Attention deficit hyperactivity disorder (ADHD) may cause problems with a person’s understanding of object permanence. Object permanence refers to the ability to understand that objects exist when they are out of sight.
While technically speaking, the potential issue in people with attention deficit hyperactivity disorder (ADHD) is not a problem with actual object permanence, there is no widely accepted term. People therefore use both the terms “object permanence” and “object constancy,” to refer to the “out of sign, out of mind” phenomenon which affects some people with ADHD. For the purpose of this article, we will use the term “object permanence.”
Problems with object permanence can sometimes cause issues with relationships in children, adolescents, and adults with ADHD. That said, there are a number of things people can do to control this symptom of ADHD.
Keep reading to learn more about how object permanence works, why it may be worse in people with ADHD, and some coping tips.
What is object permanence?
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Object permanence, put simply, is the ability to understand that an object continues to exist, even though it can no longer be seen, heard or touched.
Swiss psychologist Jean Piaget was the first person to coin the term in the 1960s. He observed how babies reacted when a favorite toy was shown to, and then hidden, from them. Babies who had not developed object permanence would appear confused or upset, as if the object had ceased to exist. Babies who had developed object permanence would continue to look for the toy.
According to The American Academy of Pediatrics, some babies can demonstrate an understanding of object permanence as early as 4–5 months of age. However, most infants do not really grasp the concept until around 9 months old.
Why is object permanence worse in people with ADHD?
ADHD is a neurodevelopmental disorder that may include some of the following traits or symptoms:
- inattention to tasks and difficulty keeping focused
- hyperactivity, including fidgeting, restlessness, and constant moving about
- impulsivity, including hasty or harmful decision-making, risk-taking, and excessive interruption
Most people with ADHD receive their diagnosis in childhood. However, others may receive their diagnosis in adulthood. According to the American Psychiatric Association, around 8.4% of children and 2.5% of adults have ADHD. It is more common in boys than girls, according to the APA.
There is not a great deal of strong research to prove that problems with object permanence may arise because of ADHD, or vice versa. Most research around object permanence focuses on infants and development during early infancy, while the average age of diagnosis for ADHD is 7 years old.
However, ADHD symptoms include difficulty in remembering that objects, tasks, or items exist, when the person with ADHD cannot see, hear, or touch them.
People with ADHD typically:
- forget about objects or tasks, especially if those objects or tasks are not right in front of them
- are easily distracted by present thoughts, people, items or tasks
Anecdotally, parents of children with ADHD often say that their children do realize things exist when they cannot see them, but have no idea, or do not care, where those things might be.
Object permanence is a key step in forming secure attachments with others. Babies who understand that a person exists, even when they are not present, are better able to form secure attachments with care-givers. This ability helps them to form secure relationships throughout life.
Studies have found clear associations between insecure attachment and people with ADHD. A 2021 study has found that insecure attachment in early infancy can increase problems in later relationships, such as the suppression of emotions, and disengaging from others.
Object permanence in adults with ADHD
ADHD symptoms often persist into adulthood, according to the Centers for Disease Control and Prevention (CDC). Adults with ADHD may not realize they have the condition.
Problems with object permanence in adults with ADHD may result in the following behaviors:
- forgetting daily tasks, such as paying bills, doing chores, or remembering to keep appointments
- forgetting to take medication
- being unable to form secure attachments with parents, siblings, peers or partners
- forgetting to stay in touch, return emails and texts, or respond to invitations
How might it affect relationships?
A 2015 review into the relationships of children with ADHD with peers and friends, found that children with ADHD tend to:
- be less liked by their peers
- have fewer friends
- experience more rejection and isolation
- have fewer “mutual” relationships
- experience more aggression and conflict within relationships
- join deviant peer groups in adolescence
The same review estimates that 50–70% of children with ADHD experience difficulties in forming and keeping relationships with their peers.
An older 2012 study on the relationships of 90 adults with ADHD found that participants were more likely to:
- be more immature
- act out in defense
- be more neurotic
- have insecure attachments
The tendency to forget important tasks, often essential to the harmonious running of a relationship or household, can also cause conflicts.
A 2018 review into ADHD found that people with the disorder are more likely to be substance abusers, demonstrate rule-breaking behaviors, and have mood disorders — all of which could negatively impact personal relationships.
Coping with absence of object permanence
The following tips may help adults overcome symptoms associated with object permanence problems, such as forgetfulness:
- not opening texts, emails and messages until they are sure they can respond immediately
- choosing a spot to place essential items, such as medication, to-do lists and important devices such as phones
- setting reminders for appointments and tasks in an online calendar with an alert function
- setting recurring appointments with loved ones for visits or calls
It is important to note that while ADHD may cause some challenges, there are also potential benefits to the condition.
Summary
Object permanence is a key part of establishing secure attachments in early life.
People with ADHD may be less likely to form secure relationships because the condition means that people are more likely to forget important tasks, objects, and people when they are not present.
Inattention, impulsivity, forgetfulness, and hyperactivity may cause conflict in relationships of people with ADHD, however, there are a number of coping tips people can try to manage any challenges.
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