Writing from lived experience and now research, ALF volunteer, Steve Ollington, shares his article covering the topics of ADHD, the "school-to-prison pipeline" and adolescence.
Introduction
An unfortunately (still) common misconception about ADHD is that it is mainly uncontrollable teenage boys getting themselves into trouble. Thankfully people are starting to learn this is incorrect, and that ADHD spans whole lifetimes into adulthood. But that very misconception has also been responsible for women and girls, who are just as affected by ADHD, being held back from getting much needed diagnoses.
It is clear that for a long time there has been a bias in diagnosis due to the way ADHD tends to manifest differently between boys and girls (generally speaking), for example where boys may be more disruptive at school while girls internalise the symptoms. This is changing, but there is still some way to go.
ADHD standing out more in boys is not just due to the traits of ADHD itself, it is also to do with societal expectations of gender and as well as other factors. For example, girls internalising instead of ‘acting up’ like boys is often due to the pressures of the ways that society expects children to behave, being more forgiving towards ‘naughty’ boys and more judgemental towards ‘boisterous’ girls.
In other words, while ADHD boys may well get into more trouble, they’re also allowed to be themselves more than ADHD girls are – something which has led to additional mental health problems in late-diagnosed women, let alone the impacts that the lack of diagnosis, support, and medication may have had on their life pathways. And it doesn’t end there, when girls become women, they are still under greater pressure to suppress their symptoms in adulthood, too. Not that all people with ADHD, men and women, don’t have to mask and cope in order to try to fit, to be accepted in a neurotypical society.
While teenagers getting into trouble is not exclusive to those with ADHD, they are significantly over-represented in the school-to-prison pipeline, with ADHD children being 100 times more likely to be suspended or expelled from school, and estimates that 25% of prisoners are ADHD despite people with ADHD making up only around 2.5% of the general population – although both of these figures should be considered as conservative, given recent but as-yet unproven discussions that over half of the prison population are neurodivergent, and many more people in general are ADHD without knowing it, or simply undiagnosed. Thankfully there are organisations like ALF seeking to tackle the school-to-prison pipeline.
Even when we zoom into ADHD teens as a segment, extra problems at school and with the legal system is not exclusive to just boys. Both boys and girls with ADHD are impacted by the impulsivity, emotional regulation challenges, justice sensitivity, rejection sensitivity, hyperactivity (in some), low frustration tolerance, and more.
There doesn’t seem to be any research to confirm (studies tend to look at both boys and girls together, or just boys, without any direct comparisons) but given that boys in England have higher school expulsion rates than girls, and the UK prison population is 96% male and 4% female, it is reasonable to assume that boys with ADHD are more likely to end up in the school-to-prison pipeline than girls with ADHD.
Circling back to the start then, I am going give my (unchecked and unproven) theory as a man with ADHD, doing a PhD on ADHD, who was expelled from multiple schools, had regular physical altercations, frequent run-ins with the law, and very nearly ended up in prison – I was most definitely in the school-to-prison pipeline in my teens. I was just lucky to have certain people around me to pull me out of it on time. Even then I still had more of these types of challenges than most. It wasn’t really until my early thirties when I got an ADHD diagnosis, started medication, and met a very patient woman who I somehow convinced to marry me, before the prison potential was finally, truly out of the frame.
Whilst I am using studies to inform this theory, I am also speaking from experience. Hence the subject being teenage boys with ADHD – some of what follows is from self-reflection and self-observations…
The Perfect Storm Theory of ADHD Teenage Boys and Confrontation
Some of the challenges of ADHD are well known in terms of the school-to-prison pipeline, so too are various environmental factors, and I’m not the first to consider ADHD combined with adolescence. However, this theory looks at the combined effect of some specific ADHD traits, adolescent behaviours, and the quest for identity - as relevant to the entry and transition periods into the school-to-prison pipeline for teenage boys with ADHD.
“For a Conflict Cocktail, mix ADHD with adolescence, identity, group and societal expectations” - Me
The ADHD Layer:
Oppositional Defiant Disorder (ODD)
Oppositional Defiant Disorder (ODD) manifests as defiant or argumentative behaviour, particularly towards authority figures, tending to result in frequent clashes with those who enforce rules or expectations. 40% of people with ADHD also meet the criteria for ODD, compared to just 3.3% of the general population.
Justice Sensitivity
Many individuals with ADHD possess heightened "justice sensitivity", a strong emotional response to perceived unfairness or injustice. While this can drive moral and ethical actions, it can also lead to excessive focus on righting perceived wrongs, even in situations where compromise or backing down would be more practical.
Impulsivity and Emotional Dysregulation
Impulsivity, a core trait of ADHD, can lead to risk-taking and snap decisions without fully considering the consequences. Combined with emotional dysregulation, which makes it harder to manage intense feelings, this impulsivity can turn minor disagreements into major confrontations. Emotional dysregulation often leads to overreactions or escalations, especially in situations perceived as unfair.
Low Frustration Tolerance
People with ADHD often experience low frustration tolerance, meaning they are quick to become overwhelmed or irritated when faced with obstacles or perceived injustices. This trait can amplify conflicts, particularly when they (commonly) feel misunderstood or dismissed by authority figures.
Rejection Sensitivity
People with ADHD frequently experience rejection sensitive dysphoria (RSD), a heightened reaction to real or perceived criticism. In confrontations, this sensitivity can make them feel personally attacked, causing defensive behaviours that may escalate the situation further.
Determination and Resilience
While determination and resilience are often strengths of those with ADHD, these traits can sometimes manifest as stubbornness and a refusal to back down. In arguments or conflicts, this persistence can lead to prolonged standoffs, particularly if the individual believes they are morally or ethically justified.
The Adolescence Layer
1. Hormonal Changes and Increased Testosterone Levels
During adolescence, boys experience a surge in testosterone, which is associated with increased aggression, dominance-seeking behaviour, and heightened emotional reactivity. These changes can make boys more prone to conflict and defiance, particularly when they perceive challenges to their autonomy or authority.
2. Cognitive Development and Emotional Regulation
The adolescent brain is still developing, particularly in areas like the prefrontal cortex, which is responsible for impulse control, decision-making, and emotional regulation (even without the ADHD effect on these). This immaturity can lead to impulsive behaviours, difficulty processing consequences, and challenges managing anger or frustration.
The Identity Layer
1. Search for Identity and Belonging
Adolescents are navigating the search for identity and a desire to belong, which may lead them to adopt behaviours they believe will earn them respect or admiration. For teenagers with ADHD, the challenges of fitting in can be heightened due to difficulties in excelling at activities that bring others together, such as sports, academics, or other group interests.
2. Self-fulfilling Prophecy
Feeling like misfits and struggling to find a role within their peer groups, unable to adopt the identity of "the smart one," "the popular one," "the athlete,", etc… they may turn to what comes easily – playing up to the "naughty" identity they’ve been labelled with due to ADHD manifestations. They may then gravitate towards other likeminded individuals, creating a group with that identity.
From there, it can be seen as a natural progression to escalate their identity from "naughty" to "tough" or "hard", which when played up to, results in aggression and violence.
The Group Pressure Layer
1. Friend Group Expectations
Boys with ADHD often seek to climb the perceived "hierarchy" of peer groups by adopting and reinforcing behaviours they believe will elevate their status. Bridging to the identity layer, this can lead to playing into roles that gain peer approval whether or not it aligns with their authentic identity.
2. Amplified Adolescent Posturing
Group pressures, such as the need to appear "tough" or impress peers can be taken to extremes as peer influence is strongly tied to the drive to appear "cool" or "gangster." Also at this developmental stage, impressing girls often becomes a significant motivator, but while many then-women will change preferences with maturity, these destructive male identities continue on.
Additionally, the heightened sensitivity to rejection common in ADHD can make peer disapproval particularly impactful, leading to intensified efforts to gain acceptance.
The Societal Expectations Layer
1. Neurodivergent in a Neuronormative Society
For some people with ADHD, criminality may also seem like the only available option – or certainly the far easier option. Due to difficulties fitting into societal norms and meeting expectations in traditional settings like school and work.
The struggles with authority, poor academic performance, and workplace challenges, leaving many feeling excluded or alienated from following a more productive path, guided by a lack of self-belief that they can. Without adequate support or understanding, these teenagers may face rejection and frustration, increasing the risk of engaging in criminal behaviour as a coping mechanism or even as a means of survival.
Escalation in Social Interactions
A mix of impulsivity and a strong sense of justice can lead to confrontations. For instance, a boy with ADHD who perceives a teacher’s reprimand as unfair may argue over minor details, viewing the situation as a matter of principle. Similarly, encounters with authority figures, such as law enforcement, can escalate if the officer approaches with a hardline attitude, triggering defensiveness and confrontation.
Impact of Societal Bullying Norms
Bullying significantly influences aggressive or defiant behaviours in boys with ADHD, leaving many feeling isolated and misunderstood. Facing higher rates of overt and subtle bullying across home, school, and peer groups, they often adopt defensive behaviours like projecting toughness to deter mistreatment, and will often fight back even if there are other, better ways to resolve matters.
Understanding ADHD Behaviour and Managing Confrontation
Not all boys with ADHD exhibit confrontational behaviour, and many that do are not necessarily doing it because they are ‘bad’. Many of them will be kind-hearted and polite, with no intent to cause harm, and will go out of their way to help people. However, their neurological traits, emotional sensitivities, and external pressures can sometimes lead to conflict.
Often, this arises not from malice but from a genuine belief in standing up for themselves or others, driven by a strong sense of fairness. This moral conviction can result in refusal to back down, escalating situations further.
The approach taken by authority figures plays a critical role in de-escalating such conflicts. Hardline or aggressive approaches often trigger defensiveness, worsening the situation. In contrast, calm and respectful communication, which allows individuals with ADHD to feel heard, is more likely to defuse tension and encourage cooperation.
ADHD is often misunderstood, with stereotypes associating it with "bad behaviour." However, many boys with ADHD are motivated by a desire to do the right thing and are caught in conflict due to a mix of neurological, emotional, and social factors.
By learning about ADHD, recognising these traits and adopting supportive strategies, parents, teachers, and law enforcement can help boys with ADHD channel their determination, creativity, and moral conviction into positive outcomes, rather than conflict. Because there are strengths to ADHD, it’s not all just challenges – but those strengths are dependant on environment, and understanding.