Telling Jeffery not to touch his brother for the one-millionth time.
The second call this week from the school was about behavior on the bus.
Another set of stitches from the walk-in clinic.
This is the life of a parent with an impulsive child…
Impulsive behaviors in children can be challenging for parents, caregivers, and kids too. While some kids may act out or go through a phase, others may have a more serious underlying condition, such as Attention-Deficit Hyperactivity Disorder (ADHD), anxiety, or a mood disorder.
However, not all impulsive behaviors in children are indicative of ADHD. Understanding the potential causes of your child's impulsive behaviors is essential to determine the first step to helping them.
Reasons Why Kids Are Impulsive
Parents and caregivers must understand the potential underlying causes of impulsive behaviors to provide their children with the appropriate support and intervention. Impulsive behaviors in children can have various underlying causes, including
Attention Deficit Hyperactivity Disorder is a common mental health condition that can cause impulsive behaviors in children.
2. Emotional Dysregulation
Kids with difficulty regulating their emotions may act impulsively, such as hitting or yelling when angry or frustrated. This could be a developmental issue or be rooted in a clinical issue such as a mood disorder, OCD, or anxiety. It may also result from sensory sensitivities.
3. Anxiety or Stress
Children who are anxious or stressed may act impulsively to cope with their emotions. Their intolerance of uncomfortable thoughts and sensations may drive impulsive actions and comments.
4. Developmental Delays
Some children may have developmental delays that cause them to act impulsively, such as not understanding social cues or struggling with impulse control.
5. Environmental Factors
Certain environmental factors, such as exposure to violence or trauma, may cause children to act impulsively to cope with their surroundings. Environmental toxins and infections can lead to brain inflammation which could result in many behaviors, including impulsivity.
6. Learning Disabilities
Children with learning disabilities may struggle with impulse control, such as interrupting conversations or speaking out of turn, due to difficulties processing information or an urge to get out what they want to say, “Before I forget.”
Some research suggests that genetics may play a role in the development of impulsive behaviors in children (Bezdjian et al., 2011). It means the behavior can run in families.
What is Impulse-Control Disorder?
Impulse-control disorder is a mental health condition characterized by persistent difficulty in controlling one's impulses, resulting in behaviors that are potentially harmful to oneself or others. These behaviors may include self-harm, binge eating, or explosive anger outbursts in children.
Impulse-control disorder is typically diagnosed when the behavioral issue persists over time and interferes with daily life or social skills and functioning. Children with this disorder may experience feelings of guilt, shame, or embarrassment due to their inability to control their impulses. They may also struggle to form and maintain healthy relationships, complete tasks, or achieve goals.
How is Impulse Control Disorder Different from ADHD?
Impulse-control disorder and Attention-Deficit/Hyperactivity Disorder (ADHD) are two different conditions, although they can share overlapping symptoms, such as impulsivity and difficulty with self-regulation.
ADHD is characterized by impulsive behaviors such as interrupting others or acting without thinking, but these behaviors are not typically harmful. Regarding the onset of symptoms, an impulse control disorder is typical during adolescence, while symptoms of ADHD usually appear in childhood.
While hyperactivity is a defining feature of ADHD, it is not typically present in impulse-control disorder. Instead, individuals with the impulse-control disorder may experience intense emotions, such as anger or frustration, which can lead to impulsive behaviors.
Treatment for impulse-control disorder typically involves therapy and science-backed solutions, while treatment for ADHD may also include behavioral interventions such as parent training and classroom accommodations.
Attention-Deficit/Hyperactivity Disorder affects children and adults. Some symptoms of ADHD are similar to impulse control disorder and can vary in severity. The signs of ADHD include:
Difficulty paying attention, being easily distracted, forgetting details, making careless mistakes, and having difficulty organizing or completing tasks.
Fidgeting, squirming, and restlessness are typical examples of this symptom. Younger children with hyperactivity may also have difficulty sitting still and may talk excessively.
Acting without thinking through the consequences of their actions, interrupting others, and struggling with waiting their turn.
4. Poor Time Management
Difficulty planning, prioritizing tasks, and often procrastinating on essential assignments. These kids also have poor organizational skills.
Frequently misplacing things, forgetting important dates or appointments, and struggling to remember instructions.
6. Difficulty with Following Instructions
Struggling to follow through on tasks or instructions, often losing track of what they were doing or were supposed to do, is common among ADHD children.
7. Emotional Dysregulation
Difficulty controlling emotions, experiencing intense reactions that seem disproportionate to the situation, and struggling to regulate emotions.
Impulse Control Disorder Symptoms
Impulsive behaviors refer to actions often carried out without considering the consequences. These behavior problems are common in children and may range from mild to severe. Here are some symptoms and examples of impulsive behaviors in kids:
1. Interrupting Others
Kids may frequently interrupt conversations or activities, even when it's not their turn to speak or participate.
2. Lack of Impulse Control
Children may act impulsively without considering the effects of their actions, such as blurting out inappropriate comments or grabbing toys from other children. When older children struggle with controlling their impulses, they may hit people or objects when angry or frustrated.
3. Taking Risks
School-age children with impulse control may engage in risky behaviors without considering the potential dangers and risk factors, such as climbing high structures or crossing busy streets without looking.
4. Difficulty Waiting or Taking Turns
Some children may have difficulty waiting their turn or become impatient when asked to wait.
Kids with impulsive behaviors may also display hyperactivity, such as fidgeting, squirming, or having difficulty sitting still.
6. Lack of Empathy
Impulsive children may have difficulty understanding and empathizing with others, resulting in excessive teasing or bullying.
7. Recurrent Impulsive Behavior
Engaging in repetitive behaviors that are difficult to control, such as gambling, shopping, binge eating, or substance abuse.
8. Difficulty Resisting Urges
Resisting impulses or urges, even when they know the behavior is harmful.
9. Emotional Dysregulation
Experiencing intense emotional reactions that seem disproportionate to the situation and struggling to regulate emotions.
10. Irritability or Aggression
Feeling irritable or agitated and experiencing anger or aggression when attempts are made to curb impulsive behaviors.
11. Relationship Problems
Experiencing problems due to impulsive behaviors, such as lying or stealing from loved ones.
12. Guilt or Remorse
Feeling guilty or remorseful after engaging in impulsive behaviors but unable to control the behavior.
Types of ADHD
There are three main types of ADHD, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, it's worth noting that ADHD can present differently in different people, and symptoms can change over time. The three types of ADHD are:
1. Predominantly Inattentive Presentation
Difficulties with attention and focus characterize this type of ADHD. Children with inattentive ADHD often struggle to organize tasks, pay attention to detail, and follow instructions. They may also have difficulty with working memory, which can affect their ability to remember and use information.
2. Predominantly Hyperactive-Impulsive Presentation
This type of ADHD is characterized by hyperactivity and impulsivity. Children with this type of ADHD may struggle to sit still, have difficulty waiting their turn, and interrupt others often. They may also act on impulse without thinking through the consequences of their actions.
3. Combined Presentation
This type of ADHD involves a combination of inattentive, impulsive, and hyperactive behaviors. People with this type of ADHD may struggle with attention, hyperactivity/impulsivity.
What is the Relationship Between ADHD and Impulse Control?
ADHD and impulse control are closely related. Impulse control refers to thinking before acting, resisting urges or temptations, and delaying gratification. People with ADHD often struggle with impulse control, leading to impulsive behavior, such as interrupting others, speaking out of turn, acting without thinking, and making impulsive decisions.
ADHD can also affect a person's ability to regulate emotions, making it harder to control impulsive behavior. For example, children with ADHD may become easily frustrated, irritable, or impulsive when faced with a challenging task or situation. They also tend to be very sensitive to rejection and criticism, and 70% also have Rejection Sensitive Dysphoria.
In addition, some symptoms of ADHD, such as hyperactivity and restlessness, can make it harder to sit still, focus, and control impulses. However, it's important to note that not all people with ADHD have problems with impulse control. It depends on the individual and the specific symptoms they are experiencing.
Treatment for ADHD typically includes strategies to improve impulse control, such as behavioral therapy. By learning techniques to improve impulse control and manage ADHD symptoms, children with ADHD can improve their ability to regulate their behavior and make better decisions.
What Makes Someone So Impulsive?
Managing an impulsive child or teen isn't easy. When I explain what it is like for a child who can't put the brakes on, I always talk about Homer Simpson. If you have ever watched “The Simpsons,” you know how loveable Homer is. But he just can't seem to stop himself from doing impulsive stuff. He means well and for sure he isn't doing it on purpose.
That is something that I want every person to understand, your kid isn't doing this on purpose!
Impulsive kids struggle to regulate the frontal lobe’s braking system. They want to stop, but their brake pads are worn out.
Several factors can contribute to someone being impulsive. Here are some possible explanations:
Some people may be naturally more impulsive due to differences in brain chemistry or genetics. For example, research has shown that people with certain genetic variations may be more likely to engage in impulsive behaviors (Anokhin et al., 2015).
Childhood experiences, upbringing, and social influences can also affect impulsivity. For example, children growing up in chaotic or unpredictable environments may be more likely to develop impulsive behaviors to cope with stress and uncertainty.
3. Mental Health
Certain mental health conditions, such as attention-deficit/hyperactivity disorder (ADHD), bipolar disorder, and borderline personality disorder, are associated with impulsive behavior.
4. Lack of Self-Control
Some people may simply struggle with self-control and find it challenging to resist immediate gratification or impulses.
5. Lack of Play
The foundation of self-regulation comes from actual play. A kid's brain learns to calm down through sensory play, such as art and building. With the dramatic increase in screen time, kids aren’t getting enough play to teach self-regulation.
The Biology of Impulse Control
Impulse control is a complex behavior that involves multiple brain regions and neurotransmitter systems. The prefrontal cortex (PFC), a region located in the front part of the brain, plays a crucial role in impulse control. That prefrontal cortex houses those all-important brakes.
The PFC is responsible for executive functions such as decision-making, planning, and inhibitory control. It receives input from other brain regions, such as the amygdala, striatum, and hippocampus, which are involved in emotional processing, reward processing, and memory.
The neurotransmitter dopamine also plays a role in impulse control. Dopamine is involved in reward processing and motivation and is released in response to pleasurable experiences. However, chronic drug use can lead to changes in the brain's dopamine system, impairing impulse control and leading to impulsive behavior.
Another neurotransmitter that is involved in impulse control is serotonin. Serotonin is known to regulate mood, anxiety, and impulsivity. Low levels of serotonin have been associated with impulsive behavior and aggression.
There is also evidence that genetics plays a role in impulse control. Certain genetic variations have been associated with impulsivity and risk-taking behavior. For example, variations in the gene encoding the dopamine transporter have been linked to impulsivity and addiction (Itohara et al., 2015).
Non-Stimulant ADHD Medications, Supplements, and Treatments
Several non-stimulant drugs are used to treat ADHD. However, using ADHD medicines could put a child's brain development at an increased risk. Instead, there are natural supplements and science-backed therapies that can significantly help instead.
1. Selective Norepinephrine Reuptake Inhibitors
Selective norepinephrine reuptake inhibitors are approved for the treatment of ADHD in both children and adults.
2. Alpha-2A Adrenergic Receptor Agonist
Alpha-2A adrenergic receptor agonist is also approved for treating ADHD in children and adolescents, and they are supposed to improve attention and reduce impulsivity.
Supplements for attention are a great alternative to ADHD medications. They can increase attention and address underlying nutrient deficiencies.
1. Omega-3 Fatty Acids
Some studies suggest that omega-3 fatty acids found in fish oil supplements may help improve symptoms of ADHD (Bloch & Qawasmi, 2011). Omega-3 supplements and healthy food can help alleviate ADHD and impulsive disorder.
One study shows that zinc supplements may help improve symptoms of ADHD, particularly in children with low levels of zinc (Dubik, 2004). Zinc plus getting enough sleep and physical activity can be a part of an effective treatment plan for ADHD.
Low iron levels have been associated with ADHD symptoms, and some children may benefit from iron supplements (Halterman et al., 2001). However, talking to a healthcare provider before taking iron supplements is essential, as too much iron can be harmful.
The nervous system relies on magnesium to function correctly, and studies have linked low levels of this mineral to increased externalizing behaviors (Black et al., 2015). Combining magnesium supplements with vitamin B6 is believed to have a potent calming effect on the central nervous system.
Coping Skills and Science-Backed Therapies
1. Cognitive Behavioral Therapy (CBT)
This behavior therapy is commonly used to help individuals identify triggers for their impulsive behaviors, develop coping strategies, and improve their emotional regulation skills.
Teaching and mastering coping skills is an important part of psychotherapy and is especially important for impulsive children who lack self-regulation. Managing frustrations, uncomfortable sensations, and negative experiences is critical to lifelong mental health, and impulsive kids need direct instruction, practice, and reinforcement to develop those skills.
Neurofeedback therapy is a method used to help children with ADHD enhance their focus and concentration skills (Cortese et al., 2016). It is a safe and natural therapy that improves focus and reduces impulsivity. The therapy teaches the child to increase attention-related brain waves like beta and decrease unfocused ones like a delta.
At our center, we use EEG neurofeedback both in-person and remotely, and this process involves reinforcing the brain when it produces a healthy combination of brain waves. As the child learns to produce these desirable brain waves, they receive positive feedback through rewards, which involves visual feedback, such as a movie playing, and auditory feedback, like hearing a sound, whenever they produce that healthy combination of brain waves.
3. CALM PEMF™
Many kids with ADHD can not only be impulsive but hyperactive as well. These children need support calming their brains and bodies. Using CALM PEMF™ can benefit individuals with ADHD as it helps to soothe the nervous system.
Regular sessions of PEMF therapy can aid in addressing the scattered focus experienced by children with ADHD, especially those with learning and behavioral issues. Furthermore, PEMF therapy may help control children's impulsive behavior without using psychiatric drugs with harmful side effects (Alfredo, 2021).
Alfredo, F.-O. (2021, June 28). Effects of Pulsed Electromagnetic Fields (PEMFS) On Cerebral Haemodynamics – EPOCH Study. Clinicaltrials.gov; National University of Singapore. https://clinicaltrials.gov/ct2/show/NCT03944993
Anokhin, A. P., Grant, J. D., Mulligan, R. C., & Heath, A. C. (2015). The Genetics of Impulsivity: Evidence for the Heritability of Delay Discounting. Biological Psychiatry, 77(10), 887–894. https://doi.org/10.1016/j.biopsych.2014.10.022
Bezdjian, S., Baker, L. A., & Tuvblad, C. (2011). Genetic and environmental influences on impulsivity: A meta-analysis of twin, family and adoption studies. Clinical Psychology Review, 31(7), 1209–1223. https://doi.org/10.1016/j.cpr.2011.07.005
Black, L. J., Allen, K. L., Jacoby, P., Trapp, G. S., Gallagher, C. M., Byrne, S. M., & Oddy, W. H. (2015). Low dietary intake of magnesium is associated with increased externalising behaviours in adolescents. Public Health Nutrition, 18(10), 1824–1830. https://doi.org/10.1017/S1368980014002432
Bloch, M. H., & Qawasmi, A. (2011). Omega-3 Fatty Acid Supplementation for the Treatment of Children With Attention-Deficit/Hyperactivity Disorder Symptomatology: Systematic Review and Meta-Analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 50(10), 991–1000. https://doi.org/10.1016/j.jaac.2011.06.008
Cortese, S., Ferrin, M., Brandeis, D., Holtmann, M., Aggensteiner, P., Daley, D., Santosh, P., Simonoff, E., Stevenson, J., Stringaris, A., Sonuga-Barke, E. J. S., Asherson, P., Banaschewski, T., Brandeis, D., Buitelaar, J., Coghill, D., Cortese, S., Daley, D., Danckaerts, M., & Dittmann, R. W. (2016). Neurofeedback for Attention-Deficit/Hyperactivity Disorder: Meta-Analysis of Clinical and Neuropsychological Outcomes From Randomized Controlled Trials. Journal of the American Academy of Child & Adolescent Psychiatry, 55(6), 444–455. https://doi.org/10.1016/j.jaac.2016.03.007
Dubik, M. (2004). Zinc, Methylphenidate, and ADHD. AAP Grand Rounds, 12(1), 6–6. https://doi.org/10.1542/gr.12-1-6
Halterman, J. S., Kaczorowski, J. M., Aligne, C. A., Auinger, P., & Szilagyi, P. G. (2001). Iron Deficiency and Cognitive Achievement Among School-Aged Children and Adolescents in the United States. PEDIATRICS, 107(6), 1381–1386. https://doi.org/10.1542/peds.107.6.1381
Itohara, S., Kobayashi, Y., & Nakashiba, T. (2015). Genetic factors underlying attention and impulsivity: mouse models of attention-deficit/hyperactivity disorder. Current Opinion in Behavioral Sciences, 2, 46–51. https://doi.org/10.1016/j.cobeha.2014.09.002
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