Written and Published by Baylor University
When experiencing loss, it’s common for children to become preoccupied with feelings related to grief: apprehension, inability to focus, overstimulation.
But for children who are diagnosed with ADHD, or attention deficit hyperactivity disorder, the manifestations of grief can exacerbate ongoing struggles to focus and manage stress.
“Their minds are occupied with adapting to all the changes that loss creates,” said Helen Harris, EdD, MSW, faculty member at Baylor University’s Diana R. Garland School of Social Work.
While traditional bereavement groups can provide stability, Harris said they are often designed for families grieving a death. But children with ADHD experience many other forms of loss and sometimes need interventions tailored to their specific needs.
How Does Ambiguous Loss Affect Children?
Dr. Pauline Boss, an educator and researcher with expertise in family stress, defines ambiguous loss in two main categories:
1. When a person is physically present but psychologically absent.
2. When a person is physically absent but psychologically present.
There are many misperceptions among adults about the ability of children to grieve, but research shows that children may, in fact, be likely to react to loss in more varied ways than adults.
“Most adults have other adults in their lives who have experienced loss and can rely on those people for support and emotional articulation,” Harris said.
Children may lack the same social support as adults because their peers haven’t yet experienced grief and might not have the language to express those feelings.
Harris points out that the “work of children is play, so therapeutic responses involving right brain activities like play, art and music are important.”
How Does Grief Affect Children Diagnosed with ADHD?
With an existing ADHD diagnosis, some children may experience compounded challenges when the symptoms of grief and ADHD overlap. Signs that children are not coping well with grief may be masked by tendencies of children with ADHD to hide their feelings.
Overlapping Symptoms of ADHD and Grief
- Trouble focusing and low attention spans
- Constant need to move body
- Distancing from peers or interests
- Poor school performance and difficulty learning new material
- Impulsivity
- Trouble eating or sleeping
Some children who exhibit these symptoms may be misdiagnosed with ADHD if caretakers jump too quickly to conclusions. Conversely, children with ADHD may see their symptoms worsen.
“We need to have empathy for the fact that ADHD may cover over what’s going on for a child in their grieving process,” said David Anderson, PhD, clinical psychologist and senior director of national programs and outreach at the Child Mind Institute. “They may in fact have deeper emotions.”
Anderson explained that frontline intervention involves training adults to look for signs and help children by meeting them where they are.
“Adults have to realize that even though they aren’t the cause of the problem, they are a part of the solution,” he said.
For younger children, interventions may consist of training caregivers to facilitate and manage positive behaviors. When children age, it becomes more common to consider medication, he explained. As for teenagers, cognitive behavioral interventions can help young people manage their symptoms while gaining independence.
Harris cautioned caregivers from making preliminary diagnoses before consulting a clinician. Assuming that a child is depressed or that medication is necessary can lead to ineffective or inappropriate treatment plans.
“We do our best treatment and intervention when we’re intervening for the right thing,” Harris said.
Experts at the American Academy of Pediatrics External caution adults to be mindful that the home environment can lend itself to more stress or exacerbate symptoms. Identifying sources of stress within the home can help caretakers more effectively intervene.
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FamilyMeans Center for Grief and Loss offers specialized therapy for children grieving. Learn more at GriefLoss.org.