Impulsive Children with ADHD-Verbal Impulsivity

Verbal impulsivity or mouthiness-sassy mouth is a symptom of ADHD in children and teens.

Last week an ADHD patient’s mom asked me what she could do about her son’s mouthiness. It seems over the summer he had missed several doses of his ADHD medication and had become “slack in doing his behavior training”.

Not surprisingly, his mom thought his “hair-trigger mouth” had become much worse than usual. His mouthiness or verbal impulsivity was a major problem now that he was back in school, as he often just seemed to say the first thing that popped into his head and was interrupting both his teachers and her conversations several times a day.

Verbal impulsivity is a trait common to ADHD and several medical, social and psychiatric problems that act just like or mimic ADHD-causing ADHD misdiagnosis.

The idea or concept of verbal impulsivity in children and teens with ADHD may be confusing to some of you, as many parents and teachers usually refer to this ADHD trait as mouthiness or a bad attitude. But once explained, I’m sure you’ll understand how not only words, sentences, and phrases; but speech patterns can be labeled impulsive.

Many ADHD teenagers have verbal impulsivity-an ADHD behavior trait

Let’s take a look at a real life example of an ADHD teen who has verbal impulsivity. His name is John and he is 16 years old and quite intelligent.

John’s mom and dad brought him in to “have his attitude adjusted”. I don’t think anyone, not even a doctor, can work magic…and that’s what it takes to adjust someone’s attitude…real magic.

Over the previous six months, they had noted John’s mouth became “unbearable”. He interrupted so much in class, that few teachers wanted him to stay for the entire period, because he disrupted everyone else’s learning experience. He even blurted out answers to questions when his teachers were quizzing other students during verbal tests. Needless to say, he usually ended up in the nurse’s office or with the principal and his parents were called to come and get him.

At first, everyone thought John was disrupting class to get out of doing class work and taking tests. But…after the tenth episode one week, it was obvious that such was not the case. By that time, he had developed the annoying habit of answering every question for which he didn’t know the answer with the phrase; “Duh…what are you stupid or something?”

If pressured to apologize for his remark, he would immediately act defensive, start cursing and take a threatening position, then refuse to speak. His teacher would spend about 15 to 20 minutes calming him down and more often than not, he would just seem to go back to normal.

In the two weeks before his doctor’s office visit, John had started offering unsolicited opinions about everything. He had referred to one teacher and three female students as “fat cows” and insulted two of his previously thought-of-as-best-friends by calling them drag queens and fags. Once again, when pressured to apologize, he started cursing, made few excuses for his behavior and eventually just quit speaking altogether for hours at a time-defiantly crossing his arms and twisting his face into a snarl.

When a child or a teen blurts out answers out of turn, interrupts conversations, or makes spontaneous, unsolicited, insulting comments about others, he or she is showing verbal impulsivity-an ADHD behavior disorder trait.

What causes an ADHD-behavior problem child to show worsening verbal impulsivity?

That’s the topic of my next post! See you there…
Dr. Frank