Module 9 – Patterns of Behaviour for Parents to be Aware Of
Patterns of Behaviour for Parents to be Aware Of
Estimated Time: 20 minutes
In this module, you will learn the following:
· What we mean by patterns of behaviour
· Key behaviour patterns to understand
· How to manage problematic patterns of behaviour
· When behaviour patterns are cause for concern
Patterns of Behaviour for Parents to be Aware Of – 06m 11s
9.1 What We Mean by Patterns of Behaviour
We have touched on this topic already, but in this module, we will examine patterns of behaviour in children with ADHD in greater detail.
A good place to start is to clarify what we mean by the term ‘patterns of behaviour’ in this context.
By patterns of behaviour, we mean the way in which a child acts in various situations, compared to the expected way of behaving for a child of the same age and ability. There is a range of behaviours to be aware of – from something as simple as an increase in fidgeting or hyperactive behaviour in situations they find boring, all the way through to the more disruptive behaviour associated with comorbid behaviour disorders such as Oppositional Defiant Disorder (ODD).
Understanding triggers is very important. If we examine the most common triggers, we can begin to look at the patterns of behaviour that are associated with them, so that the individual with ADHD can take the appropriate steps to avoid triggers and thereby lessen the subsequent impact on thoughts and emotions.
In psychology, the term trigger refers to something that can create a reaction, whether that be a positive or a negative. When looking at the concept of patterns of behaviour we must also examine the triggers, in order to fully understand the behaviour.
The triggers for problem behaviours will be different for everyone with ADHD. For some, a major trigger could be a lack of good quality sleep; others could find their symptoms worsened by certain food additives. There are many potential issues. However, there are some which are more common than others – for example, stress and overstimulation.
Stress
When it comes to triggers for ADHD, it is stress that tends to be at the top of the list – and the problem is that it does affect things in a number of ways.
Stressful situations make it harder to focus and sustain attention. Also, stress increases levels of certain hormones in the body, including cortisol – which is responsible for the ‘flight or fight’ reaction. When cortisol is raised above normal levels for any length of time, it has a significant negative impact on physical and mental health.
A further difficulty is that whilst stress can trigger ADHD symptoms, it is also true that ADHD can itself cause stress because the condition comes with a number of symptoms which are consistently challenging and frustrating. It can be tough for an individual with ADHD to break the stress-ADHD cycle.
Overstimulation
If an individual is being overstimulated, this can also be another major trigger and set off negative patterns of behaviour. The reason why being overstimulated is so difficult is because of the way it makes an individual feel overwhelmed.
Overstimulation is where the different senses are bombarded with information – making it even more difficult for the individual to filter out different feelings and to make sense of the world. This can affect anyone but is especially a problem for those with ADHD.
Stress and overstimulation are not the only ways in which certain behaviours may be triggered, but they are certainly two of the most common. If you have ADHD or know someone who does, you can probably list several other triggers.
The next part is to examine how triggers lead to certain, predictable patterns of behaviour.
To answer this, we have to look at certain key points of the condition, in particular, emotional dysregulation, impulsivity and intense emotions. We all have limits that can trigger certain reactions within us, whether that be positive or negative reactions, but it is made harder for people with ADHD because they feel things more intensely and have issues controlling their reactions.
For example:
Imagine a child with ADHD has been taken for a milkshake at a café. It’s busy and noisy with conversation and the clattering of crockery, glass and cutlery. In addition, the background music playing is quite loud, so it can be heard over the relentless sound of the coffee machine. The overhead lights are bright, and the décor is generally full of bold colours. The person on the table next to our individual with ADHD is wearing strong perfume and the smell is quite overpowering.
Many people would find this situation uncomfortable, and would be unlikely to spend long in the café! But people with ADHD often struggle with sensitivity to certain stimuli such as sound, smells or bright lights, and so for them, the experience is even worse. In addition, they often have emotional dysregulation and a tendency to feel emotions more intensely than neurotypical people. It’s easy to understand how, for an individual with ADHD, being exposed to loud noises, strong smells or bright lights – or all of them at once – could lead to sensory overload which could trigger negative behaviour.
9.2 Key Patterns of Behaviour to Understand
But what about the actual patterns? How do they present?
There is no set pattern that every individual with ADHD will follow. Instead, what you will tend to find is a general escalation of behaviour or an increase in the intensity of ADHD symptoms.
One common behavioural pattern exhibited by children with ADHD is volatile temper outbursts and tantrums. They find it difficult to process rising feelings of agitation, stress and emotions, and often burst out with their feelings in the form of a tantrum.
In order to better understand this, we have to distinguish between the three different types of ADHD, as the way in which triggers and the patterns of behaviour present will be slightly different in each case.
Inattentive Type ADHD
With the individual who is inattentive, the triggers will tend to be too many distractions, too much going on – or, alternatively, perhaps it is too quiet, allowing their mind to drift. Generally, they will be unable to prevent distraction from what they should be focusing on. As a result, this could lead to certain issues, such as a loss of focus, making mistakes or abandoning tasks halfway through.
Parents may notice one or more of the following behaviour patterns in children with inattentive ADHD:
- Your child gets bored easily and finds it difficult to get through tasks
- They lose papers, pencils, pens etc. needed to organise the task
- They process information slowly and appear to be daydreaming a lot
- They have trouble following complex directions
A child with inattentive type ADHD is prone to becoming frustrated by their own lack of concentration. They can also become upset that their symptoms cause them to misunderstand what is expected of them.
For example:
Imagine the child is at school and has completely lost focus on what the teacher has been explaining to the class, and has only a vague idea of the task that they are expected to complete. They ask the teacher to explain again, but they are still unable to concentrate enough to take it all in. This leads to feelings of frustration and irritation, and they give up on making any real effort with the task. By the end of the lesson, they are so frustrated and disappointed that by now they are quite upset.
In this scenario, the child is then likely to vent the frustration which has built up by losing their temper. That’s not to say that an outburst is inevitable, but it would be understandable given the circumstances.
Hyperactivity-impulsivity Type ADHD
We will now look at hyperactive-impulsive children and how things can escalate for them – and their potential patterns of behaviour. Again, frustration is at the root of many of their problem behaviours.
A child with hyperactivity symptoms could get bored and restless easily in certain situations, such as waiting in a queue or sitting through a show they find boring. You might notice them fidgeting more, and getting frustrated and agitated.
Furthermore, their impulsivity symptoms could mean that they start to act out. They are not doing this deliberately – it’s just that they’re unable to control their response to how they feel.
For example:
The child has been taken to the doctor but there is a 20-minute wait to get seen. After a short time, they start to show signs of boredom and restlessness. This soon leads to them leaving their seat and running around the waiting room, or climbing on furniture.
It is likely in this scenario that the parent would become embarrassed and annoyed with the child. Any reprimand from them would be likely to lead to further upset and frustration for the child, who feels misunderstood. It is easy to imagine this situation leading to an emotional outburst.
Combination Type ADHD
The triggers and patterns of behaviour for this type of ADHD will depend largely on the severity of the individual symptoms experienced by the child but will be similar to the examples explored above.
As you can see, there are different ways in which patterns of behaviour can manifest themselves – and that is why you need to spend time really getting to grips with ADHD and how it affects each person as an individual. By doing this, you will then have a better understanding of how behaviour can develop and, as a result, be in a better position to make the correct decisions and react accordingly.
FACT
The term ADHD refers to a pattern of specific behaviours that affect children in most situations, and this condition is evident in children from an early age. Most of these behaviours appear when a child enters school.
Source: Great Ormond Street Hospital
9.3 How to React to Problematic Patterns of Behaviour
The question now is how to react when you spot the behaviour in question because the way in which you do react will make a huge difference to the outcome.
Furthermore, we mentioned earlier the need for you to stay calm; even when it may be extremely difficult to do so. Devising a behaviour support plan allows you to prepare a scripted approach to the type of language that can be used in difficult situations. This will ultimately allow you to gain control of the situation and calm things down.
It could be argued that when you are able to identify this kind of behaviour, you should have your own guidelines as to how you will react – and this is something that you will more than likely adjust to fit the person in question.
Have a plan of action
The best way to react to difficult behaviour is to be prepared in the first place. Have a plan of action and use it. The key is to remain consistent with how you react, simply because consistency in a reaction can lead to a modification in behaviour in some situations. Your reaction will play a part in how the child’s behaviour develops over time, so always react in a clear and predictable manner.
Agree goals and consequences ahead of time
Parents should consider which kinds of behaviour they can tolerate, and those they can’t. Children should be rewarded for sticking to desirable behaviour, and have privileges removed for poor behaviour. Parents should be very clear and consistent on this so that the child understands that there will consequences to their actions.
Parents should be willing to pick their battles and be realistic about what their child can reasonably achieve. It can be prudent to turn a blind eye to some unintentionally disruptive behaviours in one-off situations (such as the doctor’s waiting room scenario above), and instead focus on daily situations that a child with ADHD might be able to navigate with success. There are greater rewards to be found in helping a child to meet their parents’ expectations than punishing them for situations that are outwith their control.
Manage tantrums effectively
This is a skill which every parent of a child with ADHD will likely have to master, as emotional outbursts are very common. Again, this is all about calm, decisive, consistent actions. Using time-outs can be very effective in helping both the child and their parents remove themselves from the situation which has triggered the outburst, and from further irritating each other.
However, there are some actions that no one should carry out under any circumstances and those are as follows:
Never overreact
If the person is displaying unacceptable behaviour, you should never overreact to the situation, as seeing you worked up and agitated will only make matters worse. Instead, approach the situation with a calm but firm attitude.
Never take things personally
When an individual with ADHD is showing negative behaviour, you must never take this personally, even though it is entirely possible that they will appear to be lashing out at you. This is not about you; instead, the person is fighting against a flood of intense negative emotions and is unable to effectively control their emotional response to them. Remove yourself from the situation and consider what is going on behind the scenes.
9.4 When Patterns of Behaviour Are Cause For Concern
Finally, we address something that will be of concern to parents of a child who has been diagnosed with ADHD – is there anything to worry about when it comes to dealing with patterns of behaviour?
In most cases, the answer to this should be ‘No’, although it does depend on how you deal with the situation. Your reactions can completely shift the mood and feeling in the family.
However, if you notice consistently hostile, aggressive, angry, argumentative and defiant behaviour in a child with ADHD, it is worth considering having them evaluated for a comorbid disruptive behaviour disorder such as Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD). It is thought that up to half of all children with ADHD also have a behaviour disorder.
Symptoms of ODD include:
- Often loses temper, is angry
- Often argues with adults, and actively defies their wishes
- Is resentful, spiteful or vindictive
- Often blames others for their mistakes
- Often annoys people on purpose
CD behaviours are more serious, ranging from lying and stealing, to destruction of property or aggression towards people and animals. Undiagnosed and untreated, CD could potentially cause the child to get into trouble with the police.
If a child with ADHD displays the behaviours above, then it’s worth speaking to their psychiatrist or therapist. Like with the ADHD diagnosis, several symptoms must be present and have occurred consistently for at least 6 months, in order for a disruptive behaviour disorder to be considered.
One other situation where there is something to be concerned about is if you simply ignore the general patterns of problem ADHD behaviour because the longer those are left unaddressed, the worse it will get – and the child will suffer as a result.
What is clear is that there is a very real need for you, as an individual dealing with somebody who has ADHD, to learn what is going on and to spot the warning signs as soon as possible. Be prepared to make slight adjustments to the situation, or to look at things that may have to change in the child’s routine that could be triggering the problem patterns of behaviour.
For example:
Is the child getting enough good quality sleep? Is their diet adequate? Are they overstimulated by having too many activities? Are they suffering an unusual level of stress at the moment?
You will find that there is often a reason which explains why certain types of behaviour are happening – and when there is a reason, there will also be a solution. Make notes of the behaviour and if possible, what went on before it. It might also be useful to seek relevant advice from the medical professional working with the child.
Supporting an individual with ADHD is not easy, but it will be helpful to you to spend time understanding the person’s behaviour and what lies beneath it. By removing a certain amount of stress and worry about these behaviours, it will give you the freedom to help the child take the necessary steps, in order to make a difference in their lives.
SUMMARY
In this module, we focused on the patterns of behaviour of a child who has ADHD.
Being able to identify behaviours and the situations that can trigger certain reactions will allow you to better shape the environment of the child and consequently help reduce the occurrence of negative behaviours.
Identifying and then appropriately managing the child’s behaviour will be beneficial to both the child and you.
The next module will focus on coping strategies for parents of a child who has ADHD.
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