ADHD Children-Mouthiness and Verbal Impulsivity


Sometimes, ADHD children and teens can’t seem to control their mouth and words flow without rhyme or reason.

Parents complain these ADHD kids are mouthy or say “it’s that mouth that gets her (or him) in trouble”. Many times it appears they just don’t think before saying things that hurt or insult others or anger or upset their moms, dads, or teachers. Doctors call this mouthiness-Verbal Impulsivity-or the tendency to speak before considering what is to be said.

In my last post, we discussed John, a 16 year-old with a terrible mouth and even worse attitude. John is the epitome of the ADHD teen who suffers from faulty executive thinking and verbal impulsivity or mouthiness. In other words, the parts of his brain that allow him to take what he sees, hears, feels, and senses and interpret them and then decide if, what and when to respond or take action are not working normally or don’t control imulsivity.

ADHD children are prone to mouthiness and all types of impulsivity, including verbal impulsivity.

This process is called executive processing or thinking and unfortunately seems to be impaired in many ADHD children, teens and adults. Executive thinking areas of the brain sort of put a damper on what we’re about to say or do until other brain areas can decide if our intended actions are correct, logical, desirable or should be avoided at all costs-impulsivity control or inhibition of actions.

Poor executive thought processing is what leads the ADHD child, teen or adult to:
• Blurt out answers out of turn
• Say things they didn’t mean to say
• Insult others without regard to their feelings
• Tell secrets without considering the consequences
• Use foul language even in the presence of children or the opposite sex.

ADHD medications help executive thinking and allow ADHD kids and teens to focus on making good decisions and remembering what they have experienced or learned for future reference.

Back to John…

Remember how mouthy he had become? How he was offering insulting, unsolicited opinions about everything?

What causes sudden mouthiness or verbal impulsivity in an ADHD child?

When parents describe John’s type of behavior in an ADHD child who previous had better behavior one or more things may have set it off or precipitated the new behavior:

1. The child or adult has stopped taking their ADHD medication (the most common reason)
2. The child or adult was misdiagnosed as ADHD and really suffers from something else-like thyroid disease, obstructive sleep apnea, post-concussive syndrome or bipolar disorder
3. The child, teen or adult has recently suffered a physical or emotional trauma-child abuse, bullying, rape, seizures, death of a loved-one, or witnessed a terrible event such as a plane crash or hurricane
4. They are taking medications (including street drugs and alcohol) that interfere with their ADHD drugs.

Which one of these things do you believe caused John’s sudden verbal impulsivity?

If you guessed #1-he stopped taking his ADHD drug…you’re right-it is the most common reason for a child or teen to suddenly become mouthy, insensitive and impulsive. In this case, John was faking taking his pills. He was “palming the pills” instead of putting them in his mouth and on top of it all, he made a big deal of doing so at the breakfast table where everyone could see him “taking his pills!

After ten days of actually taking his Concerta, John’s mouthiness went away and he no longer blurted out answers, interrupted teachers or his mom and dad, and the insults ceased flowing from “that mouth”.

It’s important to be sure your ADHD child is really taking his or her medication if you see a sudden change in any of their previously improved behaviors!

ADHD kids, teens and adults who suffer from verbal impulsivity or mouthiness are at risk for both academic-school and work failure.
Dr. Frank

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