Characteristics of AD/HD: inattention, hyperactivity and impulsivity.

Problems arise when a child has trouble regulating his or her emotions. These problems manifest as inattention, hyperactivity and impulsivity, all of which are characteristics of AD/HD. In other words, children with AD/HD display inappropriate and excessive levels of inattention, hyperactivity and impulsivity, so much so that the child’s ability to inhibit responses to situations or events is impaired. It is a problem of self-control (Barkley, 2000, p. 61). It is hard to diagnose AD/HD because even though AD/HD is a legitimate disorder, it exists without any evident underlying disease or pathology (Barkley, 2000, p. 21). Children may share common symptoms but each child has a different combination of symptoms, with different degrees of severity, varying in different situations (Jacobs, 2000, p. 47). According to Barkley (2000), the impairment of self-control is due to an abnormality of the orbital-frontal cortex, the very front part of our brain, which, in this case, is not as active as it is in those who do not have AD/HD (p.61). Barkley (2000) also points out that several studies indicate this under-activity of the brain and relate it to impairment in impulse control or inhibition (p.61). Even though AD/HD may evoke empathy in parents and caregivers, it does not mean that we should stop holding children with AD/HD accountable for their behavior; on the contrary, we must make them more accountable, not less so (Barkley, 2000, p.62). According to Barkley (2000) "we must devise consequences that are more immediate, more frequent, and more salient than they would normally be in any given situation. Thus we can help them compensate for their deficit and live more normal, functional lives" (p. 62). This is where the parents or caregivers come into the picture, as their decision to take up the role of guidance described above can make an enormous difference for younger children with AD/HD.

Significant influence of parents on younger children with AD/HD

The symptoms of AD/HD usually appear before the age 6. In order to help parents to cope with children with AD/HD, we first must understand the behavior and cognitive processes of the toddler. Since a child’s self-regulation is firmly established in the care-giving system, i.e. the family, it is crucial to understand that caregiver behaviors may facilitate or retard the child’s progress in achieving internal controls at each different phase of early development, either through direct social interaction or the manner in which the caregiver structures the physical environment (Sandberg, 2002, p. 250). Therefore, parents play a significant role in influencing the outcomes of children with AD/HD. Jacobvitz and Sroufe (as cited in Sandberg, 2002) pointed out that the way children behave differed according to qualities of early care giving. Children in the hyperactive group had mothers who scored highly on a rating measure of maternal intrusiveness/interference (p. 256). Also, Sandberg (2002) reviewed that “a substantial body of research indicates that highly directive, negatively toned parent-toddler interactions are associated with noncompliance and other early manifestations of self-control problems” (p. 258). Also, restrictive, controlling maternal behavior towards toddlers predicted disruptive behavior problems (Sandberg, 2002, p. 259). When there is a deficit of functionality in the inhibitory capacity, it affects the self-regulative form of attention (Sandberg, 2002, p. 266). Barkley (2000) has a similar point of view: “the hyperactivity and the impulsiveness seen in children with AD/HD are part of the same underlying problem—a problem with inhibiting behavior” (p.43). When a child lacks the inhibitory capacity, it results in problems with inattention, hyperactivity and impulsivity. Barkley (2000) pointed out that children with AD/HD were less compliant with their parents’ instructions than other children (p.45). Behavior and cognitive processes are interrelated: when there is a behavioral problem, it indicates a cognitive dysfunction. Therefore, dysfunctions in mechanisms of inhibition underlie most of the cognitive and behavioral manifestations of AD/HD (Sandberg, 2002, p. 266). The parenting style also influences cognitive and behavioral processes. One study shows that firm parental discipline combined with high levels of parental warmth and support were associated with positive social adjustment in boys with ADHD (Hinshaw et al. as cited in Sandberg, 2002, p. 275).