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Emotional responding in ADHD
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There is a large body of evidence that now considers the fact that children with ADHD show impairment in their emotional regulation, as a function of the recruitment of the top-down processes of their cognitive abilities.

We also now acknowledge that the reduced recruitment of certain brain areas for ADHD children is significantly correlated with the severity of symptoms and the hyperactivity displayed by them.

The disruption in recruitment of cortical regions in ADHD may be responsible for heightened representation of emotional stimuli, but not a general failure in emotional regulation, which means that rather than stimulant medication there is a possibility of creating neural cortical changes over a period of time - that can help ADHD children overcome and learn to manage their behaviour with metacognitive awareness.

Once a positive diagnosis of ADHD has been established, not just by a simple rating Scale – as rating scales only confirm observed symptoms - which can be due to various exogenous factors - we can begin to work towards helping the child in the domains of school and home functioning.

ADHD if it is actually present, and has been correctly diagnosed, presents as a persistent pattern of inattention and/or hyperactivity – impulsivity that impacts the functioning domains at school and at home.

In both of the two spheres, we are are noticing an increased potential emotional dysfunction, with difficulty in regulating positive emotions as compared to peers and children who do not have any form of ADD - AD/HD or AD/HD-I.

Emotional reactivity as a bottom-up aspect creates significant severity of emotional turmoil, with severe difficulty in behavioural inhibition and symptoms of internalisation.

Within the sphere of emotional regulation we believe that there may be two sets of control processes.

One that represents a form of emotional conflict adaptation and which has a basis in disruption of the circuitry in brain responsible for emotional regulatory efforts. This causes typical responses to emotional distractors.

The other represents a state, which may allow the priming of the relevant representations at the expense of the relevant representations.

It is possible that in this case, children with ADHD are not able to willfully alter irrelevant stimulus - due to their inability to control emotional distraction.

Thus there might be dysfunctionality in both - atypical responses to emotional regulation - and an inability to inhibit or disinhibit an atypical response, which is something, like an immediate atypical reaction.

Faced with the normal situation, where a non-ADHD child would be able to cognitively control emotional responding, a child with ADHD may subconsciously prime task irrelevant representations in his brain and the inability to suppress emotional distraction will lead to externalizing - and behaviours which are symptomatically observable.

The symptoms that we see are not willful misbehavior on the part of the child who is suspected of having ADHD. In all likelihood we believe in an equivocal manner that these contrasting representations are the result of a form of disruption in the neural circuitry of a specific part of the brain, and a reduced ability in ADHD to recruit higher-level cognitive functions, which may relate to the problem. The circuitry is also responsible for sustained attention tasks and impairment here relates to failure in task performance in ADHD.

This task failure and impaired recruitment of regions in the brain responsible for task - at relevant stimuli priming means that children with ADHD eventually demonstrate a heightened response to emotional stimuli which a non-ADHD child would not show.

It is possible that negative as well as positive emotions are difficult to regulate for children with ADHD leading to a larger proportion of general problems given the heightened integration of positive emotional stimuli response from ADHD children who are especially irritable - and possibly extremely hyperactive.

At the Dyslexia Association of India™ we firmly are of the opinion that stimulant medication is not the answer to the ADD behaviours that a child may be throwing up. The overreliance and over prescription of stimulant medication which contains the compound ‘methylphenidate’ is not the solution in treating your child as this stimulant may downplay the symptoms for a while but the long term consequences of neural disorganization is very high.

To remediate deficient emotional self-regulation, which involves quick bursts of outsized anger, frustration, impatience, or excitability or any sort of reflexive, emotionally laden reaction, which forms a part of the ADHD childs personality, we need to first assess what is causing the dysregulation. In one case, which was presented to the DAI™ what, was being labeled as ADHD eventually emerged as the young lady being bullied at school and not being given the time and space at home to ‘calm down’ or in her words being understood. When assessed, it was discovered that she had an auditory issue and would speak very loudly as she herself could not hear what the others were saying. So when asked a question in school, she would repeatedly ask the teacher – “what did you say” and was eventually hauled up for being ‘rude’.

Children, who have deficient emotional self-regulation, don’t have inhibitory capacity to censor emotional reactions even when they’re not under any form of stresses and this is a neurobiological issue that needs to be addressed immediately.

For a child with ADHD, we see abnormalities in response inhibition as a central component in their psychopathology and a pervasive deficit in all forms of stimuli related response disinhibition. This leads to secondary impairments in memory, internalisation of speech, self-regulation of affect-motivation-arousal, and reconstitution. And this is what you a s a parent observe when your child sits down to study and can’t stay on his desk for more than a few minutes - disturbances in self-control and goal-directed behaviour.
The DAI™ works on the lines of remediating the Behavioural Activation System and not the Behavioural Inhibition System so that your child learns to control the initiation of behaviour.

We believe that children have the unique ability to control or attenuate primitive emotional responses through conscious evaluation. Using a behavioural activation system to generate self-reasoning, rationalizing and labeling experience to control emotions we can ensure a profound impact on emotional experiences of a child with ADHD.

As a parent you must remember that ADHD once thought to be exclusively a childhood disorder, frequently persists into adulthood, afflicting approximately in our personal and very equivocal view 15-20% of the India specific adult population and generating significant impairment in academic, occupational, social and emotional functioning. This impairment includes completion of fewer years of education and elevated rates of unemployment, antisocial behavior, interpersonal conflict, marital separation, and divorce. In addition, children with ADHD are at significantly greater risk for substance and alcohol abuse disorders when they reach adulthood as well as other comorbid disorders such as anxiety and depression.

To know more how we can help your child who may be displaying symptoms of ADHD, please call us at +91 8826022886 or email us at info@dyslexiaindia.org.in.

(Views and observations expressed in our articles are equivocal and personal based on our observations and experience of contributing authors. Being equivocal and personal they are non contestable under any circumstances and conditions and Individuals are under no pressure to confirm to our views, thoughts and observations. The accuracy ratio for screening and remedial processes of the DAI™ is extremely high.)

   
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