Impulsivity is a common symptom among children with ADHD who have difficulty thinking through their actions and, instead, act on their immediate desires, doing what feels best in the moment. They do not consider the consequences of their actions, which at best may be annoying but at worst may put them in danger.
Typical behaviors associated with kids who are unable to control their impulses are behaviors that appear to others as unplanned, such as speaking out of turn, running, jumping, and rough-housing in places where they can hurt themselves or damage things around them. In some cases, children present with extreme emotional reactions that appear to be an overreaction to the situation that triggers them.
For teenagers, impulsivity often comes with a dose of defiance. For instance, a teen may leave the house without permission or not tell you where they’re going. They may stay up late despite needing to be up early the next day and seek thrills by partaking in negative behaviors (drinking, vaping, driving fast, etc.).
Impulsivity at School
Many of the behaviors that these kids exhibit at home are visible at school as well. An impulsive child may struggle to raise their hand, remain on task, or wait their turn. They might appear restless and make hasty decisions. Sometimes, impulsive children are mislabeled as “the class clown” due, in part, to their quick wit and timing when delivering a punchline. However, this behavior often stems from an inability to regulate.
Over time, impulsive actions may result in frequent visits to the principal’s office or detentions. Younger children may not face formal consequences; however, they are not exempt from punishment. Instead, they may have their name moved down on a behavior chart for all to see. Consequently, this can lead to a child associating their impulsivity, something they cannot yet regulate, with “bad” behavior, which impacts self-esteem. In more extreme cases, impulsivity can be mislabeled and misdiagnosed as Oppositional Defiant Disorder (ODD).
Some children begin to recognize they are impulsive and try to overcontrol their behavior by turning inward. These children may appear anxious or emotionally dysregulated. This is because the child is working so hard to hold it together that they are depleting their cognitive reserves just to suppress their impulses.
How You Can Help
It’s important to recognize that these children may not be able to fully control their impulses. Awareness of impulse control emerges between first and third grade, but the area of the brain that helps to govern impulse control is not fully developed until late adolescence. This means that children need help learning this skill, as well as understanding and patience when they are unable to regulate themselves. They will benefit from explicit teaching, modeling, and practice to improve the skill.
Stop-Think-Do is one way to help children learn impulse control. This technique can be taught by a teacher or caregiver through modeling and co-regulated teaching to demonstrate how to pause, reflect, and react to situations in real time. Here’s how it works:
- Stop: The first step is to stop the behavior by pausing before engaging in an undesirable action. The purpose is to teach children how to take a brief break, creating space between them and their impulsive thoughts or actions.
- Think: Think about the current situation. What are the possible consequences of this situation? Is there a best course of action? Lead your child in reflection framing questions about (1) what am I about to do? (2) Is it appropriate? Is it safe? (3) What are the potential consequences of this behavior? What do I think the reaction will be from those who are around me? (4) What is the best course of action?
- Do: Now that your child has paused and reflected on the potential consequences of their actions, it is time for them to act deliberately, knowing that they are making the best possible decision.
The advantage of this method is that, once mastered, children can independently and efficiently complete it in virtually any setting. In addition to managing impulses, Stop-Think-Do helps to teach children how to reflect meaningfully and develop a sense of self-control and autonomy in decision-making.
Dr. Erin Micali is a neuropsychologist at Sasco River Center in Darien, CT who specializes in pediatric neuropsychological evaluations. Her focus areas include neurodevelopmental disorders and early childhood evaluations.