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Using the BioPsychoSocial Model to understand ADHD
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Using the BioPsychoSocial Model to Understand ADHD
Jaime Hottinger
Biological Contributors
Biological Contributors
Sensory
Sensory
- Sensory systems inform us of our environment
(Speilman et al., 2020)
- Sensory overload occurs during the over-stimulation from one or more senses
- May cause abnormal reactions
- Lashing out
- Shutting down
(Mae, 2023)
Neurodivergent Affect
ADHD and Sensory Issues
- Individuals with neurodevelopmental conditions are more susceptible to sensory overload
(Mae, 2023)
- 57.9% of ADHD individuals have atypical sensory processing compared to 0% TD
(Dellapiazza et al., 2021)
ADHD and Sensory Issues
- Association to sensory processing problems and attention difficulty
- Children presenting more atypical sensory processing exhibited attention deficits
(Dellapiazza et al., 2021)
- Abnormal sensitivity to surroundings
- Difficulty functioning during overload
(Mae, 2023)
Auditory
Auditory
- Processed in the temporal lobe
(Speilman et al., 2020)
- Atypical neural reactions to auditory processing with ADHD
- 75% of ADHD individuals experience auditory processing abnormality to 0% TD
(Dellapiazza et al., 2021)
Visual
Visual
- Processed in the occipital lobe
(Speilman et al., 2020)
- Atypical neural reactions with ADHD
(Dellapiazza et al., 2021)
- 69% of ADHD adults experience oversensitivity to light
(Cohut, 2017)
Touch
Touch
- Processed in the parietal lobe
(Speilman et al., 2020)
- Atypical neural reactions to touch processing
- 64.3% with ADHD experience sensation-avoidant atypical sensory processing
- 0% with typical development
(Dellapiazza et al., 2021)
Sleep
- 30-50% experience sleep disorders at some point
(Speilman et al., 2020)
- Increased likelihood with ADHD
(Snitselaar et al., 2019)
Sleep
Insomnia
Insomnia
- Insomnia describes difficulty falling or staying asleep
(Speilman et al., 2020)
- Insomnia patients show more symptoms of ADHD
- 85% of ADHD individuals experience insomnia
- 63.8% in typical development
(Snitselaar et al., 2019)
Restless leg syndrome
Restless Leg Syndrome
- Disturbs sleep with urges to move during rest
(Cohut, 2017)
- 23.4% ADHD individuals experience restless leg syndrome
(Snitselaar et al., 2019)
Delayed Sleep Phase Disorder
Delayed Sleep Phase Syndrome
- Difficulty falling asleep
(Cohut, 2017)
- Delayed sleep onset
- Delayed dim light melatonin onset
(Snitselaar et al., 2019)
Delayed Sleep Phase Syndrome
- Strong association with ADHD
- 28% of ADHD individuals
- 13.6% of controls
(Snitselaar et al., 2019)
- Comorbid individuals delay melatonin production 1.5 hours
(Cohut, 2017)
Psychological Contributors
Psychological Contributors
Mental
Mental
- Attention shapes perception
(Speilman et al., 2020)
- Reduced attention span with ADHD
(Cohut, 2017)
- Difficulty managing attention with ADHD
(CDC, 2023)
- ADHD children have greater difficulty with modulating attention during reactivity
(Bertin, 2022)
Academic Deficits
Academic deficits of ADHD
- 30-70% of individuals with ADHD also have a learning disability
(Speilman et al., 2020)
- Memory deficits
(Fonseca et al., 2019)
- ADHD medication increases Dopamine
- Effects executive functioning and reward motivation
(Langley, Sahakian, 2023)
- Dopamine influences learning
(Speilman et al., 2020)
Academic deficits of ADHD
- May require
- Movement and fidgeting
- Additional testing time
- Individual instruction
(CDC, 2023)
- Benefits from tutoring
(Gaastra et al., 2020)
- Children with ADHD benefit from repetitive studying
(Speilman et al., 2020)
Behavioral
Hyperactivity
Hyperactivity
- ADHD often involves hyperactivity
(Cohut, 2017)
- Characterized by excessive movement
- Presents with loud and rambunctious behaviors
(Speilman et al., 2020)
Impulse Control
Impulse Control
- Difficulty with ADHD
- Restlessness
(CDC, 2023)
- Disruptive behaviors
(Bertin, 2022)
- Cause odd and inappropriate behaviors
(Speilman et al., 2020)
Engaging in Bullying
Bullying
- The ongoing mistreatment of another individual
(Speilman et al., 2020)
- Children with ADHD perpetuate bullying more frequently
(Fonseca et al., 2019)
Emotions
- ADHD children have more problems with emotions
(Langley, Sahakian, 2023)
- Increased negative emotionality
(Lugo-Candelas et al., 2017)
Emotional
ADHD impairs emotional understanding in children
Understanding
- The ability to discern self or others’ emotions
- Limited emotional vocabulary
- Reduced facial expression labeling accuracy
(Lugo-Candelas et al., 2017)
- Seven emotions have distinct facial expressions
(Speilman et al., 2020)
Sensitivity
Sensitivity
- Increased emotional sensitivity
(CDC, 2023)
- More sensitive to bullying
- Reduced ostracism resilience found with ADHD
- ADHD self-reported ostracism significance of 27.59%
- 12.77% in controls
(Fonseca et al., 2019)
Reactivity
Reactivity
- Expression and experience of intense emotional arousal
- Greater frustration during challenge
- ADHD frustration score M=1.759
- M=1.310 in controls
(Lugo-Candelas et al., 2017)
- Reduced likelihood of spontaneously attempting to emotionally regulate
(Langley, Sahakian, 2023)
Regulation
- Modifies our emotions and expressed responses
(Speilman et al., 2020)
- Defecit is primary symptom of ADHD
(Langley, Sahakian, 2023)
- Greater frustration during attempted suppression with ADHD
- ADHD frustration score M=2.138
- Control M=1.103
(Lugo-Candelas et al., 2017)
Social Contributors
Social Contributors
- Social support reduces stress
- Strong social relationships increase survival by 50%
(Speilman et al., 2020).
Peers
Peers
- Emotional competence is connected to socioemotional function
(Langley, Sahakian, 2023)
- ADHD individuals have fewer friendships
(Speilman et al., 2020).
Communication challenges
Communication Challenges
- Forget details
- Excessive talking
- Difficulty staying present in conversation
- May go off-topic
(Bertin, 2022)
- Difficulty perceiving social cues
(Fonseca et al., 2019)
Bullying
Bullying
- Being the victim of bullying harms individuals' physical and mental health
(Speilman et al., 2020)
- Children with ADHD experience more ostracism
- ADHD ostracism score M=6.79
- Control ostracism score M=5.94
(Fonseca et al., 2019)
Teachers
Teachers
- Children with ADHD experience more difficulty in school
(CDC, 2023)
- ADHD linked to greater high school dropout rates
(Speilman et al., 2020)
- 29.2% of teachers reported interest in learning about ADHD needs
(Gaastra et al., 2020)
Classroom Management Strategies
Classroom Management Strategies
- Classroom management strategies assist ADHD children
(CDC, 2023)
- Teachers with understanding of ADHD more likely to utilize
(Gaastra et al., 2020)
Antecedent-based
- Control the situation ahead of the event to promote a desired behavior
- Benefits academic performance
(Gaastra et al., 2020)
- Provide warnings before transitions
- Ensure students understand instructions
(CDC, 2023)
Antecedent-based
- Our brains learn by associating events and stimuli
(Speilman et al., 2020)
- Teachers provide individual assignment assistance
- ADHD student frequency M=2.96
- ADHD student effectiveness M=3.06
(Gaastra et al., 2020)
Consequence-based
- Managing situations following the behavior
- Rewards/ Punishment
(Gaastra et al., 2020)
- Frequent feedback
(CDC, 2023)
- When shaping we reward progress, not just the target behavior
(Speilman et al., 2020)
Consequence-based
- Individuals learn link to behaviors and their consequences through operant conditioning
(Speilman et al., 2020)
- Teachers praise appropriate behavior
- ADHD student frequency M=3.20
- ADHD student effectiveness M=3.14
(Gaastra et al., 2020)
Self-regulation
- Student implemented interventions
- Self-monitoring
(Gaastra et al., 2020)
- Allow fidget toys
- Provide alternative formats to show mastery
(CDC, 2023)
Self-regulation
- Observational learning is the act of watching and imitating others' behavior
(Speilman et al., 2020)
- Benefits behavior
- Teach self-instruction techniques
- ADHD frequency M=2.18
- ADHD effectiveness M=2.29
(Gaastra et al., 2020)
Families
- Parents of ADHD children under 12 are twice as likely to get divorced compared to parents of non-ADHD children
(Bertin, 2022)
- ADHD individuals are more likely to be divorced
(Speilman et al., 2020)
Families
Strategy
Parental strategies
- Parenting greatly affects a child’s socioemotional growth
- Children with ADHD are more frequently in trouble with their parents
(Speilman et al., 2020)
- Understand ADHD
- Advocate for child needs
- Encourage children
(CDC, 2023)
Parental strategies to reduce the effects of ADHD
- Children with ADHD are more frequently in trouble in school
(Speilman et al., 2020)
- Communicate with teachers and school
- Utilize documentation
- Create systems to assist with homework
(CDC, 2023)
- Praise, money, toys, and other rewards can reinforce learning
(Speilman et al., 2020)
Perceived Vulnerability
Perceived Vulnerability
- Greater parental perception of vulnerability
- Caregivers reported higher rates of bullying in ADHD children
- ADHD caregiver Victim score M=6 compared to typically developing caregiver Victim score M=4.16
(Fonseca et al., 2019)
References
References
Cohut, M. (2017, September 3rd). ADHD and sleeplessness: A critical link? Medical News Today. https://www.medicalnewstoday.com/articles/319233
Snitselaar, M. A., Smits, M. G., & Spijker, J. (2019). ADHD symptoms in adults with delayed sleep phase disorder. Sleep & Biological Rhythms, 17(1), 11–18. https://doi-org.ccco.idm.oclc.org/10.1007/s41105-018-0188-0
Mae, A. (2023, November 13th). What to know about ADHD and sensory overload. Medical News Today. https://www.medicalnewstoday.com/articles/adhd-sensory-overload#adhd-and-sensory-overload
References
Dellapiazza, F., Michelon, C., Vernhet, C., Muratori, F., Blanc, N., Picot, M.-C., Baghdadli, A., for ELENA study group, Chabaux, C., Chatel, C., Cohen, D., Damville, E., Geoffray, M.-M., Gicquel, L., Jardri, R., Maffre, T., Novo, A., Odoyer, R., Oreve, M.-J., & Périsse, D. (2021). Sensory processing related to attention in children with ASD, ADHD, or typical development: results from the ELENA cohort. European Child & Adolescent Psychiatry, 30(2), 283–291. https://doi-org.ccco.idm.oclc.org/10.1007/s00787-020-01516-5
Centers for Disease Control and Prevention. (2023, September 27th). ADHD in the classroom. Attention-Deficit / Hyperactivity Disorder (ADHD). https://www.cdc.gov/ncbddd/adhd/school-success.html
References
Gaastra, G. F., Groen, Y., Tucha, L., & Tucha, O. (2020). Unknown, Unloved? Teachers’ Reported Use and Effectiveness of Classroom Management Strategies for Students with Symptoms of ADHD. Child & Youth Care Forum, 49(1), 1–22. https://doi-org.ccco.idm.oclc.org/10.1007/s10566-019-09515-7
Langley, C., Sahakian, B.J., (2023, June 18th), ADHD: inattention and hyperactivity have been the research focus – but emotional problems may be the missing link. Psypost. https://www.psypost.org/2023/06/adhd-inattention-and-hyperactivity-have-been-the-focus-of-research-but-emotional-problems-may-be-the-missing-link-165885
References
Lugo-Candelas, C., Flegenheimer, C., McDermott, J., Harvey, E., & McDermott, J. M. (2017). Emotional Understanding, Reactivity, and Regulation in Young Children with ADHD Symptoms. Journal of Abnormal Child Psychology, 45(7), 1297–1310. https://doi-org.ccco.idm.oclc.org/10.1007/s10802-016-0244-7
Bertin, M. (2022, May 13th) Autism and ADHD: The Complete Playbook for Social Challenges. ADDitude. https://www.additudemag.com/autism-and-adhd/
References
Fonseca, A., Kral, M. C., Lally, M. D., Boan, A. D., & Macias, M. M. (2019). Bullying and ostracism in youth with and without ADHD: implications for risk and resilience. Children’s Health Care, 48(2), 164–175. https://doi-org.ccco.idm.oclc.org/10.1080/02739615.2018.1514607
Spielman, R.M., Jenkins, W.J., & Lovett M.D. (2020). Psychology 2e. OpenStax.
Houston, TX https://openstax.org/details/books/psychology-2e