Using a different lens for neurodivergent children: Don’t treat them as younger, give them the tools to achieve

A little while ago someone on my Facebook posted a meme that supposedly showed the functional age of a child with ADHD according to their chronological age. The meme contained a list: if your child was eight years old, for example, you should think of them as being six years old. If they were 10 years old, consider them to be eight years old.

The meme was hugely shared; its popularity came from the recognition within it that expectations need to adjust to meet the child. When your eight-year-old child with ADHD doesn’t sit and focus in class in the way that the next eight-year-old child does, they’re not being naughty. The adults around them should have different expectations of them. This much is true. We should recognise that neurological differences are significant and adjust our expectations accordingly.

So why did that meme bother me so much?

Different paradigms

There are different paradigms through which we look at children. That sounds fancy, but it's much like looking through different coloured sunglasses. What you see will depend on what colour glasses you are wearing. 

colour blind test
example of colourblindness testing plates

We used to view children very much through a behaviourist lens: our understanding was based on ideas of cause and effect, behaviour happens because something causes it (this part of this lens is useful because it gets us asking “what happened before this, to trigger this behaviour”) or motivates it (like the carrot on a stick). To ‘fix’ behaviour we must either motivate or punish. 

When you look at children through a behaviourist lens, you think star charts and wall displays with clouds and rainbows on and pegs with children’s names showing where they are on those displays are good ideas. From time to time, people get curious about such approaches, for example, how come it's always the same children on the rainbow, and the same children on the cloud? Is this supporting behaviour change or simply a way of shaming children?

Research into these approaches shows that they are very effective in the short term, but in the longer term the kickback against them can be hard, and what the children learn as a result of being a part of them is probably not what you want to be teaching them. How does it feel to be the child who is always on the cloud?

We often view children through a cognitivist lens: our understanding is based on the idea of a brain maturing. We recognise the development of a child’s brain and know that our expectations must match where they are. This is certainly a more nuanced lens than the blunt stick of behaviourism, but it is still a lens. It shows us certain things and hides others.

What lens are you using?

I am not here to say one lens is right and one is wrong (I’ve only mentioned two, there are plenty more specs in this sunglasses shop). I am simply pointing out that whether we recognise it or not, we are wearing these lenses and our opinions are being influenced by them. Different lenses make you look at different things, ask different questions.

Here is the problem with the cognitivist lens and that meme that it clearly inspired. An 8-year-old with ADHD is NOT a six-year-old without ADHD. Their brains just are wired differently. It is a neurological difference, not a behavioural difference and that difference is significant and important. What was tragic about that meme was that it gave a cut-off point, announcing with authority that an ADHD mind would never age past a certain point. The parents I saw sharing it, celebrated the “understanding” it gave them of their children and lamented the plight of those children whose brains would never reach full maturity. I was so upset, because, in my opinion, viewing those children in that way could genuinely stunt their progress. Not because their progress was always destined to be stunted, but because people were wearing the wrong lenses and being given duff advice.

Trying on different lenses

Let’s try on a particular pair of glasses that will help you see neuro-difference as just that: a different wiring of the brain, not as a behaviour difference. You’ll see that the behaviour is different, but recognise that this difference is a consequence of the neuro-difference. Here is that 8-year-old with ADHD again: one of the differences many neurodivergent people experience is a difference in their executive functioning, located in the frontal lobe of the brain. An example of what your executive functioning does is list-making. So when this child’s parent tells them to go upstairs, brush their teeth and get their school clothes on, that child needs to hold the following list in their head:

  1. Go upstairs
  2. Brush teeth
  3. Get dressed.

Actually, the list is more complicated isn’t it:

  1. Go upstairs
  2. Go to the bathroom
  3. Brush teeth
  4. Go to the bedroom
  5. Get dressed in their school clothes.

I expect you could add an even more detailed list.

If you have a brain that struggles to hold lists, then you’ll probably go upstairs, go into your bedroom, forget why you are there and begin to play. Then the parent comes up and you’re in trouble for not doing what was asked of you.

If I, as the professional, say to your parent, “don’t worry just think of them as a six-year-old” then your parent shifts their expectations of you, and you no longer get in trouble, maybe you get help to brush your teeth. Did I do something helpful? No, I did not. What I did was ignore the neuro-difference, brush it under the carpet, and help to infantilise you.

But! We are wearing those lovely glasses that help us recognise neuro-difference. We realise that what is going wrong with the morning routine isn’t a result of bad behaviour, it is a result of neuro-difference. We learn what that neuro-difference might be and when we come across the bit about executive function we think, “Ah-ha! That’s what is happening here”. Then, just as we would with someone with a physical difference, we seek to find the environmental adaptation that enables that child to do as we have asked. In this case, it is a picture symbol strip with the symbols on showing the list and a little envelope at the bottom into which they can pop the symbols when each task is done. 

Example of a "getting ready for school" interactive comic, using laminated images with magnetic strips for brushing teeth, breakfast and school clothes to stick on  when accomplished (courtesy Marco Tirraoro)
Example of a "getting ready for school" interactive comic, using laminated images with magnetic strips for brushing teeth, breakfast and school clothes to stick on when accomplished (© Marco Tirraoro)

That symbol strip externalises a process usually done internally in the brain. We, as parents and professionals, support the child to get into a habit of using it. Over time that 8-year-old child gets the hang of creating and using these lists, and begins achieving in line with peer-aged children. 

Physical vs Cognitive disability

Imagine if someone tried wearing the first lens when considering a child who has a lower limb disability, telling the parents, “They might be eight, but they’ve got the physical ability of a 2-year-old”.  We would consider this madness! We recognise physical disability because we can see it, the child with a lower limb mobility issue does not suffer the fate of the child with a hidden difference. No one says, “Just lower your expectations”. Everyone recognises there is a need for an external adjustment.

Let’s go back to that child with ADHD, the eight-year-old whose parents are told to, “Just think of them as if they were six”. How does the child feel when those expectations of them are dropped? And how do they feel two years later, 10 years later, when they are still struggling through the world without any of the adaptations they need?

Neuro-differences are significant. They do not equate to behavioural differences. A child with a neuro-difference who doesn't show any unwanted behaviours, still benefits from adjustments being made through an understanding of their neurotype. I am waiting for the meme that says, “Your child has ADHD, they might not be doing what peers their age are doing. Here’s some adaptions you could try to support them in getting there.” 

Imagine that child who, because they confidently learned to manage their symbol strips aged eight, learned a strategy that enabled them to bridge the neuro-divide for the rest of their lives. They learn they are capable, they get to achieve. And not only that, but they and their family know that it is possible to find these tools so the next time they hit a barrier, instead of just lowering their expectations they’ll look for the adaptation they need.

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