Podcast

Dr. Sarah (00:00):

This week’s Beyond the Sessions episode is all about ADHD. And as a mom who has diagnosed ADHD, this is a topic very near and dear to my heart. My whole life I’ve had to figure out my own unique hack to help my neurodiverse brain function in a society that wasn’t exactly made with a brain like mine in mind. That is why when I find a product that I think can help parents and kids with ADHD, I’m so excited to share it with you and also to start using it myself. And that is exactly what happened with BestSelf. BestSelf has so many cool products. They have journals, card decks, and organizational systems that are great for all parents, but they’re an absolute game changer for those of us with ADHD and really for parents and kids alike. My personal favorite is my best self planner that helps me to stay focused in the midst of running my psychology practice, producing courses and podcast episodes and parenting two kids and just trying to find a way to organize and balance all of these moving parts. Plus they also have this really amazing set of cards called Little Talk Deck that I use with my own kids and as a therapist with my young patients. And this deck is really great for taking the guesswork out of coming up with engaging conversation topics and it helps to foster a deep bond and connection. There’s truly something here for everyone.

(01:21):

And because I told them how much I love their products, they’re offering securely attached listeners, 15% off your entire purchase with code DRSARAHBREN15. So just go to bestself.co, that’s bestself.co and use code DRSARAHBREN15 and then DM me and let me know what you bought and how you are liking it.

(01:47):

Ever wonder what psychologists moms talk about when we get together, whether we’re consulting one another about a challenging case or one of our own kids, or just leaning on each other when parenting feels hard, because trust me, even when we do this for a living, it’s still hard. Joining me each week in these special Thursday shows are two of my closest friends, both moms, both psychologists, they’re the people I call when I need a sounding board. These are our unfiltered answers to your parenting questions. We’re letting you in on the conversations the three of us usually have behind closed doors. This is Securely Attached: Beyond the Sessions.

(02:29):

So welcome back everyone to Beyond the Sessions, our segment of securely attached podcast where we answer your listener questions. Dr. Emily Upshur, Dr. Rebecca Hershberg. So glad you’re both here. Thank you for joining me again, always. So today’s question is very near and dear to my own heart because as a person who was diagnosed with ADHD in adulthood, I very personally know how strategies for managing that can be super vital, especially as a parent with ADHD. So let me go ahead and I’ll read the question. Hi, Dr. Bren, my 6-year-old was just diagnosed with ADHD. I’ve been Googling a bit, but was wondering if you could do a podcast episode with some suggestions for what I can do to help support him as someone new to this diagnosis. Thanks so much. I love listening to the podcast. We have so much I could say about ADHD, but I want to jump, I want to just kind of hit the ball off to Emily first. What are some things that come to your mind as ways that this mom can think about ADHD and also support her son? And then just

Dr. Emily (03:45):

That’s a big one. I mean, my first thought, as you were saying that was trying to organize the categories in my head of how to support this kid and how the parent could be supportive. And I think that’s a big part of it, coming up with a roadmap and a strategic plan and feeling like you have some of those boxes filled in and of course they’ll move and shift. But I think if this is a 6-year-old, one of my first things is always having a good relationship with the school and having an open line of communication. So I’m assuming this came up potentially in the school setting since ADHD has to be diagnosed in more than one setting. So open communications with the school, if we’re going broad strokes, I’d say at home, having some really structured parenting strategy is laying out. This is big picture.

(04:39):

I think we can get into the weeds a little bit more later, but I think it’s having sort of a strategy when my child feels, when his body feels out of control, what do I do when he’s physically climbing and unsafe? How do I handle that if he’s bothering his sister, how do I do that? If he’s not paying attention to the instructions or can’t follow multi-step commands, how do I deal with that? And then socially. So those are the big buckets socially, how do I come up with social environments or how do I facilitate play dates or those types of things that are setting my child up to be successful? How do I make sports or creative artistic activities more successful? So I think it’s really taking a big picture, looking at these massive buckets that our children’s lives and coming up with the people that can help us support us in those sort of a plan for how that might go, which knowing it’ll always change, but really sort of like a strategy and then the communication back and forth between those environments and how, I know I didn’t really answer your question, but I think it’s a big one and it’s sort of hard to figure out where to start, where to dig in, but those would be my big balloons.

Dr. Sarah (05:55):

Yeah, I think that makes a lot of sense. I also think understanding a little bit about the ADHD brain too, and one of the things that makes ADHD, ADHD is a difficulty in regulating attention and other executive functioning skills including emotion regulation. But if we have a view of first of all, so I think that’s step one, my step one, I like your steps too, but I think my step one is understanding a little bit about how the ADHD brain works. She says she’s Googling a bit and my guess is more than a bit, because this is how I’m the same, we go down these rabbit holes, there’s so much information, it’s very overwhelming. I feel like finding a source of really vetted information probably through maybe connecting with your pediatrician or a mental health professional or the person that gave that diagnosis instead of Google, because it can be really overwhelming. But

Dr. Rebecca (07:03):

Wait, can I just interrupt you for a second, Sarah? What I was, I think it’s really important when there’s a new diagnosis, I see the word Google and Google can be tricky, whereas we are three mental health professionals who know what the trustworthy sources on this are. And there’s some amazing places to go. ADDitudemagazine.com, I forget the exact website, but we can find it and put it in the show notes. But “ADD” in caps. Russell Barkley is a…

Dr. Emily (07:32):

Russell Barkley, mhmm.

Dr. Rebecca (07:33):

And he wrote a book recently that came out this summer. I believe that is 12 Principles for Raising a Child with ADHD. It’s just really boiled down in very simple language and it’s all science-based. And then the last book that I always recommend to families, including my own, because we have an ADHD person is, I think it’s by Sharon Saline and What Your ADHD Child Wishes You Knew: Working Together to Empower Kids for Success in School and Life

 working together to empower kids for success in school and life. And it’s based on a lot of interviews of kids with ADHD and the things that they wish grownups knew. That’s where I would start, honestly. I mean we can certainly talk on this website about kind of broad strokes, but there’s really, really good resources out there. And Google, it’s not always your friend, but those are the three that I would start with and Emily and Sarah May have others to add, but I think it actually, it is such a big topic and so overwhelming that I don’t want to do this listener a disservice by just like, here’s what I’m thinking about today when it comes to A-D-H-D-A more methodical reading through I think is actually worthwhile. That’s where I would go.

Dr. Emily (08:45):

I love Russell Barkley, so I would definitely recommend anything. Russell Barkley, there’s also social media attached to his work and it’s really research based and a lot of cutting edge stuff and has always been that way. So I support that wholeheartedly and very practical.

Dr. Rebecca (09:01):

Also, I mean it’s research, but I don’t want parents to get about, it has to do with the brain, all that. It’s like, yes. And it’s very just like you can take away concrete tips within minutes.

Dr. Emily (09:12):

I guess the other thing, I think that, I love your point there because another book called Smart But Scattered, and I think I really love, I recommend that book a lot too because I think one of the things that it’s, Sarah, back to your point, I think in the beginning of a little of what is the brain like is there’s a lot of misconceptions around ADHD. It has nothing to do with intelligence, really. There are different things. And so I think it’s important to educate yourself on exactly what’s happening. And the other thing that kept thinking this whole time was, so your child, 6-year-old gets a diagnosis of a ADHD. What does that look like for your child? Right? We’re really talking about a collection of symptoms and they’re going to be unique for different children and different ages. And really, the thing I always say to parents is, I’m going to probably treat your kid the same regardless of if they have a diagnosis or not. It’s sort of can be helpful in containing and I think give some direction, but thinking about what the biggest symptoms are for you and your child and how to address those is also probably a better place to start than learning everything under the sun about ADHD.

Dr. Rebecca (10:32):

The one broad strokes point that I actually should have started with that I think is important that originally I think I heard from Russell Barkley is just how, what a misnomer ADHD is for that kind of a really big disservice. We did ourselves as a field and we did families aiming at that because it’s actually more of an executive functioning and emotional regulation disorder. And so a lot of times parents will say, well, I know my kid doesn’t have ADHD because they’re not hyper and they have no trouble paying attention. And it’s sort of like, okay, I understand why you would think that that would be, but as it turns out, trit, there’s so many symptoms, just to your point, Emily, of how different it can look. It really can look vastly different from one child to the next depending on the presentation. And so just to be aware of that.

Dr. Sarah (11:26):

Yeah, it also can present really differently in girls and boys, which I think is another thing. A lot of girls, I’ve heard some statistic, I’m going to ruin the statistics, I don’t remember it exactly, but it’s something like 50 plus percent of women who have ADHD are not diagnosed with it because girls tend to internalize their symptoms more and boys tend not to, obviously not always the case, but it’s just more common for girls to fly under the radar. I think we’re getting better as a field of recognizing the different ways that it can show up. But I think I did not get diagnosed until I was an adult, in part because I had all these compensatory strategies that worked and nobody knew. And it was, in looking back now, it’s almost like, oh my God, it’s so obvious that I had ADHD. But it was like those things in and of themselves did not raise a bell. And it wasn’t until you looked backwards and were like, duh, duh. But I guess my point to that is it’s not always as obvious and a kids can have strong compensatory strategies that mask it and some don’t. And it’s more, it breaks through the surface more obviously.

Dr. Rebecca (12:56):

So that would be kind of when it’s there and not perceived or diagnosed. And then the other thing that happens with ADHD is that it’s not there and then it is perceived and diagnosed. And that happens a lot in boys, young boys, particularly boys of color. It’s one of those diagnoses that is both over and underdiagnosed at the same time if you slice the pie differently. And so frankly, the best thing about this listener’s question I thought, is that she got the diagnosis. It wasn’t like, I’m wondering if my kid has this, and I’ve taken a deep dive on Google because it is a real diagnosis when ADHD is there. It’s real. There are differences in your kid’s brain. It’s important, it’s common and highly treatable. But really it’s a thing. A lot of people in older generations don’t necessarily think it’s a thing. It is. There’s a ton of science and because it can look so different in different people, there’s a tendency either to discount it as important or misdiagnose it or misunderstand it. And that’s why I think our pointing you toward real evidence-based professionals and mental health professionals who’ve devoted their lives to this is kind of the best service we can do.

Dr. Emily (14:19):

And I think even as a parent, right, as a parent, I have a child with ADHD, and as a parent, I think it’s a good reminder, right? Because you see, it’s internally frustrating as a parent to see your child have these really inconsistent pockets of things they can do. My child can build complex Lego systems and complex things and sit for hours and do that and can’t attend to five minutes of a math worksheet or can, but it’s much more painful. So I think as a parent reminding ourselves of that too, in terms of the question, this listener’s question of how you can be supportive is also like, you might learn all this, but you might have to remind yourself over and over again of some of these things because really it’s not, to Rebecca’s point, it’s a different brain. It’s a different type of interaction with the world. And so if you don’t have, I don’t definitively don’t have ADHD, it’s I have to be very, very mindful to mindful, really try to understand it so that I can have the best interactions and the most mindful parenting with it.

Dr. Sarah (15:37):

Yeah, it’s interesting too. I think we’re moving as a field and hopefully as a society more towards this idea of looking at ADHD from a strengths, strengths-based lens of really all diagnostic mental health issues and brain divergences diverse brains as being strength-based. But this idea of, okay, for example, Emily, you were just saying that your son can do these really complex Lego systems and hyperfocus for hours. That is an example of an ADHD brain not regulating attention, but it doesn’t look like what we think of. It’s hyper focusing on stuff, and that’s a strength, but it’s part of the dysfunction of the brain. I’m using dysfunction in quotes, but that’s it behaving in an anomalous way, in a non-typical way. Just like when he sits down to do the homework on the math, he has a hard time regulating his focus and his attention and his body not sitting still.

(16:49):

That’s all because also, but we were very quick to look at that, not being able to sit still, not be able to regulate our attention with the math homework and say, that’s a deficit. And then not look being able to regulate your focus with the Lego and by not being able to regulate it. I mean, hyper-focus for hours on something and we forget to say, Hey, that’s actually still the deficit, that’s still the brain doing its weird thing, but it’s really, really strengths-based. And so I think, I guess to tie this into this listener’s question is how can you look at some of the things that your child’s brain does as strengths as an ability to tap into complex thinking and things that interest them? It’s also an interest based regulating thing. The brain of an ADHD person can regulate attention better when there’s a lot of interest.

(17:53):

And so knowing that allows you to work with the brain rather than against it. How do you gamify things for a kid? ADHD brains don’t like boring, mundane, non-no things. They like complexity. They like things that are interesting to them. So if you can infuse mundane, boring tasks that your ADHD kid wants to tend to avoid, if you can infuse them with things that they’re interested in, making it a game. We talk about gamification a lot when we’re working with kids with ADHD, you can activate that interest. So you’re basically kind of hacking a little bit of what makes their brain unique and special. So that’s just something to think about and a thread to pull on. Go find resources that say strength, that’ll look at it through strengths-based lens, which I think also Barkley does well.

Dr. Emily (18:48):

Yeah, and I think even if it’s not so much active in those moments, I think that’s a great point not to undervalue that, but I also think sort of balancing out your child’s life too. Making sure if one area is a real struggle, that there are areas that they really builds them up that resonates for them. So let’s say school is hard, but they love guitar. Make sure that you prioritize and value and give sort of weight to those other interests that are self-esteem building and competency building. And to your point, strengths-based things because there are a lot of, we could flip this upside down, there’s a lot of good qualities as well.

Dr. Sarah (19:34):

Yeah, I love that. And so I do think, just to sort of summarize, one is learn a little bit about the structure of the ADHD brain. Learn a little bit about what makes an ADHD brain different, what it means to regulate attention or regulate executive functioning skills or regulate emotions. If you can learn about that, you’re going to be in a really good place. And in terms of just understanding what’s happening when your kid is having a hard time with something, how to look at it from a strengths-based lens, and then really being thoughtful about where your sources of information are and going to those before you go to Google. I think if you start there, you’ll have a lot, lot to work with. And then another thing that Rebecca said that I think is really important is get an actual diagnosis. Because this is not so obvious necessarily.

(20:33):

It can be something that is a child who looks unquote classic. ADHD might not have A-D-H-D-A kid that doesn’t might. So if you’re not sure, if you don’t really have, if you could feel like something’s not right, but you’re not really sure what it is or you think it’s ADHD, but it’s worth it, I think to go and actually meet with a mental health professional who can actually diagnose. And that may or may not involve a neuropsych evaluation. That’s not the, yes, a neuropsych evaluation is pretty much the gold standard for getting a diagnosis of ADHD, but there are other ways to get that diagnosis that aren’t as intensive. So I think if you go to our website, Emily, our website, the upshurbren.com, we have resources there as well for if you’re in New York state, obviously for working with a mental health professional that is able to diagnose ADHD. If you’re not in New York state, then you can check with your pediatrician because they’ll definitely know where to send you. But I hope this is helpful.

Dr. Emily (21:40):

Yeah.

Dr. Rebecca (21:41):

Thanks. Always such a pleasure to be here and have these conversations.

Dr. Sarah (21:47):Thank you so much for listening. As you can hear, parenting is not one size fits all. It’s nuanced and it’s complicated. So I really hope that this series where we’re answering your questions really helps you to cut through some of the noise and find out what works best for you and your unique child. If you have a burning parenting question, something you’re struggling to navigate or a topic you really want us to shed light on or share research about, we want to know, go to drsarahbren.com/question to send in anything that you want, Rebecca, Emily, and me to answer in this new series Securely Attached: Beyond the Sessions. That’s drsarahbren.com/question. And check back for a brand new securely attached next Tuesday. And until then, don’t be a stranger.


✨We want to hear from you! Go to https://drsarahbren.com/question to send us a question or a topic you want to hear us answer on Securely Attached – Beyond the Sessions! ✨

167. BTS: What can parents do to help support their child with ADHD?

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