I remember meeting a fellow teen many years ago (many) who wasn’t participating in the group project. He’d nod off, he’d space out, and he neglected to take notes when the teacher gave directions. One day he confessed to the group, rightfully frustrated with our grumbling, that he had ADHD. He went on to explain that every day tasks were harder for him. I admit, we blew him off—hard core. We uttered behind his back that he was just being lazy, riding on all our hard work to get a good grade, rather than pull his weight.
This situation came to my mind the day my own child was diagnosed with ADHD. Thankfully, I’ve learned that ADHD is very much real and isn’t an excuse—and I learned this long before my child was diagnosed. I honestly wish that I could find that kid and apologize to him for my ignorance. Since October is ADHD Awareness Month, I think it’s the perfect time to share what I’ve learned about the disorder.
ADHD isn’t just one disorder.
Dr. Sanam Hafeez, a neuropsychologist in NYC whom I recently interviewed, defines ADHD as “a neurological condition with many behavioral layers, such as a motor and a cognitive component.” There are three subtypes of attention deficit hyperactivity disorder, or ADHD. In the past, there were two disorders: ADD and ADHD. Currently, ADD is now a subtype of ADHD called “inattentive type ADHD” in which the person has “difficulty sustaining attention, following detailed instructions, and organizing tasks and activities.” Furthermore, they have “weak working memory, are easily distracted by external stimuli, and often lose things.” This subtype is often seen in girls and in adults.
Another subtype of ADHD is the hyperactive and impulsive type. They “feel the need for constant movement,” “they often fidget, squirm, and struggle to stay seated,” and they act as if “’driven by a motor.’” They may also “talk non-stop, interrupt others, blurt out answers, and struggle with self-control.” It’s more commonly diagnosed in kids and in men. Then there’s the third type referred to as the combined type. They have “six or more symptoms of inattention, and six or more symptoms of hyperactivity and impulsivity.”
Getting an ADHD diagnosis can be challenging.
We saw three different doctors before our child was properly diagnosed. This took a lot of time, money, and patience. Getting into specialists can take six months or longer, and meanwhile, our kid was suffering, both at home and at school. One doctor said my child’s behavior and activity level were “normal for a boy.” Yet, according to the CDC, 9.4% of children have an ADHD diagnosis, with more boys diagnosed than girls. I share this to say, ADHD isn’t all that uncommon. I knew my child had ADHD, but it took years to receive a proper diagnosis.
Dr. Hafeez chimes in that ADHD “is often present in some form from early childhood, but it is most commonly diagnosed when children start to suffer in school.” She adds, “There is a large amount of overlap, and it can make for a tricky diagnosis.” She has tools, like “standardized testing and assessment” to help her make a proper diagnosis. She encourages anyone who suspects their child (or themselves) has ADHD to seek a “formal diagnosis,” which is “critical in setting yourself or your child up for success.”
ADHD may be treated in different ways.
When I was growing up, Ritalin was the go-to medication for people with ADHD, but today there’s a greater understanding of the disorder and various treatment options. Dr. Haffez shares, “Not only is ADHD treatable with medication, it has been shown to respond incredibly well to behavior modification, and cognitive behavioral therapy (CBT), that goes a much longer way by teaching you strategies and technique to cope. We know the brain is plastic, hence, it can be retrained and rewired to a degree, by engaging in practices that become lasting habits. “
We have found help with both speech and occupational therapy, as well as play therapy (before COVID shut that down). Speech therapy can help with working memory, language disorders, vocabulary, and social skills. Occupational therapy helps with handwriting struggles and strategies to meet the child’s sensory needs. Play therapy helps the child learn to follow directions, engage in social conversations, express frustrations, and develop strategies to cope with those frustrations.
Some parents opt for dietary and other lifestyle changes in addition to or in lieu of medications. For example, many parents eliminate artificial food dyes and processed foods from their child’s diet and give them omega supplements. The decision to medicate a child with ADHD isn’t easy, as common medication side effects can include sleep and eating issues. When helping a family decide how to treat the child, Dr. Hafeez told me she takes a “holistic approach.” She informs them of the benefits and side effects of medication, encourages them to track their child’s progress on the medication, and advocates for therapies (which help to enhance the medication benefits). Unlike therapy, which can take months to produce positive results, medication, if it’s working properly, has immediate benefits.
ADHD is becoming de-stigmatized.
When my peer shared that he had ADHD, our group’s reaction was downright rude, mostly because ADHD was a stigma back then. Many people (us included—as ignorant as we were) believed that ADHD wasn’t real. However, today, ADHD is a more accepted and understood diagnosis. I want to be clear that ADHD is not a label. It is a medical diagnosis.
It’s also important to know that along with accepting a child’s ADHD diagnosis, the child may have other diagnoses. A child with ADHD is more likely to have a behavioral diagnosis, such as oppositional defiance disorder (ODD) and conduct disorder (CD). Learning disabilities (LD) are also a possible co-morbidity of ADHD. These include dysgraphia (writing), dyslexia (reading), and dyscalculia (math) disorders. Kids with ADHD are also at risk of having anxiety and depression, mental health conditions. Dr. Hafeez remarks that a good doctor works to properly diagnose a patient.
A child with ADHD may qualify for a 504 or an IEP in the public school setting. An IEP or a 504 gives a child the opportunity to have accommodations in place, and possibly therapies and special education, to meet their educational needs, making sure they have access to the same education as their neurotypical peers. Due to the Least Restrictive Environment Law, children with special needs should be placed in the educational setting that best fits their needs and isn’t over-the-top restrictive.
ADHD isn’t a parenting fail.
Another common myth is that a child who has ADHD has parents who are failing. If we would just discipline our kids more or better, if we would just stop spoiling our children, if we would stop tolerating their meltdowns, our kids would be just fine. (I’ve heard it all.)
The ADHD brain, a neurodivergent brain, doesn’t operate the way other brains do. There’s no cure for ADHD, including better or different parenting. The bottom line is that ADHD isn’t caused by parenting, and children with ADHD aren’t “bad” kids. Dr. Hafeez shares that parents need to know that “children with ADHD thrive with structure, consistency and a calm, safe environment. It allows them to predict certain routines, and with positive reinforcement and consequences, their brains start to make connections without a lot of talk.”
Though parents aren’t the cause of their child’s ADHD, we aren’t off the hook. She advises, “A child with ADHD can frustrate the calmest of parents, so it is wise to seek help if you find yourself stressed or flying off the handle. You are your child’s greatest ally and if you become an aversive figure or someone they fear, then their chances of success, diminish.” We have learned to identify our child’s strengths and triggers and work with those. We have learned that typical parenting, including discipline, doesn’t work on our child with ADHD and in fact, completely backfires. I highly recommend reading The Explosive Child for more information—though the title says a lot, doesn’t it? Other books like The Yes Brain and The Whole Brain Child have helped us.
Thankfully, society’s acceptance and understanding of ADHD has come a long way since ADHD seemingly emerged when I was a teenager. There are more resources and options to help children who have been diagnosed. Most importantly, children can be more empowered to advocate for themselves and celebrate their successes.