My experience with individuals diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) began more than twenty years ago during my days as a student clinician. During that time, I worked with children, adolescents and adults experiencing speech, language, and hearing challenges. My understanding of ADHD was limited to theoretical knowledge that I gained through interactions with my professors and with children diagnosed with ADHD.

It wasn’t until 2007 that I began working closely with children diagnosed with Autism Spectrum Disorders (ASD), Learning Disabilities (LD), and ADHD. In some instances, I also worked with children with hearing impairment, intellectual disability, Specific Language Impairment (SLI), Developmental Apraxia of Speech (CAS), stuttering, cleft lip and palate, and such conditions.

My most impactful experience was with Kiran (name changed), a child with ADHD at an institute of speech and hearing in South India, where he attended therapy sessions. ​“Tsunami Kiran”, as we would affectionately call him, would burst into the group therapy room like a tsunami and his endless energy would exhaust us. He was an ​“explosive child” as Ross Greene would describe him — a child who seemed easily frustrated and was very inflexible. Getting him to work on any activity was a challenge, but he made significant progress as he started getting comfortable with the group (a peer group of 5 children with similar or related characteristics) and the routine of the therapy sessions. He had endearing ways to avoid tasks but slowly found the motivation to complete the tasks assigned. It was both challenging and enjoyable to work with him. 

Apart from working with children like Kiran, I was also teaching courses in Speech Language Therapy at the same institute. Thus, my professional life was balanced between teaching future therapists and working with individuals facing various communication difficulties, including language loss post-stroke, stammering, voice disorders, and various developmental disabilities.

As a clinician and teacher, I was able to support second- and third-year students of Speech Language Therapy and Audiology in their courses. A lot of this was possible because of my clinical experiences with children, adolescents and adults with various communication difficulties which served as ready references while teaching. 

Beginning 2013, when I set up a centre for children with special needs, my focus shifted to supporting children with various developmental disabilities and learning disabilities. During this time, I also taught courses on clinical linguistics and allied courses of speech language therapy to postgraduate students at the institute of speech and hearing, but none of them really had identified themselves as neurodivergent.

When I joined Azim Premji University in 2021, I began interacting more with neurodiverse adults on campus. Some had formal diagnoses from their school years, while others came to me with a self-diagnosis of ADHD. While I was empathetic towards their self-identification, and did not want to invalidate their feelings, I was also concerned, as I was well aware of the perils of self-diagnosis. This is when the University promptly referred them for detailed evaluation and diagnosis. It was a relief because ADHD is a multifaceted condition and cannot be oversimplified to hyperactivity or inattention. 

Despite increased awareness and testing leading to a rise in ADHD diagnoses, the trend of self-diagnosis is concerning. Professor Joseph Davis at University of Virginia calls it ​“personal appropriation” rather than ​“self-diagnosis,” emphasising that a diagnosis should follow a medical examination by a qualified professional.

Since ADHD-like characteristics may be caused by other factors such as stress, medical practitioners and mental health professionals need to rule out these factors during diagnosis. While overdiagnoses and misdiagnoses are prevalent, there are also adults who get diagnosed only late in life, thus giving an official name to their unknown struggles. It is noteworthy that without proper diagnosis and management, ADHD can lead to other mental health conditions like anxiety, depression or other issues such as substance abuse.

Oftentimes, ADHD is not clearly understood by the general public. Misconceptions about ADHD are also reinforced by stereotypes perpetuated by social media, which has in the past led to the popularisation of many mental health conditions. 

Personal experiences, especially with mental health concerns, seem to be very influential on social media, and this is perhaps why many young adults try to identify themselves with a mental health condition or a neurodiverse condition like ADHD (although this may not always be true). For university students, being identified with such a condition may bring some relief in the form of academic accommodations. Such intentions of young adults complicate the general understanding of this condition and stigmatise those genuinely affected by ADHD.

ADHD is a clinical condition that may require expert medical intervention, and in some cases, a recommendation for medication. These recommendations are precise and calculated and need to be followed strictly. ADHD involves a spectrum of issues, including challenges with executive function, impulse control, attentional issues (impacting learning), and emotional regulation. These need confirmation by a qualified mental health professional and a licensed medical practitioner. Once confirmed, whether medication is prescribed or not, persons with ADHD will benefit from structured intervention sessions. For instance, I worked with a student who had a formal diagnosis, focusing on enhancing their executive functions through goal-setting, monitoring goals, using metacognitive strategies, self-evaluation of progress, task analysis, and time management, outside of their class hours.

Understanding and addressing ADHD requires a nuanced approach, recognising the various layers of its complexity and the necessity for professional diagnosis and intervention. It is crucial to address these concerns with sensitivity, ensuring that those genuinely affected receive the support they need while also ensuring a responsible discourse around mental health.

Suggested Readings

• Brown, T. E. (2013). A New Understanding of ADHD in Children and Adults: Executive Function Impairments. Routledge.
• Greene, R. W. (1998). The Explosive Child: A New Approach for Understanding and Parenting Easily Frustrated, ​“Chronically Inflexible” Children. HarperCollins.
• Greene, R. W. (2008). Lost at School: Why Our Kids with Behavioral Challenges are Falling Through the Cracks and How We Can Help Them. Simon and Schuster.
• Hallowell, E, M. & Ratey, J. J. (1995). Driven to Distraction: Recognising and Coping With Attention Deficit. Touchstone.
• Zylowska, L. (2012). The Mindfulness Prescription for Adult ADHD: An 8‑Step Programme for Strengthening Attention, Managing Emotions, and Achieving Your Goals. Shambhala Publications.

Image Credit: Moondance, Pixabay

About the Author

Bhuvaneswari B is involved with the early childhood education programme as well as the programme on teaching children with learning disabilities, at the School of Education, Azim Premji University, Bengaluru. She has training and experience in Speech-Language Therapy. Her areas of work include early intervention, parent training, emergent literacy, language acquisition and disorders, learning disabilities, autism spectrum disorders, and other neurodiversities.