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ADHD - What now beyond medication?

A growing number of medical studies have acknowledged that ADHD requires more than medication for a successful outcome. As therapists, we have seen how medicating a student with ADHD has brought about nice changes. Our older students can testify that medication has helped them think better.


Medication helps in these cases to set the stage for the next steps of learning to occur. Medicating an ADHD student, however, does not mean that the individual can now automatically acquire all those skills of planning and organizing themselves effectively. In fact, the next step of our work would be to equip the students with the type of mental processes that would help them navigate the maze of learning challenges more efficiently.


Processes of Thinking

The Feuerstein Institute has a wonderful way of describing the thinking processes. It breaks the thinking process into the Input, Elaboration, and Output Phases. The Input phase (a phase that is often impaired in students with ADHD) describes first-level mental processes that help one to gather information efficiently. Often the impulsivity of students with ADHD would mean they take a broad and sweeping view of the task in front of them. They may fail to use the cues provided, or they may not know that there is a systematic way of seeking out information in order not to miss out on important details. Our therapists have found it gratifying to equip these true ADHD students with those sets of thinking tools.


Co-morbidities or Overlapping Conditions?


Co-morbidities of ASD and ADHD

There have been a number of studies of co-morbidities of ASD and ADHD – which means that they can both exist in an individual.


Medicating a child with ASD with stimulants for ADHD is still controversial. Certain qualities that we often associate with children with ASD may seem awfully similar to that of ADHD. They may seem less focused on what you are saying. They may be tangential in their speech, and language development may seem patchy. They may be impulsive and self-directed when they have yet to acquire a proper perspective of the expectations of those around them.


However, the roots of which impulsivity would be an important consideration for an appropriate course of action. For the child with ASD, when the focus is placed on building connections with parents, and others, and understanding the expectations of others, this in turn would have a regulating effect on their behaviour and attention.


In practice, we have also encountered many instances where those with dyslexia or difficulty with literacy appear like inattentiveness. Dyslexics, particularly older students with more self-awareness may encounter the battles of the mind daily where the mis-spelling of a single word may send one into a spiral of feelings of shame and guilt. While the brain is trying to decode a word, shame interferes with the thinking process, and somehow hijacks one’s ability to understand what was being read.


How to help children with co-morbidities of ASD and ADHD?

When targeting dyslexics, it is important for therapists to be sensitive to this and not treat the student as someone who lacks interest or focus in reading. An approach that is sensitive and sympathetic offers the student an accessible route, by building confidence in reading through sound methods of remediation and meaningful scaffolds.


The best outcome can be achieved by parents taking time to understand their child’s condition and by working closely with the therapists to gain feedback and implement strategies at home wherever applicable.


Contact Total Communication for helping children with co-morbidities of ASD and ADHD.

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