Mislabeled Lazy: Empathy and Strategies for ADHD, Predominantly Inattentive Type

 

By Jan Hammer, Psy.D.

 

            Imagine two different children. The first child often fidgets, leaves his/her seat in class, blurts out answers before questions are completed, and talks excessively. The second child often avoids or is reluctant to do schoolwork, does not follow through on instructions, fails to finish schoolwork and chores, and makes careless mistakes when he/she does complete tasks. The first child presents with symptoms of Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type and the second child presents with symptoms of Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type. Now ask yourself, “Which child is more likely to be recognized as having symptoms of Attention-Deficit/Hyperactivity Disorder or ADHD and which child is more likely to be mislabeled as lazy?”

            Unfortunately, children with ADHD, Predominantly Inattentive Type may slip through the cracks and remain undiagnosed. As a result, they do not receive the understanding and support they need to succeed. Instead, they may receive the message that they are lazy. Over time, they start to believe this is true about themselves. The guilt, shame, and negative self-image that accompany this belief can lead to the development of anxiety and depression. These children may still be undiagnosed as they grow into young adults. They may feel a lack direction and struggle significantly with successfully transitioning into a fulfilling, independent adulthood.

            Other symptoms of ADHD, Predominantly Inattentive Type include the following: often has difficulty sustaining attention in tasks, does not seem to listen when spoken to directly, has difficulty organizing tasks, loses things that are necessary for tasks (e.g. school assignments, books, pencils, etc.), is easily distracted, and is forgetful in daily activities. The first step towards gaining an understanding of children and adolescents with these difficulties is an evaluation to obtain an accurate diagnosis and recommendations for treatment. Once parents and teachers understand that laziness is not the problem, they can start to empathize with people who have ADHD and help them to develop strategies to deal with the challenges they face.

            Executive functioning is an area in which people with ADHD, Predominantly Inattentive Type struggle. It entails task initiation, sustained attention, organization, time management, and planning.

There are many strategies that can be utilized to address these issues including the following:

 

  • Use a dry-erase board to keep track of routines (for example morning routine, homework routine, chore routine).
  • Make a schedule of daily activities by listing activities/tasks, identifying how long activities/tasks will take, and determining when you will complete each one.
  • Use organizational tools (for example calendars, planners, and cell phone alarms) to keep track of activities, appointments, tests/quizzes, & short and long-term assignments.
  • Study in a quiet environment that is free from clutter and distractions, and take brief breaks as needed.
  •  Break down large tasks such as papers and projects into manageable parts and assign a due date to each part that proceeds the final due date. Make a checklist of the steps that need to be completed and check them off as you go along.
  • When you feel like procrastinating, first identify why you feel like procrastinating, then make a plan.

      If you feel like procrastinating because a task is unpleasant or boring, plan a reward for yourself that you will enjoy after completing the task. You can also think about how good you will feel when the task is done and any other positive effects of completing the task.

      If you feel like procrastinating because the task is overwhelming, break the task into smaller parts and only focus on the first step. If you need help with this, or if you don't understand the material to complete the task, ask for help.

 

            Working with a therapist can help you identify your specific areas for growth and develop effective strategies for greater success in life. If you are a young adult who is struggling and feeling stuck, actively participating in therapy can help you to start moving towards the future you want for yourself. Children and adolescents can also be empowered by working with a therapist to strengthen their skills and reach their goals. In addition, a therapist can be a resource for parents in empathizing with their children and supporting them in dealing with the challenges they encounter. If you are a parent who has mislabeled your child as lazy in the past, please let go of any guilt that may be weighing you down. Instead, pour your energy into understanding and supporting your child. There are a number of therapists who have experience treating ADHD, and when parents, children, and therapists collaborate with each other there is potential for positive change.