Introduction to ADHD and Curriculum
00:00:00
Speaker
Hello, my friends. Welcome back to the Play On Words podcast from Big City Readers. It is Miss Beth and today's episode we have psychologist and ADHD expert, Dr. Carrie Jackson. I can't wait for you to listen to this episode. We answer all of the questions that you sent us ahead of time. And there are linked in the show notes a whole bunch of free resources for you. I also wanted to remind you, spoiler alert, you'll hear both of us talk about having ADHD, what that looked like for us as kids and what that looks like for us as adults. And as you probably know, as an adult, I developed a curriculum that I felt was what I needed as a child. So people always say,
00:00:48
Speaker
Are your classes good for kids who have learning differences or dyslexia or ADHD? And what I always say is that's exactly who I had in mind when I created these. I wanted to create something that was fast enough and fun enough and simplified enough so that you don't need to have kids sitting on their screen watching this lesson for hours or sitting in a classroom for hours. The lessons are 15 minutes. And you can learn so much, not only systematic structured literacy instruction for our classes for kids that are four to 10, but
00:01:27
Speaker
It's all rooted in strategies around mindfulness and anti-perfectionism and has so much subliminal messaging about how we want to help kids learn to talk to themselves, not just as they're reading and writing, but in every area of their life. So this class is not specific or our classes at Big City Readers are not specific to just those kids that might have ADHD or anxiety or dyslexia, but they definitely are designed with an extra touch in those areas.
Enrolling in ADHD-Friendly Classes
00:02:05
Speaker
So you don't have to have any of those things in order to take the class, but it's definitely um something that we considered as we built out these classes. So as a reminder, go to bigcityreaders.com.
00:02:18
Speaker
to get the right class for your child and you can just work in 15-minute lessons two times a week and get your child exactly where they need to be, whether it's in the school year or the summer time. Let me know if you have any questions or need help picking out the right class for you. You can DM me on Instagram at Big City Readers or send me an email at hello at bigcityreaders.com.
Understanding ADHD: A Professional's Insight
00:02:40
Speaker
Okay, here's today's episode.
00:02:51
Speaker
Okay, welcome back to the play on words podcast. It has ah been a little break since we have had a special guest. I'm so excited today. Yay, we have Dr. Carrie Jackson, um who is a child psychologist who specializes in ADHD, which is one of my favorite things to talk about. Carrie, how are you? I am good. Thank you so much for having me on. Also one of my favorite things to talk about as well. Obviously, that's why I specialize in it. So very excited to talk to you today. Yeah. Okay. So you own a private practice, right? Yeah. In California.
00:03:27
Speaker
And you also um are a speaker. what what else Tell us a little bit about you. Sure. Yeah. Well, so like even backing you up as a psychologist, that means, at least in the US, I have my PhD in psychology, but I cannot prescribe medication. So I know that's a very big misconception. um So what I do is I do evaluations for kids who may have ADHD, dyslexia, dysgraphia, all those things, um anxiety as well too, and then I do therapy. um And so I also like to share content online as you do about evidence-based information for supporting kids with ADHD. So I'm located in California and have a private practice here. That's my main thing that I'm doing, I guess.
00:04:10
Speaker
I love it. And you, I love following you because it's really simple and practical tips you share on social media. That's, that's what I'm trying to do. Also like as a person with an 80 with ADHD, I'm like, people don't have, I lose them. Like just give them one. Here's the thing and here's how to fix it. And you do that. Um, okay. But I want to say one thing already off the bat. You said, so you don't prescribe medication, but you do diagnosing. And I think, That is even confusing to parents because I know we've talked on another episode when we were talking about dyslexia um That even a dyslexia specialist does not necessarily mean that they can diagnose dyslexia And I think that that is or and or like dangerously I think like a teacher being like oh, I think that your child has ADHD because they don't sit still Can you say more about that?
00:05:02
Speaker
Yeah. So I mean, as a psychologist, I do do evaluations and they can be pretty extensive also for something like dyslexia. And so if you're working with someone who does specialize in dyslexia, they may specialize in treatment, but not necessarily the diagnostic pieces, because there's typically some testing involved the same way with ADHD. I mean, other people, they may like just see your child being more hyperactive and think maybe they do have ADHD. But the reality is you don't necessarily know until you have a professional opinion about it. Yeah, and and I actually do specialize in dyslexia, and I will say like there are some things that I know, but I always make it so clear when I'm working with parents, like I am not diagnosing. These are things that are sometimes typical for you to notice at home, and if you're noticing them frequently, maybe then it's time to go to a diagnostician.
00:05:55
Speaker
um And, and I think that is though confusing because I think a lot of parents think that like teachers can say, Oh, they're dyslexic. Oh, they have ADHD. Yeah. And I mean, to parents credit also, I will say that teachers are really good typically at spotting potential signs, right? So even though teachers cannot diagnose, they are often one of the first people to be like, Hey, I am noticing some concerns, right? Your child is a little bit more hyperactive. That may prompt a parent to go get an evaluation, but the teacher, they're not able to medically diagnose your child with ADHD. Yeah. I think that's like kind of like in law when it's like allegedly, you know, like for a teacher to be like, this is what I've noticed is what they can say. So I think like, you know, some parents would be like, why didn't my teacher say something? And then some parents would be like, Oh, the teacher said they have ADHD. So it is, is a confusing area for both parents and teachers. So the parents and teachers and any other professionals can say, this is what I'm noticing. And then you can take that to get a diagnosis.
00:06:51
Speaker
Yep, exactly. And also as a psychologist, I'm not the only person who can diagnose ADHD. So I think that's important. You know, there are psychiatrists who actually do prescribed medication. Also, I will say some psychologists in some states can prescribe medication, but you have to do more training. And so I was in school for long enough where I was like, I'm good. I don't want to do any more school, but psychiatrists, therapists, as well as pediatricians are often really well trained. in diagnosing ADHD. The most important thing I would say is just finding somebody who actually specializes in ADHD because there's a lot of therapists who may have a more general specialty rather than ADHD.
00:07:28
Speaker
Yeah, I think that's, we had a, I had a speech pathologist on and I asked her a question about, um, school age and she was like, I actually specialize in the feeding stage. And I was like, Oh my gosh, we should do this on every episode to remind people, because I think, you know, people think, Oh, they're a teacher. They're an expert in this, or they're a therapist. They're an expert in all these things, but that's so many things to really niche down and they might be familiar with it,
ADHD Diagnosis and Stigmas
00:07:55
Speaker
but. I think that's such a good point. So I love that you specialize in ADHD. Why did you pick this area to specialize in? ah Well, I myself have ADHD. It's something that I share you know like on my page. And so when I went to graduate school, actually, though, I was not diagnosed with ADHD. So I did not get diagnosed with ADHD until I was an adult. Hindsight is always 20-20, though, because looking back now, I'm like, oh my gosh, the signs were there as a child.
00:08:23
Speaker
But really it was kind of just like luck that I ended up specializing with it in the first place because I started working in a clinic where we were working with a lot of kids who had ADHD. And I was like, wow, I really love working with the parents who they can then support their kids because so much therapy is actually just working with the kids themselves. But for ADHD is often working with the parents. so found that I love that and then eventually I myself got diagnosed with ADHD as well and so it's really just continued to be something that I absolutely love.
00:08:55
Speaker
I love that. So okay, you just maybe had so many ideas. um One was I love that you're like, that's open. and I share that because i i don't i'm i'm I have my learning behavior specialization, but um I talk more about reading. So it's not something that comes up often, but when it does come up and I say it, people often are like, oh, you share that? And I'm like, yeah, that means I'm smarter. okay And I think people still, I forget that like people don't have enough information on it. I'm like, Oh no, this is like, actually anyone with ADHD, I'm like, Oh, they're just, their brain's so fast. I heard someone say it's like a Lamborghini brain. Oh yeah.
00:09:37
Speaker
absolutely So do you, I guess like maybe let's talk for a second about like stigmas and like that, like about late diagnosis or like, why why do you see people are, do you think people are afraid of that diagnosis for themselves or for their kid? There's like so many ways I want to go down this now. Cause maybe if someone, I'm like thinking if someone has their child get diagnosed, then are they like, Oh shoot, is it from me? You know, and then is it, you know, okay, can you answer that? Yes. Oh my gosh. There's so many things I feel like we can talk about. like so First off, with diagnosing in general, most kids get diagnosed around seven years old because that's like when you know school teachers, they're starting to notice the signs. Or as a parent, you may notice like my child is struggling in school more. But for girls, typically, they are diagnosed more so during the teenage years because with hormonal changes, actually, it can lead to a worsening of ADHD symptoms. right
00:10:30
Speaker
so huge differences from just like a, um, gender standpoint and the diagnosis of ADHD. But because of like, I mean, people, they sometimes will think like, Oh, it's just ADHD. Like it's not that significant, but I don't think people realize it can be really deep debilitating. Right. And so I think there's still so much stigma around ADHD. And even as it's become more um normalize, like to share about having ADHD. In some ways I feel like that has further stigmatized it because now people are like, oh, everybody has ADHD. And I'm like, that is such a lie. Like not everybody has ADHD is considered a disorder for a reason. um So I can share like myself, I felt a lot of like stress around getting my own diagnosis because I was like,
00:11:19
Speaker
basically gaslighting myself. I will say I was like, did, do I really have ADHD? Like I'm smart. I got through a PhD program, but like the signs were there, they were there. And so I can see like why it's very hard a lot of the times for people to seek out that diagnosis. Yeah, actually that's, that's pretty funny because I, not funny, interesting. Um, I, I've gone back and forth because I think I was 10 when I was diagnosed, but I remember like crying in the doctor's office when they like said, oh, like my mom was like telling them the symptoms, and I remember like feeling ashamed. like and My mom didn't do anything, like but I'm a very like intuitive like child and adult, and I just like knew that that was like not great, and the doctor was great. I was i loved my pediatrician. I remember that. and
00:12:08
Speaker
And my mom wasn't like, oh, she's struggling with this. like she was very My mom had adopted a bunch of kids with special needs. I have a huge family. I'm the youngest biological of four. And then they adopted a large range, kids with a lot of different learning needs. So my mom is like a huge expert, huge advocate. like She knows what she's doing. And I still felt shame. I also think like what you're sharing about like, do I share this diagnosis with the child or not is something important to discuss. And whenever I do like an evaluation with parents, I always talk about like the risks and benefits, right? Because I just find that it's so unique to each child. Like when we do share the diagnosis, sometimes they can be like, okay, now I have an explanation for why some things are hard for me. And for some kids, it actually does like boost their self esteem because they're like,
00:12:57
Speaker
It's not just me. It's not my personality. I'm not a lazy child. I'm not a bad kid. Right. But then for other kids, certainly it can be like, wow, I am different. And it can take a little bit more time to help them understand and accept that as well too. Right. And so, I mean, I think like just starting off the conversation with kids about that, I think is. really challenging for parents but I would say that like over time it definitely does get better but I think it's important to have that conversation if you are considering things like medication or even maybe therapy or treatment and you can talk about it as like
00:13:34
Speaker
you know like just like focusing or helping with like when we're hyperactive or impulsive like sometimes you don't have to put a name to it especially when you're talking with kids which I think is really helpful because many parents I work with they typically are already talking about how you know You were really impulsive or i get strugglingally struggling to sit down. and so If you're considering medication, you could talk to your child about those pieces as well. but That being said, I think meditation is a great treatment option for for many families, especially you know when you've consulted with your doctor, of course, but it's very effective for kids. and
00:14:11
Speaker
Most kids do see some improvement with it as well. um That being said, there's also other treatment options like therapy that are helpful, classroom accommodations. So medication is not a fix all like magic pill, but it
ADHD Strengths in Entrepreneurship
00:14:25
Speaker
can be a helpful support option. like that it's more common to be talked about now. And so then how everyone's like, well, everyone has ADHD, but I do have a lot of friends who have ADHD, which kind of makes sense because all of my friends are entrepreneurs and like, so it's like who I like work with. We have the same schedules and like, we can be like in the middle of a conversation and then like not talk for four weeks and then like pick up in that conversation again. So like our brains connect really well in that.
00:14:54
Speaker
Um, but I do, it's really funny. I do have a friend who she always is like, I have ADHD. Sorry. I stopped listening. I'm like, no, you can't just be like that. I'm like, and in the group, like there's like eight of us. And then, you know, one of our other friends goes, we all do. We're all working on it. um But i think I think that is like a really good point that we want to do like a lot of things, not just like, OK, this medicine is going to fix your brain. But like helping a kid or even adult like understand how their brain works and that there's nothing wrong with it, it just works differently. not like Not as well, just different, I think is a great point.
00:15:33
Speaker
Yeah, yeah, just explain that, you know, every brain is different, right? Because everybody has their own strengths and areas that they need to support further. And so that's how I look at ADHD. And I mean, I think there are a lot of strengths to ADHD. Like, I think, again, it is very challenging. But at the same time, there are so many big strengths. Like you said, entrepreneurs, I would not be an entrepreneur without having my ADHD, because like, I literally cannot imagine sitting down for a nine to five job for the rest of my life. So I love that I'm able to do this. And I think that also can offer hope to a lot of parents, because they're like, your child, they will do do great, right? They can succeed with the right supports. A lot of the times, it's just about finding where they fit and getting those supports early on. Thinking about like both like the practical strategies, like you were saying, as well as the medication. We know that early intervention for kids actually does really train change their trajectory in the future, where they do much better in school, college, or even just jobs after high school, too.
00:16:33
Speaker
Yeah. Oh, that's amazing. I do want to talk about the difference of noticing it between others. So I want to talk to you for 14 hours because I'm like, okay, I want to talk about the difference between boys and girls because I think like a big thing about ADHD is that people think, oh, they're really hyperactive, but Could you talk about, and I feel like I've like researched this on my own just because I find it fascinating and I, but you're obviously an expert in this, but I feel like I once read that there's like three or a couple of different types. um And that one is like more of like a daydreamer, but I don't know. Maybe you know what I'm talking about.
00:17:09
Speaker
Yeah, absolutely. First off, add me to your group chat about the ADHD group. That's what I was going to say. We didn't keep talking for 14 hours, but um yes. So there are technically three presentations of ADHD.
ADHD Presentations and Gender Differences
00:17:22
Speaker
So there is the inattentive presentation. which is a lot of inattentiveness. And it's what most people think of as ADD, but we actually don't have that term diagnostically anymore. It's just the three different presentations. And so ADD is ADHD, an attentive presentation. Then there is the hyperactive impulsive presentation, which is if you have most of those hyperactivity symptoms. And then there is the combined presentation, which is when you have a mix of both inattentiveness and hyperactive impulsivity.
00:17:52
Speaker
So typically, boys are more so diagnosed with the hyperactive impulsive presentation, girls are more diagnosed with the inattentive presentation. So because of that, I mean, inattentiveness can be a lot harder to spot because you're just like zoning out a lot of the times daydreaming versus if you're hyperactive in a classroom setting or like at home, that can be a lot more disruptive and challenging. And so that's ah a big reason why girls they are going to be missed with their diagnosis, but then boys are going to more so be identified early on. And that of course leads to like a delay in treatment a lot of the times for girls, unfortunately. Yeah, I just saw like a video of some ADHD account, which I like love those. accounts ah They're so funny, but or it's just like so relatable. um And it was like talking about it explained ADHD and women in like 25 seconds.
00:18:45
Speaker
And it said that it often comes with um like a late diagnosis, which has like a lot of like grief around that, that like girls were just told, you know, they just felt misunderstood, which just added to the list. But but because I think that's, you know, as an adult for me, like I lean into it and I'm like, Oh, there's nothing wrong with me. I'm really successful. Sometimes It's hard for me to like finish my thought, but this is my superpower, where as a kid, I really did internalize that there was like, I was so, no one would understand. And I didn't even have the words to like name it. I just like, but I was a great student. I was like, I was perfect. I was every teacher's favorite. I got good grades, not like the best, but I think for me, it was more like emotional focused.
00:19:40
Speaker
Which, do you see that more in girls? Or can you talk about like the emotional side? I think people think it's strictly like impulsive and can't focus on tasks, but I think it's a lot of emotional regulation too, right? Yes, ADHD is so much more than just the inattentiveness or the hyperactivity. We know that kids and adults with ADHD struggle with emotions so much more. I read a research study that says that kids and adults with ADHD, they have stronger reactions to all emotions. so positive or challenging emotions, right? And I'm like, that fits to a T like you get super excited about something. But then also like, when something even minor happens, it's like the feelings don't fit the facts of what is going on. And and I feel like that was literally
00:20:24
Speaker
me as a child. like My emotions were so all over the place. I definitely struggle with a lot of the inattentiveness too, but even as an adult, I feel like sometimes my emotions are a big big challenge as well too. and you know so like If your child does have ADHD, they're probably not just struggling with the hyperactivity, the inattentiveness, and like you said, they can be doing great at school. like They can be super smart, excelling. I don't think I studied for a test until like the end of high school and so because of that it was just like skating through nobody noticed anything but looking back all the signs are there.
Personal ADHD Experiences and Insights
00:21:00
Speaker
Yeah can you is there like one big sign that you're like how did how did that get missed?
00:21:06
Speaker
Oh my goodness, okay well we were both talking about like the south earlier before we started recording and I can think back on the phrases my family would use and they are like diagnostic southern phrases I will say so my my family they would always say like Carrie you would lose your head if it wasn't attached to your body.
00:21:26
Speaker
And because I would lose everything, right? And so like, that would be something that would happen a lot. Like I would lose everything. That's the diagnostic symptom of ADHD. My family, they would also say, you're like a, not a deer in headlights. They would say like, the the lights are on, but nobody's home because I'd be zoning out. And I did not, like it was funny to me as a child. Like it did not bother me, I will say, but those things looking back, I'm like, wow, that is so clear. ADHD as a child. Like I was losing everything so forgetful. My parents, they were like, I would have to tell you to do things so many times. But I will say my mom is like, but you weren't hyperactive, right? Because she didn't know. She did not know. And I love my parents. They're amazing. But yeah, they just didn't know at the time.
00:22:12
Speaker
Yeah. And i think you know I think people think, okay, impulsive or hyperactive looks one way. And like when you're saying that, I'm like, well, that's not me actually. So then my my brain, I think like a human brain is designed to go, well, she's actually an expert and she's describing ADHD and that was her childhood. But me, I had everything in order and I knew where everything is and I i still have my closet color coordinated. So maybe I don't have it.
00:22:38
Speaker
Oh my gosh, no, definitely not because there's so many symptoms that go along with ADHD. And it's actually funny because I don't know if you feel this way, but I will have co-workers and friends who will tell me, you are so organized. And I'm just like, oh my gosh, really? Because I feel like I am a mess. So I think I'm like compensating for the fact that I'm so disorganized like in my brain and in other ways that I have to be more organized. Yeah, and mine is like, that's so funny. Like I literally, I remember like my partner, I was like making dinner one time and he like came in and like hugged me and I like reached behind him to like wipe something off the wall. And he was like, I'm hugging you. And I was like, I know, but there's just like a little bit of dirt there. And it's like but almost like a hyper focus on like, okay, but make sure everything is clean and orderly all the time. and It's like,
00:23:31
Speaker
Okay, let it go, but I can't like what if I forget that that's there and then I think about it later That okay, that is such a good point also because it's like ADHD the name is horrible like attention deficit hyperactivity disorder because it's actually not a deficit of attention is Difficulties regulating your attention to like what you're doing in the moment or what's needed so like for example that like not what's needed in the moment, right? But your brain could not regulate your attention to it. So a lot of parents they'll even say like, well, but my child, they can focus so well on some things like video games or like sports tennis, but then with schoolwork, it's really hard. Or like when we're doing chores, it's really hard. its And I can see how parents they would say like, okay, is it just because these are like really, really boring tasks? And I'm like, not necessarily. It's really because ADHD is really just about like that trouble with regulating your attention to what you need in that moment.
00:24:25
Speaker
Yeah. Okay. So do you have any tips for people that would say that? So like they're really, I know they're really, do you have any tips for me? Um, just kidding. But, uh, but like, so if they're like, well, it's sometimes, you know, I feel like that is such, what you just said is like such a thing that parents feel like I talked to parents and they're like, Oh no, no, he's such a good student. Oh, she's, she's so good at following directions. And, and I often am like, you know, if it's someone I'm close with, obviously I don't do diagnostic, but if it's someone I'm like one of my really good friends, I'm like, ah that emotional dysregulation is like, I would i would go get that test because they're like, no, they just have big feelings. And I'm like, I don't know. It like kind of seems, so yeah, can you can you share more about that?
00:25:08
Speaker
Yeah. Well, so I would say like some tips just around like some of the like regulating your attention. I think that first like visual supports can be helpful for adults so or for kids. So one um quick tip that I love, especially for kids as they get even like a little bit older that they can use at class or at home is let's say that something pops into their mind and like their brain is probably just like, I need to say this, I need to say this, or I need to do this right now. having a sticky note of all those distractions that pop into your mind so you can write them down and then go back to them at a time where it's actually more relevant because typically those distractions come up during the least helpful time, right? So like when you're doing something in work. And so especially with like kids when they get older into the tween teen years, that can be helpful or they can use it even in class if they have like a question or they want to raise their hand and say it, but it's just not the right time.
00:26:01
Speaker
They have a sticky note on their desk and they can write it down. That is super, super helpful. So that's one visual support that I like to use with adults, teens, and kids, I would say. But I use so many visual supports, I will say, for myself. and like Calendars, those are always important, although people with ADHD tend to hate them. It's like a necessary evil, honestly. It really is so funny. it's like I will get a calendar. i got i have like I have every calendar. I have the big one that's dry erase. I'm like, okay, get yourself a cool calendar. and Then I'm like, I stopped using it. and i but I have noticed that in my phone, because all my like work like this is in my phone. and
00:26:39
Speaker
if I have an actual meeting, but I've realized as an entrepreneur, I don't put everything else I work on unless it's like a client or a podcast or a meeting with someone on my team. But like there's things like blog edits and checking emails and editing the podcast and all these other things or like even like um reading current research. So I started putting that in my calendar to do. and Even though I don't always do it in the time that it's there, it does help me like be like, okay, remember, because then I'm like, I didn't do any work today. Even though I'm like, you know, like reading and listening and all the things, but I'm, if I see it, I'm like, Oh, he did do that. Okay. And so that, that visual does help. I would say.
00:27:21
Speaker
I'm trying to do that too, where I block off time in my schedule to do all of those other things. And I have to admit, I'm not the best at it because I will see it pop up. And then I'll be in the middle of doing something else. And I'll be like, oh, I'll do that later, which is such a mind trick that a lot of people with ADHD play on themselves. It's like, I'll get to that later, or I'll remember to do that. And it's like, you need to write it down because you're not. like You're lying to yourself. I literally, yeah, I write everything down. i and But I still am lying to myself. Yeah, that's something I work with a lot of kids and teens with. I call them like um thinking glitches or thinking errors that people with ADHD have. We've talked a lot about ADHD, or sorry, thinking errors with like anxiety or depression, thinking of things in black and white, but they're there with ADHD too, where you think, I don't need to like set my keys down in the place that I have for them because I'll remember where I put them. No, they're gonna be lost in the couch, or I don't need to plan out this project. I'll i'll get to it, it's fine.
00:28:19
Speaker
or or like the one you were saying like, I don't need to write that down. It's cool. I'll remember it. You will not remember it. So you're playing a trick on yourself with those thinking errors. It is so true. I can't tell you how many times I put my keys in like, like a ridiculous spot, like next to a plant and I go, I'm going to remember that, that they're right there. Like, It's like, why wouldn't you just put them two feet away? And the thing that, but it just, it makes sense in the moment. I don't know how to explain it. It makes sense in the moment. And it's like, you truly believe, but it's like without those environmental changes, right? Where you have like a basket that you put your keys in or a tile or like a
00:29:01
Speaker
AirTag, where you will remember it. It's just so not easy. And I look at those as big environmental pieces that can help you. I also want to say one thing about the emotional piece, RSD, rejection sensitive dysphoria, because I know we were wanting to talk about that. That's what I wanted to dive into, too. Yeah. So for people who are listening to, you may have heard of RSD or rejection sensitivity dysphoria. I don't think a lot of people have. Really? Okay. Yeah. i but The messages already are coming in. They're like, oh my gosh, this sounds like my son. This sounds like my daughter. This sounds like me. How have I never heard of this? I'm like, I know. Yes. Yeah. And so from the start, so, and I'm going to just refer to it as RSD from here on out because it's a mouthful basically, but um RSD, it is not a mental health diagnosis. So you can't go to a doctor or a psychologist or a therapist who will be like, your child has rejection sensitivity dysphoria, but
00:29:57
Speaker
it really speaks to the idea that a lot of people with ADHD, they tend to have higher levels of rejection sensitivity, which is this feeling that they have where they feel like they're more likely to be rejected in a certain situation, often social, I will say, and so they tend to anticipate that rejection coming up. But I will say also rejection sensitivity isn't unique to ADHD. There have been studies that it's a little bit higher in people who have anxiety or depression as well too, but some signs of it may be things like your child saying, I don't want to go to a birthday party because I'm worried no one's going to want to hang out with me or
00:30:34
Speaker
I'm scared to start this new sport because what if like people don't want to like play with me or my friend hasn't texted me back. This can be for adults. My friend hasn't texted me back. Do they hate me? Are they mad at me? Those types of challenges can come up with RSD and I will say that is something of the emotional side of ADHD a lot of times. So you said you said a couple examples of like, I'm worried that they that no one will play with me or I'm worried I won't make the team is what if they aren't saying I'm worried that they're just saying everyone hates me? ah is yeah Is that similar? Or is that like something that you would see? Or what what would you say about that? Very similar. And I would say also in kids much more common because they are looking at as a fact, right? And so if you're saying,
00:31:22
Speaker
No one is going to hang out with me. That is very much so. Black and white thinking, it is a fact. I 100% know it's going to happen when the reality is often much more gray. And so how do you like help a child understand gray, like say, yes, you have like a six year old, like, that I'm thinking of one of my nephew, and when he was six, and he was like very much like, he's so empathetic, deeply feeling like, just really, but I mean, the emotions up and down and
00:31:54
Speaker
Sometimes he'll say, he would say like, no, they don't like me. How do you, I would say like, Oh, okay. It feels like that. I know. But remember when they said this, like, I don't know. What do you, what would you say to help that child get in the gray area? Yeah, I definitely think starting with the validation, like you were sharing is very important, right? Because acknowledging how they're feeling is going to help them get to the point of changing how they're feeling and thinking about their thoughts. So starting with acknowledging, like, it must be hard to feel left out, right? Or I can see you're feeling really scared about this. I think those are a great place to start. And then trying to see, like first, if they're willing to try to like engage with those people or like to go to the situation they're wanting to avoid. So encouraging them, let's just test it out and see what happens, right? Oftentimes, what happens is not there their thought, right? So people do end up talking to them, right? So let's just test it out and see. and if
00:32:52
Speaker
If people aren't talking to you, we can try and talk to them and see what happens. And then I'll also try and talk to them about like, okay, well, has this happened in the past? Which the reality is, unfortunately with kids with ADHD, it may have, right? But it's oftentimes that they are looking at like that one time in the past that it did happen rather than the overwhelming times that it did not happen. And so trying to draw their attention to those other times is going to be super important too. Oh, that's so good. I feel like I'm thinking of my nephew in particular. I feel like if I, he he would like, he's in that state, he wouldn't really like believe like, you know, but if I said, let's go to the park right now and try it, like, I feel like he would be like, okay, like, I feel like that, like that practical thing is, would get a lot of kids with ADHD be like, okay, yeah, actually, let's go test it out. Like, let's go do it.
00:33:41
Speaker
Yes, like seeing is believing for kids a lot of the times. And so you truly do need to help them test it out because if, let's say they do avoid going to the park because they're like, what if, right? Like what if nobody tarce me, them not going to the park is essentially confirming that belief about themselves. And so to disconfirm it, we've got to like, try it out. We've got to test it out like an experiment, basically.
Managing ADHD in Children: Q&A
00:34:03
Speaker
Oh, that's brilliant. Um, okay. I'm thinking there's so many questions. I want to do some rapid fire questions. Um, and just like, see, I mean, if there's something that you really want to dive further into, great, but let's just see how many rapid fire we can get. Okay. Seven year old newly diagnosed. How can someone know if a child needs medication has the inactive ADHD is what they said. Is that, was it an attentive that you said?
00:34:29
Speaker
Yes, inattentive ADHD. Yeah. So, I mean, if you are concerned that your child is struggling like at school or at home, you could speak with a psychiatrist or a pediatrician about the possibility of ADHD medication. But the thing I would share with this, this parent in particular is don't look just at school as an indicator of if your child needs medication or not because ADHD medication has been shown to lead to improvements in emotion regulation, social skills, so many things outside of just schoolwork. And so if your child is struggling with any of those pieces, it's definitely worth like at least like talking to a psychiatrist about if it can be helpful or or not. um There's even some research now showing that when you start meditation earlier, it can actually
00:35:14
Speaker
have like a, not a protective factor on your brain, but it can lead to like increases in some of the brain areas, like the frontal lobe, where people with ADHD tend to struggle with. So it can be neuro generative, I believe is the correct medical term that, yes. Amazing. Okay. Well, that was a great answer. Um, how can parents rapid fire, how can parents best support them overall socially and academically? Okay, that was a big question rapid fire. Okay, I will say biggest thing academically is if your child is struggling in school, look and see if there are support options for them such as a 504 plan or an IEP because those are evidence based treatment options for kids with ADHD. and the school is going to have a much bigger effect on how your child's doing in school, then you will at home like their school behavior in particular. But then I would say socially, my my biggest advice is to first like have a lot of things at your house because so many parents get stressed when their kids go other places, right? Because they're like, is my kid going to be too impulsive? Are they doing a struggle in this new place? Post things at your house to give them that experience and so you can be
00:36:27
Speaker
Like the person who is noticing all the positives that they're doing at your home and your child is going to feel more comfortable at your home first. And so that'll give them great practice too. Oh, that's great. Okay. Speaking of impulsive, how to get an impulsive kid with ADHD to stop being physical. um Okay. Yes. So first thing is to definitely notice the positive times where your child is being calm with their body, right? So kids with ADHD, they really function where they are trying to get arousal in different ways. So this may be being physical in aggressive ways, right? So like hitting or kicking, or it could just be being overly physical with their body.
00:37:02
Speaker
So if you are giving them that stimulation by first like praising them for all of the times that they're being calm with their body, that will help. And then trying to get them involved in like some sensory activities like hard work, hard work or heavy work activities that can be super helpful too. Oh good. And do you think sports help? Oh yeah. And also like with sports. So if your child is struggling with like attention, especially around homework, doing some high intensity cardio exercises before doing some like focus activity can help improve their attention for like a really short period of time. So that can be super helpful too.
00:37:37
Speaker
I actually once heard a podcast from somebody with ADHD and um he said that he gets up to ride to his Peloton bike for three hours first thing in the morning. And that's how he gets all his work done. I was like, what? This feels insane. by Oh my gosh. Three hours. That is insane. I don't have that much time honestly in the mornings, but like just 20 minutes, honestly. And one of my friends, Dr. Patrick would count. He's actually the research consultant on the how to ADHD channel. So he has a research study on. how if you do high intensity exercise, just 20 minutes, so like have your kid go running outside, that will help their attention for a short period. Okay, that's good. Yeah, I do. I did get um a trampoline at one point in my life. I feel like jumping on that for 20 minutes right when you wake up helps me.
00:38:22
Speaker
I was just talking to my boyfriend about how I want one of those rebounder trampolines to help with my energy. And he was like, you are going to break your ankle again. Like, no, but I will be getting it. But I will be getting it. Um, wait. Okay. You broke your ankle. I broke my ankle. People with ADHD are more likely to get injured. Yes. You're more likely, I think it's two to three times more likely to break a bone. I have broken three in my lifetime and I'm 33 years old. So it's definitely more likely. I'm 33 too, and I have broken or sprained to my ankles 11 times total. i've Yeah, so I've sprained mine multiple times. The doctors, when they're doing the surgery, they're like, we think you actually broke it before. like
00:39:05
Speaker
This is a mess. It's a mess. of Okay. Two early questions. One, ah one is, should we medicate a four year old? Which I feel like you said, usually you get diagnosed around seven. Is that too early to be diagnosed or what do you, what are your thoughts on that? I followed the American Academy of Pediatrics recommendations, which they actually do state that the earliest age you can get diagnosed reliably is four years old. And when you are diagnosed at four years old, like they they've done studies where they're like following these kids to see are these symptoms continuing? And they are for the most for most kids. But when your child is four years old, so if they're under the age of six, the recommendation is actually to start with parent training, which I hate that name, but it's basically as a parent learning.
00:39:52
Speaker
specialized skills to support your child with ADHD because most parents will see improvements in their child's emotional regulation at home, their listening and their impulsivity through that parent treatment. But then if those aren't successful, then at that point, it's recommended by the American Academy of Pediatrics to consider medications such as methylphenidate, which I believe is Ritalin. um But starting with the parent training is definitely going to be the first step at the age of four. Amazing. um And then someone else said, what are early signs in toddlers?
00:40:27
Speaker
Yeah. So with all toddlers, you're probably going to see impulsivity, hyperactivity and an attention. So all toddlers, you yes, with all toddlers, because it's pretty typical, right at that age to have some impulsivity. So you really cannot diagnose it effectively at that age, but you still may see some overactive like behavior. So these kids, they may tend to show like a lot more energy than other kids as well too, but really until the age of like four, I myself personally do not diagnose until that age. And there are even some some families that I've worked with where if it's four years old and it's like kind of on the fence, we have to wait um because you need to see these symptoms across like multiple areas, so not just home. And so at four kids, they may be in daycare or preschool where you can get a better idea comparing to other kids.
00:41:21
Speaker
That's great advice. I always tell parents like when they're unsure about something or like do I go like or now we're on the wait list to get diagnosed. I always say to like just in your notes app like keep as much data as you can. It doesn't need to be like formal but just be like okay every day after lunch this is the behavior I see or like oh at bre you know kind of like and the more you can bring the better. Would you ah Yeah, absolutely. The more like and specific examples that you have, the better. I think that's really great. I have even like a blog post. I can always share it to you that you can put the show notes, but it's about like preparing for an ADHD evaluation, and it gives parents some things to like write down and and to look at for before going into that so they'll be able to provide the evaluator or pediatrician with the most helpful information.
Positive Reinforcement and Teaching Methods
00:42:07
Speaker
Okay, great. um What about discipline techniques for a child with ADHD? Is there a different type of discipline? Do you think that certain things work better?
00:42:15
Speaker
Yeah, we actually do know that certain things do work better. So a lot of the positive reinforcement strategies work really, really well for kids with ADHD. So that's going to be praise, rewards. Those are going to be the most helpful from the get-go because you're noticing the positive things that they are doing. And so they also build self-esteem too. um Consequences, they are not as effective for kids with ADHD. I'm not saying you shouldn't use them because I think that they do have their time in place, but kids with ADHD have more emotional reactions and they're a little bit less effective. So I always tell parents to really focus on praise, rewards, setting clear limits, and also like routines, building some of that structure for them can be helpful.
00:42:56
Speaker
Yeah, you know i um I'm always trying to learn something new so that I like can get myself in the headspace of how kids are learning and like you know the the anxiety I feel about going to a new place or you know all the things just to help parents understand that more. And i'm learning well i'm I played tennis before, but I'm like taking lessons now. And I realized that I'm like, i really I really do not. And I don't know if it's RSD, but like I had this instructor for like six weeks. I don't think she listened to this podcast, but i have this I had this instructor for like six weeks with the same group and it was fine. And then um though she said something to me, she was like ranking everyone if they were going to go up to the next level or stay at the same. And she said to me, she's like, you need one more round at this level. And I was like,
00:43:44
Speaker
No, i I in my head, I didn't say this to her, but I was like, No, I don't. And I was like, in that moment, I was like, she doesn't see me. And I stopped going, even though I had paid for four more sessions, I stopped going, except for the day that it was a sub and that sub like was so different of a teacher. He was like, she would be like, what did he do wrong there? Look at what, why did that ball go out? And it was so like negative focus where this guy was like, right there, where your arm is right there. Did you feel how good that felt? Do that again, replicate it. Like, and he was like, that's how it should feel in that part of your arm. And I was like a different person. And I asked this guy that I was playing with and that I had played for a while. and I go, why do I respond so much more to this teacher than her? And he was like,
00:44:25
Speaker
he was like because he gets you out of your head like he's like telling you to get in your body and she was like making me and I'm like I'm already analyzing things I don't want to analyze is that does that sound like yes that is so relevant okay you're doing a laugh so hard about this too because I also like do adult tennis lessons I used to play like during high school which is this is how I broke my ankle was playing tennis actually unfortunately that I sprained mine playing pickleball Oh my gosh, but I had a very similar experience. I will say like with coaches in general where it's like, I remember one time a coach, they made a comment to me and they're like, wow, this is giving me like a lot of information on areas we need to improve on. And I was like, Oh my gosh, like, okay, like, and that's where like the stress came up versus like, when a coach they're saying like, Oh, you did such a great job with this. That's great. Exactly. That positive feedback.
00:45:19
Speaker
is helping you improve, but it's also doing it in a more helpful way, right? Than just pointing out being negative. And that can be hard for parents of kids with ADHD to do because realistically, they're going to be more impulsive. So there's going to be times where they're getting that negative feedback where you're having to say like, Stop, don't do that. right Just like don't do that pet that thing you're doing impulsively. But if you can train your brain to notice, like even like at the dinner table or before bed, I'm going to point out five things that they're doing really well right now. That is huge for them. And it's better when it's immediate. right So with tennis, for example, he was giving you that positive feedback in the moment. You can actually connect it and change what you're doing in that moment.
00:45:58
Speaker
Yeah, I wonder, that's that's that seems like a really practical thing that parents can do because I think i think like we're we're thinking, you know someone will say, make it like so they don't feel like it's forced or whatever. But even I feel like it would I would respond to someone being like, oh, I just noticed five things that you did great. And i think for I'm imagining for our kid with ADHD, they're going to They're moving very fast. So they're not really noticing the things that they're doing great. So that in another way is like helping them to like see oh Wait, I did that. I didn't even know that I did that and so if we say like stop hitting your brother You're instigating everything you're you're always in a bad mood Like you can't act like this then that just like kind of I think would make someone with ADHD like spiral I'm bad and the worst like no one gets me I'm too much Everything I'm feeling isn't like it's too much. But if it's like if somebody said you did these five things it's like
00:46:51
Speaker
Oh, oh, wait, I'm here. Like it kind of like makes you go like, Oh, slow down a minute. Like, Oh, thank you. Okay, I'm here. Mm hmm. Yeah, because like you were describing like that shame spiral, I call it when kids with ADHD, when something is pointing out that they did something wrong or negatively, it's like, it can really lead them into a spiral. And like, of course, there are gonna be times where you need to address negative things. So I'm not saying that. But I'm still saying that for a lot of parents, finding the positives and really noting those is going to help your child so much. Yeah. Okay. Let me see if I can find a couple more. Um, you are. So this is like, I think going to change people's lives as this episode, you're answering so
Genetics, Environment, and ADHD
00:47:25
Speaker
many questions. Okay. Um, why isn't RSD recognized in DSM? Why is it not more talked about is the question. What's DSM stand for? That's our diagnostic manual. So that is, um, basically all the mental health diagnoses are in there. And so it's not included in there. Um, I believe because there's actually not enough research currently to show that it is like a,
00:47:47
Speaker
stand alone disorder, right? And also because we're seeing that there are just traits of it across multiple disorders. So that is the reason why. Okay. Is it genetics that causes it? A lot of ADHD is actually highly, highly genetic. um ah There is this really, really interesting podcast with Dr. Russell Barkley. I listened to, I'll try and find an incentive to you, but he talks about how like 75% of the cases they are genetic, but at the same time, that doesn't necessarily mean that someone in your family pass it on to your child. There is a large percentage of like let's say you you have ADHD and your partner doesn't have ADHD, your child is more likely still to have ADHD, but there's even um some research now showing that like with in general women and families like delaying their first pregnancy that just there's some environmental changes that
00:48:38
Speaker
potentially lead to more likely to have ADHD but yes mostly it is genetics that are the cause. Some other things like even with the birth you know so like having like low oxygen at birth which something I was affected by as ah as an infant like I have low oxygen at birth or even like a premature birth that can actually lead to ADHD as well. You know, I know this isn't what we were going to talk about, but I did have a therapist friend one day that like a lot of trauma accidentally gets diagnosed as ADHD. And it's like ah unresolved trauma. And then if you work through that, you actually like don't have it. Have you noticed that at all?
ADHD and Mental Health Overlaps
00:49:15
Speaker
So it's interesting because trauma can look like ADHD a lot of the times in kids, because especially in kids, one of the symptoms of trauma is having a hyper reactivity to things. And so being really reactive, sometimes aggressive also with kids that can show up. um But there is, again, this is so interesting how brains work. So people with ADHD, if you do experience a trauma, you may actually be more susceptible to PTSD. So there could just be like a bigger overlap as well too. So I don't know, the brains are just very interesting, but there is an overlap there. And you could have both. Yeah, you could. Yes, unfortunately. um What is the difference between ADHD and anxiety in children?
00:49:56
Speaker
Oh, I love this question too. So both share some common symptoms. So avoidance is a big one that they share. So avoidance of tasks that you really dislike is common with ADHD, but with anxiety, you're often avoiding things that make you anxious, right? So like going to a birthday party, meeting new people. talking to someone new, doing a presentation, but there's also distractibility. So inattentiveness is actually a symptom of anxiety, which I don't think many people know. Oftentimes though, like if you're looking at why is somebody with anxiety inattentive, it's typically because their mind is going different places. They're thinking, they're ruminating, and so they're less focused in the moment.
00:50:36
Speaker
versus somebody with ADHD, their brain is shooting off in different directions, but not necessarily like anxiety related thoughts. um I've also seen like a big overlap though, where it's like, if you have ADHD, you're like putting off work and you're really, then you become stressed by it and then the anxiety starts too. Yeah, I had a therapist friend explain this one time because I think I said something like, Oh, maybe I just have anxiety. And she's like, I don't think that you have anxiety. Um, like she did, we were newer friends and I, and I didn't like, had I hadn't said that I had ADHD. And she goes, um, have you ever considered that you might have like a focus? And I was like, Oh, I have ADHD. But she was like, that is the thing. So anxiety is like, what if, what if, what if, what if? And ADHD is just like producing thoughts. Like, that's that. That might happen. But not like worrying through it where anxiety is like, oh, no, what's going to like? And so I was like, oh, yeah, I'm not really worried.
Sensory Issues and ADHD Management
00:51:27
Speaker
I'm just having a lot of rapid thoughts. Yeah, absolutely. I love it. OK, let me find like one more really good one.
00:51:36
Speaker
um Oh my gosh, these are such good questions. ah Oh, do you ever see ADHD linked to sensory issues with food? Yes. um Do you know what ARFID is? No chance. Okay, so this is in the DSM, which again is considered is considered an eating disorder, but it's avoidant restricted food intake and just avoidant restricted food intake disorder. It's really, really
00:52:08
Speaker
sensory driven, I will say in a lot of cases where it's like kids who have extreme picky eating or sensory characteristics of food really, really are hard for them. And so that's like on one end of the spectrum where those sensory difficulties can come up a lot of the times with kids with ADHD. But I will say, like even with kids without that diagnostic um piece of having ARFID, there's often sensory issues as well, like with eating or even with clothes and stuff too. Some of that can be normal, I would say, especially like through like eight years old, but at the same time, like it can be more pronounced and more intense for kids with ADHD.
00:52:46
Speaker
Okay, and I want to end with a good strategy. So strategies for when the overwhelming explosive emotions take over this person didn't specify for adults or kids. Okay, well, I will share my favorite strategy for every age. So, okay, so my favorite strategy is actually from a therapy called dbt, which is really about intense emotion. So they have a skill called the tip skill and the T stands for temperature. Okay, so Basically, when you're feeling really angry, really intense emotions, your body, like your heat goes up, right? But with the temperature skill, what you do is you actually want to like have an ice pack on your forehead, and then you want to even like put your, I don't know how I can explain this, I wish I could show it like through the camera more easily, but like you put your head basically on your knees, you just want it bending down.
00:53:37
Speaker
It engages what is called your dive reflex, which automatically slows down your heart rate. You want to hold it there for like 30 seconds. Yeah. So there is like a legit reason why it calms you down for kids with ADHD. I find that they really like it because it's not just someone telling them. take deep breaths, count to 10. It's like a little bit more fun. You can get a cool ice pack. And for adults, you might see this on TikTok where people, they're like dipping their faces in ice, fast of water. Cause you can use it for panic attacks too, but you can use it for all intense emotions. So that
00:54:09
Speaker
It's a strategy I love, I will say. In the moment, do that. In the moment, literally do that. And if you can't, I've even like talked to some families about how you can take a break in the bathroom just to splash some water on your face, right? Or it's summertime while we're recording this, so you can like go jump in the pool and literally go swimming. That will engage your dive reflex. You know, that's, that's really interesting. I was just thinking one of my friends has a cold plunge and I was talking with her about her child who has a lot of emotions. And I was, I am listening to them like, I wonder if he should start cold plunging. Yes. Right. Like 22 degrees. It's like 48 degrees, but still it's freezing. That is really cold. Yeah. Some parents they'll say like their kid, when they started swim lessons, it made a huge difference in their emotions. So I think that's a really cool.
00:54:57
Speaker
coal potential coping strategy too. Okay, that is good to know.
ADHD Diagnosis and Support Systems
00:55:01
Speaker
um Is there anything else? I mean, they' I'm like looking at the questions, there's more and I'm like, I know I have to cut this um to respect your time, but we talked about how it's not, it's not a death sentence. It is something that is really exciting. You just have to work with it. um That the difference between girls and boys treatment, anything else you want to add to that part? No, I think we've got that one. I mean, there's always so much more, but yeah. right Yeah. Mike, do we answer that enough? um Age to get diagnosed, strategies to help. And okay. So if someone just got diagnosed that's listening to this or their child just got diagnosed, what is the very, very first thing they should do in your opinion?
00:55:44
Speaker
Oh yeah. Okay. The very first thing that they should do is, well, first look at all of the options for support that are there for you, right? So I will say like, not even for your child, but you as a parent, you are going to need support. rather Whether it is people in your family or people outside of your family, because realistically, like parenting a child with ADHD, there's going to be some roller coaster moments where like, you're going to feel like you got it. And then you're going to also struggle at times, even like when they come into the tween teen years, it's going to be like a roller coaster. So you're going to want to know from other people what it's like and how they can support you. So that's why I would say it would be my first tip for finding i that
ADHD in Women and Hormonal Impacts
00:56:20
Speaker
support. That is amazing. Well, I wish that more people had access to you earlier. I know. I know me too. I wish I could clone myself also in true ADHD fashion. Like when you're telling me, is there anything else like
00:56:34
Speaker
girls-wise, boys-wise, ah something popped into my head. So I talked about how girls are diagnosed like later because of hormone changes. So there's also, like if like you're a woman who is listening to this, and there's also another time where typically ADHD symptoms become worse, which is after childbirth because of, again, the changes in hormones. So typically during pregnancy, because of the increase in estrogen, women's ADHD symptoms actually improve a lot, but then post childbirth, they can actually be much worse and they can be challenging. And so that's another big time where women will be diagnosed. And a lot of the times they're feeling like, okay, maybe this is just being a new mom, like struggling with things. But so if you're feeling that way and you're thinking, is this ADHD? You're not alone and you should look into it because it can realistically show itself more at that time as well.
00:57:27
Speaker
Yeah, and you know that just reminded me, of in true ADHD fashion, um that I think that also, as adults, it's easier. you know like A lot of people are like, oh, it's depression. It's anxiety. But like they ADHD is more likely. You are more likely to have some depression and anxiety. Is that true? I feel like I heard that. um So it's kind of, I do feel like people are likely to just be like, oh, that's what it is. Instead of like looking at it, could be it could be more. than just being a new mom and kind of depressed or anxious. like maybe Maybe it's something that you never ever were diagnosed with. Yeah, absolutely. And that's why, you know like especially in that case, like I know that you're getting care right right from your OBGYN or your PCP, but you may want to look at like a therapist that specifically specializes in late stage. i don't late Late stage sounds so weird because typically you're like you're not like
00:58:21
Speaker
very old, but still anyways, just like lay diagnosed women with ADHD because they will be able to identify the signs.
Resources and Community Support for ADHD
00:58:27
Speaker
Yeah, because I think like a lot of people would be like, Oh, I can't, I can't get out of bed. I'm depressed. But there's like, you you could just like rot. I feel like people with ADHD would like be like lay around and like have that lazy feeling. And it's actually not necessarily depression. It's just like, Oh man, no motivation. Yes. That's struggling with task initiation. Yep. Yeah. I love it. Oh my gosh. You are amazing. I can't wait to get this episode shared with the world. And I'll link where they can follow you and anything that we mentioned. Oh, the blog post you'll see. You can send that to me and great.
00:59:06
Speaker
Yeah, perfect. Yeah. And I have lots of free resources, like free guides for parents, which I think is like a great place to start. So I'll send you those too, so people can download them. I've got them for kids and for tweens and teens. So that way they can just down download them and get support early. That's so great. I feel like there's like the, the teen and tween space kind of drops off. So that's, I'm excited to share those. Me too. Yeah. Thank you so much for having me. This has been so fun.