It makes sense to question the concept of masking in ADHD children. Defining characteristics of the condition are impulsivity and the inability to inhibit behaviours. So, if your child can inhibit their behaviours at school and comply, are they not ADHD? Or not “ADHD enough”?
I recall reading there was “sub-clinical” ADHD which I’ll explore later, but in short, the consensus seems to be: yes, ADHD children can mask. But as Russell Barkley writes:
Although people with ADHD may be able to learn consciously to inhibit their behaviour in certain situations, this takes a great deal of effort – far more than is required by others of their age.1
This refers to the ‘coke-bottle effect’ https://connectivefamily.com/the-coke-bottle-effect/, which if you’re reading this – you’re probably all too familiar with.
- Taking Charge of ADHD by Russell A Barkley, p63. (2020 Guilford Press) ↩︎
Our journey: fine at school
From nursery up until mid primary, we had nothing but positive feedback about Cora’s ability to follow rules and “meet behavioural expectations”. The fiercely demand-avoidant, explosive child we knew at home showed no signs of being disruptive in the classroom.
The ‘coke-bottle’ effect began aged 3, at school nursery: I would come to collect Cora, and she’d refuse to leave. We’d make it to the playground, or the gates, and an almighty meltdown would ensue.
I had her baby sister with me and, hampered by a buggy or sling, could not manage to pick up the screaming, kicking child hurling herself on the floor. We’d sometimes still be stood by the gates at 4pm, waiting for Cora to calm and walk home.
At this stage we weren’t thinking about neurodiversity; and covid soon came to significantly interrupt Cora’s education. But by year 1, things were desperate as the meltdowns were taking place both before and after school. The house was being trashed. Cora refused to wear uniform. We’d arrive to school late, emotionally wrought and probably dishevelled, and receive a rebuke for Cora wearing a plain white cotton top instead of a polo shirt (she refused these for years – part of the sensory processing issues you can have with ADHD, as we realised later.)
“She’s not distressed, she’s just defiant”
The frequency and severity of Cora’s meltdowns at the age of 5, and the fact she wasn’t sleeping until gone 10pm, made me realise something else had to be at play. I called our GP, who was in fact very understanding and made a referral to CAHMS. We spoke to school, who referred us to their Family support worker (a post I think is now redundant due to cuts.)
The upshot was a few meetings with the support worker, who clearly thought I was an anxious wet drip of a mother, who had created a rod for her own back by giving in to this child. When I described Cora as seeming anxious, she quickly retorted that Cora was just being defiant and wanting her own way.
Cora had always been defiant though; this was something else. Still, she had no observable signs in school of being anything other than neurotypical, according to her teacher.
And unsurprisingly when CAMHS responded, it was to say there was nothing they could offer – this issue could be dealt with by the school.
Part 2