It-tifel/tifla tiegħi għandu dijanjosi ta’ ADHD

Seeking Information or Guidance on Coping and Support

It can be challenging to live with ADHD, as our society often has expectations that may be difficult for ADHD brains to meet. ADHD medication can be helpful, however it is not a magic fix and there are many other things that can and should be done to support a person who has ADHD alongside medication use.

1️⃣ I would like to know more about what ADHD is and how it affects people.

2️⃣ I am a parent or caregiver of an ADHD child and I am seeking advice on:

I want to know more about ADHD and how it affects people

ADHD is a condition that affects the brain and system that controls and supports it, and this in turn affects behaviour.

ADHD is largely genetic, which means that if a child has ADHD, then probably (but not always) one or both parents also have ADHD or another neurodevelopmental disorder such as dyslexia or autism.

One of the ways that ADHD affects a person is that their “executive functions” develop slower than other children, and even as an adult, that person probably has weaker executive functions than other people. This means that people with ADHD usually have to try harder and spend more energy to do things that need executive function, for example:

  • Control of attention: ADHD brains are attracted to anything new, interesting, or exciting, making it very difficult to pay attention to anything that is boring to them. They are easily distracted by what they can hear or see, and can even be distracted by their own thoughts!
  • Motivation: ADHD brains do not feel the same motivation that most other people do – important tasks just don’t feel important and some may leave things pending till right before deadlines, until the last minute panic and urgency can finally help motivate the brain to feel motivated and productive. This means that ADHDers often procrastinate.  Things like paperwork, admin tasks, housework, school homework, assignments or studying, paying bills, filing taxes often get left behind and pile up
  • Working memory: the ability to remember what you were doing, what you just did, or what you are supposed to be doing right now. ADHD brains often forget important tasks, dates or information – not because they don’t care, not because they are irresponsible, but because they may struggle to remember current information. They may still remember highly-emotional conversations from years ago though – that’s a different kind of memory!
  • Emotional regulation: this is an important skill, the ability to calm yourself when you are angry, for example. ADHD brains often struggle with this, so people can seem to be “hot-tempered” or “easily upset” or a “crybaby” – this is not because they are immature, but because their ability to self-regulate is impaired.
    • RSD or “Rejection Sensitive Dysphoria” is a fairly newly-recognised condition that many ADHD people also have – it causes people to react very strongly to negative criticism, and to worry a lot about how other people view them. Someone with RSD might get very upset if they think that someone is judging them, and might react by getting very sad or even very angry.
  • Planning: ADHD brains tend to live in the present moment, and many are not really able to look ahead to the future. This makes it difficult to find enough motivation to spend time on planning in advance. Unfortunately, the lack of planning can often cause further complex problems later on.
    • Difficulty planning also makes it difficult to prioritise – ADHD brains tend to focus on the immediate problems, possibly ignoring long-term goals. Projects or tasks with deadlines tend to be worked on in a hurry right before the deadline, when they become urgent enough to trigger action.
  • Task Initiation: The hardest part of a task is often the “getting started”! ADHD brains can feel overwhelmed when a task or project is big and vaguely defined, and there is no clear starting point or process. On the other hand, if there is clarity but also a long to-do list, that can also trigger overwhelm, especially if the to-do list is full of tasks that don’t excite or inspire the ADHD brain. This means that tasks or projects are often procrastinated, leading to problems such as running out of petrol, missing deadlines (even for nice things like buying performance tickets), and getting fined for filing taxes too late.
  • Time Awareness: ADHD brains often are not aware of time passing, and an hour can feel like a few minutes. This is one of the reasons why ADHD people are often late – it’s because they underestimate how long it will actually take them to get ready, leave the house, and arrive at their destination. Or else they just… lose track of time!
  • Impulse Control 
  • Ineffective Delegation: Reluctance to delegate due to perfectionism or an inability to organize the steps necessary for others to take over, which increases the executive’s own administrative burden.
  • Impulsive Decision-Making: Moving quickly on new ideas without fully considering long-term consequences, or interrupting colleagues during high-stakes meetings.
  • Disorganized Workspaces: Maintaining a chaotic physical or digital environment—such as a cluttered office or a buried inbox—making it difficult to locate essential documents or track follow-ups.
  • Difficulty with Task Switching: Struggling to transition from “big-picture” strategic thinking to granular operational details, or vice versa, causing significant mental fatigue.

Unfortunately, many people think that these behaviours are choices, and they blame ADHDers for “choosing” to behave like this – but that is not what is actually happening.

Therapy and training to improve these issues may not work well if it only focuses on trying to change the behaviour. It is always important to understand what is causing the difficulties and then try to support that underlying need.

I am a parent or caregiver of an ADHD child and I am seeking advice on:

1. Parenting issues

Parenting a child with ADHD can feel lonely and confusing at times. People around (including family) may leave you feeling that you should be ‘more disciplined’, that you’re ‘spoiling them’, that ‘they are old enough to be independent’ and ‘you’re doing too much for them’… You may find that what people around you are saying does not feel quite right for your child, however you wonder if you are doing the right thing. Certain parts of daily life, such as getting your child out of bed, washed, dressed, out of the house and to school on time may feel unduly hard, however when you discuss this with friends, they say they have these problems too. However, somehow, you feel that your struggles are more, different… or else that for some reason you seem to not be succeeding as well. In fact research shows that stress levels can be higher in families with ADHD. So, after a child is diagnosed, what should a parent do?
  • Learn as much about ADHD as you can – understanding what ADHD is helps
  • Attend an ADHD-savvy parenting course (this is recommended as first line treatment by the NICE guidelines, especially when the child is young) //Add link to courses page here please
  • Reach out to other families who have a child with ADHD – community helps! (Join ADHD Malta – family group) //Add link to the family group here please https://www.facebook.com/groups/fadhdmt/
  • Be aware that ADHD is genetic – if you feel you may have ADHD, get assessed and get treatment – treating our ADHD as parents helps us be more regulated and parent better
  • If your child is struggling and it is recommended, do try giving prescribed ADHD medication and see if it helps
  • Remember first and foremost that the most important thing is building a relationship with your child. It is important to choose your battles and do not go head-to-head with your child 

2. Child’s Behaviour

Raising a child with ADHD can be both rewarding and demanding. ADHD is a neurodevelopmental difference that affects attention, impulse control, activity levels, and executive functioning (skills such as planning, organising, and regulating emotions). Children with ADHD often find it harder to pause, think ahead, and regulate their behaviour, especially in stimulating environments. As a result, they may appear impulsive, highly energetic, talkative, or easily distracted. These behaviours are not intentional misbehaviour; rather, they reflect differences in how the brain manages attention, motivation, and self-regulation. Parents may notice that their child:
  • moves quickly between activities
  • struggles to follow instructions consistently
  • has difficulty managing strong emotions
  • speaks frequently or interrupts conversations
  • acts before thinking about possible consequences
In early childhood, this may mean more mess, more broken toys, or more conflicts between siblings. These challenges can be tiring for parents and carers. ADHD is not caused by parenting style, however, parenting approaches can make a significant difference in helping children develop regulation skills. Children with ADHD usually require more structure, guidance, and support than many of their peers and benefit from consistent, predictable responses from all caregivers. When parents work together and share strategies, children experience clearer expectations and greater emotional security.   Research also suggests that positive engagement with multiple caregivers can help children develop stronger self-regulation skills and confidence. It is really important that all caregivers are involved, supported, and informed about the child’s needs.

3. School Issues

Factors linked to ADHD may affect school life too.   Some pupils find learning challenging both academically and socially because of difficulties with attention, emotional regulation and behaviour. These difficulties can affect their ability to concentrate, follow instructions, organise their work and interact successfully with others. At times, these behaviours may also affect the learning environment for other pupils and can place additional demands on teachers and school staff. The behaviours associated with ADHD are often considered within the broader category of emotional and behavioural difficulties. However, ADHD is widely understood as a neurodevelopmental condition, meaning that differences in brain development and functioning play an important role in the difficulties experienced. It is important that schools (and parents) understand behaviour within the context of a child’s learning and developmental needs, rather than viewing it simply as misbehaviour.
– Applying to get extra support – an LSE
At times extra support may be needed in school to support the child with ADHD’s learning to help them reach their full potential.  (For assessment, and statementing procedures press here).
–  IEP (Individualised Educational Programme) and Exam Access Arrangements (EAA)
Parents of children who have an LSE will be invited to an IEP meeting. During this meeting, a year’s goals for the child’s education will be discussed. It is important that parents (and older children) participate in the meeting and that decisions are understood and agreed upon – if you do not agree with something, this is the time to speak up and discuss. Whether a child has an LSE or a diagnosis only, they may benefit from access arrangements. Exam access arrangements are designed to remove barriers so that a student can show their true ability. In Malta access arrangements are given to students who have:
  • Specific learning difficulties (e.g. dyslexia, ADHD)
  • Physical or sensory disabilities (e.g. visual/hearing impairment)
  • Medical conditions
  • Emotional or mental health needs
  • Speech, language, or communication difficulties
The recommendations are found in the psychologist’s report and the supports depend on the student’s needs and official approval. Common EAAs in Malta include:
  • Extra time during exams
  • Reader or scribe (someone reads/writes for the student)
  • Use of a computer or assistive technology
  • Reader pens or audio support
  • Rest breaks during exams
  • Separate room or smaller group setting
  • Modified papers (e.g. large print)
Schools help submit applications for EAAs in secondary school.  The MATSEC Board (University of Malta) approves arrangements.  It is important to have an updated psychological report before students start secondary education (year 9).

4. Medication (starting, changing or adjusting)

After an ADHD diagnosis, the psychiatrist may recommend starting ADHD medication. What medications are there? In Malta, the main ADHD meds are:
  • Methylphenidate (Ritalin / Concerta / generics) are usually the first ADHD medications prescribed. It is normal to start off with Ritalin (the original can be bought from pharmacies or the generics of Ritalin which are available on the Pharmacy of Your Choice (POYC).  This is the short-acting form of the medication – and lasts a maximum of four hours (for Ritalin) and less for the generic brands.
After three months of using Ritalin/generic, a recommendation to use longer activating Concerta (can be bought) or the generic long-acting medication (POYC) can be made. Concerta lasts twelve hours whereas the generic medications last a shorter time.
  • Atomoxetine (Strattera) is a non-stimulant medication. This medication lasts 24 hours and is also available on POYC. 
  • Amphetamines (e.g. lisdexamfetamine) – the use of this medication is still limited but being prescribed more when methylphenidate or atomoxetine are deemed as less ideal for the individual.
Titration – Titration is a very important part of starting medication – it’s the process of gradually adjusting the medication dose to find the “just right” balance between effectiveness and side effects.   It is normal to start with a low dose, increasing it slowly over weeks and monitoring how your child responds to it. Titration should be monitored at school (getting feedback from educators including the time and behaviour observed is ideal) and at home. Observations should be discussed with the psychiatrist and dose should be regulated accordingly. This form may help with monitoring. Some people need higher doses whilst for others a low dose may be sufficient.  When starting medication the child’s body needs to adjust.  (Signs the dose may be too high are increased anxiety or irritability, insomnia, appetite loss, heart palpitations.) When trying to find the right dose it is important to know what you feel is a struggle – why medication is being given.  Some goals could be focus improving at school, emotional regulation, less impulsivity, executive function improvement.
Managing side effects
One of the best ways of avoiding side-effects of medication are starting slow and increasing slowly until an ideal dose is found.  It is important for the child to have frequent sips of water. Over-the-counter magnesium supplements may help the medication being released in a smoother way.
  1. Managing appetite loss – sometimes ADHD medication causes loss of appetite. It is beneficial to give your child a good breakfast (the ideal is protein-rich) and meals in between medication doses.  Healthy snacks (which also keep blood sugar stable and help to maintain mood) help, as well as eating larger portions in the evening when medication wears off.
  2. Managing sleep problems – Difficulties with sleep are part-and-parcel of ADHD. Doctors suggest not giving the final stimulant medication dose too late in order to avoid making it harder for the child to fall asleep. Reducing screentime before bed and having a bedtime routine also help.
  3. Irritability or emotional changes – 
Medication can make a person irritable or tired when the dose is too high or when medication is wearing off. If you are still titrating it is important to let the doctor know as he may lower the dose. Switching to a long-acting medication and topping up with a small dose may also help if the issues arise when the medication is wearing off.