In The Gift of ADHD, child psychologist Lara Honos-Webb, PhD, tells parents not to focus on words like "deficit" and "disorder" in their children's ADHD diagnosis.
"I tell parents it is a brain difference, not a brain disorder," Honos-Webb says. "Children's sense of identity is not yet formed at the time of ADHD diagnosis. Reframing the disorder as a gift helps them define themselves by what is working, not by what isn't working."
Kids with ADHD often have trouble in school. They can’t sit still, and they have trouble focusing their attention on a single task. They may have outbursts of emotion.
Despite their challenges, Honos-Webb says, children with ADHD tend to also have:
- Emotional expressiveness
- Interpersonal intuition
- A special relationship with nature
"Just by finding and focusing on gifts, people change in positive, noticeable ways," Honos-Webb says. "You build on strengths and motivation; you give them the confidence to try harder. And the more they try, the more they can change their brains."
The Challenges of ADHD
Emory University psychologist Ann Abramowitz, PhD, doesn't see ADHD as a gift. She says the very diagnosis means a child is having problems. "If a child has ADHD symptoms but is not impaired, we don't diagnose ADHD.”
Abramowitz, an ADHD and special education expert, directed Emory's Center for Learning and Attention Deficit Disorders from 1989 to 2001.
Abramowitz and Honos-Webb agree that ADHD is often carelessly diagnosed by primary care doctors under pressure from frustrated teachers and distraught parents. Since there's no single test for ADHD, getting the right evaluation takes time, expertise, and judgment. Other things that might affect a child's behavior, such as a disruptive family situation or an unmet medical need, need to be ruled out.
Abramowitz says she sees the value in building on whatever special strengths a child with ADHD may have.
"ADHD kids have a lot of gifts and a lot of good things about them," says Elza Vasconcellos, MD, of the WeMind Institute in Miami. Vasconcellos treats children with ADHD and is the mother of a child with the condition. "Many are very artistic with music, with art. They are talkative, able to multitask, and social. When I talk to parents, I try to encourage those gifts."
On the other hand, Vasconcellos says, ADHD often makes it hard for children to draw from their strengths. For example, she says, while many tend to be social, “some are so impulsive other kids have trouble being around them." And when it comes to creativity, “Some of these children cannot even focus long enough to draw a straight line," she says.
Behavioral-developmental pediatrician Lawrence Diller, MD, author of Remembering Ritalin, sees ADHD "more as personality- and temperament-based rather than a mental disorder or a chemical imbalance."
"Impulsivity can be seen as spontaneity, and hyperactivity could be vitality -- but, there is a big 'but,'" he says. “Once you go beyond the mild, ADHD is the flip side of something positive. The children's struggles with family, schools, and peers diminish the positiveness of it."
Honos-Webb doesn't make this distinction. Her view is that ADHD is not something a child has, but a set of behaviors a child does. By working to understand why their child behaves in those ways, she says parents can find ways to motivate the child to change those behaviors.
"Many parents actually buy into the idea their child cannot succeed, and many more are fearful their children will fail," she says. "If they find a child's gifts, it is like a jet stream. They get to where they want to go with less pushing." Above all, Honos-Webb says: "The question parents should ask is, 'What is right with my child?'
The Right Treatment
Honos-Webb doesn’t see medication as the treatment to start with, but agrees that it helps many children respond to behavioral therapy. "The first thing I recommend is a child and family get 12 sessions of psychotherapy first before they even get evaluation for diagnosis, and certainly before trying medication," she says.
"Of course, you need to consider medications if a child is about to fail to meet a major developmental milestone, or faces getting kicked out of school or being totally socially ostracized because they can't manage themselves," Honos-Webb says.
Other experts aren't likely to call for so many sessions before trying medication. Abramowitz says after she diagnoses a child with ADHD, she brings up the topic of medication in her first feedback session with parents.
"There are many times when I recommend medications," she says. "If the parent is comfortable with the idea, I say, 'Let's do a trial.' And then we talk about what makes a trial good instead of sloppy."
"If they want to try interventions without medications, I say fine.”
Many parents find a combination of therapy and medication works best. Talk with your child’s doctor. Together, you can decide on the best treatment plan for your child.