ADHD Symptoms Series: Impulsivity

by Anne Windermere Patient Advocate

Parents who have a child having ADHD symptoms could probably fill a book with stories of how their child acted impulsively. I can still recall the day when I was taking a walk with my Max, his brother and a friend of mine and her two children. Max was about three or four. We were walking to the neighborhood playground and along the path there was a man-made lake complete with a big fountain in the middle. It was very pretty to look at but was not for swimming. I was in mid conversation with my friend when Max darted ahead on the path. I saw his blonde curls sink into the landscape and I panicked. Fully clothed, Max was walking straight into the lake My friend ran with me with her baby in tow. When we reached Max he was almost fully submerged and was totally drenched. Totally unaware of the danger he was in, he smiled, pleased at his adventure.

After I took him home, bathed and dried him I called my friend. It was the first time I said out loud, "I think my child may have a problem."

Add to this memory, the time Max tried to squeeze a large snake by its middle that a curator at the museum was holding for the kids to see. Or the time he tried to make a campfire from Lincoln logs in the bathroom. Or the times he has decided to cut his own hair. I am sure we all have our stories to tell. If you are a parent who has to constantly call out, "DANGER!" or "Don't touch, put that down, keep away, what are you thinking?" then you may have a child who has problems with impulsivity.

What is impulsivity?

Impulsive behavior generally includes behaviors in which the child reacts before thinking about the consequences of those actions. While most children act impulsively on occasion, a child with ADHD may be extreme in the frequency in which they engage in impulsive behaviors. Impulsivity can be worrisome for parents because it can impair your child's social skills and ability to get along with others, it can cause your child to take unnecessary risks which may place your child in danger, and it can also cause your child to make some unwise decisions in life.

But as our Eileen Bailey reminds us, there can be a silver lining to ADHD symptoms, including impulsivity:

Impulsiveness, however, is not always a negative trait. Being a leader requires people to make quick decisions and to think on their feet. Other situations, such as emergencies, require quick thinking and action rather than thought. Impulsiveness also can add variety and spice to your life, letting you be spontaneous or to jump into new situations.

I will add to what Eileen has said here by saying that impulsivity and spontaneity may be essential ingredients of creativity. Many individuals having ADHD symptoms possess a gift of being creative. The key is to fine tune this impulsive trait so that it doesn't cause your child negative consequences.

What does impulsivity look like?

I have already described what impulsive behavior looks like for my child. It can manifest in a variety of ways and each child is different. Likewise, the impulsivity of a 3-year-old may be quite different from that of a teen or an adult. Here are some general ways impulsivity can result in problem behaviors for children and teens:

  • Aggressiveness as in hitting, kicking, biting and scratching.

  • Interrupting other's conversations or activities.

  • Blurting out answers in class, not waiting for turns in activities and games, and cutting in line.

  • Grabbing toys or items from others.

  • Acting out when frustrated over disappointments or mistakes.

  • Being loud at times when one should be quiet.

  • Reacting poorly to reprimands or perceived criticism.

  • Engaging in risky or dangerous activities.

  • Saying the wrong thing at the wrong time.

  • On multiple choice tests, the child may guess at the right answers instead of thinking the answer through.

What causes impulsivity?

Some people may think that this trait is just a sign of a willful child who is trying to be bad. The next time a relative or neighbor gives you flack about your impulsive child, send them here to read the latest ADHD research.

If you think your child is wired differently, there is scientific truth to back up your gut feeling. The brain of a child who has ADHD may be different from child who does not have this disorder. In this Health Scout article, a study was cited where it was found that a part of the brain called the ventral striatum was smaller in children with ADHD than those children who do not have this disorder. The study, which was published in the journal Biological Psychiatry, concludes that this brain anomaly may be associated with symptoms of hyperactivity and impulsiveness in children having ADHD.

The neurology of ADHD is a fascinating topic and they are finding out new things all the time. In this Psychiatric Times report, you can read the details about high resolution MRI studies where they examine the ADHD brain structure. It seems that increases in the volume of gray matter in large areas of the brain such as the posterior temporal and inferior parietal cortices of children with ADHD may also play a part in symptoms such as inattention and impulse control.

Find out more about how differences in the brain can trigger ADHD symptoms can impulsivity be treated?

There are basically two ways to treat any symptom of ADHD: through the use of medications or through behavioral means. Many parents use both approaches in combination. This combination approach is what I am presently using for my son. My son's neurologist suggested a medication called Clonidine, which is a blood pressure medication used off-label to treat symptoms such as impulsivity, aggression, and sleep problems associated with ADHD and/or autism spectrum disorders. We just started this medication so I will be sure to write another post about how this is working or not working for my son's symptoms.

There are many medications which have been developed for the sole purpose of treating ADHD symptoms such as impulsivity, inattention, and hyperactivity. To see a full list please visit our ADHD Drug Information page.

The following are some non-prescription ways to treat the symptom of impulsiveness:

  • If there is one skill your impulsive child will need to learn is how to wait. Please find advice on how to teach this essential skill to your child in my post, Teaching Your Child How to Wait.

  • Give your child or teen creative and physical outlets to utilize their spontaneity and impulsiveness in socially appropriate ways. Dance classes, sports, painting, music and drama are all venues for putting this trait to good use.

  • Sometimes role play can help where you act out certain situations where your child has a pattern of acting impulsively. Let him or her see alternative ways of dealing with the situation which will not produce negative effects. The time to teach this is when the child is calm and not in crisis.

  • One ADHD blogger wrote on the ADDitude Magazine web site about a game which is designed to teach children with ADHD about how to curb their impulses and learn about consequences of their behavior. The game is called Remote Control Impulse Control where players learn impulse control strategies to deal with hypothetical real life situations where decision making is required.

Now we wish to hear from our members. How have you handled your child's impulsive behaviors? Are there any strategies which have worked better than others? Let us know your thoughts. We are eager to hear from you!

Anne Windermere
Meet Our Writer
Anne Windermere

These articles were written by a longtime HealthCentral community member who shared valuable insights from her experience living with multiple chronic health conditions. She used the pen name "Merely Me."