Behavior in ADHD Children Often Based on Perception


Changes in an ADHD child’s behavior might be caused by misperception based on poor communication.

An ADHD child’s behavior and grades are often heavily influenced by what they perceive has happened to them or what they are told about what has occurred.

Unfortunately, we as adults do not do the best job when explaining things to our children or teens. We more often than not tend to use adult language, adult metaphors, and assume that our children understand what we have just said to them.

How many times did you nod yes or say yes when your mom, dad, or teacher asked you if you understood something…when in actuality, you really didn’t understand a thing, but were afraid to admit so? If you answered “none” to the question, then you probably shouldn’t read any further, because you were one of the 0.001% of kids who were a childhood prodigy-already capable of adult thinking and comprehension. No, seriously…

For the rest of us, we know what is going on in that child’s mind and we should do all we can to help our children, grandchildren, and patients avoid misbehavior caused by perception problems. To reach that goal, I’d like to share a short story about Duane, a fifth grade patient of my friend Dr. James Sutton. Dr. Sutton has graciously offered to let me include his article about handling childhood perceptions in a child with failing grades in this article.

I think you will clearly “see” how much pain and suffering this child went through because of misperception caused by poor communication between Duane and his parents, teachers and doctors.

As you read Duane’s story, please keep in mind that children with ADHD will react even more drastically, with failing grades and terrible, sometimes violent behavior when they misperceive what has been said to them, what is happening to them and what has been done to them.

Children and teens with ADHD behavior problems react poorly under these circumstances because they usually have problems with executive thinking when their ADHD is not properly treated. They don’t automatically have one of those “adult ah ha moments” and suddenly realize that what is being said wasn’t intended to degrade them or make them inferior or less of a person emotionally or physically.

A good example would be that of the parent who constantly tells his or her son that he is a bad boy in hopes that he will suddenly realize they disapprove of his behavior and will instantly change his behavior, grades, or attitude on his own.

I can tell you right now; that’s not what is going to happen. That child is going to suffer self-esteem and confidence problems and if he is ADHD, these problems will often be severe. He will be confused about his value as a person and his place in his own family and will often times withdraw and suffer in silence to avoid further degrading remarks. These kids feel insecure with their family and sometimes feel as if their parents will abandon them or fail to protect them. So they often strike out at the very people who should love, nurture and protect them.

These children will often grow into insecure adults who suffer depression and anxiety, have poor social skills, have problems keeping a job and may still be living at home with their parents at age 30. As adults, they are in and out of legal troubles and have a higher risk of drug abuse and premature sex-pregnancy.

While keeping these thoughts clearly in mind, let’s take a look at Dr. Sutton’s patient, Duane.


Good or Bad, Children Live What They Believe

Dr. James Sutton, Psychologist

Perception always trumps reality: What our kids believe becomes real enough to direct their lives and their behavior. The problem is that parents often don’t know what’s going on inside their son’s or daughter’s head; so it’s often difficult clear up a misplaced dose of toxic confusion. Perhaps this story will help reinforce the notion that young people don’t always tell us where it hurts. That’s when we need to listen to the behaviors and not be afraid to play a hunch, especially when that’s about all we have.

Duane, a fifth grader, had a brain tumor. Fortunately, it was benign. The tumor was removed and the boy healed quickly and completely … physically.

Academically, however, it was a different story. Duane had been a solid and capable student before the brain surgery. After the surgery, however, he began failing everything.

Everyone was puzzled; there was no reason why he should be having difficulty. Doctors assured the school and Duane’s folks that the boy should be able to do everything he could do before the surgery, only better. I was assigned to work with Duane and (hopefully) arrive at a solution to the problem.

This boy was your proverbial “Good Kid.” Duane was a polite and respectful young man, the sort you wouldn’t mind taking home with you. The testing I administered didn’t point to any issues that would account for his present difficulty.

In short, I was stumped, also. Then it hit me!

Could it be? Could it really be?

I could hardly wait to get back to the school the next day and visit again with Duane.

“Duane, when you had that surgery …”

“Yes sir?”

“Did you think they removed your brain?”

“Yes sir,” he replied.

“Your WHOLE brain, Duane?”

“Yes, sir. Didn’t they?”

“No Duane; they didn’t. They just took out the tumor, the part that was making you sick. Your brain is STILL there, better than before.”

“Really?” His eyes filled with tears as a smile filled his face.

“Absolutely! You shouldn’t have ANY more trouble with it.”

And he didn’t. Duane was instantly happier, and his grades shot up in a matter of hours.

We MUST be careful how we explain things to our children, and we must keep the channels of conversation clear. Also, hunches can pay off. Do be afraid to use them. ### JS

Although a nationally recognized child and adolescent psychologist, Dr. James Sutton deeply values his first calling as a Special Education teacher. Today he is in demand for his expertise on emotionally and behaviorally troubled youngsters and his skill for speaking, writing, and training on this subject. He is the author of numerous articles and books on the subject, including his latest work, The Changing Behavior Book: A Fresh Approach to the Difficult Child. His monthly publication, the ODD Management Digest, is available at no cost through his website,

Wow, I’m sure you agree that Dr. Sutton’s insight into figuring out why Duane went from making great grades to making poor grades and the way he fixed the problem is a fantastic example of what can happen in a child’s mind when the wrong words or in the end-when the right words are used to explain thing!

In my next article, we’ll discuss ways you can avoid misperception and the emotional damage that poor communication might cause in children and teens with behavior problems, those who misbehave, or those with ADHD or with learning problems.

Dr. Frank 

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