While traditional bereavement groups can provide stability, Harris said they are often designed for families grieving a death. But children with ADHD experience many other forms of loss and sometimes need interventions tailored to their specific needs.
How Does Ambiguous Loss Affect Children?
Dr. Pauline Boss, an educator and researcher with expertise in family stress, defines ambiguous loss in two main categories:
When a person is physically present but psychologically absent.
When a person is physically absent but psychologically present.
How Does Grief Affect Children Diagnosed with ADHD?
With an existing ADHD diagnosis, some children may experience compounded challenges when the symptoms of grief and ADHD overlap. Signs that children are not coping well with grief may be masked by tendencies of children with ADHD to hide their feelings.
Overlapping Symptoms of ADHD and Grief
Trouble focusing and low attention spans
Constant need to move body
Distancing from peers or interests
Poor school performance and difficulty learning new material
Trouble eating or sleeping
Some children who exhibit these symptoms may be misdiagnosed with ADHD if caretakers jump too quickly to conclusions. Conversely, children with ADHD may see their symptoms worsen.
“We need to have empathy for the fact that ADHD may cover over what’s going on for a child in their grieving process,” said David Anderson, PhD, clinical psychologist and senior director of national programs and outreach at the Child Mind Institute. “They may in fact have deeper emotions.”
Anderson explained that frontline intervention involves training adults to look for signs and help children by meeting them where they are.
“Adults have to realize that even though they aren’t the cause of the problem, they are a part of the solution,” he said.
For younger children, interventions may consist of training caregivers to facilitate and manage positive behaviors. When children age, it becomes more common to consider medication, he explained. As for teenagers, cognitive behavioral interventions can help young people manage their symptoms while gaining independence.
Harris cautioned caregivers from making preliminary diagnoses before consulting a clinician. Assuming that a child is depressed or that medication is necessary can lead to ineffective or inappropriate treatment plans.
“We do our best treatment and intervention when we’re intervening for the right thing,” Harris said.
Strategies for Interventions
Be open and available to listen to needs.
Create spaces where children can focus.
Monitor eating and sleeping routines.
Refer to a bereavement group to provide stability.
Have child meet with a mental health care provider.
Talk to a medical provider about medication.
Experts at the American Academy of Pediatrics caution adults to be mindful that the home environment can lend itself to more stress or exacerbate symptoms. Identifying sources of stress within the home can help caretakers more effectively intervene.
Modeling Healthy Coping Mechanisms for Children with ADHD Modeling Healthy Coping Mechanisms for Children with ADHD Modeling Healthy Coping Mechanisms for Children with ADHD
In most cases, children with loss initially experience shock and denial. They may protest, rail against it, get angry, strike out, and break things.
“Our cultural response is to tell children to stop behaving badly,” Harris said.
It’s easy to punish misbehavior and expect that kids will learn from repeated consequences. But adults must understand that kids’ feelings and behaviors are connected, she said.
Caretakers can’t expect the drivers of behavior will just go away with time nor that medication will eliminate the tendencies for unhealthy coping. Harris pointed out children often learn behaviors by mimicking the actions of people they look up to; adults can be pivotal role models in displaying responses to grief in constructive and positive ways.
How to Model Healthy Expressions of Grief
Be honest about negative feelings but not destructive.
Acknowledge that pain exists.
Have a conversation and take ownership of your feelings.
The Role of Social Workers in Connecting Children with Care
Even after a child leaves the presence of a caregiver, they still may struggle with navigating grief. That’s why it’s important to think holistically about the continuum of care — the concept that healing and treatment can be a part of every environment or social group in a person’s life.
“A social worker’s role is to communicate hope, caring, community, and support.”
Social workers can be a valuable source of support during challenging times. Children who have lost adult role models may need a companion who can be empathetic to their situation.
“A social worker’s role is to communicate hope, caring, community, and support,” Harris said.
Anyone can be part of the continuum of care, but Harris said it’s important for social workers to identify a caregiver who will be a constant and stable part of the child’s life.
Who can be part of the continuum of care?
Caregiver or legal guardian
Grandparents or extended family
Teachers and educators
In addition to finding and training stable caregivers for children in need of support, social workers can help children build resilience and navigate their emotions. These practices can help children through adolescence and young adulthood.
“Be a fellow traveler — someone who can accompany [them] on [their] journey,” Harris said.
For more information about grief and ADHD interventions, consider the following resources: