Aggression & ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a frequently diagnosed behavioral disorder that can cause a lot of issues if not treated properly. By examining aggression, a feature often associated with ADHD, you will be able to recognize what is going on with your loved one and how best to help them cope.

Definition

• ADHD is a chronic behavioral condition that impacts a person's ability to pay attention, control impulses and organize thoughts and behaviors (Nolen-Hoeksema, 2004). The three primary features of ADHD are inattentiveness, hyperactivity and impulsivity.

  The Center for Disease Control estimated in 2006 there were 4.5 million children between the ages 5 to 17 diagnosed with ADHD. However, not all children with this disorder have problems with aggression.

  However, Dr. Russell Barkley, PhD, a researcher on ADHD, has found that approximately 65 percent of children with ADHD do have discipline problems, meaning that aggression can be a prominent feature of these disciplinary-related issues.

Symptoms

• The Mayo clinic provides a list of signs and symptoms pertaining to ADHD in its two main forms--Inattentive Type or Hyperactive/Impulsive Type.

  A child with ADHD, Inattentive Type will most likely not have problems with aggression because their main issue is focusing, not controlling their impulses.

  For children with the Hyperactive/Impulsive Type, aggression is often an impulsive reaction. Some signs to watch out for are: leaving one's seat in class frequently without permission while everyone else is seated; fidgeting/squirming and or running and playing at inappropriate times; difficulty playing quietly and/or talks too much; difficulty waiting for one's turn; and often interrupts or intrudes on others' conversations or games.

Causes of Aggression

• Children with Hyperactive/Impulsive ADHD have difficulty waiting or accepting situations that are not based on their terms or meeting their immediate needs. Because of this, they are more likely to become irritated or impatient simply because they are not wired with the same ability to control impulses as their peers.

  When children with this type of ADHD do not have their needs met immediately, they react impulsively. This often involves verbal or physical aggression because these children see this as an immediate way to get what they are looking for or need.

  This aggression can look like name-calling, yelling, screaming, belittling, punching, pushing and kicking. Most of these behaviors are seen in combination with one another.

Prevention/Solution

• What makes impulsivity in ADHD dangerous is the lack of any concrete way to predict whether a child will become verbally or physically aggressive. The best tools when working with or parenting an ADHD child are routines, clear and reasonable expectations and set consequences for unacceptable behaviors that are continually reinforced.

  For example, if you parent a child with ADHD who is physically aggressive when not allowed to leave the table without finishing his meal, it may make sense to instead allow the child to get up for 5 to 10 minutes and walk around with the expectation they will not disturb the rest of the family or play games or watch TV. This satisfies the immediate need to get up and move around and helps avoid an episode of aggressive behavior.

Setting Consequences

• Setting Consequences for aggressive behavior must be done ahead of time so they are predictable. Children with ADHD are not able to make the connection between a consequence handed to them today for behavior displayed yesterday.

  For example, if that child becomes verbally aggressive at the kitchen table and refuses to stop, an immediate consequence can be that child loses 5 minutes of video game time he is allowed after dinner. Do not try to maintain the child at the table as a consequence instead of allowing him to get up as this will only increase the likelihood of physical aggression.

Treatment Options

• The most effective treatment currently available for ADHD is medication. There are several on the market, including Concerta, Stattera and Vyvanse.

  It is important when considering medication to take your child to see a psychiatrist. Although many primary care physicians might be able to prescribe ADHD medications, they are not qualified to diagnose the disorder and other mental health issues that sometimes accompany ADHD.