the menu and decide what to order. Any unexpected deviation from the plan would cause Josh unbearable anxiety.
Poor linguistic skills
Children and adults with ADHD often battle to express themselves properly. Firstly it is sometimes difficult to hear what they are saying because they mumble; and secondly it is also difficult to understand what they are trying to convey. Their speech is often rapid, mumbled or incoherent. They also tend to weave a number of different stories together and it can be difficult to make head or tail of what they are trying to tell you.
However, I have often noticed that the children are able to communicate very effectively with one another. At my workshops and games or swimming days at my practice at the end of the school term, I will regularly have groups of twenty or more children with ADHD together. It looks like chaos, but the children have a wonderful time playing together and they understand one another perfectly well. In years gone by I often wanted to intervene to get everyone involved and to explain the rules. However, they are perfectly capable of doing it themselves, albeit in a language that is very difficult to follow. They involve one another and no-one is sidelined or rejected.
Overhastiness
ADHD suffers often misinterpret instructions and other information because they react overhastily. This applies to both children and adults. They also often have poor auditory processing skills and do not always understand what they hear (on those occasions when they are actually listening!). It often seems that they do not hear or understand what is being said, but then one is amazed at what they have in fact taken in. The patience of Job sometimes seems insufficient when it comes to preparing an ADHD child for a test. After the mother has summarised