Here's What You Need to Know:

ADHD is a complex situation and is really misnamed. It should be called a disorder of regulation, because attentional factors are only a small part of the whole picture. It involves the proper regulation of many things including impulse control, emotional reaction, planning and organization, effort and motivation and other factors as well as regulating attention.

Many other processing difficulties may “look like” attentional difficulties in the classroom but really involve something totally different. For example, you could look like you can’t pay attention when you really have problems with auditory processing, are gifted and bored, have a language processing disorder, have another type of learning disability that makes it difficult for you to understand or keep up with instruction or are depressed.

ADHD regulation problems primarily reflect difficulties in the prefrontal cortex of the brain. In people who truly have ADHD, this area of the brain is under activated so that many of the functions supported by this area are not working at full capacity.

So what are some of the things that the prefrontal cortex or PFC is responsible for?

  • Basically, this part of the brain monitors, supervises, guides, directs and focuses your behavior. Sounds like regulation, right.
  • It is sometimes referred to as the executive portion of your brain since it is involved with making decisions related to judgments, time management, planning and organization, communication with others, thinking things through critically, and in being motivated by future events.
  • So the PFC helps us to make goals, carry them out, change course if necessary, improvise and get things accomplished – without – external structure or direction from others.
  • It also helps us to think about what we say before we say it (so you don’t blurt out that you find your boss’ conversation exceedingly boring), to see ahead to consequences and to make the best choice from several possibilities.
  • The PFC allows us to notice our mistakes and learn from them so we don’t continue to make the same mistake over and over. If your PFC is not working like it should you would have trouble learning from past frustrating situations and may put off things to the last minute.
  • The wonderful PFC also helps us to regulate and sustain our attention, focus on the most important stuff and filter out less significant sensations and thoughts. The ability to do this is vital for short-term memory and learning.
  • The PFC is interconnected with many different areas of the brain. It helps you keep on task, sticking with it until the project is finished.
  • If the PFC is underactive, you are likely to be more distractible since the underlying regulation functions are not working as well.
  • The PFC is also important for feeling and expressing emotions and to act in consistent and thoughtful ways rather than impulsively.
  • When put into situations that require impulse control, concentration and quick reactions, people with PFC problems have difficulty adjusting. Therefore, test anxiety and social anxiety are often seen.
Folks with ADHD/regulation problems have difficulty sustaining attention over longer periods of time. In the classroom they may be thinking about other things on their mind – or what they want to do – rather than what the teacher is saying.

Signs of ADHD:

Now they can pay attention fine to things that are novel, stimulating, interesting or even frightening. Students with ADHD are often experts at video games or may be glued to their iPod and parents cannot understand how they can have an “attention deficit” when they can do this – for hours at a time. But just remember that word “regulation”. Since these activities are intrinsically motivating and stimulating, the PFC is activated enough to do its job. What the ADHD student cannot do though is regulate attention and effort toward more regular, routine, mundane tasks in everyday life – such as written schoolwork, homework or chores. ADHD folks need more excitement and interest to get their PFC revved up and working.

When the PFC is underactive it is not able to filter out all the stimuli and sensory information that bombards the brain. So in a classroom of 30 children there will be a big difference in how the student performs compared to in a one to one situation. This little guy or girl (or grown-up) will tend to notice everything going on around them, forget what they were saying, look bored or interrupt you with a thought of their own. They can also be excessively talkative, not realizing that they are going off all over the place and talking all around a subject. All of these things will contribute to incompletion of class work or taking a very long time to get things done. Yet sometimes, they are in such a hurry to get things done – to get to something better – that they will rush through and have very little quality control.

ADHD/regulation folks can get themselves into trouble because they have difficulty stopping themselves before they say or do something inappropriately. They can sometimes blurt out something before really processing the thought. Many ADHD students want immediate solutions and gratification so they fail to think a problem through – not really thoroughly evaluating the consequences. This can be in a child or an adult, when dealing with teachers or when dealing with spouses, bosses and coworkers.

It is not unusual for people with ADHD to want to engender conflict because it is stimulating. Remember, ADHD folks want to be involved in stimulating activities to rev up the PFC. They may not be consciously aware of this at all – but just want for their brain to feel more tuned in. Overactivity, noisemaking, humming, incessant tapping of pencils, restlessness may all be ways of self stimulating. Unconsciously seeking conflict or turmoil can be examples of this as well. Kids may know just how to push your buttons and can be experts at upsetting parents. Sometimes this need for self stimulation takes the form of worrying or focusing on problems so that the resulting stress chemicals stimulate the brain.

One of the biggest problems you see with ADHD individuals is disorganization. This is really number one and becomes much more evident in students when they’re entering middle school or junior high. Typically, they may have many projects going on but finish few of them, may be chronically late or procrastinate. They may not know how to plan and organize to do a task and often think that they have “studied” when all they have really done is look over their notes. Their PFC problems have interfered with their ability to know “how to learn” as well as to monitor and reflect on the effectiveness of their approach. One of the gifts of ADHD is that these folks are often the entrepreneurs of the world – they get very stimulated and excited to develop ideas and new things with enthusiasm and energy. But they may need others to follow through with the more tedious aspects of the project.

When you have an underactive PFC, its ability to regulate another brain area, the limbic system, which is involved with emotional processing, can be diminished. In this case the limbic system can become overactive, leading to difficulty in controlling mood. So many ADHD individuals can be prone to being moody, irritable and negative. This is all part of problems in regulating emotions.

Brain imaging studies have revealed that when an individual without ADHD is put in a situation where she must concentrate significantly, the PFC activates or lights up. However, when the ADHD individual is put in a situation requiring heavy concentration, the PFC actually deactivates. This can lead to behaviors such as “drawing a blank” during a test even though the student studied for it.

How to Help ADHD Folks:

A Relaxing Environment

ADHD folks will function best in an environment that is highly interesting, stimulating and engaging and relatively relaxed. Although all of us do better when we receive praise, it is absolutely essential for folks with ADHD. Remember this, it is very rare to find a “lazy” child. Children want to do well and please. Don’t assume that your child is lazy when he really may have a neurological problem that is interfering with his ability to be as productive as he really wants to be.


Medication is one tool that can often be helpful for ADHD folks.  What does medication do?  Almost all the medications prescribed for ADHD increase the availability of the neurotransmitter dopamine in the prefrontal cortex.  This can help that area of the brain do its job better.  Studies have found that it works particularly well with focusing attention, reducing impulsivity and decreasing motor restlessness.  However, it is not likely to work as well for many of the other functions of the PFC and additional strategies and supports are needed to improve processes such as planning and organization, time management, prioritizing, emotional self-control and other regulation functions.

Strategic Learning Coaching

Children, adolescents and adults are often helped by working with a strategic learning coach to learn strategies to improve in all of these areas and to facilitate building new neural connections in the PFC. Parents and their children can also be helped substantially by learning behavioral techniques that facilitate growth in emotional and behavioral self-control.


As you can see ADHD or ADD or Regulation Dysfunction is a very complex phenomenon.

It is different in every person that has it, because each has a different set of characteristic problems and challenges as well as notable strengths and supports. It is important to understand the specific profile of the student so that interventions, strategies and tools for helping can be targeted efficiently. Think of it this way- Sometimes it is not so much a “disability” as a mismatch between the way the student needs to learn and the way the student is taught. We need to concentrate on multiple ways of helping the student – by maximizing the teaching strategy and environment to meet the needs of the student, to develop strategies to improve the functioning of the PFC and to help the ADHD student find what works best for them and then continue to do it. We simply need to understand.