‘What you see, is not always what you get.’
How many examples can you think of in working with your neurodivergent teen or young adult child where this adage rings particularly true?
Parents, educators, and neurodivergent individuals have known for some time, particularly for ADHD, that many of the day to day challenges of what you see, may not actually indicate the overall difficulties and frustrations experienced by the individual.
Otherwise known as the ADHD Iceberg.
This comprehensive guide explores the ADHD Iceberg, offering parents and educators an in-depth understanding of this unique visualization of ADHD complexities that often lie below the surface. We’ll explore scientific insights, practical advice, and ways to apply this knowledge in supporting your teen or young adult.
Click here to jump to the TL;DR summary
What You Need to Know About the ADHD Iceberg
What is the ADHD Iceberg?
The visible part of the iceberg represents the core symptoms of ADHD, such as inattention, hyperactivity, and impulsivity, which are well-documented and widely recognized. These are what we commonly see discussed in clinical research, where medication trials have been primarily dedicated, and what has become established in our educational institutions.
Yet, the hidden part of the iceberg encompasses a range of issues that individuals with ADHD may experience, including emotional dysregulation, difficulties with executive functioning skills like planning, organization, and time management, as well as challenges in social relationships. In addition, Ziegler and colleagues recognize the various comorbid conditions such as anxiety, depression, autism, and others that can significantly shape what is outwardly observed by others.
Is the ADHD Iceberg evidence-based?
While no formal peer-reviewed research publications have cited the ADHD Iceberg, it has been utilized and described in a variety of texts and teaching materials. The ADHD Iceberg first appeared in print in the late 1990’s. Created by Chris A. Ziegler Dendy, MS, educator, mental health practitioner, and author of many notable books about ADHD, along with her son Alex, the visualization depicted what Ziegler knew her son regularly faced both above and below the surface. It’s been translated into multiple languages and can be downloaded for free here: The ADHD Iceberg
How to Apply The ADHD Iceberg With Your Teen: A Parent’s Perspective
Understanding What’s Above and Below The Surface
As a parent, recognizing that ADHD involves both visible symptoms and invisible challenges is the first step toward effective support for your teen or young adult.
Know that the visible parts, such as hyperactivity or inattention which you frequently observe, may just be the tip of the iceberg for your child.
Below the surface, your teen or young adult might also be experiencing challenges with executive functioning, emotional regulation, and social interactions. Some of these may be secondary behaviors that may not occur with the same frequency. Others may be by-products or consequences of difficulties with inattention or hyperactivity. Other below the surface parts of the ADHD Iceberg may be related to challenges with motivation or barriers in the environment that make it more difficult for your teen to succeed.
As you begin to learn more about the ADHD Iceberg, here are several strategies to help you apply the visualization with your child:
Create a Personalized ADHD Iceberg Visualization
As you begin, take some time with your child to create a personalized Iceberg visualization. First, begin by answering “How do others know I have ADHD?” These are the elements that are above the surface and things that others may commonly see as outward and observable behaviors. Above the surface items listed may be both challenges facing your neurodivergent teen, or areas that are unique to them.
Then, start to review the below the surface items. These are not so obvious behaviors, thoughts, or concerns your teen faces that others may not necessarily see. Aim to help your teen answer: “What are the challenges and barriers right now?” “What do I have to work hard at to succeed?” “What are the things that others don’t know I struggle with?”
Sometimes creating the ADHD Iceberg visualization can be frustrating or challenging for neurodivergent learners. Be patient with your teen. Set aside time when they’re free of distractions and in a comfortable, relaxed environment to start the discussion. If it’s initially challenging, take a break and revisit the conversation at a later time.
For a free .pdf downloadable worksheet to start your ADHD Iceberg visualization, sign up below.
Identify Strategies for Home
Once you have the ADHD Iceberg visualization created, then it can become easier to identify strategies and goals that you and your teen can work towards to support their success. Some strategies to consider for home include:
- Creating a Structured Environment: Individuals with ADHD thrive in environments where they know what to expect. Work with your teen to establish consistent routines, organized living spaces, and clear expectations for life at home. This doesn’t mean rigidity, but rather a set of ground rules to work from.
- Embed Executive Functioning Supports: There are hundreds of tools and supports that can help boost the below the surface challenges with executive functioning. Use the iceberg visualization to help your teen identify 1-2 areas they’d like to work on first, and then use the Executive Functioning 101 Resource Hub to generate strategies on how you can support them in that area at home.
- Enhance Social Skills Opportunities: It’s often misunderstood just how much the items in the ADHD Iceberg can impact your teen’s relationships and social behaviors. Behaviors like missing assignments, running late, or forgetting important dates can over time result in negative experiences with others. Spend time at home talking about social skills, rehearsing and role playing social situations, and helping your teen understand the complex ways that ADHD impacts their relationships.
- Model Good Behaviors: Your teen may have listed things like high stress, anxiety, intense emotions or struggles with additional mental health challenges on the ADHD Iceberg. If that’s the case, it’s important to model healthy coping mechanisms for these experiences. Be a good example to your teen of healthy behaviors like exercise, using mindfulness, seeking professional support, and getting sufficient sleep.
Identify Strategies for School and Work
Strategies don’t have to be just limited to home. As a parent, you can also help your teen succeed with the ADHD Iceberg at school and work. These might include:
- Creating a Collaborative Team: If your teen or young adult feels comfortable, share the ADHD Iceberg with their educational or vocational team. Have a discussion about the supports that are happening at home and how you might be able to collaborate together with school or work to better support the above and below the surface challenges.
- Advocate for Individualized Supports: No two ADHD Iceberg visualizations will be the same as each neurodivergent teen has their own unique set of strengths and challenges. Once you have the visualization in place, it can be an effective tool to advocate for specific strategies, accommodations and supports that are tailored to the specific behaviors that are below the surface.
- Build a Social Community: Encourage your teen or young adult to connect with support networks, whether online communities, support groups, or clubs related to their interests. These networks can provide valuable advice, coping strategies, and a sense of belonging.
- Focus on Strengths and Passions: The ADHD Iceberg shouldn’t only focus on what’s challenging. It’s essential to help your teen recognize and nurture the unique strengths and talents that also are on the iceberg. Support your child by connecting them with school and work environments that help them pursue their passions and interests.
Understanding and applying the ADHD Iceberg concept in everyday life is about celebrating the visible achievements while also diving deep to support and uplift your teen through the struggles that others may not always immediately see. By embracing both the challenges and strengths, you can navigate the complex waters of ADHD but still explore the vast potential beneath the surface.
Additional Resources and Tools
Finally, Life Skills Advocate specializes in many of the “below the surface” behaviors, including executive functioning skills. Because we know how important customized interventions are, we’ve assembled some additional tools and resources you may find helpful for your teen or young adult. Check out the following resources:
- The Real Life Executive Functioning Workbook (coupon code LSA20 for 20% off)
- From School to Home: How to Promote Generalization of Executive Functioning Skills
- For a list of IEP goals for individuals with ADHD see the Executive Functioning IEP Goal Resource Hub
- For a trained professional who can support your learner with their ADHD Iceberg journey, check out our Executive Functioning Coaching programs.
TL;DR – (Too Long, Didn’t Read)
This post offers a comprehensive guide for parents and educators on navigating the complexities of ADHD in teens and young adults, emphasizing the “ADHD Iceberg” visualization to illustrate that the visible symptoms of ADHD (such as inattention, hyperactivity, and impulsivity) are just the tip of the iceberg.
Below the surface, neurodivergent individuals, including those with ADHD often face additional challenges including emotional dysregulation, difficulties with executive functioning, and social challenges.
This guide suggests creating a personalized ADHD Iceberg visualization for each learner to understand and address both visible and hidden challenges. Once the visualization has been created, it’s easier to identify and implement additional strategies for a teen, including:
- providing structured environments at home
- enhancing executive functioning and social skills
- modeling healthy behaviors
- advocating for individualized supports in educational and vocational settings
- and encouraging the building of a supportive social community.
Finally, it’s important to also focus on every individual’s strengths and passions. The ADHD Iceberg is one way to foster a supportive environment that recognizes and nurtures your teen or young adult’s unique talents alongside managing the skills they continue to grow in.
Further Reading
- Chris A. Zeigler Dendy Consulting – The ADHD Iceberg
- Life Skills Advocate: The Real Life Executive Functioning Workbook (coupon code LSA20 for 20% off)
- Life Skills Advocate: From School to Home: How to Promote Generalization of Executive Functioning Skills
- Life Skills Advocate: Emotional Regulation and ADHD: What You Need to Know
- Life Skills Advocate: Social Isolation and ADHD – How to Reconnect With Others for More Meaningful Relationships
- Executive Functioning IEP Goal Resource Hub
- Executive Functioning Coaching