<body><div>Key points<ul><li>There is more to ADHD than the external behaviors of inattention, hyperactivity, and impulsivity. </li><li>Roughly two-thirds of ADHD behaviors are internal, unseen challenges. </li><li>Effectively helping your child to manage their ADHD involves an understanding of their internal challenges. </li></ul>What are the behaviors that come to mind when you think about a child with ADHD? Prior to writing my book Andrew's Awesome Adventures with His ADHD Brain, I surveyed some moms and dads in our school district and asked them what came to mind when they thought about a child with ADHD, and most of their responses included behaviors like “impulsive, can’t sit still, energetic, fidgets.” Although this was not a formal research study with hundreds of participants, it makes a point that when most people think about a child with ADHD, they relate it to the external impulsive and hyperactive behaviors.Having a child with ADHD forced me to change my perception of what I thought I knew about the disorder, which was the outward symptoms of inattention, daydreaming, hyperactivity and impulsivity. But what are the reasons for these behaviors, and what can’t we observe? Most of us may remember the 1980s tag line for Transformers action figures: “There’s more than meets the eye." The same is true for ADHD. The observable behaviors in ADHD are only a small piece of the whole picture, and the majority of the challenges ADHD individuals face lie beneath the surface.<figure><img src="https://img.particlenews.com/image.php?type=thumbnail_580x000&amp;url=48Zu4g_0wBOtifR00" alt="https://img.particlenews.com/image.php?url=48Zu4g_0wBOtifR00" width="320" height="320" ></figure>This concept was illustrated by ADHD advocate Chris Zeigler Dendy in her "ADHD Iceberg," one of the most-searched ADHD topics. According to Dendy, roughly two-thirds of ADHD behaviors are internal and unobservable. As a result, it is difficult for neurotypicals to understand the cognitive dysfunction associated with ADHD: missed deadlines are not due to laziness or apathy, but to working memory deficits, and being late is not a purposeful disregard for another but the result of poor time management skills. <h2>Looking beneath the surface</h2>Before my son was diagnosed with ADHD, we took him to a psychologist to help him manage his anger and emotional outbursts. At the time, we didn’t understand that his outbursts were caused by the emotional dysregulation associated with ADHD. We only saw his external behavior, the yelling and slamming doors, and not his internal challenge of managing his frustration. I was only seeing part of the picture, or the “tip of the iceberg." Similarly, my son’s difficulty with team sports was the result of his internal behavioral challenges. According to Dr. Patricia Quinn, a developmental pediatrician specializing in ADHD, team sports like basketball and football, which require the participants to know where players are on the field, anticipate player movements, and strategize are not ideal for children with ADHD, who have difficulty with executive function skills like planning, prioritization and working memory. When my son was in elementary and middle school, he played basketball. Despite playing for a few years he never learned where to be on the court, never knew if he was on offense or defense, and never seemed to be able to make a basket. Finally, in seventh grade, he decided basketball was no longer for him.The most familiar symptoms of ADHD are easily recognizable: inattention, hyperactivity, and impulsivity. But as parents and caregivers, we need to take a deep dive and realize the unseen challenges our kids face which include: a neurochemical imbalance, executive dysfunction, time-blindness, delayed brain maturation, learning difficulties, emotional dysregulation, and sleep disturbances. Understanding the ADHD Iceberg helps us to be better parents and caregivers to our ADHD childrenOur ADHD children do not want to fail classes, be disorganized, or have uncontrollable emotional outbursts. The unseen challenges of ADHD make it difficult for individuals with ADHD to perform like their neurotypical peers. So how can an understanding of their internal difficulties help us to be better parents and caregivers?<ul><li>Advocacy: I have always believed that one of my most important jobs as a parent of a neurodivergent son is to advocate for him. ADHD symptoms can make it difficult to show what you know at school and at work; there are missed deadlines, forgotten assignments or meetings, and careless mistakes on homework, tests, or projects. Academic success begins with communicating with your child’s teacher: What are your child’s strengths and challenges? What type of learner is your child (visual, auditory)? What academic accommodations in their 504 Plan or individual Education Plan (IEP) do they need the most help with? Sharing information about your child with coaches or other adults that they interact with may also be beneficial. Modeling advocacy for your child will also help them to learn how to advocate for themselves.</li><li>Relationship building: There is no doubt that living with someone with ADHD can put a strain on family relationships. The external symptoms of ADHD, like interrupting people, forgetting dates and times, or having a meltdown in a public place can all cause relationship issues. Learning to respond, instead of react, to our kids’ behaviors will help us to develop a collaborative relationship based on communication, trust, and mutual problem-solving. We need to involve our kids in the conversation, listen to their responses and respect their ideas. For example, when I was on a mission to corral my son’s clutter, a constant battle between the two of us, I realized I had to ask him what organizational system would work for his ADHD brain, and stop trying to force him (repeatedly) to organize in a way that works for me. </li><li>Modifying our expectations: One of the ADHD Iceberg’s internal challenges is delayed brain maturation. Children with ADHD are roughly three years behind their peers when it comes to maturity, responsibility, and executive function skills. So, as a parent and a caregiver, it’s important to meet your child where they are, not where everyone expects they will be, keeping in mind your child’s executive function age rather than their biological age. When you expect a task to be easy for your 15-year-old, ask yourself if you would expect the same from a 12-year-old. Creating an environment that works for your child based on what they are capable of at the time is a key to their success. </li><li>Recognize your child’s strengths: Hidden ADHD behaviors are not only challenges, but include your child’s strengths as well. Independence, risk-taking, high energy, curiosity, humor, and artistic gifts are traits that have been identified in creative individuals, entrepreneurs, and children with ADHD. Creativity has been found to be important in successful job performance, healthy relationships, and careers involving science, technology, engineering, mathematics, and art. Encouraging your child’s interests can make them an expert at something, boosting their self-esteem, and decreasing negative self-talk. Awareness of their interests and passions can also help your child with deciding on their next best steps, creating their path to success. </li></ul></div></body>

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The ADHD Iceberg: What Lies Beneath

There is more to ADHD than the external behaviors of inattention, hyperactivity, and impulsivity. Roughly two-thirds of ADHD behaviors are internal, unseen challenges. Effectively helping your child to manage their ADHD involves an understanding of their internal challenges. What are the behaviors that come to mind when you think about...

The ADHD Iceberg: What Lies Beneath

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