By Dr. David Velkoff
Disciplining an ADHD impulsive child needs to be done with compassion and understanding.
Often, parents will tell me jokingly that their impulsive ADHD child’s middle name is “Unfair,” and that their child will complain that they are being treated unfairly or that they didn’t do anything wrong. When the parent asks the child for an explanation regarding their impulsive actions, the child simply shrugs and claims that they “don’t know.”
The reality is that these children truly may not know: impulsive actions can occur because their brain may not be fully processing their impulses and temporarily inhibiting them, so the child is not able to consider the consequences before acting on the impulse. It is in their nature or brain wiring to act on the impulse spontaneously without thinking, and, when they do occur, it is our responsibility as parents and doctors to provide them with the very best in treatment and guidance.
When impulsive ADHD children experience an impulse, they may lack the neurobiologic processing to resist the impulse. There is “no pause” after the impulse to give them time to think about how to respond appropriately.
Consequently, they do not understand why their impulsive actions cause negative reactions from others around them. Hence, their conclusion is that those around them are treating them unfairly as they don’t identify with our traditional notion of cause and effect.
If impulsivity in children is left untreated, it will negatively impact functioning in many areas of their lives, including behavioral, academic, self-esteem, and social functioning, as resulting from repeated unsuccessful interactions with peers, family, and difficulty staying on task.
This impulsivity leads the child to violate the personal space of other children, and may lead to them coming off as bossy and controlling to those around them. Impulsive ADHD children really may not be able to help it: the impulsive ADHD child is driven by his impulses “without full brakes”, and his or her actions are not consciously intentional.
Impulsive behavior in ADHD children is the result of unfiltered, unprocessed impulses in the brain, so when the child experiences an impulse, all they can do is succumb to the action associated with that impulse.
This is why it is so important to get your child evaluated for impulsive ADHD, as the child’s brain simply cannot inhibit these impulses efficiently, consistently, or prevent them from taking over.
When taking these details into account, it becomes easier to empathize with the child, but their impulses will remain difficult to manage unless the child is provided with treatment.
Despite the parent’s attempt to set boundaries and discipline their child, these efforts ultimately may be in vain since the child cannot overcome their neurobiological weaknesses without treatment, resulting in the associated impulsive behavior. This impulsivity is a result of the only way the child’s brain has ever functioned, so being impulsive feels “normal” to them. As a result, the impulsive ADHD child feels that he or she is not being fully accepted or loved for who they are when being themselves.
It’s no wonder that up to 60% of impulsive kids have a comorbid or a secondary diagnosis of Oppositional Defiant Disorder. These children honestly feel that the people surrounding them are unfair for criticizing their impulsive acts because they cannot see these acts as being abnormal. They have no previous point of reference or experience of not acting spontaneously on their impulses.
At the Drake Institute, we approach this problem by first conducting a comprehensive qEEG Brain Mapping procedure, which allows us to identify weaknesses or dysregulated networks in the brain linked to symptoms. Based on the results of the Brain Map, we then determine a plan for treating the root of the problem, rather than simply masking its symptoms (like the commonly accepted approach via medication).
Frequently, our Brain Maps for impulsive children show abnormal brain wave activity in the right frontal side of the brain—the part of the brain that can be linked to impulsivity. To effectively control one’s impulses, multiple regions of the brain have to be working together coherently, not be under activated nor over activated , and in impulsive children, this is often not the case.
Our treatment process for ADHD and impulsivity in children has proven successful for about 80% of patients, and centers around brain map-guided neurofeedback, which develops and strengthens areas or networks of the brain responsible for inhibiting impulsivity. This carefully guided approach allows us to mitigate the troubles associated with impulsiveness in children by enabling them to develop improved regulation of brain networks essential for controlling their own impulsivity, putting them on the path to recovery and a happier, more fulfilling life.
If you or your child are not a patient at the Drake Institute and are in need of help, please contact us to schedule a no-cost screening consultation today.
Interview with Dr. David Velkoff
Interview with Dr. David Velkoff
Spanish News Feature
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“David F. Velkoff, M.D., our Medical Director and co-founder, supervises all evaluation procedures and treatment programs. He is recognized as a physician pioneer in using biofeedback, qEEG brain mapping, neurofeedback, and neuromodulation in the treatment of ADHD, Autism Spectrum Disorders, and stress related illnesses including anxiety, depression, insomnia, and high blood pressure. Dr. David Velkoff earned his Master’s degree in Psychology from the California State University at Los Angeles in 1975, and his Doctor of Medicine degree from Emory University School of Medicine in Atlanta in 1976. This was followed by Dr. Velkoff completing his internship in Obstetrics and Gynecology with an elective in Neurology at the University of California Medical Center in Irvine. He then shifted his specialty to Behavioral Medicine and received his initial training in biofeedback/neurofeedback in Behavioral Medicine from the leading doctors in the world in biofeedback at the renown Menninger Clinic in Topeka, Kansas. In 1980, he co-founded the Drake Institute of Behavioral Medicine. Seeking to better understand the link between illness and the mind, Dr. Velkoff served as the clinical director of an international research study on psychoneuroimmunology with the UCLA School of Medicine, Department of Microbiology and Immunology, and the Pasteur Institute in Paris. This was a follow-up study to an earlier clinical collaborative effort with UCLA School of Medicine demonstrating how the Drake Institute's stress treatment resulted in improved immune functioning of natural killer cell activity. Dr. Velkoff served as one of the founding associate editors of the scientific publication, Journal of Neurotherapy. He has been an invited guest lecturer at Los Angeles Children's Hospital, UCLA, Cedars Sinai Medical Center-Thalians Mental Health Center, St. John's Hospital in Santa Monica, California, and CHADD. He has been a medical consultant in Behavioral Medicine to CNN, National Geographic Channel, Discovery Channel, Univision, and PBS.”