He just can’t seem to sit still. His parents and sister are chatting while he constantly moves around on his chair, fiddles with the sugar sachets on the table and regularly – and loudly – interrupts their conversation.
Two women at an adjacent table in the coffee shop occasionally glance at the family and it’s clear what’s going through their minds: “His parents aren’t strict enough, that’s why he’s like that.”
Bad behaviour or bad parenting are just two of the many myths about attention deficit hyperactivity disorder (ADHD) that need to be dismissed.
“There’s a lot of misinformation about the causes, treatment and diagnosis of ADHD,” says psychologist Magdel Pretorius. “And this misinformation can lead to many children, and also adults, missing out on interventions that could help them reach their full potential.”
We asked experts to explain some of the most common myths.
Read more | What moms need to know about ADHD
Myth 1: ADHD isn’t a real medical condition
“Because there’s no blood test to test for ADHD objectively, some people think it’s not a real medical condition,” Pretorius says.
But the same can be said of a number of other conditions, such as depression and alcoholism, she adds. These are all legitimate medical conditions that create difficulties for the individuals who have them – even though these are invisible to others.
Brain-imaging studies have found that specific neurotransmitters and nerve pathways in the brain are dysfunctional in those with ADHD, says Durban psychiatrist Dr Shaquir Salduker.
These differences in the ADHD brain play out in various ways – concentration problems, difficulty with impulse control, difficulty regulating emotions and weak planning and organisational skills.
It’s also important to remember that some cases are more severe than others.
“ADHD is a spectrum condition – meaning it varies in intensity and presentation,” Dr Salduker explains. “In some people it doesn’t impair functioning and quality of life enough to warrant treatment.”
Where it’s warranted, he adds, the appropriate treatment can improve symptoms – and some will need lifelong treatment.
Myth 2: Kids with ADHD must just try harder
“This myth exists because parents or teachers know the child has the ability to do something but he or she just can’t seem to follow through – so it looks like laziness or lack of motivation,” Pretorius says.
But the real reason is that children with ADHD find it difficult to prioritise, struggle to organise tasks and battle to stay focused on the task at hand, she adds. “So no matter how hard they try, they sometimes struggle to complete even basic tasks.”
Telling a child with ADHD to “just try harder” or “just focus” is like telling someone who is near-sighted to “just see farther”.
Those with ADHD aren’t struggling because they’re not trying hard.
Myth 3: ADHD is a learning disability
This common misconception exists because while ADHD is not a learning disability, it does make learning difficult.
“ADHD is a combination of inattention, hyperactivity and impulsiveness – all of which may lead to difficulty with learning,” Dr Salduker says.
Children with ADHD might struggle with reading, spelling and maths because they’re not focused, Pretorius explains. But ADHD itself is not a learning disability, which is defined as a deficit in reading, writing and mathematical skills.
Myth 4: ADHD can be cured, or a child can outgrow it
“You never outgrow ADHD, but you can learn how to cope and adapt in order to become more functional in daily life,” says Professor André Venter, a paediatrician and former head of paediatrics and child health at the University of the Free State.
It’s also a common misconception that ADHD is only present during school years, Dr Salduker adds
“Sometimes doctors only treat patients until they matriculate, but treatment should continue into adulthood, along with appropriate counselling or therapy so the individual can develop coping strategies.”
ADHD is a chronic condition that can’t be cured.
“But if people with ADHD are put in an environment they find interesting, they can thrive,” Professor Venter says, adding that some might reach a point later in life where they no longer need medication to function.
Myth 5: My child focuses on computer games for hours – surely he can’t have ADHD?
While it’s true that people with ADHD have trouble focusing, when they’re very interested in something they are able to focus on it intensely.
This is called hyperfocus, says Dr Thomas E Brown, who founded the Clinic for Attention and Related Disorders in the US. People with ADHD can focus very well on one or two things that interest them, but they are easily distracted the rest of the time.
This can be difficult for others to understand, but Dr Brown is adamant it is not a problem of willpower but rather a problem with how the brain is wired.
“Kids with ADHD can focus well on things or subjects they find interesting, novel or fun,” Pretorius says. “Computer games are designed to be stimulating in terms of visual effects and sounds, so they’re easy to focus on. By contrast, schoolwork can be perceived as boring and repetitive.”
Myth 6: Sugar consumption influences ADHD symptoms
“People tend to think that a high sugar intake may ‘turn on’ or worsen the hyperactive or restless behaviour of ADHD children,” says Bloemfontein dietitian Donna van Zyl. “But several studies have demonstrated that this isn’t the case. Sugar has no direct impact on ADHD and isn’t the cause of ADHD symptoms.”
Excessive sugar consumption can be damaging as it offers plenty of “empty energy” with little nutrition. It’s more likely that kids who eat lots of sweets are missing out on essential nutrients that might help keep them calm and focused, Van Zyl says.