Understanding ADHD

🧠 Understanding ADHD: A Complete Guide for Care and Support Workers in the UK

Introduction: Why ADHD Knowledge Matters in Care Work

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental conditions, yet also one of the most misunderstood.

Many people still think ADHD is just “being distracted,” “hyperactive,” or “lazy.” In reality, ADHD is a brain-based difference that affects how a person focuses, controls impulses, manages emotions, remembers information, and responds to everyday situations.

For care and support workers in the UK, understanding ADHD is crucial. Many individuals in supported living, residential care, or community services either have a diagnosed ADHD condition or display ADHD-related traits. With the right knowledge and strategies, care staff can provide more effective, respectful, and person-centred support.

1. It’s Not About a Lack of Attention — It’s About Attention Regulation

People with ADHD don’t have less attention. T

People with ADHD do not have less attention. Instead, they struggle to regulate where and when their attention goes.

• Their focus can jump rapidly from one thing to another.
• Or they can go into deep hyperfocus on something they find interesting.
• The problem is not switching on attention — it’s controlling it.

💡 Think of the ADHD brain as having only two attention settings: “off” or “overdrive.” There’s no smooth dial in between.

This means that when a task isn’t engaging, their brain may shut down or drift away, even if they want to focus. But when something is stimulating or meaningful to them, they may stay locked in for hours.

Practical tip for care workers:

• Give short, clear instructions instead of long explanations.
• Use visual prompts or step-by-step reminders.
• Offer choice and flexibility when possible to help engagement.

hey have trouble managing their attention. Their focus can switch quickly or go into “hyperfocus.”

• Example: They may ignore something one moment but give full attention the next.
• This is not about choice; it’s about how their brain works.

2. ADHD Is a Wiring Issue, Not a Willpower Problem

A common misunderstanding is: “If they can focus on games or hobbies, why can’t they focus on daily tasks?”
This happens because the ADHD brain is wired differently. It activates best when something is:

• Highly interesting, or
• Urgent or emotionally charged.

Unlike neurotypical people who can push through boring but necessary tasks through motivation or discipline, people with ADHD cannot voluntarily “force” their brain to engage in the same way.

⚡ Dr. Thomas E. Brown calls it a “performance inconsistency,” not a lack of effort.

Practical tip for care workers:

• Avoid blaming or shaming for lack of focus.
• Create structure: set timers, break tasks into chunks, use reminders.
• Celebrate effort, not just outcomes.

3. ADHD Is Like a Race Car with Bicycle Brakes

Dr. Ned Hallowell famously said,

“Having ADHD is like having a Ferrari brain with bicycle brakes.”

This means:

• Their brain runs fast — lots of ideas, energy, curiosity.
• But self-regulation and control (the “brakes”) can be weak.
• The same trait that causes restlessness or impulsivity can also lead to innovation, creativity, and problem-solving.

For care workers, this means looking beyond the “symptoms” to see the strengths. Many individuals with ADHD are entrepreneurial, enthusiastic, and energetic.

Practical tip for care workers:

• Support structured routines to help build stronger “brakes.”
• Use their strengths — let them engage in activities they find stimulating.
• Provide gentle redirection instead of confrontation when impulses take over.

4. The Emotional World of ADHD Is Intense but Invisible

Emotional regulation difficulties are often not listed in diagnostic criteria, but they’re a core part of ADHD.

• A small trigger can lead to a huge emotional response (e.g., noise, rejection, sudden change).
• Once overwhelmed, the brain may feel “hijacked” — making it hard to think or respond rationally.
• Emotions linger longer and feel more intense than for others.

🧠 One person with ADHD described it as “having sunburn on your emotions — even small things hurt.”

This can show up as frustration, irritability, tearfulness, or even shutting down completely.

Practical tip for care workers:

• Recognise emotional triggers early.
• Speak calmly, offer reassurance, and avoid escalation.
• Allow time and space to regulate before expecting engagement again.
• Remember: emotional outbursts are not “bad behaviour” — they are a neurological reaction.

5. Memory Problems Are About Working Memory, Not Intelligence

People with ADHD often have excellent long-term memory, but working memory — the brain’s short-term holding space — is affected.
Common signs include:

• Forgetting why they walked into a room.
• Losing track of instructions halfway through a task.
• Remembering information one day but drawing a blank the next.

This isn’t carelessness. Their brain struggles to hold and use information in real time.

Practical tip for care workers:

• Use written reminders, checklists, or phone alarms.
• Give one instruction at a time.
• Encourage repeat-back — asking them to repeat instructions to ensure understanding.

6. ADHD Often Overlaps with Other Conditions

Many people with ADHD also have co-occurring conditions, such as:

• Anxiety or depression
• Autism Spectrum Condition (ASC)
• Learning disabilities or speech/language difficulties
• Sleep difficulties or sensory sensitivities

Understanding this helps care workers see the bigger picture. What looks like “defiance” may actually be a stress response or sensory overload.

Practical tip for care workers:

• Observe patterns, not just incidents.
• Work closely with families, professionals, or support teams.
• Follow individual care plans and communication strategies.

7. Supporting People with ADHD: A Person-Centred Approach

Good support for ADHD is not about “fixing” the person. It’s about adapting the environment and offering the right strategies.

✅ What helps:

• Predictable routines and clear structure
• Step-by-step instructions
• Visual aids and reminders
• Calm communication and emotional support
• Flexibility where possible
• Positive reinforcement for small successes

🚫 What doesn’t help:

• Punishing forgetfulness or inattention
• Long lectures or complicated instructions
• Overloading with too many tasks at once
• Misunderstanding emotional reactions as “bad behaviour”

Conclusion:
Empathy + Knowledge = Better Care

ADHD is not a moral failing. It’s a neurological difference that affects attention, impulse control, emotions, and memory.
When care and support workers understand the brain behind the behaviour, they can:

• Reduce frustration (for both staff and the person),
• Build trust and cooperation,
• And help individuals with ADHD thrive in supported settings.

👉 Your role as a care worker is powerful — not just in providing care, but in creating an environment where neurodiverse people can be their best selves.