Updated: Apr 26
Table of Contents
Have you any of these things said about your kid?
"He is SO distractible!"
"She's so fidgety..."
"You have a messy kid."
"She is ALWAYS running late."
You might be thinking, thank you for distastefully pointing out my child's ADHD symptoms...Anything else you'd like to share?
These statements minimize the Attention Deficit Hyperactivity Disorder (ADHD) experience to a set of personality defects, rather than speaking to the root of the symptoms which is executive dysfunction.
See, most people are unaware what lies below the external symptoms of ADHD.
Yes, co-occurring conditions of ADHD like hyperactivity and time blindness are obvious, but what about nightly homework battles and the countless times you've sat with your kid helping them break their homework into manageable chunks?
Symptoms like "hyperactive" are only the tip of what is really going on.
And like the colossal formation lying below an iceberg, you are acutely conscious of the symptoms that are invisible to average observer.
The internal experiences of students with ADHD manifest in different ways which may include emotional dysregulation, chronic disorganization, depression, communication difficulties and deep-seated fears of rejection.
Don't be that person that calls a child "fidgety" without properly acknowledging the battle they are fighting inside.
Noticing the tip of the iceberg is the first step in helping your student chart a safe course around what lies below for students (and adults) who have been diagnosed with ADHD.
What is the ADHD Iceberg analogy?
The ADHD Iceberg is a visual way of explaining the many symptoms of ADHD that kids experience internally (rather than displaying externally).
Created by famed ADHD researcher, Russell Barkley, it has become so widely shared it is now a popular meme used to explain the difference between what meets the eye and what is invisible.
When you look at an iceberg you see just the tip of ice.
This represents the symptoms of ADHD that are seen by the average person and may include:
What you don’t see when you look at an iceberg is the massive block of ice below the surface.
Like an iceberg, the invisible symptoms of ADHD are ever-present and cause waves of emotions and impulses that make managing school a Herculean task.
And like the captain of the Titanic miscalculating the unseen aspects of the iceberg in his path, a person who sees accounts for the visible symptoms of ADHD is bound to misunderstand (and potentially harm) the student with ADHD.
Here is what you might hear if you peeked below the ADHD iceberg and into the internal dialogue of a middle, high school or college student with ADHD:
"I can't focus no matter what I try!"
"Why don't other students like me?"
"I've read this page three times and I still don't understand."
"Falling asleep is impossible. I just keep replaying things that are bugging me."
"What's the point of working on these assignments if I am bound to fail?"
"What was I looking for in here?"
"Did I remember to lock my door?"
"Why is life so much harder for me than my friends?"
How can you use the ADHD Iceberg to help your student?
Parents, executive function coaches, mental health professionals, and thoughtful educators can use the ADHD iceberg analogy to help people understand what people with ADHD are experiencing on a day to day basis.
If your student does not have an ADHD diagnosis, the ADHD symptoms found in the image of the iceberg can be indicators to share with a doctor, psychologist, therapist or school administrator to decide if doing a full assessment may be helpful.
Additionally, beyond the external symptoms that are above the surface, you can use the ADHD iceberg to identify if other issues or symptoms of ADHD are present in your children or students.
How does this relate to executive functioning?
Most of the external symptoms that are at just the tip of the iceberg AND the internal experiences below the water can be linked back to a condition known as executive dysfunction.
If your student has been diagnosed with ADHD, you have likely heard this term thrown around quite a bit.
So what is executive dysfunction?
Executive dysfunction describes the scope of emotional, behavioral and cognitive challenges which occur as a result of ADHD and/or a traumatic brain injury.
In addition to hyperactivity, time blindness, or inattention in class, people with ADHD and executive dysfunction often struggle with:
Time blindness (a lack of awareness of time)
Emotional dysregulation (overwhelming emotions)
Automatic Negative Thoughts (ANTs)
Sensory processing disorder
Rejection sensitive dysphoria
Social phobia or social anxiety
Guilt and embarassment over impulsive actions or decisions
Often times, people with ADHD will also have comorbid conditions such as ADHD and disorders that may include:
Obsessive Compulsive Disorder (OCD)
Generalized Anxiety Disorder
People with ADHD are more at risk for many social challenges including:
Relationship challenges including divorce
Mental health disorders
Work place challenges
It goes back to the science of ADHD which indicates:
"If your child has ADHD, they may be low in dopamine but high in something called dopamine transporters. That’s because their low dopamine may actually result from having too many of the transporters that take dopamine out of their brain cells. Those transporters wash dopamine out of your child’s brain before the chemical can finish its job."
And if your child is lacking dopamine, the key driver for feelings of pleasure and regulating attention, they are more prone to impulsive behaviors that are pleasurable and attention holding.
This makes key executive functioning skills like planning, consideration and self-regulation much more difficult.
ADHD can have a MAJOR impact on quality of life which is why it is so demeaning to limit it to simplified labels like "fidgety" or "restless."
If you've read some of my other posts, you know one of my favorite research studies is John Hattie's, “Visible Learning," in which he ranked 256 influences that are related to academic success (and a lack thereof).
At the VERY bottom of those 256 factors that impact student achievement is the factor that has the greatest NEGATIVE impact on student achievement.
Can you guess what it is?
For this reason (and many others), it is vital to develop an ADHD treatment plan to support the development of skills and behaviors that increase the probability of a successful transition to adulthood.
There can be no treatment plan without a diagnosis.
We can do better.
What are ADHD treatment options for students?
While every person's experience is different, most students with ADHD are prone to developmental delays, especially in the areas of executive functioning skills and emotional development.
If you have an innate sense that your child may be struggling with the symptoms that lie below the tip of the ADHD iceberg, connect with a qualified professional who is trained to assess and/or support the development of compensatory strategies and executive function skills.
This may include:
Psychiatrists who specialize in ADHD
Mental health professionals such as licensed therapist or psycholgoists
Executive functioning coaches
At public school you can also contact these people to share your observation of ADHD symptoms:
Special education instructors
Speech langauge pathologists
These individuals can help to develop an assessment plan that will include a target behavior list for your student with ADHD to work on.
To learn how to get a free assessment for your child, review my articles about assessment to explore this option more:
Pro tip: if you are seeking a private assessment, make sure to ask around for multiple options because assessment professionals are often booked 6 months to a year in advance.
Once this assessment is complete, special education instructors, executive function coaches, and other skilled professionals can provide direct instruction to develop executive functioning skills.
Because many assessments that include an ADHD diagnosis will share the recommendation to work with an executive functioning coach, I'll explain what executive function coaches do here.
Executive function coaches help students with executive dysfunction by teaching skills in the areas of:
Initiation of tasks
Visualizing outcomes (non-verbal working memory)
If you are interested in learning more about executive functioning coaching and how to identify the right coach for your family, check out my article, Executive function coaching: The definitive guide (2022)
Many students who experience childhood difficulty with ADHD become highly organized and productive adults because of the range of compensatory strategies they learn through the treatment process.
ADHD experiences are all unique; some students may present as overly organized because of fear of criticism or rejection if they are not meeting "standards".
Some ADHD symptoms will have hidden layers.
For example, a student who is easily distracted may be struggling with an undiagnosed auditory processing disorder.
A student who is not responding to teacher emails may have intense fear around communicating with adults.
You just never know until you take the time to truly understand what is going on below the surface.
If you want a reminder, just look up ADHD iceberg to see all the different challenges kids might be experiencing.
3 ways EF coaching can address ADHD issues below the surface
Their brain style becomes demystified
Every child with ADHD knows there is something different about themselves, but struggles to put their finger on it.
When your child works with a skilled executive functioning coach (or mental health professional who focuses on executive functioning), they will begin to see that their attention style is unique and has many advantages that include:
A bias toward action
They may also learn that people with ADHD have made significant contributions to society in so many areas including:
Technology (Steve Jobs)
Sports (Simone Biles)
Entertainment (Walt Disney)
Business (IKEA founder and chairman Ingvar Kamprad)
And so many more!
You can use the ADHD iceberg analogy to focus on students strengths to contribute to their understanding of their unique abilities.
Insert positive image of iceberg here
When a student start to understands both the challenges and strengths associated with their ADHD diagnosis, he or she can develop behaviors to address them.
This will often include learning key executive function skills that include:
Using a calendar (either digital or physical) to track deadlines and assignments
Keeping their physical items tidy so things are easy to find
Learning how to identify their emotions and engage in self-regulation strategies
Understanding their impulsive urges and "scheduling" them for appropriate times
Using timers to track engagement with assignments
Finding strategies to initiate non-preferred tasks
Creating vision boards to stay focused on long-term goals
Shifting priorities flexibly to align with their developing vision
All these skills take time and patience to develop.
Parents should anticipate a student will need to work with a professional who can address executive dysfunction for at least one semester.
This gives the student plenty of opportunities to apply these skills and determine what method is best for them.
Improved Self-Esteem & Mental Health Outcomes
When people with ADHD begin to see that their "disorder" can also be their greatest strength many good things will follow.
Their self-esteem will begin to increase.
They will begin to feel more motivated.
They will start to visualize a future with goals that once seemed impossible.
I've seen this over and over after working with hundreds of families to support executive function skill development.
People with ADHD can be the most organized, least distractible, empathetic individuals IF they are taught to address the symptoms of ADHD that are at the bottom of the iceberg.
Start by sharing this ADHD Iceberg Infographic with your student's teachers, therapists, coaches, and administrators, so you can find ways to work together in supporting your student.
Has the ADHD iceberg analogy been helpful for you?
Did you learn something new that you weren't aware of?
I'd like to know!
Drop it in the comments below.
About the author
Sean G. McCormick is a parent, husband and international executive function coach. He is the founder of Executive Function Specialists, an online coaching business which guides middle, high school, and college students in overcoming procrastination, disorganization and anxiety by teaching time management, prioritization and communication skills so they feel motivated, prepared, and empowered.
He has also spoken about executive function at prominent venues including the Association of Educational Therapists' National Conference (2021), The Executive Function Online Summit (TEFOS 2022) and at Marin County Psychological Association.
Sean is regularly featured across media channels for his expertise on executive function, ADHD and special education.
Executive Functions, Inc. is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. Some of the links in this post may be Amazon.com affiliate links, which means if you make a purchase, Executive Functions, Inc. will earn a commission. However, we only promote products we actually use or those which have been vetted by the greater community of families and professionals who support individuals with diverse learning needs.