The Missing "I" in ADHD.

ADHD, Attention Deficit Hyperactivity Disorder is the most commonly diagnosed psychiatric disorder in children effecting approximately 5% of all children.  The rates among children with autism are cited to be over 50% (Leyfer et al, 2006) and in my experience, children with other developmental disabilities have a much higher rate of ADHD as well. 

The symptoms of ADHD are well known:

• High rates of distractability, inattentiveness and inability to focus or concentrate
• Hyperactivity that can include motor (fidgetiness) and hyperverbosity (chatterbox)
• Impulsivity, both verbal and physical (aggression)

The last symptom, impulsivity, doesn't get credit in the ADHD title, however.  Shouldn't it be ADHID?  My advocacy for the missing "I" is due to the frequent incidence that I've found in how challenging (frustrating, maddening, crazy making, choose your descriptor) impulsivity is. 

Kids blurting out how much they "hate" their parents, siblings, family members and teachers.  Death threats, rarely meant, but in our current world in need of stern attention, inadvertently reinforcing the behavior to boot.  Physical aggression against family, peers etc.  These are the behaviors that try parents' patience to the hilt - and so many parents end up over-responding and thus adding to the inadvertent reinforcement of what is, essentially, just a symptom of ADHD.  One test, by the way (not infallible) of whether the impulsivity is really based in ADHD is whether the child has remorse afterwards when calm.  We like remorse for bad behavior. 

So, for those of you with kids with ADHD, remember, those really challenging behaviors that make you want to tear your hair out - could they be the result of the missing "I?"  It's worth keeping in mind.