Attention Deficit Hyperactivity Disorder (ADHD) in the Workplace

How to Optimize the Performance of Employees with Adult ADHD

2009 Volume 12 Issue 2

Managers often have employees who are a challenge to motivate. Consider a scenario where you tell an employee that his or her performance is not up to standard. You take the time to meet with the employee to discuss actions to improve his or her performance, but no matter what you do, the employee continues to make the same mistakes. You may form the opinion that the employee is careless, lazy, or non-motivated.[1] However, this assumption may be incorrect your employee could simply have a brain dysfunction, such as Attention Deficit Hyperactivity Disorder (ADHD).






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This article explores elements of ADHD in order to help managers optimize the performance of these workers. Very often, when there are attempts to accommodate a specific group of people within an organization, the results have a positive impact on the entire workforce. While adopting these tools will benefit the ADHD employee, the managerial practices required to implement these tools should have a positive effect on all of the organization’s employees. Although this article focuses on the difficulties ADHD adults encounter in the workplace, it would be a disservice to ADHD adults to present this information solely in a negative light. ADHD adults bring many positive attributes to the workplace; they can be highly intelligent, creative, and outside-the-box thinkers. They may also have high energy levels, be very persistent, and take risks.[2]

ADHD and the Law

Title I of the Americans with Disabilities Act of 1990 (ADA) prohibits all employers with 25 or more employees (15 or more prior to July 1994) from discriminating against individuals with disabilities who are otherwise qualified in the application, hiring, firing, advancement, and other conditions of employment.[3] Although the ADA does not specifically list ADHD or other related brain dysfunctions as disabilities, it provides the following criteria for determining who is a person with a disability:

  • Has a physical or mental impairment that substantially limits one or more life activities;
  • Has a record of such an impairment; or
  • Is regarded as having such an impairment.[4]

As a result, some people with ADHD may have a disability, while others may not. Most courts have ruled that ADHD is a disability because it does impair one or more major life activities.[5]

There are many ways to treat ADHD, such as with medication, behavior intervention, and counseling.[6] There may be implications for the employer’s health benefit costs, medical leave policies, and other legal issues. This article focuses on helping managers and supervisors deal with the uniqueness of ADHD adults, rather than the diagnostic and medical treatment of ADHD.

ADHD Characteristics

Studies show that 5 to 8 percent of children in the United States have ADHD[7] and that up to 60 percent of these children will exhibit ADHD symptoms well into adulthood.[8] Many ADHD adults live most of their lives not knowing what is wrong with them.[9] They encounter difficulties in all facets of their lives and are sometimes unable to understand the problems they face. Lacking an ADHD diagnosis, these adults think there is something wrong with them, and since they do not know what, they internalize the prescribed flaws others assign to them, specifically that they are unmotivated, careless, reckless, and unreliable. However, it is neither laziness nor lack of motivation that hinders these adults.

ADHD adults live in constant turmoil because of the way their brains function. They have difficulty organizing work, sustaining attention, avoiding distractions, and remembering things.[10] However, under certain circumstances, their brains function quite clearly, which only adds to their confusion “Why does my brain not work sometimes?” Because of the inconsistency associated with these ADHD impairments, parents, teachers, bosses, and even mental health professionals experience confusion, and may see these contradictory behaviors as flaws.[11] Brain functioning is not something that can be turned on or off at the whim of an individual, however.

When we take tests in school, the instructions often advise us to skip over the questions we do not know the answer to and return to them later. For ADHD adults, there is no later. If the answer is not there when they read the question, it may not come to mind later on, and the harder an ADHD person tries, the deeper the answer seems to be buried to the point of being inaccessible.[12] However, as soon as they turn in the test, the answer may well pop into their brain. This difficulty in concentration is not restricted to test taking, but extends to job demands, family pressures, and other social expectations. Problems arise because a parent, teacher, associate, or boss misinterprets this lack of concentration as misconduct.[13] Although these difficulties are common among ADHD adults, it is rare that any one individual will display all of them.[14]

Managing the ADHD Employee

Under ideal conditions, the ADHD adult will have received a diagnosis and some intervention prior to entering the workforce. However, as previously mentioned, many adults are not diagnosed until later in life; in some cases, not until well into their 80s.[15] In other cases, the adult may never receive an ADHD diagnosis. In addition, because there is a negative stigma attached to ADHD, a worker with a documented ADHD disability may never mention the disability to his or her boss and simply try to do his or her best without asking for any accommodations.

The suggestions below are also useful for employees who exhibit the symptoms of ADHD without necessarily having the diagnosis. For example, many workers have difficulty with time management, regardless of whether or not ADHD is a factor. The recommendations for dealing with time management issues will benefit those workers, as well. It is imperative that managers do not attempt to diagnose a worker as having ADHD, but they can make suggestions to assist the worker in overcoming job deficiencies as they arise, as they would any other employee.

1. Short attention span is a classic symptom of ADHD .[16] These individuals have difficulty maintaining concentration and are often distracted. At times, the ADHD person can concentrate for sustained periods, for example, when the project is new, highly stimulating, interesting, or frightening.[17] However, ADHD adults may be quite interested in something and still not be able to concentrate.

ADHD adults have difficulty tolerating a set routine and constantly seek new stimulations. They get bored easily, especially if the work is repetitive and routine even if the work was initially exciting to them. “Repetitive” does not mean doing the exact same thing every time; however, it is often more complex than that.

Recommendation: A change in schedule, a break in the routine, or a job where the employee can do something more stimulating will keep these employees on top of their games.[18]

2. Distractibility has to do with an ADHD person’s hypersensitivity to the environment.[19] Most people can block out the environmental noises that surround us, such as traffic, the whir of a fan, or someone sitting near us breathing noisily. ADHD adults are more sensitive to these noises and other stimuli in the environment. Unlike others, ADHD adults are not always able to block out external distractions, even when reading a book for pleasure.[20] While reading, the minds of ADHD adults may drift off to some totally unrelated topic, with no logical explanation for the transition.

Recommendation: Encourage ADHD employees to have quiet workspaces by:

  • Closing their office doors
  • Moving their offices to low-traffic areas.[21]
  • Moving their inboxes outside of their offices
  • Asking all employees to wear headsets when on the phone

Nonetheless, it is important to acknowledge that it is impossible to eliminate external distractions altogether.

3. Hyper-focusing causes ADHD adults to get so focused on a task that they become oblivious to everything else.[22] Often, ADHD adults will miss meetings, lunch, or other appointments without realizing it until it is too late.

Recommendation: Break tasks into manageable chunks and set an alarm to ring at pre-determined times to rouse the employee from the hyper-focused state.[23] The alarm must be outside of arm’s reach and must be loud enough to demand the employee’s attention, or they may ignore it.

4. Hyperactivity can make ADHD adults feel trapped, especially if their job is sedentary.[24] Any activity that gets the employee moving during the day will benefit that employee’s performance.[25]

Recommendation: Encourage the employee to take several short breaks throughout the workday. Sometimes, just getting up to get a cup of coffee or make copies can constitute enough movement to help the hyperactive adult cope with a sedentary job.

5. Memory problems are common amongst ADHD individuals.[26] Sometimes, it appears that these memory problems are associated with lack of motivation or irresponsibility. At other times, it might appear that the worker can remember information without any problem.

Recommendation: Follow up all oral conversations with emails so that the employee will have written records. In addition, encourage the employee to explore memorization techniques and practices, such as carrying a day planner, writing everything down, and taking notes in meetings.[27]

Unfortunately, however, carrying a day planner does not guarantee that ADHD adults will remember to read their notes.






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6. Time management can be a problem for anyone, but for ADHD adults time management can be a devastating hazard. ADHD employees have difficulty organizing their time, projects, and long-term goals,[28] or always seem to be running late. Even when they plan to arrive early, unforeseen events like a ringing phone or an interruption by a colleague while they are walking out the door can contribute to habitual lateness.

Recommendation: Sustained attempts to arrive early (as opposed to on time) and remain focused in the face of intermediate distractions will help the ADHD adult arrive on time. It is better to arrive early for an appointment, and have some work to do while you wait, than try to complete the work before leaving and end up being late.[29]

7. Over-commitment and procrastination are two time-management-related problems for ADHD adults.[30] Often, ADHD adults will not think about what else is going on when they are asked to take on a new project. Therefore, over-commitment to the point where they cannot accomplish anything productively is a risk. Putting things off to the last minute is also common among ADHD adults. In reality, however, they intend to complete the project on time and may start working on it many times. Consequently, interruptions and other commitments can cause the worker to delay completion of the project. Although these are valid problems for non-ADHD workers, as well, for the ADHD worker they are even more prevalent and problematic.

Recommendation: Frequently ask ADHD employees for progress reports on current projects.

Social Skills

Some of the problems encountered by ADHD adults are caused by deficiencies resulting from other factors, such as a lack of social skills.[31] Children diagnosed as ADHD will generally receive the support and guidance necessary to develop these skills, which include strong motivation, determination, self-control, a goal-oriented approach, and the ability to seek help without becoming dependent[32] as part of their treatment. Self-esteem is also an essential tool. Quite often, the self-esteem of ADHD adults is low because of the turmoil they suffer[33] the constant conflict with parents, teachers, and others as well as from personal negative input. Although conflict helps to build self-esteem, ADHD adults may interpret conflict in a manner that damages their self-esteem. Without the ADHD diagnosis or treatment they will not develop these skills or will do so at a much slower pace.

Leadership Style

By understanding and wishing to address the symptoms displayed by ADHD adults that other employees might also exhibit, managers have a better chance of determining when it is best to use different situational leadership styles. Praise is the best approach when dealing with ADHD adults, as with all employees, whether teaching, supervising, or managing them. Situational leadership dictates that leaders be flexible enough to adapt their style of leadership so that they are directing, coaching, supporting, or delegating as needed.[34] Blanchard et al. offer the following suggestions in choosing a leadership style:[35]

Directive: for employees who lack competence but are enthusiastic and committed.

Coaching: for employees who have some competence but lack commitment.

Supportive: for employees who have competence but lack confidence or motivation.

Delegative: for employees who have both competence and commitment.

It is imperative that the manager consult individual workers to determine which strategies work best for them. Unfortunately, some workers may not know which strategies work best for them. When attempting to find the correct medication and dosage to give a patient, a physician tries several different medications through trial and error. Likewise, it may be necessary for managers and supervisors to try several approaches in order to hone in on the correct strategy to use with ADHD adults.

When dealing with employees, and especially with ADHD adults, managers will need to look at the employee’s behavior in a particular situation and adapt their leadership style to fit the person in that situation. Nonetheless, the success of certain motivational techniques may vary based on the particular task or circumstances. What works in one situation may not work again in another situation, or in the same situation at a different time. Therefore, the manager must constantly reassess the employee and the situation. This will make the employee more productive and will help the manager cut costs by reducing unnecessary turnover. Increasing productivity and lowering costs are the benefits of helping all employees, especially ADHD adults, be successful, which should more than outweigh the additional time commitment the manager makes to work with the employee.

Conclusion

This article provides an understanding of how ADHD influences an individual within the work environment. The authors attempt to show how situational leadership may be best for addressing the issues of ADHD, but also how these same tools can be beneficial in managing all employees. By understanding how ADHD affects the individual, managers can better supervise these and other employees, regardless of whether the employee is in an entry-level position, or at the top of the organization.

Douglas McGregor opined that management’s task is to implement policies and procedures that are conducive to allowing workers to achieve their own goals while navigating toward organizational objectives.[36] This task should also include improving conditions to help workers overcome their personal barriers to success, such as the issues associated with ADHD. By understanding and assisting adults with ADHD, managers can help increase the individual productivity of these and other workers in meeting the organizations’ objectives and improving the bottom line.


[1] Michele Novotni, What Does Everybody Else Know That I Don’t? (Plantation, FL: Specialty Press, 2001), 29.

[2] Daniel Amen, Change Your Brain, Change your Life, (New York: Three Rivers Press, 1998).

[3] The U.S. Equal Employment Opportunity Commission, “The ADA: Your Responsibility as an Employer,” The U.S. Equal Employment Opportunity Commission, http://www.eeoc.gov/facts/ada17.html.

[4] Ibid.

[5] Suzanne Gosden Kitchen, “Accommodation and Compliance Series: Employees with Attention Deficit-Hyperactivity Disorder,” white paper, Job Accommodations Network, Office of Disability Employment Policy,  U.S. Department of Labor, September 4, 2008.

[6] Daniel Amen, Healing ADD: The Breakthrough Program that Allows You to See and Heal the 6 Types of ADD, (New York: G. P. Putnam’s Sons, 2001).

[7] Edward M. Hallowell and John J. Ratey, Answers to Distraction, (New York: Bantam, 1996), 1.

[8] Belinda Jackson and David Farrugia, “Diagnosis and Treatment of Adults with Attention Deficit Hyperactivity Disorder,” Journal of Counseling and Development, 75, no. 4 (1997), 4.

[9] Ibid, 21.

[10] Amen, Healing ADD, 12.

[11] Sari Solden, Journey Through ADDulthood, (New York: Walker & Company, 2002), 10.

[12] Amen, Change Your Brain, Change your Life, 117.

[13] Novotni, 3.

[14] Kitchen.

[15] Ibid.

[16] Ibid.

[17] Amen, Healing ADD, 13.

[18] Kathleen Nadeau, ADD in the Workplace: Choices, Changes and Challenges, (New York: Brunner-Routledge, 1997), 31.

[19] Amen, Change Your Brain, Change your Life, 118.

[20] Amen, Healing ADD, 15.

[21] Nadeau, 36.

[22] Ibid, 32.

[23] Ibid.

[24] Ibid, 33.

[25] Ibid.

[26] Amen, Healing ADD, 249.

[27] Nadeau, 35.

[28] Amen, Healing ADD, 16.

[29] Nadeau, 39.

[30] Ibid, 36 37.

[31] Novotni, 22.

[32] Nadeau, 111.

[33] Antony Amen, Sharon Johnson, and Daniel Amen, A Teenager’s Guide to ADD: Understanding and Treating Attention Deficit Disorder Through the Teenage Years, (Fairfield, CA: MindWorks Press, 1996), 141.

[34] Kenneth Blanchard, Patricia Zigarmi, and Drea Zigarmi, Leadership and the One-Minute Manager: Increasing Effectiveness through Situational Leadership, (New York: William Murrow and Company, 1985), 57.

[35] Ibid.

[36] Douglas McGregor, “Adventures in Thought and Action,” The Management Review, 46 (1957), 26.

About the Author(s)

Bill Carnes, DM, is a Visiting Professor of Management at Metropolitan State College of Denver in Denver, Colorado. He served as adjunct faculty for various online and on-ground universities, teaching primarily in the management, workforce diversity, and organizational behavior fields, with a growing interest in incorporating Appreciative Inquiry (AI) into his courses of instruction. In 1996, he retired from the U.S. Army and relocated with his family to Colorado. Recently, he was honored in the 2008-2009 edition of Madison's Who's Who. He has published and presented several papers on ADHD and incorporating AI into teaching workforce diversity courses in conference proceedings.

Madison Holloway, PhD, received his doctorate from the University of Colorado in 1977 and has been teaching management since then. He has been a professor of management at Metropolitan State College of Denver since 1988, receiving numerous awards, including the Golden Key International Honor Society Outstanding Faculty Teacher Award and the MSCD Distinguished Service Award. His areas of expertise are effective team building and organizational change and development utilizing the Appreciative Inquiry approach. He has served as a consultant for the Kaiser Permanente Insurance Company, Northwest Airlines, the Denver Water Department, and the Denver African American Leadership Institute.

Comments

MiMi

July 20, 2011 at 6:13 pm

This is an extremely helpful article. I am an employee with Narcolepsy, experiencing ADHD-like symptoms. I now have some suggestions for my supervisors – suggestions they/I can use to become a bit more productive. Thank you.


Terri Dirik

September 21, 2011 at 7:58 pm

Please advise me on how to apply for Disability related to ADHD. I have this condition and am on meds however it is still quiet difficult to teach 6t grade social studies and seventh grade Texas history daily (class size is approximatey 28:1. I’ve been asked to record test for al the children who must receive oral administration and then burn CDs. It is difficult to follow the instruction sheet given to us. I believe
the Special Education department should be in charge of this. This extra responsibility is very difficult to add to my job expectations. I was told that i could do this from 8-8:40. However, I have mandatory tutorials two mornings a week, duty one morning and staff meeting once a week. That only leaves one day to do this..
Am I entitled to extra help from someone to do this additional job which is outside the duty of the classroom teacher?
Please advise
Sincerely
Terri Dirik
tdirik@aol.com


Laura Frederick

January 5, 2012 at 2:12 pm

Thank you for a clear, concise review of how ADD/ADHD can impact one’s work. I was diagnosed as an adult two years ago and have been learning how this disorder affects my life ever since.

Although I did disclose to my employer, it was not well received. I ended up taking a lesser position in order to provide my own accomodation.


Anonymous

March 28, 2012 at 8:40 am

I unfortunately hired someone with ADHD and didn’t know at the time. Now I’m dealing with a very difficult person to work with.


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