So you think your young’n is exhibiting some ADHD traits. Maybe she seems to have a bit more trouble transitioning or initiating tasks than others her age, or perhaps he has particularly strong emotional reactions to criticism or frustration. Now what?
Understatement: Parenting is hard. Under-er statement: Parenting + ADHD can be even harder. One of the reasons behavioral therapy for ADHD is hit or miss is because behavioral treatments aren’t really that effective long term or across multiple settings. ADHD differs from other mental illnesses by being a genetic neurodevelopmental disability characterized by differences in the brain, so it’s less of something you treat and more of something you manage. Though there are new discoveries and studies happening every day, currently the most effective treatment for ADHD by far is stimulant medication.
That being said, there are plenty of things caregivers can – and should – do to support the small ADHDers in their life; and many have the added bonus of being super helpful for most children. So when ADHD kids come in for therapy, I spend the majority of my time working with the adults that care for them. Everyone is different, but here’s a few of the suggestions I give frequently.*
- Consult with their pediatrician first. There are several medical conditions that can mimic or exacerbate ADHD symptoms, and it’s important to rule out/in autism spectrum disorder – which overlaps with ADHD quite a bit.
- ADHD is not a disorder of knowing what to do, it is a disorder of doing what you know. I’m going to repeat that because it’s so important: ADHD is not a disorder of knowing what to do. It is a disorder of doing what you know. Maybe I’ll hang this in my office somewhere, because I think this is where we as adults fail when it comes to addressing ADHD kids. We tend to approach their shortcomings as “teaching moments.” We lecture, or try to explain the right way to do something and why what they did was the wrong way. And they’ve already tuned us out. Because most of the time, they know it. They just can’t do it. They don’t need someone to tell them what to do; they need someone to model how to do it. So with that in mind:
- Remember that until their brains are developed to do so on their own, you are their emotional regulator. They will follow your lead. Stay calm and be as direct as you can. Be present with them as long as you’re able, and help them de-escalate. Show them what it looks like to be in control of your reactions. It’s always a good thing to teach coping skills like deep breathing and taking a walk, but remember that even if they know those things they won’t be able to do them on their own – while upset – for a long time. Brains with ADHD are on average three years behind neurotypical brains developmentally. I hate saying that (selfishly), but it is pretty well-supported. Try to use this information to hold realistic expectations and give your child, and yourself, a break.
- However: Let ADHD kids gain competence whenever possible. While this is important for all kids, it is essential for ADHD kids. It is soooo hard to watch a kid struggle with a task we could complete in seven seconds (especially if we also have ADHD). But the more you give them opportunity to make choices and take agency, the stronger their neural pathways will become and the less you will need to engage in power struggles.
- By age 12, researchers estimate that ADHD kids receive 20,000 more negative comments than their neurotypical peers. This not only sucks, it might make ADHD symptoms worse. Whatever positive affirmation you’re giving, double it. Some parents have found it helpful to carry coins or poker chips in their pocket and remove one for every positive comment, in order to remind themselves to point out what their kids are doing right.
- Exercise! Make sure your ADHD kids are getting plenty of outside and activity time – especially if they are having behavior issues. I really discourage taking away physical activity or outside recreation as a means of discipline, because that can make behavior much worse.
- Amp up the protein and omega-3s (like fish) in their diet. Protein is a more steady source of dopamine and omega-3s can improve memory.
- Prioritize sleep hygiene for ADHD kids even more than their peers. We tend to need even more sleep to function well, and difficulty falling/staying asleep is very common for us. Things like a consistent bedtime routine (even on weekends), a long wind down period with no screens, and guided meditation or reading can go a long way.
- Don’t be scared of meds. Stimulant medication gets a really bad rep, but the truth is it’s extremely safe. The first documented use of stimulants for ADHD symptoms in kids was in 1937. The two most common medications, methylphenidate and amphetamine/dextroamphetamine (Ritalin and Adderall), have been in circulation since the 50s. Therapy and environmental support is important too, but medication is a crucial part of a multimodal approach because it can actually help the brain retain the benefits of behavioral interventions.
- Talk with them about their diagnosis. Don’t make it shameful. Sometimes we withhold this kind of information from kids to prevent them from feeling abnormal or alienated, or using their disability as a “crutch.” I assure you, they already feel abnormal and alienated. Providing a name for that alienation is a powerful gift you can give your child. Remember that without speaking about their ADHD, you are not only hiding the limitations that come with it – you are also hiding their unique strengths. I like to use the analogy of Spiderman when talking with kids about ADHD…when Spiderman discovered his powers, it was really hard to get the hang of them at first. He couldn’t figure out how to make his web work, and he was knocking over lamps and stuff. But he trained, and practiced, and eventually he could practically fly. That’s what they can do: fly.
*I am not a parent. My experience and education/training can speak to what research says is best for child development and ADHD treatment, but my recommendations on how to get there are based on what I’ve observed through my work and not what I have tried personally.
Parents: What do you do with your ADHD kids that works?
Adult ADHDers: What kind of support do you wish you had as a kid?