Parents and educators of children with ADHD are likely familiar with what are considered the “hallmark” behavioural symptoms of the condition: trouble with attending to tasks, impulsivity, and, particularly in younger children, restlessness and hyperactivity. However, many children diagnosed with ADHD also struggle with an equally important but less frequently discussed social and behavioural challenge: emotional regulation. Ongoing research has shown that individuals with neurodevelopmental disorders such as ADHD are more prone to emotional dysregulation.
Children with ADHD ultimately experience the same standard set of feelings and emotional states (happiness, anger, sadness, joy, disgust, and fear) as their neurotypical peers. The brain mechanisms that help identify, express and manage emotions, however, are affected in children with ADHD, and as a result, emotional regulation is impacted. For example, children with ADHD are hypersensitive to what is happening inside and/or outside them and easily get flooded by their emotions causing them to become overwhelmed and react in challenging ways.
Emotional regulation is defined as an individual's capacity to adapt their emotional state in a manner designed to encourage flexible, targeted behaviour. It includes the mechanisms that allow an individual to choose, attend to, evaluate and respond to emotionally stimulating stimuli in a healthy manner. These mechanisms elicit behavioural and physiological reactions.
Emotion dysregulation occurs when these adaptive mechanisms are disrupted, resulting in behaviour that is detrimental to the child and those around them.
This includes excessive emotional outbursts and experiences that are contextually inappropriate with respect to social standards, abrupt fluctuations in mood, and irregular management of attentiveness to emotional cues.
Most children struggle with emotional regulation, or the ability to identify and control their “big” feelings in a socially appropriate manner, in early childhood (think: tantrums!), and gradually develop more acceptable responses and self-soothing techniques as they grow older.
Children with ADHD, however, often take longer to acquire these skills for a number of reasons.
Firstly, due to an overall difference in how their brain handles a process called executive functioning—essentially, the ability to organise thoughts, adapt quickly to new information and ideas, and keep track of multiple things at one time. Each of these core components of executive functioning is directly related to and necessary for emotional regulation.
For example, keeping track of multiple things at one time (also known as “working memory”) helps children follow instructions, remain safe in their environment, and handle increasingly complex social and academic situations. Similarly, being flexible with new information allows children to process disappointment when things do not go their way, and learning to organise and attend to thoughts allows children to build self-control, plan, and learn with fewer mistakes.
Children who struggle with one or more of these processes, as children with ADHD often do, frequently become overwhelmed by their feelings surrounding information and events and respond in a very “big” and outsized way compared to their peers. Emotional episodes may also happen more frequently, as deficits in executive functioning leave children more sensitive to responding impulsively to environmental “triggers", and last longer, as children with ADHD often struggle to shift their attention away from their heightened emotional state.
Secondly, deficits in emotional regulation in children with ADHD may be caused by a variety of psychological and neurological processes. Recently developed hypotheses distinguished between mechanisms that enable or influence regulation from the "bottom up" processes and "top-down" processes mechanisms such as the redirection of attention to emotionally arousing input.
Regulation of emotion depends on two fundamental mechanisms: awareness of important emotional stimuli and evaluation of reward signals. Attention systems must be able to detect and signal the possible occurrence of relevant stimuli to control emotion. An anomaly in the early attentiveness to emotional signals has been linked to ADHD. Emotional misconception, along with flippant and extreme emotional reactions, might be the result of emotion dysregulation.
An additional factor that influences how children with ADHD process emotions centers around the ways in which children are typically taught emotional regulation strategies, both in school and in the home.
Neurotypical children are more likely to respond positively to rules and cognitive reasoning, such as being told which behaviours are desired and which are not (i.e., right vs wrong) and can work to match their feelings and responses to the social cues and expectations of their surroundings.
A child with ADHD who must work harder to organise information is less likely to reliably remember these skills when upset, and needs more targeted strategies to recognise and separate themselves from their emotional reactions. In addition to helping the child remove any secondary feelings, such as shame and confusion, surrounding his or her responses through validation and identification of the problem, hand-on techniques that provide children with a multisensory approach to dealing with feelings are often beneficial.
These include but are not limited to, modeling and rehearsal of appropriate responses, labeling feelings and the physical responses they elicit in the body, and visual supports and cue words to help children identify when they are approaching an emotional threshold.
Many parents and teachers may have experience with the intense emotions of their child or student with ADHD, but lack awareness as to why these occur or how to help a child cope. With both increased understanding of the processes that help children control emotions as well as deeper knowledge on effective tools for teaching this valuable skill, parents and educators alike may find themselves better prepared to be a positive force in shaping their child’s behaviour.
If you would like to learn more about ADHD take a look at our online course 'Positive Behaviour Support Strategies for Children and Adolescents with Attention Deficit Hyperactivity Disorder'. Following completion of this course, you will be equipped with:
- A toolkit of practical strategies to assess, manage and prevent challenging behaviour in children and adolescents with ADHD,
- Guidance to develop a behaviour support plan,
- Lifetime access to the Behaviour Help app to create individualised behaviour support plans,
- Free copy of ebook ‘Positive Behaviour Support for Students with ADHD,
- A certificate of participation of 5 hours CPD,
- Completion of an accredited Teacher Quality Institute of ACT and NSW Education Standards Authority (NESA) course.
If you would like to learn more about Emotional regulation, we also have an online course called Guiding the Development of Emotional Regulation Skills which discusses a range of strategies based on the evidence based Cognitive Behaviour Therapy (CBT) approach. CBT is a form of psychological therapy that helps the individual build a set of skills to take CHARGE of one’s thoughts, feelings, and behaviours to achieve symptom reduction, improvement in functioning and overall quality of life.