🧠 ADHD: A Nervous System Perspective

A holistic understanding for parents and caregivers

✨ What is ADHD?

ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental condition that causes severe and persistent patterns of inattention, hyperactivity, and/or impulsivity.

It’s not a behaviour issue or a discipline problem — it’s a difference in how the brain develops, particularly in areas related to:
- Attention regulation
- Impulse control
- Hyperactivity (external or internal)

Symptoms must begin before age 12 and significantly impact daily life — not just at school, but at home, in relationships, and in emotional wellbeing.

🧩 ADHD and Brain Development

The key brain region affected in ADHD is the prefrontal cortex — the area just behind the forehead that is responsible for:
- Attention and focus
- Emotional regulation
- Behavioural inhibition and judgement

In neurotypical children, the prefrontal cortex begins to “come online” around age 5 and continues developing into the late 20s — with many parts not fully matured until around age 30.

In children with ADHD, this development happens more slowly or functions differently:
- Delayed cortical maturation, particularly in the prefrontal cortex
- Lower levels of dopamine and norepinephrine, affecting motivation, focus, and reward
- Struggles to activate executive functioning under pressure or boredom

Here’s a key insight:
🔍 When a child with ADHD tries to focus on a boring, repetitive or low-stimulation task, their brain doesn’t switch on — it dims.
The prefrontal cortex actually reduces activity the harder they try to concentrate without stimulation.

That’s why children with ADHD may appear to 'give up,' become distracted, or get frustrated — not because they don’t care, but because their brain isn’t getting the fuel it needs to engage.

🧪 What Happens When the Brain Has Low Dopamine?

Children and adults with ADHD often have lower levels of dopamine, a key neurotransmitter involved in:
- Motivation
- Focus
- Reward processing
- Initiating tasks
- Effort regulation

When dopamine is low, everyday tasks that are boring, repetitive, or require delayed gratification feel almost physically painful to start or sustain. The brain simply doesn’t register reward from doing things that seem “normal” to others — like brushing teeth, finishing homework, or listening in class.

This is why kids with ADHD often:
- Avoid boring tasks
- Struggle to get started, even if they want to
- Seek stimulation, novelty, or movement
- Can hyperfocus on exciting things, but not shift easily to other tasks

🔥 What Helps “Switch On” the ADHD Brain?

To compensate for low dopamine, the ADHD brain seeks external stimulation — anything that gives it a quick dopamine “hit,” including:
- Movement (running, fidgeting, bouncing)
- Novelty (new tasks, changing environments)
- Stimulants like caffeine, nicotine, sugar
- ADHD medication (e.g., Ritalin, Vyvanse), which increases dopamine and norepinephrine availability

These activities and supports don’t “fix” ADHD — but they help the brain engage in a way that feels doable and rewarding.

Important note: This is also why children and teens with ADHD are at higher risk of addiction — because their brains are constantly searching for something that makes them feel alert, present, and good.

🧠 The Role of Nurturance in Brain Development

The brain is shaped by relationships. Warm, responsive caregiving actually promotes healthy prefrontal cortex growth.

The more connection, safety, and emotional attunement a child receives, the stronger their capacity for self-regulation and judgement over time.

🧠 What ADHD Means for the Nervous System

- ADHD brains are often under-stimulated, leading to restlessness, impulsivity, and zoning out
- Transitions and unstructured tasks can be very challenging
- Emotional reactions are often intense and quick
- Children may appear unmotivated when they are actually dysregulated

⚖️ Co-Occurring Challenges and Risks

- 3x increased risk of depression
- 20% experience anxiety
- 25–33% also diagnosed with OCD
- 25% of boys with ADHD develop ODD; 40% of those develop conduct disorder
- Higher risk of addiction, sleep issues, learning difficulties
- Trauma can mimic ADHD
- Girls often internalise symptoms and are underdiagnosed

🪴 A Holistic Perspective

Support should be holistic and include:
- Diet: Stable blood sugar helps regulation
- Sleep: ADHD brains often struggle to rest
- Movement: Vital for nervous system regulation
- Connection: Protective against shame and stress
- Behavioural support: Helps scaffold expectations

Children with ADHD are wired differently — and they need to be parented differently, with more structure and more compassion.

🧰 PBS-Informed Support Strategies

- Break tasks into smaller steps
- Use visual schedules and timers
- Offer movement and sensory breaks
- Use “When/Then” phrasing: “When we clean up, then we can go outside.”
- Celebrate effort, not just outcomes
- Co-regulate and stay calm
- Structure over control: clarity instead of criticism

❓ Helpful Questions to Ask

- Is this a focus or regulation problem?
- What kind of sensory input might help?
- Am I offering scaffolding or just pressure?
- What might be underneath this behaviour — stress, hunger, fear?