When many people think of ADHD, they picture a child who can’t sit still, constantly interrupts, and has endless energy.
While this can certainly describe some children with ADHD, it is only part of the picture.
At The Therapy Network (TTN), we work with children, adolescents and young adults who experience ADHD in many different ways. Some are energetic and impulsive, while others are quiet, thoughtful and easily overlooked because their challenges are less obvious.
ADHD is not a personality type, nor is it a measure of intelligence, motivation or parenting. It is a neurodevelopmental condition that affects how the brain regulates attention, behaviour, emotions and executive functioning.
Perhaps the most important thing to remember is this:
No two children with ADHD are exactly alike.
What Is ADHD?
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that affects the brain’s executive functioning skills. These skills help us to:
- Focus attention
- Organise tasks
- Plan ahead
- Start and finish activities
- Regulate emotions
- Manage impulses
- Shift between tasks
- Monitor our own behaviour
- Remember information while completing tasks (working memory)
Children with ADHD are capable learners. However, the pathways their brains use to manage attention, movement and self-regulation work differently, meaning they often require different strategies to succeed.
The Three Presentations of ADHD
Health professionals generally recognise three presentations of ADHD.
These presentations describe the pattern of behaviours a person experiences. They are not fixed labels, and a person’s presentation may change over time as they develop and as life demands increase.
1. Predominantly Inattentive Presentation
This presentation is often the least recognised because children are not necessarily disruptive.
Instead, they may appear to:
- Daydream frequently
- Lose belongings
- Forget instructions
- Miss important details
- Struggle to complete tasks
- Become overwhelmed by lengthy work
- Have difficulty organising materials
- Appear to “switch off”
- Need frequent reminders
- Seem forgetful despite trying hard
These children are often described as:
- Quiet
- Sensitive
- Creative
- Gentle
- Easily distracted
Because they are not drawing attention to themselves, their difficulties may go unnoticed for years—particularly in girls, who are more likely to present with predominantly inattentive traits, although boys can experience this presentation too.
2. Predominantly Hyperactive-Impulsive Presentation
These children tend to be highly active and find it difficult to slow down.
They may:
- Fidget constantly
- Leave their seat
- Climb or run when inappropriate
- Talk excessively
- Interrupt conversations
- Answer before questions are finished
- Find waiting extremely difficult
- Act before thinking
- Seek movement throughout the day
These children are often described as:
- Energetic
- Enthusiastic
- Curious
- Adventurous
- Fun-loving
Their energy can be a wonderful strength, but without support it can also make classroom participation, friendships and daily routines more challenging.
3. Combined Presentation
Many children experience characteristics from both presentations.
For example, they may:
- Become distracted easily
- Forget instructions
- Be highly impulsive
- Struggle to stay organised
- Need frequent movement
- Find emotional regulation difficult
- Rush through work
- Lose focus midway through tasks
This is known as the combined presentation, and it is the most commonly identified presentation of ADHD.
Looking Beyond the Label
While the three presentations help clinicians understand patterns of behaviour, they do not tell the whole story.
Every child also has their own:
- Personality
- Interests
- Strengths
- Family environment
- Learning style
- Sensory preferences
- Communication style
- Emotional experiences
Two children with the same ADHD presentation may have completely different support needs.
That is why occupational therapists focus on understanding the individual child, not just their diagnosis.
ADHD Is About More Than Attention
Many people are surprised to learn that attention is only one part of ADHD.
Children may also experience challenges with:
Executive Functioning
Including:
- Planning
- Organisation
- Time management
- Working memory
- Flexible thinking
- Inhibition
- Self-monitoring
Emotional Regulation
Some children experience emotions very intensely.
They may:
- Become frustrated quickly
- Feel overwhelmed by small setbacks
- Find transitions difficult
- Need longer to recover after disappointment
These are often differences in emotional regulation rather than intentional behaviour.
Sensory Processing
Many children with ADHD also experience sensory differences.
Some may:
- Constantly seek movement
- Fidget to stay alert
- Enjoy rough-and-tumble play
- Chew on clothing or pencils
Others may become overwhelmed by:
- Noise
- Busy classrooms
- Bright lights
- Certain clothing textures
Understanding these sensory preferences can make everyday routines much more successful.
Daily Living Skills
Executive functioning challenges can affect everyday tasks such as:
- Packing a school bag
- Remembering homework
- Brushing teeth
- Organising bedrooms
- Managing morning routines
- Preparing for school
- Completing chores
- Managing time
These skills often require explicit teaching and repetition.
Strengths Matter Too
Children with ADHD often possess incredible strengths that deserve just as much attention as their challenges.
Many are:
- Creative thinkers
- Excellent problem-solvers
- Funny and engaging
- Passionate about their interests
- Curious learners
- Energetic
- Compassionate
- Innovative
- Resilient
- Willing to think differently
Recognising these strengths helps build confidence, motivation and self-esteem.
How Occupational Therapy Can Help
Occupational therapists do not try to “fix” ADHD.
Instead, we help children understand how their own brain works and develop practical strategies that support participation in everyday life.
Support may include:
Building executive functioning skills
Helping children improve planning, organisation, working memory and self-monitoring.
Supporting emotional regulation
Teaching children to recognise emotions and develop strategies to regulate their responses.
Addressing sensory needs
Identifying sensory preferences and developing personalised regulation strategies.
Improving daily living skills
Building independence with routines such as dressing, homework, organisation and self-care.
Supporting school participation
Collaborating with families and educators to adapt environments and implement practical supports that help children learn successfully.
Coaching families
Helping parents understand their child’s unique profile and develop realistic strategies that work across home, school and community settings.
Supporting Your Child at Home
Remember that behaviour is communication.
Instead of asking:
“Why won’t they just do it?”
Try asking:
- What is making this task difficult?
- Are the expectations realistic?
- Does my child need movement before they can focus?
- Would visual supports help?
- Is this an executive functioning challenge rather than a motivation issue?
This shift in perspective often changes the way children experience support.
Final Thoughts
ADHD is not one-size-fits-all.
Some children appear busy and impulsive. Others seem quiet and distracted. Many experience a combination of both. Each child brings a unique blend of strengths, challenges, interests and ways of engaging with the world.
At The Therapy Network (TTN), we believe that understanding the child behind the diagnosis is the key to effective support. By looking beyond labels, we can build on strengths, address meaningful challenges, and help children, adolescents and young adults develop the skills and confidence they need to participate fully in everyday life.
Every child with ADHD has their own story—and every child deserves support that reflects who they are, not just the name of their diagnosis.
