The Triad of ADHD and How to Manage It

October 1, 2012

Taming the Triad – a registered trademark

The triad of inattention, hyperactivity, and impulsivity are the hallmark characteristics of the spectrum of attention deficit disorders, now under the broad category of attention-deficit hyperactivity disorder (ADHD) formerly known as attention deficit disorder (ADD). ADHD is sub-classified as with or without hyperactivity because some persons with this disorder can actually be hypoactive or more withdrawn in their activity level.

ADHD begins in childhood and may last a lifetime. It can also have its onset in adulthood as a result of brain trauma, infection, drugs, and other insults to the brain.

Because ADHD can have a wide variety of presentations and can co-exist with other conditions such as autism, obsessive-compulsive disorder, etc., it can be difficult to diagnose. This does not mean, however, that the symptoms cannot be managed. While it is helpful for optimum treatment to know the underlying cause of inattention, hyperactivity, and impulsivity, these symptoms can still be managed, regardless of their cause. Some suggestions follow. Be sure to discuss your concerns with your primary care provider to get the best possible diagnosis and treatment for the best outcome.


  • Spend only small amounts of time, maybe 10 – 15 minutes at a time on a task and build up the amount of time slowly to train the brain to become more attentive. In toddlers and pre-school children, this might need to be only 2 minutes in the beginning!
  • Vigorous activity between tasks can help improve attention.
  • Some need to be active during the task at hand (standing, tapping, etc.) While this may not be productive motion, as long as it doesn’t cause distraction to others, it may help the person with ADHD to be more attentive to the task at hand.
  • If learning disorders are present, be sure to make appropriate accommodations. Low frustration tolerance from inability to perform adds to inattention. Conversely, giving a person with ADHD a task to perform that is below their ability level also causes inattention because the person is bored by the task and doesn’t have the appropriate stimulation or challenge to maintain attention.
  • Music, bright colors, and other sensory stimulation might improve attention span but some, especially those with autism might have an adverse response.


  • Provide plenty of time for adequate uninterrupted sleep, about  7 – 8 hours per night.
  • Get plenty of exercise.
  • Maintain a healthy diet and consider nutritional supplements.
  • Avoid concentrated sweets. Besides obesity, sugar has other negative health consequences and can increase hyperactivity and even cause lethargy as the blood sugar level bottoms out after the  sugar “high”.
  • Caffeine may or may not cause attention problems, but it should be avoided in children.
  • Treat any medical conditions that could be impacting hyperactivity such as allergies, sleep apnea, etc.


  • Maintain a routine for meals, bedtime, and scheduled activities. Be sure to also provide free time during the day. Over-scheduling is just as detrimental as not having a routine.
  • Try to minimize schedule changes that will disrupt the routine, especially in the beginning. As the child gets comfortable with a routine, impulsivity tends to improve.
  • Try to anticipate the needs of the child so that the child doesn’t get frustrated. Frustration commonly leads to impulsive behaviors.
  • Redirect an activity instead punishing the impulsive act whenever possible.
  • Maintain discipline. Enforce rules consistently to avoid confusion, frustration, and manipulative behavior.

These are just a few of the ways to help minimize the behaviors that are problematic. Over time and with maturity, the child develops coping skills and learns to anticipate situations that can cause behavior problems. These suggestions also work for adults with inattention, hyperactivity, and impulsivity, regardless of the cause.

Coaching is also a good way to help work on some of these behaviors. Feel free to contact me with any questions you might have.

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