Understanding ADHD Children

try to reassure their kids. And really what kids need is validation rather than reassurance because you as their parent, you can't be there all the time to let them know it's going to work out. And frankly, you don't know. That it's gonna work out. What we wanna do instead is to validate, yes, you know what, it makes sense that you're afraid on the first day of school. Lots of kids are.

That's Dr. Sharon Saline, author of What Your ADHD Child Wishes You Knew, working together to empower kids for success in school and life. How can parents better understand the internal perspective of their past surface-level traits and identify their greatest areas of need? How can we as parents build more empowering relationships with our kids when every day feels like a struggle? And what are the

Simple steps that parents and educators can take to support a child's specific areas of need. We are bringing this. Discussion back from the vault today. I'm Emily Kircher Morris. A conversation with Dr. Sharon Selene is up next on episode 317. You are eighty four. Yeah. so sneaky in therapy because it often sounds reasonable at first. A client says, I just want to do a good job, or I don't want to disappoint anyone, or I need to think through it a little more before I start.

But underneath that, there may be a whole set of secret rules they're living by. I can't start unless I know how to do it right. I can't stop until it's perfect. If someone is disappointed in me, I've failed. If I need help, it means I wasn't capable enough in the first place.

That's why I'm really looking forward to our June 5th continuing education training with Dr. Matt Sikresky: Overcoming Perfectionism in Therapy, supporting neurodivergent clients who keep moving the finish line. For neurodivergent clients, those rules can Masking, executive functioning, giftedness, rejection sensitivity, and years of being misunderstood. So what looks like procrastination or rigidity, avoidance or overworking may actually be a client trying desperately to stay safe.

In this APA and NBCC approved training, clinicians will get a better understanding on how to recognize perfectionism, understand the anxiety underneath it, and use evidence-based approaches to help clients challenge those internal rules. If you can't attend live, the replay will be available to everyone who registers. You can sign up at Neurodiversity.university or just click the link in the show notes. Sharon Selene is next.

Start with the notion of I have a neurodiverse nervous system, but I'm not. They're already They are survivors. They got to be able to do it. On their own. You're already Fundamental changes. It makes all the difference. Nothing either good normal. Look for episode. in your favorite podcast app.

Today I'm talking with Dr. Sharon Saline, author of What Your ADHD Child Wishes You Knew, working together to empower kids for success in school and life. So, Sharon, thank you so much for joining us today. I'm so happy to be here. Thank you for inviting me. I think to start off, I know a lot of people have an awareness of ADHD, but maybe if you can just give us a bit of insight into some of the different characteristics we might see in ADHD kids.

Just so we all kind of are on the same page with that as we start off. So we know that ADHD is a biologically based condition. It's largely hereditary, but not exclusively. Around fifty-five percent of kids with ADHD have at least one parent who has ADHD. even if they are not necessarily aware of it. You know, signs of ADHD would be impulsivity, hyperactivity. It could also be inattentiveness, uh kind of dreamy equality, a lack of focus.

Uh we can also see, particularly in girls, um social issues, and we see these in boys too, difficulty making and maintaining friendships. impulse control, uh, challenges, emotional dysregulation, as well as issues with memory and follow through and being able to kind of stick with something even if it's unpleasant. Because one of the things that happens for

all all people with ADHD is that they have lower amounts of dopamine and norepinephrine in their brains. And those are two pretty important uh neurotransmitters. Dopamine has to do with pleasure and reward and interest and satisfaction, and norepinephrine has to do with concentration and sleep. And so we'll see, particularly in the dopamine pathways in the brain, that there's either less activity

Or there's there's just a kind of unusual activity. You know, it depends on everyone's brain is a little bit different. And so this is why people take medication. They may choose to or not, but they often take medication to assist with uh the neurotransmitters who are like the fairies of of of the brain. They basically take a message from one neuron to another. Across the synapse, which is like a river. So it's like a ferry crossing. And um in people with ADHD, sometimes those ferries just

There's not enough of them. Sometimes they run too slowly. Sometimes they run too quickly. They pick up the message and they take and they deliver it when it actually needs to hang out in the river a little bit. And so everybody's brain is different.

I think that's one of the things that is hard to overcome and that is the the stigma about ADHD because it looks like from an external point of view a lack of effort or a lack of caring. And if you just tried harder you know, then things would be okay. And that's the message that a lot of ADHDers get quite a bit, which isn't accurate.

It's completely inaccurate because the dopamine pathways have a lot of connections to the prefrontal cortex. So if you're listening, you take your hand and you put it on your forehead and you say, What were you thinking? or Oh my goodness, or in my culture, Oy Vey. Um that's the part of the brain behind your hand, behind your forehead that is the prefrontal cortex, and it's um responsible for executing tasks.

So that's where the executive functioning skills really, that term comes from. And uh there's a lot of connection through the dopamine and the norepinephrine pathways to the prefrontal cortex. And there's also sometimes some structural differences in people's brains with ADHD. So when adults, um, and sadly parents, um,

think of their kids as just not trying hard enough. Like you can play you can play your video game for, you know, two hours and be fine and concentrate. But, you know, when I ask you to rake the yard, you can only do it for five minutes. And I would say, Well, of course. That's because the the games are a high dopamine activity. There's a lot of reward and satisfaction and stimulation. And Ricagnyard is a low dopamine

co frankly, boring activity where I can't even see the results. And if I do make a big pile of leaves, I wanna jump into that and which will undo my work. So, uh you know, today I was talking with someone who I c w um I do some supervision and you know, she was telling me about this boy who's in high school and his parents are so down on him, you know, and he's not done well. He's very bright, but he's low grades and he's, you know, becoming a senior and

you know, he doesn't really trust adults and he d she's trying hard to make a connection. Um, but it's it's very challenging. Um, partially because the message he gets is like something's wrong with you because you can't Take out the trash. Mm-hmm. And remember to do that. I was working with um during COVID a a college student who was living at home.

And um her parents really wanted her to do a better job with the dishes. And she's quite bright. So she fits in the two E category, you know, which is right in your ballpark, Emily, and also in mine and Um and she's like, Why can't you just do the dishes? Why can't you just do the dishes? And she said to me, I hate doing the dishes. Like, I'll do any other chore. I'll do the litter box.

I'll do the composting, I'll take the trash out. I just I'm I don't really see the dishes and I hate doing them. So we talked about how to have a conversation with your parents and say, could we make a trade? You know, I'll do this thing that actually means something to me and and I'll put my dishes in the sink. But um or I'll work with you after dinner, but I can't really do it myself. I'm just not good at it.

And her parents who were really enlightened and one of them is a therapist were like, Okay, we'll try and see how this works.

And they did and it worked better because she actually did the things that she said she what. Yeah. That's kind of what I talk about a lot in my book and in my card deck and on my website, which is meeting kids where they are. instead of where you want them to be or you think they should be. Well and I know one of the other major influences, especially even in our house, is

uh the various needs that all of us have because of our own different flavors of neurodiversity. So you know, especially when it comes to trying to be an ADHD parent. for ADHD kids, it can get a little overwhelming. I think on all sides. Like you mentioned, that's one of the topics that that you always kind of try to address, which is how can parents better understand and communicate with their kids and really hear what their kids are saying.

Mm-hmm. Well, th I in my five C's approach, I try to address this. So the first C is self-control. We as adults manage ourselves first so that we can then um help our kids regulate. Right. The second C is compassion. We try to meet our kids where they are. We try to imagine what it's like to walk

you know, five minutes in their shoes. And um and that compassion is also directed towards ourselves as adults because we're not perfect and we're not going to get it right all the time. And neither are our kids. And I think today, particularly with social media, people have very high expectations for their parenting. unrealistic expectations. And there's a lot of compare and despair out there in the world of parenting, um, neurodivergent kids.

The third C is is collaboration. How do you work with your child given who they are and what matters to them so they have buy in and want to participate in what then the task that you're asking them to do or the program that you're setting up. It's a it's a together process. So that kids can feel like there's an incentive that matters to them and that you actually also can see that they're participating.

in in something that matters to you. So everybody wins. Yeah. The fourth one is consistency. So a lot of times, you know, that perfectionism, you know, rears its ugly head and we expect um ourselves to do it right all the time. We expect our kids to be able to follow through or complete tasks more often than not, more often than they might be capable of given their working memory challenges or their processing speed.

Um so we wanna look for, you know, um what I call efforting. You we wanna notice that. And then we also want to pay attention to um when things are making progress, they're not necessarily perfect, but that, you know, practice makes progress. And then the last C is celebration. And that is actually

really important and this comes from positive psychology, which is noticing what's going well. You know, kids with ADHD hear a lot about how they're missing the mark, what they're not getting, what they're doing wrong. And Dr. Barbara Frederickson and her colleagues at the University of Pennsylvania in the around two thousand ten did a lot of research and they found that the ideal positive ratio in all areas of life is three to one.

three positives for every negative. That's not what most kids are experiencing. They're experiencing for anywhere from ten, if you ask some kids thirty or forty negatives per day. So we really want to acknowledge, affirm, notice when things are going well. We don't want to bake a cake because your kid cleared the table, but we want to say hi uh uh you know give them a high five and say thanks for clearing your plate. I love when you do that. Yeah. Exactly.

I think another thing that that is really important to address, um, and I know that this is a topic that you think a lot about and talk a lot about, is ADHD and anxiety. Because I think so often those two things go hand in hand. Even if we aren't necessarily talking about clinical anxiety, what are your thoughts about the connection between those two pieces?

It's a great question, thank you. According to the statistics and the research, about thirty-four percent of kids with ADHD have co-occurring anxiety. That is clinically diagnosed. personally in my practice and probably in yours and for everybody who's listening You see this more often. A child or a teen or an adult may not meet the the criteria to have a a a diagnosis, but they may still live with a lot of anxiety.

And actually the statistics for adults with anxiety with ADHD are even higher, closer to 50%. Yeah. That's something that is is it's important for us to really take a few minutes, just as you've suggested, and explore that. One of the things that I think happens with ADHD and anxiety is that People with ADHD are a little more hyper-vigilant about themselves and about things in the world. And some of that comes from that negative feedback that uh that kids get early on about.

missing the mark when they're not even sure what they did, about saying something inappropriate when they didn't know it was it was not the strong choice. um about maybe tripping or having um a speech impediment or stuttering or whatever it is. And so what happens is over time, the kids start to develop a nervousness about themselves.

Which can then develop into anxiety. Like when is the next time that I'm gonna mess up that I didn't even know I was doing? Or when is the next time that something bad is gonna happen? Because it always does. And so this then develops, you know, general anxiety. And then over time what we see is a is a is a transition sometimes into panic. um into social anxiety, uh, and of course the the the everyday concerns about, you know, am I safe? Am I gonna feel okay? Uh is it secure?

And so um these are these are things that we see. We also see perfectionism, which is a sort of a manifestation of anxiety, and of course procrastination, which is also a manifestation of anxiety, because if you follow it along the line, it's like Oh, you know, am I going to be able to do this? I haven't done this in the past. What makes me think I'm going to do it this time? Pfft, forget it.

I think one of the things that's interesting too is that once those patterns are there Even if you're working on the ADHD and the executive function skills, and even if you try medication and the medication is really effective, I think it's really hard to then unlearn those patterns of anxiety.

The executive function stuff maybe is almost a little bit easier to quote unquote fix. I don't think that's really the right word, but you know what I mean. But once those beliefs are there, once those worries are there, once that hypervigilance is there, it's just hard to escape that. It is and you know, there is a a a a genetic

sort of susceptibility to anxiety, you know, a anxious parents have anxious kids. Um and anxious kids may have anxious parents. They're it's not so much a predisposition as it is um with with depression But it is a a kind of proclivity that we see that anxiety often runs in families. And of course, because many people with ADHD struggle with emotional regulation, so what happens is you have a little

un uncertainty. And because it's difficult for you to manage the intensity of your emotions when you have ADHD, that little bit of uncertainty or insecurity can feel like a tidal wave. in certain situations and then you're just struggling to keep your head above water. And so what happens is that a lot of times adults and well-intentioned parents try to reassure their kids.

Um, and really what kids need is validation rather than reassurance because you as their parent, you can't be there all the time to let them know it's gonna work out. And frankly, you don't know that it's gonna work out. What we wanna do instead is to validate, yes, you know what? It makes sense that you're afraid on the first day of school. Lots of kids are. You're not sure who your teacher is or what it's gonna be like to be in this class. I get it. Instead of don't worry, you'll be fine.

It always works out. So it's a tough, it's a tough dance for us because yes, we want to love them up and help them believe in themselves. And the way that we want to do that is to actually be the memory bank of past successes. Times when they overcame anxiety that we could bring into this situation so that they understand that that they have the capacity in them to get through this, even though it is a little scary.

You know, another area that is always very uh interesting for me and and that I have a lot of curiosity about is kind of sorting through ADHD and autism because I think that's another place where we have a lot of overlap there. And it's interesting because well, you can get online on pick your social media site and find all sorts of theories and ideas and And self-diagnosis tips for each of these things, you know, in varying degrees of of accuracy. But can you talk a little bit just about?

what the differences are, what it kinda looks like when they're layered, you know, and just maybe uh kind of trying to tease out where the executive functioning difficulties that go along with autism are compared to with ADHD. So everybody with ADHD has more executive functioning deficits or several really impactful executive functioning deficits that impact their daily living skills.

Yeah. Part of having ADHD means h having these executive functioning challenges, s severe challenges in some areas. And that's not necessarily the case with autism. So the diff some of the differences for me with ADHD is that kids with ADHD understand for the most part the rules of social engagement. Um, they may not follow them, but they understand them. And kids with autism often don't understand the rules of social engagement.

uh particularly well and they miss cu they miss cues. So kids with ADHD miss cues because they're distracted. Um kids with autism miss cues because they can't read them or it's too much information. coming at them. So your facial information is too much for me to process at one time. So I need to look, you know, at your hairline here. And that's a skill I that I've I've learned, you know, f from my counselor Emily, who is so great.

Whereas kids with ADHD, um, they get overwhelmed but they're and they're overwhelmed by a lot of uh information, both sensory and uh auditory and visual. And they share that with kids with autism, but you know, the the process of that is somewhat different. I think it's worth noting that about 50% of kids whose primary diagnosis is autism also have a co-occurring ADHD diagnosis.

But only about 14% of kids whose primary diagnosis is ADHD have a coexisting um autism diagnosis. So it's actually kind of different. And there has been some research Um that shows that if you um have a child or a teen who um is diagnosed with autism has some of the signs but may even may not meet the full criteria for ADHD.

and you uh use ADHD medication with them, that it will actually uh target both the s s some of the symptoms of autism and ADHD simultaneously, which is interesting to think about. I know that there's so much stigma surrounding medication as well. Mm-hmm. It sounds like you notice benefits with your clients who use ADHD medication.

Yes. And I also have clients who can't use it. Yeah. Like they've they've tried a couple of different things and then they just say, No, we're done. Um, it's a very frightening thing to give medication to a child uh for a parent. Um, I'm a parent, you're a parent. Uh I think i it would be scary. Um and so what we see a lot is that in elementary school parents are much more reluctant unless

behaviors are extreme to use medication. But by the time kids sort of get to secondary school, whether it's middle school or high school, and they're really struggling, both the kids and the parents themselves are much more willing to try anything at this point because they wanna have friends, they wanna be able to change classes, they want a locker that doesn't have papers fli you know, flying out when you open it.

they want to be able to, you know, have talked to people at lunch. Yeah. There is sort of this pattern um that I see quite a bit.

What about emotional regulation with ADHD? Because I feel like that's one of the things that is obviously to me a major part of ADHD, but sometimes kind of get it doesn't really get ignored, but people don't always realize it is part of the ADHD. Like do you have any ideas about like what's causing that within the ADHD? To me sometimes it looks like impulsiveness. And and just those big emotions. But I'm curious if you have any insights to that as well.

Uh you know, I would agree with you on that. I think that there is impulse control. There's verbal impulse control and there's behavioral impulse control. And and the thing that happens with these emotions, particularly anxiety, is that our body has a stress response. So our body and and particularly for ADHD brains.

kicks in very quickly to the fight, flight, or freeze modality. And so that amygdala is it th the loop is is very it's just very reactive. And so what we see is that it's hard for a lot of kids with ADHD to um slow down. I don't like the term calm down because I don't know about you, Emily, but when someone tells me I need to calm down, I'm just like, get away from me. It's gonna escalate everything. It's gonna escalate everything, exactly. But slow down actually is something I could

I could personally relate to and my clients relate to it. Um, you know, and how do we slow down? So I talk about this, you know, a lot in my cards or my book or whatever, my my website. Basically stop, think. Uh and recover. In fact, I've I've I've actually changed it in my book. It's just stop, think, act. But since I wrote my book, I've noticed, oh wait, there's a recovery time. Oh wait, there's a teaching time. So it's really like start.

And so I think about starting uh something different. You're pivoting and you're going to stop. You're gonna call a pause in the action because you yourself may need to calm down and your kids I said calm down, but Slow down. Yeah. That's because I said it about myself, you know. Different. And your child may need to slow down. So what are some activities that are okay to do in that pause moment?

And that pause moment might be, I wanna sit on the couch with you and have you read me a story when the last thing you as a parent wanna do is that. You know, it might be a hug. It might be, I'm gonna go play with our bunny, you know, whatever it is. And you can go into the bathroom and wash your face and look in the mirror and say, I know I can do this. I'm just having a hard time. Or text a friend or a parent or your partner. Yeah.

So we have that stop. We call that pause in the action. And and I think that's particularly hard in school because people don't call pause in the action. You're just expected to move on. over and over again. And kids, particularly neurodivergent kids, they need time to integrate. and regroup because when you're an overwhelm, your system is in you're in a stress response. You're highly activated and it's not like you can switch to something

slower. You know, peop for people who use use the zones of regulation, you can't go from red to green. You're gonna go red, then maybe a little orange, then maybe a little yellow, then maybe a little lime green, and then maybe forest green, right? You know Yeah. It's a process.

So, um, and then we have um think and think is when you come together and you actually use your best reflective listening skills and you say, Well, what do you think hat was going on? What would you have liked to have seen be different? Where do you think we are we should go from here? What's our next right step?

And then we take that next right step, action. And then we let things recover. We do not talk about what happened. We do not use a teaching moment because we're still too close to the red zone. So we're gonna just recover later, maybe three hours later, or the next day uh when you're driving in the car, you might be able to say, you know, yesterday when this thing happened, I'm just wondering if maybe next time

uh we could try something different and then talk about what that might be. But you you need space between the recovery and the teaching. So I've sort of shifted that to be from s T A sta to start.

Yeah. I like it. I like it. Well, I know you've given so many good ideas that parents can really use and I know that I could I could definitely sit here and talk to you all day. But As we wrap up in the essence of time, I have one last question for you. So if you were talking to a parent who is in the throes of trying to help their ADHD child but is just really struggling. What would you say to them? Like what is it that you would want them to hear?

Such a good question. I would want to s to say to them Take a deep breath and zoom out. This is this is a long journey. You know, and what your child mostly needs from you is attunement. acknowledgement and noticing, as well as appropriate boundaries. You care for yourself and you care for them.

I've been doing this for a long time, Emily, and I will tell you that I've had the privilege of working with people when they were six, seven, and eight, and then having them come back in my office at twenty eight. and see how they've actually created a life for themselves. I'm working with someone now and she um tried to go to college, it didn't really work out. She took some continuing ed courses on programming.

and worked with her father who does um cabinet making for a while and just applied for a job with a company who said, We want to take a chance on you. And, you know, got a job for like seventy five thousand dollars a year. And they said, and we also want to pay for you to take uh one or two courses so it per s per year per semester or a year so that you can get your bachelor's.

I mean, you know, you just don't know where things are gonna turn out. And I think when you're in the thick of struggling, all you see is, oh my God, my child is never gonna mature into a self-sufficient adult. And and I will say from my seat that I have yet to see someone who doesn't mature into a self-sufficient adult. Um, with the one exception of kids who, um, to be honest, um, become overuse marijuana.

or any other sort of substance. But even those kids often get treatment and they they kind of rebuild. There's a fundamental resiliency here. So be kind to yourself as a parent and be Accepting of your kids where they are and and remembering that i th there's a la a developmental lag for kids with ADHD uh in terms of brain maturity and that has to do with um the connectivity that we call myelination um between uh the prefrontal cortex and the rest of the brain.

and of uh there's a lag of about three years. So you may have a ten year old who may very well sometimes act like they're seven, and that is actually okay and and very common and to be expected, um, in certain areas. I know you said one thing, but it's so complicated. I know, it's a lot, it's a lot. Well, and and I think any words of encouragement are good, you know. And so, uh Dr. Sharon Selene, author of What Your ADHD Child. Thanks so much for the time to talk to me today.

Thank you so much for having me, Emily. It's been a great pleasure.

I think ADHD suffers from being the type of neurodiversity that people think they understand, but really don't. ADHD has been part of the conversation between parents, doctors, and teachers for decades, but even still, the characteristics associated with it are attributed to personality flaws. It's minimized by people who claim that every moment of distraction is part of ADHD, or who claim that ADHD can't exist because don't we all get a little distracted or procrastinate?

ADHDers are constantly trying to prove that they need supports. If Europe teacher of an ADHDer or you are an ADHDer yourself, just know that I see you. And together we'll keep doing the work to build awareness, acceptance, and understanding of ADHD. I'm Emily Kircher Morris. I'll see you next time on the Neurodiversity Podcast. Thanks to Sharon Selene. We appreciate her time. There are links to her work in the show notes.

Something you might not know, Sharon was also a guest in one of our professional hubs. We have the Educator Hub and the Therapist Hub, where professionals like you hang out and share ideas and get great content. Much of which counts, by the way, as continuing education credits, and we have exciting guests who can

your teaching skills or your therapy approach to be more neurodiversity affirming. We open the gates periodically so keep listening for the chance to join up with one of our membership groups. That's it for episode 317. Our host is Emily Kircher Morris. Cory Oric is our office coordinator and assistant producer. Hannah Hadike Swift is the program coordinator.

Andy Kahn is our chief clinical advisor, Amanda Morin is our hub co-facilitator, and I'm the executive producer Dave Morris. For all of us, thank you for listening, and we'll see you next time. This is a service of the Neurodiversity Alliance.