Sitting here as a 42-year-old woman, I can definitively say that I have mixed presentation ADHD. Unfortunately, as a girl with ADHD in the 80’s and 90’s (when everyone was pretty sure that ADHD only existed in hyperactive boys), it has taken me my entire life to get to this diagnosis. As a first grader, I was identified by my teacher as being behind the rest of the class. Someone came in and “assessed” me and the feedback given to my parents was, “she’s fine, she just needs to pay attention and try harder.” That statement led to over a decade of developing obsessive study strategies, severe school anxiety that eventually morphed into generalized anxiety, and depression. I was a sophomore in college before I saw a segment on the news that outlined ADHD symptoms in girls. I stood there, staring at my TV as I checked off every item on the list for myself. Given that I was a psychology major, I went to the resources at hand, and I confirmed my ADHD hypothesis. In the remainder of my undergraduate career as a psychology major, in my graduate program as an Occupational Therapist, and in the time between, I would confirm this diagnosis for myself over and over again. I took every assessment and questionnaire that I could find, read all of the articles and textbooks I could get my hands on, until I could confidently say that I had this diagnosis. It would take me another 15 years to find a psychologist who agreed with me.
Now, as a mother to a son with ADHD and an OT who has worked with many kids with ADHD, I wanted to provide a resource that might help caregivers and others better understand what ADHD can look like. What if I had known about my ADHD as a kid? What if, instead of thinking that I was incapable or stupid, what if I had learned that my brain was fundamentally different? What do I wish I had known then, or what do I wish my parents had understood about my brain? I decided to draft a comprehensive, if not all-inclusive, list of those things that might have changed my self-view, my confidence, my ability to learn, and my ability to interact with others. My hope is that, in sharing my experiences from my own ADHD journey, it might shed some light into understanding yourself or someone you love who has ADHD. With that said, this is not a substitute for going to a medical and/or psychological professional to get a full diagnosis and treatment. This is just a glimpse into my brain in the hopes that it helps someone else.
ADHD impacted my ability to learn how to read
One of my earliest memories of school was being asked, in second grade, to read aloud out of my religion textbook (9 years in Catholic school for this girl). I remember looking at the page and just seeing alphabet soup. I didn’t know where words began or ended, let alone sentences. Nor was it clear to me where to being reading. I sat in silence until my teacher finally moved on and chose another student.
In my professional practice as an OT, I have taken many hours of continuing education courses about ADHD and the developing brain. Now, I know that ADHD plays a role in all learning, but especially in learning how to read. Unfortunately, the explanation isn’t necessarily easy as our brains, whether neurodivergent or not, are incredibly complex. A good place to begin, though, is with dysfunctional sensory processing. Before I get too ahead of myself, let me take a quick moment to explain what that means. When a therapist refers to sensory processing, they are not referring to your ability to see/touch/taste/hear/smell, etc. What they are referring to is how your brain interprets that information. For example, let’s say you walk into your living room and right in the middle of the carpet is a huge spider. You brain tells your body to go into fight or flight mode—your heart rate will increase, your pupils will dilate, and muscles will tense in preparation to run for your safety. As you approach the spider, you realize that it’s just a large piece of dryer lint. Your brain tells your body that it can relax—your heart rate will slow, and your muscles will relax. So, what happened? Did your vision change between when you saw a spider and when you saw dryer lint? No. What changed is how your brain interpreted that information. That is one example of sensory perception.
In my brain, my ADHD impacted both my auditory and visual perception skills. To this day, I still struggle to correctly interpret quickly spoken words, accents, and funny voices. In addition to that, my overall auditory processing is slow, so when someone is speaking to me, it will take me a minute to catch up to what they’re saying, process it, and generate a response. What makes that problematic in learning to read is an inability to correctly interpret letter names and sounds. Couple that with an inability to focus on what the teacher is saying, and one key piece of literacy is out the window.
In addition to my auditory and visual processing, I also had an inability to cross midline. What does that mean? Well, your body is divided in half by imaginary lines—you have your right and left sides, top and bottom of your body, and front and back of your body. All of these divisions are referred to as the midline, but for simplicity’s sake, we’re going to focus on the one that divides us into left and right. This is a skill that, as a therapist, I have spent countless hours on. We need to practice crossing our arms and legs over that midline so that we’re able to effectively dress and bathe ourselves, feed ourselves, and to move efficiently in our environment.
Another key component of crossing the midline is that your eyes have to cross the middle of words and sentences in order to read effectively and efficiently. Simply put, to read you need to be able to track letters and words from left to right across a page. My eyes did not cross midline. Even as I began to learn accommodations that made learning to read easier, my eyes would get to the middle of a sentence and bounce back to the left-hand side of the page. Unfortunately, I didn’t know that there are exercises out there that help develop the skill of crossing midline. Heck, I didn’t even realize that my problem had a name let alone a corrective method. To further complicate the situation, I also had visual processing issues—this is where my alphabet soup page begins to make sense. My brain didn’t interpret spaces on the page as indicating where one word ended and another began, nor did my brain differentiate one line of text from another.
I’m sitting here now with a Master’s degree, so mastering these skills is entirely possible, but it does take a lot of patience. Some therapy tricks up your sleeve won’t hurt either! One of the first things that I recommend to parents of children with visual processing concerns is that they decrease the amount of visual information on a page. This can be as simple as taking a plain white piece of paper and using it to cover all of the sentences on the page except the one that you want your student to read. There are more fancy devices out there that achieve the same thing, but buying something special isn’t always necessary. Your student’s visual system is overloaded, so eliminate as much of the load as you can. In some cases, this might mean that as you progress through a passage, you’ll need a piece of paper to cover what has already been read along with the sentences that have yet to be read.
Another technique that I really love is allowing the kiddo to use their finger to track the sentence. Over the years, this seems to have fallen away a bit and that’s a real shame, especially for our neurodivergent children. Having a finger on the physical page provides tactile sensory feedback, which so many of us crave, while giving our eyes a literal visual cue as to where they should be focusing.
As reading starts to become more automatic, some of these accommodations will no longer be necessary, but they sure can help in the meantime. Another concern that I wish adults were more aware of is that an ADHD brain can read for speed or comprehension, but rarely both. I have sat in countless IEP meetings where parents tell me that their son/daughter reads books like crazy, but when asked, they can’t recall characters, details of the plot, or the overall story line. These kids are just reading words—they’re not actually reading a book. Having been in this position myself as a kid, I completely relate. My reading has been painfully slow for most of my life, so, sometimes, you just give up trying to remember or understand what you’re reading just so you can keep pace with your peers. That’s not exactly helpful, though, when you need to learn or understand the information. Even though I thought I had mastered this skill by the time I left high school, I quickly realized in college that technical reading was still extremely difficult for me. Reading a book for a literature class was no sweat, but a psychology or neuroscience textbook where words were unfamiliar, and concepts were more complex—it was back to snail pace reading.
To combat that, I pulled out many of the strategies that worked for me previously and I added one more. Instead of using a piece of paper to focus on one sentence at a time, I would use a ruler. Instead of tracking with my finger, I would quietly read aloud to myself. Having to see and articulate the words gave my brain more avenues in which to process the information. Additionally, I learned to take notes. Highlighting a text doesn’t do much for you. When you physically write out notes, though, you begin building a foundation for learning the material. Our brains learn best with movement—handwriting is a series of movements that have been shown to help us learn and retain new information.
I am living proof that underdeveloped visual and auditory processing skills and ADHD are not indicative of intelligence or someone’s professional potential. These are skills sets that can be developed and improved with patience, being open to trial-and-error of different methods and strategies, and the right professional interventions. While I can say these things with confidence now, I can tell you that when I was a kid, I didn’t believe that I was smart. I saw my poor reading skills as proof that I was stupid and I developed a mindset that I would never be able to catch up to my peers academically unless I pursued academics obsessively (that’s a story for another blog post, though).
Now, as a mother of a son with ADHD, I can tell him that his brain is pretty amazing. He’s more likely to be creative, think on his feet, and be better at problem solving because he’ll be less scared of trying new or different things. He is amazing at sports because he applies his hyperfocus there while also being able to see the bigger picture of a play. Learning differently does not mean that learning is impossible. Having a different brain does not make your mind any less special or any less worthy of sharing. So, tell your kids that you’re proud of them. Acknowledge how hard their little brains are working and be supportive in finding techniques that work for both of you. After reading this, my hope is that you have a little more insight into what specific learning difficulties a child with ADHD might face. I hope that it helps you find grace and patience in the circular arguments that you have every week, the constant reminders you give, and in endless meetings with teachers.
If you’re interested in learning more, I highly recommend ADDitude.com. I’m not affiliated with them in any way, but I have gone back to this resource often. It was one of the first resources that I found when I was trying to learn about my own brain, and I continue to go back to it to learn further. You’ll find reliable and vetted information there, so you can rest easy knowing that what you’re reading is accurate and up to date.