Helping Children with ADHD and Anxiety

Helping Children with ADHD and Anxiety | ADHD

Parenting is hard, but parenting kids with special needs can be harder

Being a parent is hard at the best of times, but when your child suffers from ADHD and anxiety the mental burden of working out the best way to parent your child and manage their behaviour and their mental wellbeing can sometimes feel overwhelming. There is help available – both for our children and ourselves – but knowing where to find it, admitting we need help and summoning the courage to ask for it can be huge hurdles.

Every child is different and experiences both ADHD and anxiety in different ways, in the same way that every adult is different and has an individual parenting style. Because each child is unique and has different needs, and so too is every parent, it is fair to say that there is no “one way” of parenting that is “right” in every given situation. However, there are agreed methods that have been shown to be more effective at meeting the needs of children with certain behavioural traits, and if we, as parents, can use these tools to better meet the needs of our children with ADHD and anxiety, then the task of parenting may become easier.

ADHD, anxiety and executive functioning

ADHD, anxiety and executive functioning

Attention Deficit Hyperactivity Disorder (ADHD) affects a child’s ability to manage executive function, which are a group of mental skills we develop that assist us to pay attention and focus on what is important; to plan, organise and manage our time; to start tasks, stay focussed on them and complete them; to keep track of what we’re doing and the tasks we’re responsible for; and to manage our emotions.

Many experts agree that these skills are related to three important areas of executive function:

1. Self-control

The technical term here is “inhibitory control”, and this one will come as no surprise to any parent of a child who has ADHD. This is the function that stops us from acting, or speaking, impulsively.

We’ve all witnessed our child’s inability to sit still, resist temptation, or stop themselves from blurting out things we’d rather they didn’t at the most inconvenient times – and it’s not easy to get them to stop and think before they speak. Their teachers may have talked to you about your child’s inability to ignore distractions or to be quiet in class – and while it’s frustrating, for us and for our teacher, and likely for other children in the child’s class, it’s not something our child can always control.

The lack of this executive function can cause our child a great deal of anxiety, as they’re constantly getting in trouble and/or being singled out, without necessarily understanding why. Kids with ADHD and anxiety often struggle to understand, reflect on or quickly process social cues, so they don’t necessarily notice when someone is annoyed with them, or wants them to be quiet. This can cause problems in class and at home, with parents and teachers, but can also affect their relationships with their classmates and their ability to make and keep friends – which can further exacerbate their anxiety.

2. Working memory

This function enables us to process new information, keep it in our minds and then use it somehow, such as being shown how to use a particular formula to solve a maths problem, then being able to hold that formula in our mind and apply it to another maths problem.

Many parents of children with ADHD and anxiety will know how hard it can be to teach their child basic skills such as tying their shoelaces, because they are simply unable to focus for long enough to input the skill into their working memory and use it the required number of times for it to be converted to short- or long-term memory, or because they get frustrated and anxious at not being able to master the task.

This function also covers our ability to remember where we’ve put things – no doubt many of us will have struggled with our child forgetting where they have put things, often because they’ve simply been distracted by something else and dropped the item wherever they’ve been standing, or left it in a random spot… like the fridge. Chances are we have tried teaching our child to put their belongings (like their shoes) in a certain place so that they can find them again… but this can often be hit and miss, depending on how distracted our child is at the time (e.g., when they take off their shoes). This inability to remember things can further increase their anxiety when they need to find the item and they simply can’t… and their inability to focus and avoid external stimuli makes it harder for them to concentrate on finding the item they’re looking for.

3. Cognitive flexibility

Cognitive flexibility, also known as “attention shifting” or “flexible thinking”, enables us to shift our attention between tasks, perspectives or strategies. It can refer to the ability to think about a certain thing in more than one way, such as using creative problem-solving, or to apply abstract reasoning and find commonalities between different concepts. However, it can also refer to our ability to adapt to a last-minute change in plans and, as many parents of children with ADHD and anxiety know, our children don’t often cope well with unexpected changes in routine or expectations.

Research suggests that children who have high levels of anxiety, or an anxiety disorder such as Generalised Anxiety Disorder (GAD), also have similar problems with executive functioning, which affect their ability to ignore external irrelevant stimuli and concentrate, and to switch their attention between tasks. It has been theorised that this may be due to additional, ever-present worries that reduce the capacity of their working memory to deal with or process new pieces of information.

The scientific jury is still out on whether the better treatment option is to help children with anxiety to improve their executive functioning and attentional capability, or whether treating their anxiety will help to improve their executive functioning and relieve problems with attention and concentration. As parents we can be guided by what specialists and paediatricians recommend, but we are often the experts on our own children and we have a better idea of what will or won’t work for them.

Helping Children with ADHD and Anxiety | ADHD

How are ADHD and anxiety linked?

ADHD and anxiety often go hand-in-hand, with research showing that children with ADHD are more than three times more likely to have anxiety than other kids, and studies suggesting that more than 18 percent of children with ADHD also have an anxiety disorder. This is often because of the stress they experience trying to manage their executive functioning skills and regulate their emotions. In fact, children with ADHD frequently have other problems, including learning disabilities and other mental health issues like depression and oppositional defiance disorder.

However, sometimes ADHD can be misdiagnosed as straight anxiety, and vice versa – – that’s because, on the surface, the two present very similarly. Where the two conditions are both present it can make it twice as difficult for a parent to help, because the underlying reasons for behaviours can be based either on differences in the brain related to the ADHD, or on preoccupations with worries and the effects of pent up nervous energy, or both.

For example, difficulty with paying attention may be simply because the wiring of the ADHD brain affects the child’s ability to focus, or may be due to the fact that the anxious child is distracted by worries, but their inattention may also be a result of a combination of the two. Likewise, kids with ADHD may struggle to make friends because of their inability to pick up on social cues, and their inability to control their impulses may annoy their peers and alienate them from other children, while social anxiety can make them fearful of social situations and talking to unfamiliar people – but when these two issues are combined it can make it doubly difficult to interact with other children and to make and keep friends.

Helping Children with ADHD and Anxiety | ADHD

Helping kids with ADHD and anxiety

As a parent, there are a number of things you can do to help a child who has ADHD and anxiety:

Become attuned to their behaviours and learn to differentiate between anxiety and ADHD behaviours

Get to know the signs of anxiety and learn their triggers, this will help you to get a better understanding of when and why your child is feeling anxious. If the behaviour is due to anxiety, rather than being a product of their ADHD, implement strategies with your child to help calm them and ease some of their worries.

Find soothing strategies

Talk to your child at a time when they’re calm and work out what kinds of things calm them down. Is there some music or a particular sound they like to listen to? Or an activity they find relaxing, like having their hair brushed, stirring something, or colouring in? Maybe there is something they like to watch, such as watching someone cook, apply nail polish or draw? There are some great ASMR (Autonomic Sensory Meridian Response) resources out there, so perhaps you could explore them together to find something that will work for your child.

Validate their feelings

If your child tells you they’re worried about something, or is worked up about something, telling them to calm down is unlikely to help. While it can be frustrating, take the time to listen to them and work together to come up with a plan to work through their fears.

Help your child to get some perspective

If your child has a meltdown or an anxiety attack because of something you might consider to be relatively unimportant in the grand scheme of things, give them some space to calm down – this would be the time to use those calming resources you discovered earlier. Once your child has calmed down, talk to them and encourage them to reflect on their reaction and how they might be able to identify when those feelings are starting to emerge and what they might be able to do to stop those feelings from becoming overwhelming.

Consider your own anxiety levels and responses

Our children are learning how to manage their emotions and their emotional responses from us. As hard as it can sometimes be, we need to try to model effective coping routines – that means, trying to stay calm, positive and in control.

It can also be helpful not to take their behaviour or responses personally – often when our anxious ADHD child lashes out at us, it’s not necessarily because of something we’ve done. Often it’s simply because they feel safe with us and they can finally let their feelings out. If our kids are learning to keep their emotions in check and holding things in while they’re at school, once they’re home and in a safe space they may just need to let off some steam. You don’t have to condone or tolerate their rude behaviour or offensive language, but it can help to change your approach – maybe give them some space to de-stress when they get home. Becoming more attuned to their behaviours, their triggers and the things that can help to calm them will help with this.

Consider getting some outside help

Talk to your GP, a psychologist, or paediatrician if you need help in managing your child’s ADHD and anxiety, particularly if they are getting the way of them enjoying life or functioning on a day-to-day basis. It can be helpful for both you and your child to see a psychologist, independently, for support and guidance.

Helping Children with ADHD and Anxiety | ADHD

Where to get help

If you’d like to find out more, or talk to someone, here are some organisations that can help:

  • Kids Helpline: 24/7 telephone and online counselling for people aged 5-25 – call 1800 55 1800. The website also has useful advice and resources for parents, carers and teachers.
  • Lifeline: 24/7 telephone and online crisis support and suicide prevention services – call 13 11 14
  • Call Parentline in your state or territory for counselling and support for parents and carers
  • eheadspace: free online and telephone support and counselling for people aged 12-25. Create an account to chat online, or use their online resources for generic advice.
  • SANE Australia: support for people living with a mental illness and their carers, e.g., if you suffer from anxiety yourself, or you’re stressing out about your anxious child – call 1800 18 7263
  • online youth mental health service. Visit the website for info or use the online forum. There are also some great resources for parents.

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