Deaf children and ADHD

When children have more than one additional need, it’s important to consider both and how they interact with each other. Both deafness and attention-deficit hyperactivity disorder (ADHD) can have a significant impact on communication and language, social learning and impulsivity, and mental well-being.

On this webpage, we focus on some of the experiences that families may face if their child is deaf and has ADHD.

What is ADHD?

ADHD is a lifelong, neurodevelopmental condition that affects a person’s behaviour and ability to concentrate. The condition will vary from person to person and throughout their life. People with ADHD may share some of the same characteristics:

• impulsive decision making, disorganisation (losing things or being late)
• hyperactivity, difficulty with concentrating, easily distracted, restless or fidgety
• difficulty regulating emotions, easily angry or upset
• sensitivity to certain things (sounds, textures, lighting)
• easily overstimulated and overwhelmed.

Find out more about possible signs of ADHD and how to support your child with ADHD.

Diagnosis

Symptoms of ADHD tend to be obvious from an early age, but most children with ADHD are diagnosed between three and seven years old. A diagnosis is most likely to happen after a change in surroundings, such as starting nursery or school. If a deaf child also has ADHD, this will often be diagnosed later than a hearing child because some of the indicators of deafness are similar to those of ADHD.

These include:

• being disruptive
• inattentiveness (not listening or paying attention)
• problems with communication
• behaviour or learning style (reliance on visual cues)
• poor academic performance (not doing well at nursery or school)
• being emotionally overwhelmed or tired at the end of the day.

The delay in making a firm diagnosis of ADHD is because the professionals need to be sure that these behaviours are due to ADHD, not deafness.

Susana, mum to Nico (7) who is profoundly deaf and has ADHD and autism. “Nico was diagnosed as deaf shortly after he was born. It was much later that we got his autism and ADHD diagnosed. Understanding about deafness was one thing but realising there were separate behaviour issues answered lots of questions.”

Some parents find it helpful to track their child’s early development using resources such as our early years development tool, 'Success from the Start'. This helps them to share information about their child with the professionals who support them.

Things to look out for are:

• difficulty concentrating and focusing
• unable to organise tasks or stay on one task at a time
• hyperactivity (constant fidgeting or being unable to sit still)
• impulsiveness (acting without thinking or with no sense of danger)
• being unable to wait their turn or finding it unusually difficult to share.

If you have any concerns, you should raise them with your GP, health visitor or Teacher of the Deaf (ToD) and ask for a referral for a possible ADHD diagnosis. For more information about ADHD, visit the NHS website.

Before a child is diagnosed with ADHD they may be placed under a 10-week period of “watchful waiting” to see if their symptoms improve. You may be invited to an ADHD-focused group education programme that is offered to parents and carers. This training is to teach you ways of helping your child and yourself.

If an assessment is deemed necessary, a diagnosis of ADHD will usually be carried out by a professional or a team of clinicians. This can include a child psychologist, a paediatrician and a healthcare professional with expertise in ADHD diagnosis. Ideally, it will be carried out by professionals who have expertise in both deafness and ADHD (although this isn’t always possible), as well as family and professionals who know the child best.

Parenting a deaf child who has ADHD

We’re still learning about the impact of ADHD on deaf children, especially when it comes to late diagnosis of ADHD. This is because symptoms are sometimes mistaken as the “normal” behaviour of a deaf child by some medical professionals.

Since ADHD and deafness will affect children in different ways, there isn’t one approach that works for every child. Finding what works for your child will often be trial and error. Young Minds have tips for helping your child with ADHD, including being understanding, building healthy routines and managing triggers.

Below are some suggestions for how you can help your deaf child with ADHD.

Treatment

Treatment is available that can relieve your child’s ADHD symptoms. Any ADHD treatment should be organised by a paediatrician or psychiatrist and monitored by your child’s GP.

The main treatments are:

• medicines
• group psychological therapy
• individual therapy
• organisation and routines
• support and adaptations at school.

Whichever treatment route you choose, understanding how it will interact with their deafness and how to communicate it to them is very important. If you live in England, ask your GP to refer you to the National Deaf Child and Adolescent Mental Health Service (Deaf CAMHS). If you live in Scotland, Wales or Northern Ireland, ask for a referral to CAMHS.

Find out more about the Deaf CAMHS and their eligibility criteria.

Communication

It’s important to be open and supportive to your child and allow them to communicate in whatever way they can.

Whatever method of communication your child uses, it should be used consistently – both at home and in education. A speech and language therapist and other professionals working with you will be able to provide support and advice.

Children with ADHD may struggle with listening to and understanding instructions, so make sure you give simple instructions using as few steps as possible. This is similar to communicating in a deaf-friendly way and can be combined with sign language if you use it.

• Make sure they’re looking at you and giving you their full attention.
• Speak calmly and clearly.
• Break down tasks into individual steps.
• Check with them that they’ve understood.

Deaf children with ADHD may benefit from supports such as visual calendars, timers or cues for routine activities and objects of reference, to help them understand. For example, asking your child to brush their teeth and then put on their pyjamas will be clearer than asking them to ‘get ready for bed’. Making sure their toothbrush and pyjamas are kept within eyesight will serve as visual reminders.

Behaviour

All behaviour is a form of communication. Deaf children with ADHD can display challenging behaviour. This can be due to the frustration of not being allowed to move about or have sensory breaks, or being told off for being late, disorganised or losing things.

It can be difficult to know why your child is behaving in a particular way, but it’s important to work with them to try to find the cause. Once you know how they feel and the reasons behind their behaviour, you can look or ask for the right support.

Kate, mum to Xander (10) who is profoundly deaf and has ADHD and autism, explains how masking (hiding his natural behaviour to fit in) at school affected his behaviour.

“The ADHD makes him so impulsive, excitable and a bit too much. It’s not a choice that the child is making to be this hyperactive and impulsive, it’s actually a physical difference in their brain. At school he’d be desperately trying to mask it while being told off and forced to sit down. He’d pick his fingers, jiggle his legs, bite his nails and try to be ‘normal’, but he was miserable and not coping.”

Education

Some deaf children with ADHD will struggle at school due to their symptoms. You can ask for support from your child’s education setting or your local authority (council). Depending on where you live in the UK, the additional support your child could receive in education will be different and have different names.

Find out more about getting additional support in education.

Whether you live in England, Northern Ireland, Scotland or Wales, if you get additional support for your child, it will be written in a legal document. These legal documents will set out your child’s special or additional needs, their recommended school placement and the support that has been agreed.

As the number of deaf children with ADHD is small, it’s unlikely that there will be a school in your area with the specialist support your child needs already in place. This means it’s vital that the different professionals supporting your child work together to make sure your child’s needs are being met and frequently reviewed.

For example, it may be agreed that a special school for the deaf is the best placement for your child. It’s very important that the school is able to meet their needs and that your child gets the adjustments they need at school.

Kate, mum to Xander (10). “Now his teachers are aware of his ADHD, he’s allowed more sensory breaks in order to be himself.”

Mental health

Like deafness, ADHD is not a mental health condition. However, deaf, neurodiverse children have a higher chance of developing problems with their emotional health and wellbeing than hearing children. Being aware of this risk can allow you and your child to take steps to develop emotional resilience and wellbeing.

The National Deaf Child and Adolescent Mental Health Services (Deaf CAMHS) may be able to help if you have any concerns about your child’s mental health.

We have more information about support your child’s mental health in our emotional health and wellbeing section.