In a study based on in-depth interviews, Noam Ringer charts how children and adolescents with the neuropsychiatric disability ADHD understand and manage their symptoms. She is also interested in how parents of children with ADHD understand children’s behavior and what they do to make everyday life work.
– The study shows that it varies a lot in children, both in terms of how they perceive the causes of the symptoms and perceptions of what consequences adhd has for their lives. Children also vary in the strategies they use to manage the symptoms. These variations need to be taken into account in order to better understand the children’s behaviors and to be able to help them in the best way.
How does your dissertation contribute to previous research?
Variation in children’s perceptions
The study identifies three different ways in which children perceive the causes of their symptoms. A group of children perceive their ADHD as something wrong with them, with thoughts like “it’s like my brain is not working”. Another group perceives that ADHD is about an inadequate environment, such as messy lessons and annoying parents. Another group thinks that ADHD is part of their own personality. In the same way, children’s strategies for dealing with the situations that arise vary.
– Children may have thoughts of trying to stifle the impulses, “I must not fight” or, “I will kill the ants in the ass”. Others are working to change their environment to deal with the situations, for example by having dinner in their room instead of with the family. A third strategy is to follow the symptoms and deal with the situations gradually, with thoughts such as “if I need to run, I will run”, and “if there is a problem, I will have to fix it.”
In the study, Noam Ringer was not able to see any differences between the sexes. She describes, however, that children who talk about ADHD as a biological cause are more self-controlling, the children who see ADHD as a result of problems in the environment make changes in their environment, and that the children who see ADHD as part of their personality accept and follow their symptoms.
What consequences arise for children who feel that “something is wrong with me”?
– I think it is important to continue to investigate it. I have done a previous study that shows that self-esteem is a big problem with ADHD. It is perhaps not so strange that it is linked to how they perceive themselves. The hope is to study further in the future which of children’s perceptions and strategies contribute to less stress, better well-being and a functioning everyday life.
Standardized solutions to problems
Noam Ringer believes that the practice around children with ADHD is often standardized – solutions to problems should work for everyone. In her work as a psychologist in both school and child and adolescent psychiatry, she has met children at a couple of first meetings before it was time to make a diagnosis. The action plan itself is usually made together with the child’s parents and other adults. Putting the children in focus has been the driving force of the study.
– I am a clinician and believe in children as actors. I have a bad conscience in front of children where I made diagnoses and made action plans, but barely examined what the children have for their own perceptions. You may meet the child in the beginning, but the adults then shape the environment.
Can the perspectives in your study be used in school?
– Now that Sweden has adopted the Convention on the Rights of the Child as Swedish law, it is important that the children are more active in shaping how everyday problems at school are handled. I do not believe in a revolution in the school world, but I think we miss something important when we do not take in the children’s perspective, and that is really the biggest reason why I started writing the dissertation.
Parents adapt and renegotiate
The dissertation describes how parents handle and adapt their behavior to prevent difficult situations for the child. It can be about adapting to the environment or using cognitive strategies such as re-evaluating and negotiating one’s values. Telling others about your child’s ADHD can be a way to prevent or prevent criticism.
– The children in the study varied a lot in how they experience their situations. But the parents did not, and one explanation is that many parents take courses that almost always have the biological perspective.
Noam Ringer describes how children experience restlessness in the body even before it manifests itself in behaviors. The parents only notice when behaviors make it in everyday life. Parents’ own values, such as appreciating caution and kindness, for example, can mean that the parent does not understand at all when the child does not meet expectations – for example, not wanting to share his or her toys.
So what can parents do to make everyday life work?
– There are those who believe that a clear schedule suits all children, because that is what we have learned. But the child may not perceive ambiguity at all, it may just be very long lessons at school, or the child may perceive that you as an adult make too high demands. We need to explore how the child thinks – how do you perceive these feelings in the body? We can help the child much better then.
How children with ADHD and their parents experience and manage the disease.
The article was first published on Stockholm University’s website.