Dr. Norrine (00:00:00):

Of course parents come to me. Well, they can pay attention to fill in the blank TikTok sports their friends. So let’s pause for a second and understand the deficit isn’t the ability to pay attention. The deficit is the brain doesn’t automatically regulate where the attention should go. So yes, parent, you are absolutely right, they can pay attention. What’s not happening is their brain is not automatically tuning into the channel they should be tuned into.

Dr. Sarah (00:00:38):

Understanding the unique workings of the brain of a child with ADHD allows parents to connect with their child on a much deeper level and support them in a way that’s most aligned with their individual neurobiology. So I am thrilled today to have Dr. Norrine Russell joining me on the podcast. Dr. Russell is the founder of Russell Coaching for Students and she’s the author of the recently published Guide for Parents Asking the Right Questions Before, During, and After Your Child’s ADHD Diagnosis. In this episode, both Dr. Russell and I will share our personal and professional experiences with ADHD, along with some very valuable evidence-based coaching and skill building techniques that will empower you with practical tools that you can use in your parenting. My hope is that by the end of this episode, you will have a really nuanced understanding of the emotional complexities associated with ADHD and have a valuable set of strategies that foster empathy and connection with your child, whether they have a neurodiverse brain or not.

(00:01:48):

This week’s 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. 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.

(00:03:31):

Hi, I’m Dr. Sarah Bren, a clinical psychologist and mom of two. In this podcast, I’ve taken all of my clinical experience, current research on brain science and child psychology and the insights I’ve gained on my own parenting journey and distilled everything down into easy to understand and actionable parenting insights. So you can tune out the noise and tune into your own authentic parenting voice with confidence and calm. This is Securely Attached.

(00:04:08):

Hello. Today we have Norrine Russell here. I am really excited for this conversation. How are you doing today?

Dr. Norrine (00:04:14):

I’m doing great, how are you?

Dr. Sarah (00:04:16):

I’m well. Thank you so much for coming on the show.

Dr. Norrine (00:04:19):

It’s an honor to be here. I’m thrilled. I have been looking at your website and studying what you do and there’s so much synergy between us and so I’m thrilled to have the opportunity to come on. Thank you.

Dr. Sarah (00:04:30):

I’m so glad and I agree we are going to have a good talk today. Before we get into all the good stuff, the stuff about ADHD and how to help our kids, can you talk a little bit about how you work, what you do, what brought you into this field and share a little bit with people?

Dr. Norrine (00:04:50):

Yep, absolutely. So I’ll tell you my story in brief and my background is in developmental psychology. So my graduate work and research was all on how do we help kids and young adults. That was my focus, be healthy socially, emotionally, cognitively, sort of all the positive psychology side of things. From there, I taught at the University of Minnesota for several years. I ran nonprofits for several years. Then I had my firstborn and he was super complicated and I retired and then I had a really interesting thing happen. I had psychologists here where I live in Tampa, Florida, say, Hey, could you work with this kid? They don’t really need therapy, but they need support, kind of like what you were doing at the nonprofit. And I said, I don’t know what you’re talking about. I’m not a clinician, I’m not a therapist, I am knowledgeable and I’ve been creating youth programs, but they’re like a life coach.

(00:05:56):

And I rolled my eyes. I’m telling you, I rolled my eyes. This was 15 years ago. The state of the science was so different, but I kept getting requests. So I started this small coaching practice. I was embarrassed. And over the years have grown to absolutely see how academic and life coaching for kids who are neurodiverse is what I have been called to do. So what does that mean? So at Russell Coaching, we provide academic life and ADHD coaching to students anywhere from elementary all the way through graduate school. My students call it you’re the person who helps me stay on track. You’re the person who realizes I can do the things that I need to get done. You’re the person who made me believe in myself. So we are hands-on, focused on education. We are knowledgeable about things like ADHD, autism, anxiety, learning differences, and we do coaching. We meet with your student once or twice a week. We look at what they actually have to get done, we look at the hurdles and we figure out a plan with your student to help them get it done. So at this point, we’ve grown into the nation’s largest student coaching practice and we are specifically for kids who are neurodiverse and complex with two or more diagnoses often. Does that make any sense you think to your listeners?

Dr. Sarah (00:07:29):

Oh my God, I think so. I think so because we talk a lot on this podcast about neurodiversity, we talk a lot about therapy and coaching and the differences being, the way I kind of conceptualize the difference between therapy and coaching is like therapy is looking at the before, the during and the future and putting it all together. And it’s usually when there’s something kind of more clinically complicated going on that’s impairing functioning coaching. The way I look at it is it’s looking at the during and the future. Here we are now and where do we want to go and how do we develop strategies to go where we want to go and deal with obstacles that get in the way of us going where we want to go. And I think the thing about ADHD and a lot of other diagnoses that are related to the brain is yes, there can be emotional

(00:08:29):

Self-esteem, personality, relational components that are impacted by that for sure. And I think therapy is a great place to unpack some of that stuff. But also it’s like the brain has, the brain is different. It works in a different way than a typically developing brain. And it’s kind of like you go to physical therapy, if you had a gross motor deficit, you’d go to occupational therapy for a lot of that stuff too, like integrating sensory stuff that’s just not developing on track. If your neurological brain structure isn’t developing the way we would’ve expected, your executive functioning skills that live in the prefrontal cortex aren’t working as well. And we’re going to talk a little bit about, I want to get nerdy if you don’t mind, about some of what we know about ADHD and how parents can totally translate all of the neuroscience into practical, realistic, what am I looking at in front of me when my kid is doing X, Y, Z? But it’s like you need sometimes to exercise those muscles in a different way. And I think coaching is actually really great for that executive functioning coaching, life coaching sort of academic coaching. These kids need to feel like they can do this stuff and they can, if they might not be able to, it might not be a straight line between A to B, it might be a little zigzaggy, but we can get there. We just have to be creative about it.

Dr. Norrine (00:10:01):

I think what’s so important about what you’re saying is our kids who are neurodiverse and our kids with ADHD might not automatically be developing those executive functioning skills. They might not automatically be figuring out, okay, how do I start this thing that I don’t want to do? How do I organize my desk? How do I manage my time? I mean, my own 15-year-old son today, his schedule is flipped. He’s supposed to have math on Friday and academics on Thursday, his other academics, but they’re flipped today because his teacher is going out of town and he’s neurodiverse in several ways. And he’s like, but I’m in the car on the way to the podiatrist. I was like, yes, but you forgot that your teacher was coming to the house today. It’s not a math day. And he says to me again, but I’m going to the podiatrist.

(00:10:53):

Yep, buddy, you sure are. You’re going to the podiatrist, but when you get home, you’re going to be doing something different from what you thought you were going to be doing. And he’s like, oh, okay, got it. And I say, it’s on your calendar. So these are skills, this time management organization starting things, finishing things. These are skills. And when we see kids around us who are sort of naturally organically developing them, of course we make the assumption, well, that’s what all kids should be doing, right? Kids organically learn how to walk, they know how to swing some kids. The process of reading seems very easy, but there are a really important segment of kids and students who don’t organically develop those executive functioning skills, but they can be taught. And that’s what executive functioning coaching is all about, is teaching those skills. And the nice thing is it’s completely evidence-based as an intervention. Now you have to make sure that you have a coaching practice and a coach who’s using scientifically based practices. But if you look at any of the recommendations from any of the medical establishments for ADHD specifically, not taking into account comorbid disorders, it’s pills and skills, it’s pills and skills, skills for the parents, skills for the student and skills for the school teaching the student those skills is absolutely essential.

Dr. Sarah (00:12:28):

Yes, and I think you bring up a really important point with the pills and skills thing. I like the way that sounds a nice ring to it, but so many times I see families medicating a child, which I am as a psychologist who does not prescribe medication. I work so collaboratively and closely with psychiatrist all the time. So many of the kids in our practice are on medication as a part of their more global treatment plan. So I’m very in favor of appropriately looking at medications as a part of the bigger picture. But I always say this, I say this is true for anything, whether it’s ADHD, anxiety, depression, whatever, the medication itself, the metaphor I usually paint for people when I’m trying to explain how to look at medication in the context of a larger picture is think of yourself in a boat.

(00:13:24):

And as we go through life, there are certain things that put sandbags in our boat. And sometimes in the case of certain things that are just genetic and biological like an ADHD diagnosis, that’s a sandbag that’s just already in our boat. And throughout life, different things either put in sandbags or take sandbags out. But if our sandbags are too heavy, we’re going to sink. And so what can we do to, we have two ways to not sink, right? We can either take sandbags out of the boat, which would be things like building executive functioning skills, creating systems inside the family, doing therapy, doing coaching, whatever that might be. But we can also add buoys to the boat to keep it afloat. And I look at things like medication as a buoy, it gets the boat up so that we could do the work to take the sandbags out and they go together, but they’re not the same thing. And so I think a lot of times people will look as medication as the thing to do, but it’s like no medication just keeps the boat a little bit more buoyant so that you can do the work of taking out the sandbags. And I think that’s true for almost everything. Medication almost always works better with a therapeutic piece to the puzzle because it just opens the pathway for us to then do the work in a way that’s more efficient and effective. But you got to do the work and that’s where the therapy comes.

Dr. Norrine (00:14:51):

Well, you’re going to love this then. Pills don’t teach skills.

Dr. Sarah (00:14:56):

Yes.

Dr. Norrine (00:15:00):

We need both.

Dr. Sarah (00:15:01):

We create an environment inside the brain where the learning might be more accessible for the skills to come in and have a place to be put and then remembered, but we got to teach those skills. I love that

Dr. Norrine (00:15:14):

And that’s consistent, and I want to reiterate this because people have such strong opinions about medication that is evidence-based best practices medicine, multimodal therapy for ADHD is what is scientifically validated. And so you need, according to the American Academy of Pediatrics, medication is first line treatment, then you need parent training and education, a school plan, and then skill building for students. And so it’s hard because so many different practitioners trained in so many different areas, touch ADHD. And so it’s hard to have a cohesive message for parents. And I see that all the time that parents don’t always get this message. So I think it’s just important for those of us who are within the science of ADHD to be strong advocates for effective treatment for kids because it’s hard to have ADHD. I have two children with ADHD. They were diagnosed very early in life. It’s very hard to have ADHD. It affects so many things. It does affect school, but it affects relationships and it affects connections. And that’s something that you and I also feel very strongly about.

Dr. Sarah (00:16:44):

Yes, I would love to talk more about that. Could you talk a little bit about what you help parents understand when they’re trying to understand their kid who has ADHD? Because they can get a bad rap.

Dr. Norrine (00:17:00):

They can. They can. And I often say to parents, your experience is real and your experience is true. And I love that on your website that the parent is the expert. I say to parents, what you are experiencing is real. Your child is having symptoms that can be annoying, frustrating. Like, yes, you are not the crazy one. Now let’s teach you to put on the lens of ADHD and start to look at this from a neurodevelopmental point of view. So when it comes to the first symptom, that inability to regulate attention, and of course parents come to me like they come to you and every practitioner, well, they can pay attention to fill in the blank, TikTok sports, their friends, what to wear to prom. Yes, yes. So let’s pause for a second and understand the deficit isn’t the ability to pay attention. The deficit is the brain doesn’t automatically regulate where the attention should go.

(00:18:12):

So yes, parent, you are absolutely right, they can pay attention. What’s not happening is their brain is not automatically tuning into the channel they should be tuned into. That’s the deficit. And I think that’s extremely helpful for parents because it takes away that, well, they’re just not trying. They’re lazy. If they just paid attention the way they pay attention to TikTok, you’re right. If they did, that would be great. But that’s the deficit. That is the delay, is that their brain doesn’t automatically do that. And for people who don’t have ADHD, their brain does, they walk into the grocery store and their brain starts going, okay, what do I need to pick up for dinner tonight? Or they walk into the doctor’s office and they’re thinking, okay, I need to get my insurance card and my driver’s license out. People with ADHD, their brains aren’t always tuned into the channel that it should be, especially when it’s a task that’s a little boring or a little not rewarding.

(00:19:13):

So I think that’s an important thing for parents to note. I think the other piece that’s so important is the impulsivity. I always say to parents, you can look at things from did they not know? Did they just genuinely not know this was the right thing to do or a wrong thing to do? Did they know but they didn’t care because that’s a different problem? Did they know? But they did it anyway and they felt bad? That’s our ADHD kid. And that’s why so many kids with ADHD end up with self-esteem problems and engage in high risk behaviors because they do so deeply know better. For example, my own son who’s 15, I think every other word out of his mouth for the last several years has been, sorry. I’m like, you don’t have to say sorry. You are an amazing human being doing your best.

(00:20:06):

The fact that you have one of the world’s most severe cases of ADHD is not your fault. You don’t need to feel bad. Sorry, mom. Sorry, sorry, sorry, sorry. No, and I haven’t yet been able to parent him effectively enough to get rid of that. But that’s something I think parents need to understand. It’s not that they acted impulsively and didn’t care. That’s a different problem. That might even be a different diagnosis. But your ADHD kids are going to know better, not be able to do better in the moment and then feel terrible. Yes. I’ll say I do see, and

Dr. Sarah (00:20:46):

I’m curious, you see this too. I see sometimes I do see a lot of those kids that are like, I do something super impulsive and I immediately realize and I’m like, ah, I’m sorry. And they feel guilty and they’re conflicted around that. They’re constantly acting out of alignment with their values, which I think is where the self-esteem part can come. I also see a different subset of kids who act really impulsively, and then they feel that internally they feel that that was not in alignment. They’re worried about how other people are feeling towards them. They’re fearing judgment, they’re feeling shame. And then there’s this secondary trigger that the shame activates this huge defensiveness that then makes it look as though they don’t care that they just did this thing and that you’re mad about it or that someone got hurt or whatever, and they get even more dysregulated.

(00:21:37):

But that again, is still, if you really, really examine what is the chain of events in this situation, it is that same thing you’re talking about. I did something impulsively. I knew immediately that I wasn’t supposed to have done it. I feel guilt and remorse. I didn’t want to do it. But that guilt and remorse and that fear of judgment activates a shame spiral that then makes it look as though they don’t care. I get so many parents saying, is my kid a sociopath? And it’s so heartbreaking and also helpful for me to explain to them what often they’re seeing as complete disregard and almost like a violent explosiveness around being reprimanded or having made a mistake or doing something wrong because they were super impulsive. That’s still very much deeply rooted in not wanting to have done the thing. They just don’t have a way of coping with the shame that comes after it.

Dr. Norrine (00:22:42):

Absolutely. Absolutely. Absolutely. And sometimes I’ll say, I think we see that a little later developmentally. I mean some younger kids, but in my experience, I see a lot of that when it comes to middle school and high school and then it becomes hard. I think parents are challenged on how do you connect with that? If my job as a parent is to make sure you are paying attention to school because I’m getting a million notes home from the first grade teacher, or I’m getting the comments on the progress report in sixth grade, it’s very hard to figure out how do you connect with your child vis-a-vis these symptoms either at school or at home. And so I think teaching parents, the first step is always going to be empathy. It’s hard to pay attention right now. You are having a hard time focusing and getting a note saying that you’re struggling with focusing during math class at school.

(00:23:45):

Tell me how you are feeling. I want to understand better. So it’s empathy. And then I want to understand the least helpful thing is to say, you need to focus. You need to try harder to focus. It doesn’t work that way. So remove that from your vocabulary. It’s empathy and then trying to understand, and then let’s do some collaborative problem solving. What do you think could help? And the child may have no idea, but that’s setting the stage for that child, becoming a person who can have some autonomy and have some tools. And so I always say to parents, it’s a three step process of listening. A, it sounds like you’re having a hard time focusing. That’s okay. That might be just how your brain is wired. Are you having a hard time focusing? What does it feel like in math class when she’s doing math facts or teaching long division or you’re starting pre-algebra and listen, just listen. Be quiet, chew gum if you have to. And then saying, what do you think might help? And maybe they know something, maybe they don’t. But I think that message is so important of what do you think might help? I have some ideas too, and your teacher might have some ideas, and if we go further down that path, we may need a plan at school. So I think that’s how you build that loving connection with your child empathy in the same way we would if they came home sick with the flu.

Dr. Sarah (00:25:34):

Right? Yeah. We don’t get mad at our kids for throwing up. We do get mad sometimes at our kids for not focusing. I say that as a person, an adult, as a mom who has ADHD myself. I look at my husband, for example. He is to his credit, learning more about ADHD and getting more empathy for me. But there are things that I do that drive him bonkers, and I know that they drive him bonkers, and I don’t do him on purpose. I will come into the kitchen in the morning to make breakfast for the kids, and it’s like I do it every single day, but no matter what, there’s just 50 extra pots and pans out. I don’t know where they all come from. And then it’s time to go. And so I’m rushing out the door and he’s always like, what is this giant mess you have left in here every single day?

(00:26:32):

And every time I’m like, sorry, got to run. I’ll clean it up later. And he gets frustrated and I get it. And so it’s like, how does he have empathy for, how do I also understand that it’s not going to work for me to constantly be a Tasmanian devil in my kitchen and I have to come up with strategies? And that comes from building awareness, creating plans, planning ahead. I’ve had to really create a lot of more conscious strategies that I have to force myself to revisit over and over and over again. And I think this is so true for our kids. They don’t mean to do a lot of the things that are genuinely annoying. It is really annoying to tell your child 50 times to put their shoes and their jacket on or to get their stuff ready to go or to clean their room and notice these are all of these mundane tasks, those non-no non exciting low reward tasks. Can you talk a little bit about that piece and maybe even the brain science, a little bit of how norepinephrine maybe works in terms of focusing our attention and how an ADHD brain doesn’t really activate that in a way neurotypical brains do?

Dr. Norrine (00:27:56):

Sure. Yeah. So important. So when we look at brain scans of people with ADHD, and I’m going to use a metaphor here instead of using scientific terms, but if you think of the pathway between the motivation center of the brain and the frontal lobe or the thinking part of the brain. So let’s just very crudely differentiate that there’s a motivation center of the brain somewhere in the brain and a thinking center, okay, we don’t have to get technical.

(00:28:28):

The pathway between those two centers in a person without ADHD can be kind of like a four or a six lane, maybe even an eight lane highway. It goes back and forth pretty continuously with information like, oh, my alarm clock’s ringing. Oh, I get to do a podcast today. Oh, I better get up on time today, get in the shower, pull myself together, make sure I eat a good breakfast and get to my desk in time to prepare. Oh, I remember when I did other podcasts and it felt really good to get that done. And people had nice things to say, oh, now I’m involving the emotional center of my brain. And all these messages are going back and forth and it’s building positive momentum. And the thinking center of my brain is getting activated by the motion Motivation center to do something because different parts of the brain and they don’t always connect.

(00:29:23):

And in the ADHD brain, the Motivation Center tends to be a little sluggish, a little sluggish, especially for things that don’t have a high reward or a lot of emotionality or feel good, doesn’t feel good to anyone to get up and go pick up the laundry basket and fold the clothes. But a person without ADHD, it will connect in their brain like, oh, but it does feel good to have the laundry put away, and I know it’s not going to really take me more than five minutes, and I felt like this before and I tolerated it before. And so the Thinking center and the Motivation Center start to work together and you’re like, okay, I can actually walk five whole steps, pick up the laundry basket and fold 20 items of clothing and put them away. The ADHD person looks at the laundry basket and is like end game.

Dr. Sarah (00:30:23):

I relate so much.

Dr. Norrine (00:30:26):

And I’m painting with very broad strokes. So then what do we do there? How do we help especially help our children with ADHD to start to do that? One of the best things that we can do is to co-regulate with them, you know what? I’ve got laundry to do also. I’m going to go get my basket and we’ll both sit here and do the laundry or what kind of music makes you feel happy and peppy? Let’s put that music on while we do the laundry. Or what’s something you’d like to do the minute we get this laundry basket sorted? You’re coaching through the process. You’re not saying you don’t have to do the laundry. You’re not saying, oh, but laundry is so great. It’s like, what are the strategies for how to get through this?

Dr. Sarah (00:31:15):

Okay, so really quick, I want to go back to something that you just said about co-regulation, because I talk a lot on this podcast about co-regulation, but oftentimes when we kind of hear in the world co-regulation as parents of young kids, we’re often thinking in terms of when they’re having a meltdown or a tantrum, we co-regulate their in fight or flight, and we’re going to help them reconnect to a sense of safety. We’re going to help share our calm nervous system with theirs and help them calm the co-regulation you’re talking about is the same thing. But I think it’s important to notice that when you’re saying co-regulating saying you’re their attention, you are coregulating, which is the same thing. And I love this so much because I always try to explain co-regulation to people and they think it means, oh, I name the feeling that you’re having.

(00:32:04):

Or I talk in this soft voice. And it’s like those are ways to co-regulate, and they could be effective ways to co-regulate in certain circumstances, but they are not in and of themselves co-regulation, right? They are tools that aid in the overall service of co-regulating, which just means helping regulate someone’s brain or body with your brain and body. And in this case, we usually talk about in terms of regulating affect and dysregulation of affect and behavior, but we’re talking here about regulating attention. So if I can show you what I’m focused on or help you focus on this thing with me, we’re sharing our attention, we’re sharing our focus, you’re sharing my regulation of attention. That is such a helpful thing. I know a lot of people in this listening to this podcast understand the concept of co-regulation, but they might not have heard it used in this way. And I think that is incredibly helpful lens to look at this process with.

Dr. Norrine (00:33:04):

And one of the best things we can do with our ADHD kids of any age is to co-regulate their attention by just being with them. I’ll say to parents all the time, bring your laptop to the kitchen table and take out the phone or the timer or say to the Alexa, okay, set a timer for 10 minutes and then say to the child, okay, you work on your math, I’m going to work on my HR policy or whatever. And when we get done, we’re going to high five and we’re going to set it for another 10. And that concept in ADHD, sometimes it’s called body doubling, but it’s so very helpful. You are co-regulating and you’re helping to set goals and you’re showing how you do task initiation. You’re basically, I agree with you, you’re co-regulating attention, but you’re the whole field of executive functioning skills.

Dr. Sarah (00:34:08):

I think that’s so fantastic. And it makes tons of sense because, and I think this is true by the way, for all kids, not just kids with ADHD, especially really little kids because they’re prefrontal cortex, which is where the executive functioning skills are housed, are very, very underdeveloped in early childhood. And so this is why we kind of avoid diagnosing kids too early. Like it’s hard to know if this is truly because of ADHD or if it’s just that their brain isn’t really at a place developmentally where they could really access these skills more organically. So little kids really have a hard time regulating their attention, regulating their motivation, regulating where they’re putting their body. And so using the strategy to help kids, any kid could be really, really helpful. And thinking how many times my kids do better getting dressed in the morning if I’m just with them versus still in bed or downstairs making breakfast, I’m not actually doing anything for them, just using my presence as kind of canoe a canoe that moves them through the river of the morning.

Dr. Norrine (00:35:22):

One of the very simple tips that I’ll often talk about when I teach a class to parents who have a kid with ADHD or I’m doing individual parent coaching is what? Move the five for Monday through Friday into your bedroom and while you are getting dressed, have your kid pull out the outfit. Some people get crazy like that for vacation. They’ve got their outfits all in Ziploc bags. I’m not that organized. We lived in those fabric bins for a long time, but throw five outfits in the fabric bin, five uniforms, whatever it is, put them in your bedroom and have them come and get dressed in your bedroom while you’re getting dressed or brushing your teeth or showering. I mean, how many times millions of parents every morning are like, go get your socks and shoes. Don’t set us all up for that frustration.

(00:36:17):

Put the socks in the kitchen by the door. Just don’t set us up for that frustration. Can’t remember to go and brush your teeth, keep the toothbrush in a cup on the kitchen counter and say, I’m handing you your toothbrush. Go walk to the bathroom and bring the toothbrush back while you’re holding it. I’m just such a fan of decreasing the frustration and increasing the connection. You think about that before school time. Nobody wants to leave for school, whether it’s the parent or the child feeling frustrated and angry, but I told you to put your socks and shoes on. I mean, we’ve all been there and ADHD, and I’ve done an entire podcast on this with ADDitude Magazine, ADHD sometimes can create real difficulties with the emotional connection between the attention that comes and goes, and then the impulsivity and the hyperactivity. And so let’s find easy things to do so we can leave for school in that I love you and you’re going to have a great day mode.

Dr. Sarah (00:37:25):

Yeah, there’s two things that you just said that made me think of something. So one is that it’s not just regulating attention, it’s regulating all kinds of things including affect emotions. Kids who have ADHD can get really, really explosive. They can get really, really irritable. They can get really, really excited. It’s hard to get that dial right? So that’s one thing that I think is important. It’s not just about can they organize themselves, they have a messy room. Do they get to school on time or forget their homework? It’s also that they get really emotionally kind all over the place. And so that’s something that is worth understanding too. So we could have empathy for that piece too. And again, just because something is a symptom of ADHD or other types of neurodiversity, it doesn’t mean we can’t reduce that symptom. We can have empathy for that.

(00:38:22):

It’s there. We can understand that it’s not something the child’s doing on purpose and it doesn’t really feel good to them either. We can build up ways to support the skill building and reduce symptoms. So that’s one thing. But the other thing that you were talking about that I think is really helpful, instead of just looking at the child’s behaviors or attention or emotions, those are important things to look at, but that’s very much requiring the child to do a lot of the work. The other thing you’re talking about that I think is super important, and I think parents get confused about is accommodations, is this idea of creating an environment that’s a little bit more conducive to the way your child’s brain works. And if people listen to this podcast a lot and they hear, have you ever listened to one of my episodes about anxiety in kids?

(00:39:16):

We talk a lot about accommodations and how when a kid has a lot of anxiety, parents get roped into doing all these kinds of accommodations to help their child avoid feeling anxious. And one of the ways we really treat anxiety is to help the parents slowly and systematically reduce those accommodations because those accommodations can actually maintain the anxiety. In ADHD, we’re talking about something very, very different. We’re talking about a structural way the brain works and may or may not ever be able to fully shift. We can create sort of scaffolding compensatory strategies, but it’s always going to be something that might be challenging. And so sometimes until we can bridge that gap of skill development, we do need to modify the environment, modify our expectations, change the way we behave and act and set up a lot of parents, I can hear you saying, I don’t want to have to put a toothbrush in my kitchen because my kids should know how to brush their teeth in the morning.

(00:40:16):

And it’s like, I totally understand that. And also if it’s easier for the child to remember by having that visual cue and they are already kind of built in a rhythm of they come downstairs, they eat their breakfast, that’s motivating, right? We’re motivated to eat food when we’re hungry. There’s a lot of reward there. It’s an easier thing to do. Although some kids who have ADHD like forget to eat all the time, another issue. But let’s say we’ve, they got that down, they’re able to get to the kitchen. It is more likely that they’re going to be able to make that leap to brushing their teeth in the morning if it’s right there in the kitchen sink than if it’s up in the bathroom that they didn’t go into this morning.

Dr. Norrine (00:40:57):

Well, and this is my response when parents say that, but then aren’t I just feeding into the ADHD? Right? Here’s the fact of the matter. Your child has ADHD, and this is usually with younger kids. We’re talking about preschool, elementary, maybe into middle school, but middle school time, you’re probably going to stop fighting about the toothbrush, but which is more important, you do want to be teaching good hygiene. You want to be teaching good habits. You most of all want to be connected, right? Because we know that connection is the most important thing for good mental health. And so you’re not going to make the ADHD go away by screaming, did you brush your teeth? Did you remember to brush your teeth? You’re back from the bathroom, but I didn’t hear any water on, I didn’t hear any teeth brushing. I sent you to get your socks, but you don’t have your socks, right?

(00:41:55):

That’s just shaming, right? And so absolutely, we don’t want to not address the ADHD, right? We want to make sure we have a treatment plan, a scientific treatment plan in place, but accommodations are a part of that. And so you are not saying to your kid it’s okay from a character or moral point of view to not care about things. What you’re saying when you do these things, putting the toothbrush in the kitchen, putting five uniforms in your bathroom, what you’re saying is, I love you the way you are and the way we start off the day is so important that this is how we’re going to do it because this is what’s peaceful in our house and this is what allows me to be present to you as you go off to your day. And as I go off to my day, there’s no successful intervention about yelling at the kid five days a week to go get their socks and chew when they forget ’em.

(00:43:04):

So sure, we would all love if our every child and especially maybe our kids with ADHD would remember to brush their teeth, brush their hair, put their socks and shoes on. But if it’s at a point where we know generally, unless they’re taking a medication that works overnight and so their symptoms are under control in the morning or they have a fast acting medicine, you wake ’em up 30 minutes before they have to start being functional. We know this is just ADHD and there’s no amount of self-talk at six or seven that is going to change that. And so when I talk with parents, I talk about it from a loving connection point of view. The accommodations aren’t always going to be the same, but yes, you are going to accommodate in a way that helps role model. How do you set up skills? It’s the same way. I mean, I don’t know about you, but we have a key holder at our house and everyone’s keys go on the key holder. I don’t feel like I’m championing disorganization there. That’s the system. The keys all go there. We have a place where our reusable grocery bags go. That’s not any different than putting the socks in the kitchen to me.

Dr. Sarah (00:44:22):

Exactly. I think some of it is rethinking what we have accepted in our brain as the correct system. The toothbrushes go in the bathroom, the clothes go in the child’s room or whatever it is. And I think being willing to say, why is that the rule? Why is that the system that’s supposed to be? And what can we have a more of? Can we create systems that work for our family, for everybody in our family? Another thing, it’s like appropriate accommodations to help scaffold skill building for a child are important, critical, and this is where I think a lot of this stuff gets an important piece gets lost, which is the parents have to be able to also have their needs met and feel separate and whole. It’s not about completely shifting and bending and contorting and abdicating important parts of your life to accommodate for a child’s neurodiverse needs. The whole family has to work together. And sometimes an accommodation might not be just about what the child needs, but what the parent can do realistically and how it works within the larger family system functionally.

Dr. Norrine (00:45:49):

And so to be a little bit lighthearted in my family, the socks and shoes would have to be in cute baskets because that matters to me. I don’t want junky shoes all over my kitchen floor by the front door. I don’t live somewhere where we have snow, so we don’t often have a whole lot of rain boots or snow boots, but yeah, it does. It has to work for you. I spent a few years of my life as a mom going, I live here too. I’m a person too. I’m not just the autism ADHD facilitator around here. I am a person with needs. And so I think some of these accommodations make it easier for us as parents to get out the door or if we have a system set up for getting home. I’m a huge proponent of if you get a diagnosis, get a set of sheet protectors diagnosis, buy a set of sheet protectors, put your lists of things in that sheet protector, put it three places, put it by both doors, put it by the kitchen table and point to that as opposed to all the verbal reminders that I think speaks to your point of are, I don’t like this word, but I’m going to say it because everyone’s going to know what I mean.

(00:47:12):

Are we enabling or are we scaffolding? Right? Check your list. Check your list. I’m not going to run through the 10 things that you need to make sure in your backpack. I’m going to point you to your list. I may have to point you to your list every day, point you to your list, you are going to be able to look at it, and then you’re going to be responsible. And that’s an adult level skill. We make lists. And so rather than verbally carrying them through every morning, make the list, put the sheet protector. We had lists in my bathroom for years of what hygiene gets practiced in the morning. Morning, what hygiene gets practiced in the evening.

Dr. Sarah (00:47:50):

I’m telling you, we are doing this all over the place right now in my house. So I have a six-year old and a four-year old. Neither of them have any diagnosis as of yet. I don’t know. We’ll see because I say that because ADHD is genetically predispositioned and I have it, so my dad has it. There’s a chance, although I’m doing this in part, I have ADHD and I always forget what needed to get out the door in the morning. But also because my kids are six and four and their prefrontal cortexes are just not really there yet in the way of whether they have a neurotypical or a neurodiverse brain, they still really struggle with ordering sequencing, initiating planning, all the stuff. So we’ve been literally sitting down and creating visual calendars for all the stuff we have to do because I’m tired of yelling and nagging.

(00:48:48):

And so for those kids who aren’t reading yet, go on Canva. Canva is great because it’s free and you can literally clip art your way into a really nice looking calendar or chart, and now it’s just there and they can see it and I don’t have to remind them. And on my door to my garage, I have a picture of shoes, a jacket and a backpack, and I’m like, because what I nag about and I’m just like, go look. Do you have everything you need? And it’s partly for them, and it’s definitely for me because I’ve forgotten their backpack a number of times and had to go back. So I’m a huge fan of visual calendars, especially for kids.

Dr. Norrine (00:49:29):

One of the things that we do at Russell Coaching that I think is so incredibly valuable when we start working with a student is we teach a schedule of what do you do when you get home? People think, oh, I get home and I do my homework, but there are 10 or 12 steps in there. I get home, I open the backpack. I have to look and see if there are notices, if my school is still like a paper school, are there notices? Where do I put the notices? Then I have to take out my stuff, whatever that is, which stuff? My binder, my book, my pencil pouch, my calculator, what supplies do I need? Then usually there’s trash in the backpack. I have to throw the trash away. Then I have to figure out where to put all that stuff. Where does the book go? Where does the binder go? Where does the pencil go? What if my pencil is broken? We teach and say all the time, getting set up for homework is just as important as doing homework and taking 10 minutes to teach a routine of how do you get set up for homework is going to be one of the most valuable skills. And when we think about it, that’s what we do as adults. I’ll tell you, I have my coffee. Do you have your drink?

Dr. Sarah (00:50:50):

Yep. Right here.

Dr. Norrine (00:50:51):

I’ve got my lip balm. My life doesn’t start without lip balm. Every morning I read my beautiful girl, you can do hard things. I’ve got my workplace set up. This is a normal human thing. We don’t often teach it to kids though. And so having a visual calendar or a written checklist of what does that mean to get started doing homework, I think is so valuable. And that’s part of coaching. That’s skills and strategies, right? It’s not the mental health component, although it affects mental health, but it is skills and strategies for daily life to help with academics, to help achieve life goals, to help achieve harmony, to decrease conflict in the family. One of the things that I’m most proud about about our practice is that 85% of our parents say that family conflict decreases within a month of starting to work with Russell Coaching.

Dr. Sarah (00:51:49):

That’s huge. I mean, that’s probably more the reason people continue to do therapy I find or coaching, is that they realize we’re not just treating symptoms, we’re treating how it feels to be a family of someone who has symptoms. And that is so powerful.

Dr. Norrine (00:52:13):

Because we need to be connected. We thrive in connection.

Dr. Sarah (00:52:19):

And as parents too, I can listen to this podcast, this conversation through the lens of someone who wants to support a child. Whether you’re a parent who has a kid who has this diagnosis or you’re a therapist who’s working with a kid who has this diagnosis, or maybe you’re relating to it because you yourself have this diagnosis, but I also really can hear the same conversation through the lens of the parent who’s like, I’m tired, I’m exhausted. I’m resenting a lot of the stuff my kid does or that I have to do. Maybe I haven’t ever really gotten a diagnosis and I don’t have a system for treating it and supporting it, or maybe I do. And it’s like even though we’re doing all this work, it’s still hard. The parents, it’s not easy. And you said something when we were talking about this episode before we hit record, but this idea that it is, this is chronic and so we evolve with our child, but the ADHD is going to be there. And so you said something that was very stuck with me. It was like parents saying something like, why is this still so hard? And I just relate to that and I feel that frustration and I empathize with it so much.

Dr. Norrine (00:53:40):

Well, and it’s a lot. I think we were talking about the need for ongoing education and support of parents. One of the things that we don’t always understand as parents when we do get a diagnosis for our child of ADHD, and both of mine have that diagnosis is this is a chronic disorder. I mean, the American Academy of Pediatrics says this is a chronic disorder and needs to be treated as such. It needs to have a medical home and a medical team. This is a chronic disorder. And I can see where some parents would really resent hearing that. I don’t want to hear that. Which is why we need ongoing education and support. I think I was telling you, I have this dear sweet, well-educated mom right now who’s just recently brought her teenagers to the practice. And she’s like, but it’s been three months. When is it going to be better? And I was like,

(00:54:42):

It does get more manageable, but it will always need to be managed. And so as practitioners, we have to help set that stage. You’re going to go through different periods of time with ADHD. There may be times when less support is needed. There may be times when more support is needed. We know from working in the field, okay, entry to school, third grade because of third grade standards, sixth grade transition to middle school when puberty hits ninth grade and 11th grade and college. I mean, we could map that out. We could create a beautiful poster in the psychologist or psychiatrist office about these are going to be the typical pain points, but where’s the book that says to parents, you’re doing a great job. You’re doing a great job. And it’s hard and there’s a lot of change. I mean, what else? There’s very little else that’s like that from a parenting point of view where you’re constantly having to reevaluate, where am I at with this? Where am I at with this? Yeah, sure. There’s a lot of social and emotional development, but it doesn’t happen in the same way that changes in ADHD happen, I mean their parents who have to change the dosage of medication three or four times over the course of the year of the most growth. Nobody says that to you. Like, oh, you could have to see the doctor and reevaluate that three or four times when that rapid period of growth is happening.

(00:56:26):

I want us collectively as practitioners to say we can and we will do a better job of helping parents understand and connecting to parents’ experiences so that they can focus on parenting.

Dr. Sarah (00:56:43):

I love that. I think that’s so important and I’m here for it. If people want to know more about your work, your book, where can they connect with you?

Dr. Norrine (00:56:53):

Sure. So the website for Russell Coaching, where again, we work with students of all ages from elementary all the way through college, postgraduate is russellcoaching.com. It’s two S’s and two L’s, but you’ll find us Russell Coaching. You can just Google me, Norrine Russell. And what you’ll see when you come to us is that we have a method of coaching called connected coaching. So you’ve been hearing me talk about connection. This is what we believe in is how do we create meaningful human connections between the coach and the parent and the student, and how do we help the student connect with skills and strategies that work for them? So you can find us at Russell Coaching. All of our socials are on there. We’re on Instagram, YouTube, all that stuff, LinkedIn, but it’s probably easiest to go to the website if you want to reach me directly.

(00:57:50):

I’m drrussell@russellcoaching.com. And I will also say that on our website, we have all of the podcasts that I’ve appeared on and all of our blogs that we’ve written over the years that are for parents who are at kind of any stage before the diagnosis, contemplating an evaluation after the diagnosis. And then my book is called Asking the Right Questions Before, During and After the ADHD Diagnosis. And it’s on Amazon and probably the easiest thing to do there is to Google my name Norrine Russell. But asking the right questions about ADHD designed not to teach you everything about ADHD, but designed to teach you how to be the best advocate for your child who may have ADHD or does have ADHD.

Dr. Sarah (00:58:42):

That’s fantastic. Thank you so much for coming on and sharing all of your insight and knowledge with us. This was super illuminating and I really appreciated it.

Dr. Norrine (00:58:52):

Well, you are welcome. And if we want to make a special offer to your listeners that if they’re listening and they’re interested in coaching services, we do, when I go on a podcast offer 10% off the first three months of ADHD coaching at our practice. And so you don’t need any special code or anything, just say that you listened to the podcast and you’ll receive 10% off those first three months because we want to be part of your team.

Dr. Sarah (00:59:22):

That’s amazing. Alright, well that’s great. And we’ll put all the links to your stuff in our show notes and hopefully we’ll have you back on sometime to talk more.

Dr. Norrine (00:59:31):

That would be great. I’d love that. Thank you for having me.

Dr. Sarah (00:59:39):

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