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What is ADHD Really? (feat. Michael M from GrowNOW ADHD)
548 Plays2 years ago
In EPISODE 52 I am joined by Michael M (@grownowadhd) who is a dad, husband, and ADHD & Executive Function Specialist. He is an ASHA Certified Speech-Language Pathologist and brings his expertise in helping you and your child through the most critical times of life. He has been working with children and adolescents across the globe since 2005. In this episode, we talk about what ADHD is and is not, the myths, warning signs, and what to do to get help.
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Transcript
Understanding ADHD: Beyond Attention Issues
00:00:00
Speaker
And the more we learn about ADHD, it's really not about attention. It's really a disorder of self-regulation and executive functioning.
Meet the Host: Travis of Therapy for Dads
00:00:10
Speaker
This is a Therapy for Dads podcast. I am your host. My name is Travis. I'm a therapist, a dad, a husband.
Podcast Mission: Integrating Mental Health and Parenthood
00:00:18
Speaker
Here at Therapy for Dads, we provide content around the integration of holistic mental health, well-researched, evidence-based education, and parenthood. Welcome.
00:00:30
Speaker
Well, good morning, good morning, welcome to the show, therapy
Special Guest Introduction: Michael McLeod
00:00:34
Speaker
for dads. I have a special guest on someone that I met through social media, through Instagram a few months back. And we as dads have been trying to connect for the past few months and have had, well, just dad and life things come up. We've had to keep rescheduling, rescheduling, but finally we're together. Finally, we're having this conversation. I'm very excited.
00:00:54
Speaker
to bring on this show and talk about, I think, a very important topic, something that I, in my private practice and my professional experience, I come across a lot, and it's something that we are seeing more and more of, but something I do notice with this conversation, I think there's a lack of good education, of understanding,
00:01:17
Speaker
A lot of misconceptions. So I am bringing to you today, Mr.
Michael's Expertise in ADHD Training
00:01:22
Speaker
Michael McLeod, who is an ADHD and executive functioning specialist who works at Philadelphia. He's the owner of Grow Now ADHD that services students and families from across the world. He conducts professional ADHD and executive functioning trainings at schools, professionals, and parents.
00:01:42
Speaker
educating them on the most up-to-date research and practices to strengthen executive functioning skills. And I will link all of his content for you in the show notes, but welcome. Good morning, Michael. Good morning. Thanks for having me. It's a privilege to be here. Yeah, so good to have you. So good to have you on. So anything else we need to know about you, Mr. Michael?
00:02:06
Speaker
I've been working with youth pretty much my whole life, summer camps and schools and residential treatment facilities. I'm a licensed and certified speech and language pathologist as well. Over time, I developed this grown-out model of strengthening executive functions via the concept of internal language.
00:02:27
Speaker
So really what I'm trying to do and my mission in life is to get rid of a lot of the misconceptions of ADHD and this old outdated view of ADHD and executive functions as someone with ADHD myself. It's a passionate topic and all the students I work with are just incredible people, incredibly families, incredible families. I just absolutely love what I do. I'm very passionate about my work
00:02:55
Speaker
being able to work with these incredible students and families each and every day out of my practice and on Zoom. It's such a privilege and it's something I love to do. Yeah, I could tell you you care about this topic and from your own experience and then working with individuals with ADHD like it's that kind of combo and I could tell you love it.
00:03:15
Speaker
Absolutely. So language is such a foundational focus of what our brain does. The ability to use nonverbal images in the brain and verbal images in the brain to visualize to ourselves, to talk to ourselves, to have an internal system of checks and balances. That's really the foundation of self-regulation. And the more we learn about ADHD, it's really not about attention.
00:03:45
Speaker
It's really a disorder of self-regulation and executive functioning.
Dispelling ADHD Misconceptions
00:03:49
Speaker
Let's just jump right in. I think we're already starting to talk about this first question is, well, what are some of the most common ADHD misconceptions? Absolutely. So a lot of it really stems from that name ADHD and a lot of the great leaders in the field, you know, this field of ADHD is such a small little niche and there's some incredible leaders in this field like Dr. Russell Barkley, Dr. George McCloskey,
00:04:13
Speaker
Sarah Ward, who was a fellow speech and language pathologist, Peg Dawson, the author of Smart but Scattered. You can look at your Attitude magazine, ADD Attitude magazine, your local chat organization. A lot of the great leaders, the prominent leaders and the local leaders, are really pushing to have this name changed in the DSM, the Diagnostic Standards Manual.
00:04:39
Speaker
because it's really a very misleading title. It's not an attention deficit, first of all. It's individuals who have an abundance of attention, too much attention to give, where they're responding to all of the stimuli in the environment and they're easily getting distracted and responding to everything out there.
00:04:57
Speaker
And this heavy focus on hyperactivity, inattentiveness, whether it's inattentive type or hyperactive type or combination type, it's really so focused on the external, you know, kids who can't sit still, kids who can't focus, kids who are lazy, kids who are disinterested.
00:05:16
Speaker
And it's causing these kids to not get the therapy that they need. It's sending them to outdated and ineffective therapies, whether it's behavioral or occupational, whatever it may be, and into these social skills groups because of things they're seeing externally.
00:05:33
Speaker
But it's really the internal executive function skills that are lacking. And Dr. Russell Barkley talks about this, Sarah Ward talks about this, is it's really EFDD, executive functioning developmental disorder or developmental delay in varying degrees of severity. So that prefrontal cortex of the brain right behind the forehead, so over time the brain develops from back to front.
00:05:59
Speaker
and the front of the brain is the last to develop, and that prefrontal cortex, the front of the brain, isn't really fully developed until around 25, 26, between 25 and 30.
ADHD and the Brain
00:06:09
Speaker
So those executive functions develop over time through relationships and experiences. So we live in a world right now where relationships and experiences are significantly decreasing, and we can certainly talk about that. But individuals with ADHD,
00:06:26
Speaker
are they have a significant developmental delay of that prefrontal cortex is developing slower there's lower rates of dopamine in the brain is a disorder of structure. Function and development of the brain so this is a true neuro diverse population in that the brain is different in terms of structure function and development.
00:06:48
Speaker
And all the areas that are affected are the areas that deal with self-regulation, self-motivation, social-emotional decisions. So this disorder of ADHD really needs to have a heavier focus on emotion management, ability to self-regulate, self-motivate, and really be able to manage your overall external behaviors internally.
00:07:17
Speaker
Hmm, and I think I have seen that as well, some of these misconceptions. I've done some of my own reading on this over the years and better understanding because I'd get all these kids with ADHD and it's something that I wasn't, you know, I didn't know much about other than, oh, it's the classic stuff, those misconceptions of fidgety, can't sit still, can't focus, hyperactive, you know, kids bouncing off the walls. I have seen those kids that for sure they have those classic, I would say, hyperactive, you know, they really do.
00:07:45
Speaker
Something else I heard, I can't remember if I read this or heard it, I can't tell you, but it was that kind of hyperactivity of the mind where it's more of like you said, there's too much focus on too many things which can look like and appear physically as either bouncing or where they kind of shut down and just don't, they're not there and present because there's like, there's too much stimuli.
00:08:08
Speaker
You got it. And that was such a eye opener. I remember when I was first trying to understand it, I was like, oh, that makes a lot more sense. That is, you know, and with my understanding too of the brain, the developmental part of the brain, the prefrontal cortex, like I know a lot about that because I do a lot of emotional control with, you know, with, with adults or, you know, teens or young adults and trying to understand, hey, trying to build this part of the brain, you know, often when we're triggered in our emotional state and we're heightened, we're not actually operating out of our part of our prefrontal
00:08:35
Speaker
to the
00:08:53
Speaker
Someone with ADHD is, we're all swimming in a pool, but people with ADHD, it's like they're swimming with one arm versus two. So they're there, but it's like they're having to work overtime to keep up. That's exactly what it is. And the way
Social Challenges and Comorbidities
00:09:11
Speaker
Dr. Russell Barkley describes it is, it's not a disorder of attention, it's a disorder of performance.
00:09:17
Speaker
And it's not a disorder of intelligence, it's a disorder of performance. So really what ADHD does is it splits the brain in half between performance and knowledge. So these kids really know the rules, they know what they have to do, they've been through these experiences before, but when it comes down to the natural environment right there in the moment, it's very hard for them to
00:09:44
Speaker
use what they know and show what they know. So they've been through these social skills groups where they know not to alienate themselves. They know how to not upset a peer or dominate a conversation. And they've been through these negative emotions before when it's hard for them to make and keep friends. It's hard for them to apply what they learn in the classroom to tests. They struggle with reading comprehension and writing.
00:10:12
Speaker
and they have all these negative emotions and negative feelings that they've been through and they want to improve and kids with ADHD have such
00:10:20
Speaker
great empathy and they want friends and they want to have lots of friends. They want to have experiences. But because of their ADHD, they end up getting stuck in video games and computers and internet and phone and screens. And kids with ADHD are heavily prone to screen addictions and video game addictions. But overall, their ability to perform in the natural environment and show what they know and
00:10:46
Speaker
Use their social skills and use their academic executive functioning skills and learn from past experiences It's so hard for them and that's really what leads to all of this negative self-talk so individuals with ADHD have very high levels of negative self-talk negative self-image and this is what leads to a lot of the comorbid issues of anxiety depression and
00:11:11
Speaker
you know, whether it's an eating disorder or whatever it may be, so many times ADHD comes with something else. And I could for sure back that up with what I've seen a lot of comorbidity, especially if it's not diagnosed or not caught, you know, it presents itself as depression.
00:11:31
Speaker
anxiety work people did they just give up because there's this expectation of the the child of the teen like why can't I just like what's something I can't seem to I can't seem to focus or on one task I can't seem to get anything done and so they're so distractible because they're thinking of 10,000 things so then it can manifest as like shame and something's wrong and so then they give up and it's like hold on there's something's going on then you get tested you're like
00:11:55
Speaker
Oh, hey, look at this, you've been struggling with this and then for some it could help because they realize, oh, it's not me, it's like my brain, you know, and that's something that I can't control, but there's ways to learn to get help. So the next question, which I think is naturally going there, what are some of the warning signs that you would say that parents, dads, moms should be aware of that would warrant further testing or further exploration that you would want to be looking for?
00:12:20
Speaker
Absolutely. So really what you want to see, especially in some of our younger kids, is are there chronic issues? So are these things coming up over and over and over again and you're not seeing this child learn from the experiences? So quite often are you getting calls from the teacher saying this student has trouble sitting still, maintaining attention to task, maintaining play with a peer and interacting positively with peers and
00:12:50
Speaker
Showing flexibility and understanding others perspectives and having fifty fifty reciprocal conversations so if they're having a lot of difficulty during Unstructured time you know whether it's circle time or play time or recess or whatever it may be they're really struggling interacting with peers and
00:13:08
Speaker
positively and consistently, that's a big warning sign. During that unstructured time, because ADHD kids really struggle during recess, during lunch, when everyone else is just reading the room and conforming to what the environment calls for, like being quiet in the library or sitting and eating and staying at your table and interacting with everybody at the table. Following along with those social norms in the social environment,
00:13:37
Speaker
if they're struggling with that consistently. So when you look at all of the testing for ADHD, it's not really your typical test where the student takes the test, you check the scores, and you say, okay, based on the student's scores, he has ADHD.
00:13:52
Speaker
Most of the ADHD tests, like the brief, the behavior rating inventory of executive functions, the McCloskey scales, so many tests really are observational rating scales. So as individuals who are with the student the most, observing them in the natural environment and taking note
ADHD Diagnosis and Social Skills
00:14:13
Speaker
of what they see,
00:14:14
Speaker
never, moderately, or often. So we're measuring how often we're seeing these behaviors and how often we're seeing these troubles. And that's really the way it's always going to be for executive functions. There's never going to be a standardized test to measure executive functions because executive functioning is a true internal skill. It's basically your imagination. So there's no way to effectively measure that. We have to observe the student. We can look at writing samples,
00:14:42
Speaker
reading comprehension samples, some social pragmatic tests here and there. There's lots of tests we can do, but we're not going to get a true picture of the student unless we're doing parent interview, teacher interview, and a very deep case history. So really what we want to do, all these warning signs we're looking for, most of them really have to be observational.
00:15:03
Speaker
So we're looking at the unstructured of lunch and recess and playtime. How are they conforming with peers? Are they standing out like a sore thumb? Are they having a lot of difficulty, consistent emotional breakdowns? That's a big one. Inability to maintain play, like I said. But in the classroom, are they having trouble initiating non-preferred academic tasks? Are they having trouble getting starting, persisting, completing? How are they doing during group work?
00:15:33
Speaker
What are they doing during, you know, lectures, those sorts of things. So, so much of these warning signs are observational, but we have to see, you know, every kid gets distracted. Every kid has emotional breakdowns. Every kid has issues with peers. But is this happening consistently over and over and over again? You've tried consequences, you've tried talking to them, you've tried everything in the book, and it continues to happen. That's when we have to start to dig deeper.
00:16:01
Speaker
Yeah, and you mentioned something too, which sounds like a possibility of a warning sign when the interaction you were saying with other peers and the instruction where you're saying kind of the 50-50 back and forth. Could you give an example of what that might look like where a kid is, maybe a kid who has ADHD where they're in that kind of social environment where there's not that back and forth, like what would that actually look like just to be practical?
00:16:25
Speaker
Yeah, so this is another huge part of ADHD that I'm really passionate about because so few people understand it. So this term ADHD is just about attention, hyperactivity, inattentiveness, and it really causes ADHD to be seen as this academic school-based disorder that's going to affect them with homework and grades and learning math and science and all that stuff. But that is literally just such a small fraction of what these kids and young adults deal with.
00:16:53
Speaker
ADHD is a disorder of executive functions, and part of that is social executive functions. So we have to be really, really aware of that, is really what social executive functioning is, and just how deeply it affects these kids, and if anything, that's the biggest source of negative self-talk, and that's the biggest source of anxiety and issues, is the inability to be successful socially.
00:17:19
Speaker
So social executive functioning is a huge component of ADHD. So number one, the number one social executive function skill is perspective taking skills. So kids with ADHD, ADHD and executive functions, part of that is self-awareness and self-evaluation. So two executive functions are self-awareness and self-evaluation. So those two skills are weakened in individuals with ADHD. The ability to be self-aware,
00:17:49
Speaker
perceive your environment, be aware of your actions and your behaviors in a given environment, and also self-evaluation, the ability to look back in the past and look at how you did something, look at your choices, look at your behaviors, and learn from them, evaluate yourself, and perform better in the present moment by reflecting on the past.
00:18:10
Speaker
So self-awareness and self-evaluation are impaired, so the ability to think about your own thinking, metacognition, is a big issue for these kids. And it's even harder for them to understand the metacognition and the thinking of others. So what types of thoughts am I putting into others' heads?
00:18:28
Speaker
Am I giving them cringy thoughts about me? Am I giving them really positive thoughts about me? Am I respecting their interests? Am I making them feel good about being with me? So what types of thoughts and feelings am I giving off based on my body language, my interactions with them, the words I'm using, all of those sorts of things. So understanding your effect on others is a major part of ADHD.
00:18:56
Speaker
And then we talked about situational awareness, which is the ability to stand back and read the room. So this is part of that internal language processing of ADHD. So like we talked about in the cafeteria, in the lunchroom, the ability to stand back
00:19:14
Speaker
and observe what everybody else is doing. So in the library, everyone's sitting down and being quiet. The kids with ADHD will have difficulty recognizing the environment, reading the room, and sitting down and doing what everybody else is doing.
00:19:31
Speaker
In the classroom, every student might be coming to class, putting their backpack in the cubbies, sitting down, starting to do now, opening their books and getting started. The kid with ADHD is going to have difficulty getting started because they're not reading the room and seeing what everybody else is doing.
00:19:46
Speaker
And you see this in unstructured environments and recess as well. So sort of reading the room and making your body, your language, your behavior look like everybody else. That's a big part of it. And then that social reciprocity, like I talked about, is really understanding the 50-50 of relationships. So kids with ADHD really struggle with that, and they really get used to relationships where it's more taking than giving.
00:20:14
Speaker
So kids with ADHD can do quite well at emotional manipulation of parents, manipulating parents into getting that extra screen time, getting that extra game, sneaking. They're really big at sneaking extra screen time and all those sorts of things. And they get so used to taking and taking and getting and getting and getting.
00:20:37
Speaker
and they really are not used to giving and having that 50-50 of relationships. And that often trickles down into social relationships where you see them dominating conversations, only talking about their preferred interests and not really taking time to get to know others beyond a surface level basis to allow for a deeper relationship. And like I said before, that's really what these kids want.
00:21:03
Speaker
They want deep relationships. They want to do things after school with peers, on the weekend with peers. They don't want to go home and play video games for five, six hours. That's not what they truly want. They want to go out and ride bikes and do things and have deeper relationships and have people to text, have people to call, have people to FaceTime.
00:21:22
Speaker
but you have to go beyond the surface level and build a deeper relationship than just a couple of topics here and there. You have to have a true interpersonal relationship and that requires a 50-50 relationship. Hmm. Gosh, I mean, hearing it put that way is so clear. It's like very clear. To understand that that's what you're seeing with kids and to see that social reciprocity, that 50-50, that social awareness,
00:21:52
Speaker
you know, reading the room, and that these kids are really, it's not that that's their fault. Like, what are some of the common labels? Before ADHD, what are some of the labels these kids get, typically, that you hear? It's endless. You know, the number one is obviously lazy.
00:22:06
Speaker
You get lazy, you get non-compliant, you get rude, disinterested, rigid. It's insane. Back in the past, we used to say sluggish cognitive tempo. That was, if you remember that term, that was around for a while. And these hyper crazy kids.
00:22:28
Speaker
The biggest thing is the lazy, the laziness, the rude, the non-compliance, all of that is just completely ridiculous because it's truly against who they are. And it's so hard for them to regulate their behaviors that the external that we see from these students is absolutely the opposite of who they are congruently and who they are internally. So the internal external are not congruent with each other.
00:22:57
Speaker
There's a disconnect there. Yeah, there's a major disconnect. Yeah, big disconnect. You know, if we were to define it like kind of what is ADHD, you kind of mentioned earlier of executive function, but what is ADHD and you know, how does it, what part of the brain is it really, which you mentioned again, but if we were to kind of put it simple and a nice bow and a present to give to parents or understanding, here's what ADHD is and here's how it affects the brain.
00:23:21
Speaker
Of course. Yep. So ADHD is a developmental delay, a disorder of the prefrontal cortex and executive functions.
Four Pillars of ADHD: Self-Regulation and More
00:23:30
Speaker
So many parents call me and say, Oh, my son has ADHD and executive functioning challenges. There's no end there.
00:23:37
Speaker
It's ADHD is a disorder of executive functions, period, end of story. So you can have executive functioning disorder or you can have executive function delays and not have ADHD, sure. But if you have ADHD, you have executive functioning challenges, period, end of story. So ADHD is E-F-D-D, executive functioning development of delay. And the way I define it is based on four separate pillars.
00:24:04
Speaker
So ADHD is a disorder of self-regulation and the ability to regulate your language, your emotions, your body, your behavior in various environments. Self-motivation towards non-preferred tasks.
00:24:20
Speaker
And that's super important is every student with ADHD has something that is preferred that they can maintain attention to for hours and hours and hours. That's that hyper focus. So which 10 times out of 10 tends to be a screen, a game, or technology. But it's hard for them to motivate towards school, homework, exercise, eating healthy, those sorts of things, doing anything non-preferred or different.
00:24:48
Speaker
self-evaluation learning from past experiences and applying it to the present and number four self-awareness So being aware of your actions and your behaviors and the effect on others that cause an effect right your overall self-awareness So you're more aware of how you are in an environment
00:25:04
Speaker
So self-regulation, self-motivation, self-evaluation, self-awareness, all of those four self-based skills are significantly impacted with ADHD and this executive functioning delay. And those four pillars are founded upon this concept of internal language, which is the grown-out model of internal language. So internal language is two separate skills that are weakened in ADHD and disconnected.
00:25:33
Speaker
And in the non ADHD brain, these two skills are developing at a typical pace and they work together in harmony. But with ADHD, they're weakened and disconnected. So the first is nonverbal working memory. So this concept of working memory. Working memory is
00:25:51
Speaker
Really, it's using your memory. So using your memories and working with them That's the best way to describe working memory. You're working with your memories. It's not just a memory you think of and feel good It's something that you use its memories that you use To change who you are and that's executive functions executive functions is taking an action to yourself To change what you would have done on impulse. So an internal system of checks and balances. So this nonverbal working memory
00:26:21
Speaker
is the visual imagery system of the brain. In simplistic terms, it's your hindsight and your foresight. So it's the ability to re-image the past and learn from past experiences, and also the image to visualize the future so you can plan, prioritize, problem-solve, and anticipate what's coming.
00:26:42
Speaker
becoming a future thinker so that you're thinking about the future and seeing what's coming so that you can get what's done now. For example, you're at home, it's time to do homework, you see yourself in class tomorrow, everyone turning in their homework, everyone getting grades, or you see a test the next day, oh I better study now, or oh our homework's getting graded tomorrow, I better get it done now.
00:27:07
Speaker
or you can see yourself in the future playing your game and say let me get my homework done now so I can have fun later. So it's visualizing the future so it changes your present behaviors.
00:27:18
Speaker
So that's nonverbal working memory, which is the foundational skill of all executive functions. All executive functioning starts with nonverbal working memory and the visual imagery system. So it's super important to think about visual images, the imagination, making mental movies. That's such a crucial part of ADHD and that's what these kids lack.
00:27:41
Speaker
And then there's verbal working memory, which is the self-talk system. So the ability to have an internal dialogue, the ability to talk to your brain and have a conversation and coach yourself and be able to motivate yourself and self-coping skills and self-regulating skills to have that conversation. And when we can apply our self-talk,
00:28:04
Speaker
to the images of nonverbal working memory. So first we're visualizing and we're saying, okay, if the future looks like that, if it looks like that, then right now I need to do this, which is the self talk. So, so we're combining the visuals with the self talk. And that is what kids with ADHD simply are not doing.
00:28:27
Speaker
And so for years, it was hyperactive impulsiveness. And as these kids are so impulsive, impulsive, but they really just weren't stopping, visualizing, talking to themselves, and then acting.
00:28:40
Speaker
Yeah, that's that barrier between the two is that, oh my gosh, that makes so much sense. That's so clear. Yeah, nice. It's so well, it's so clear, so specific, so really it makes you understand more what's happening in the brain because really, as you said, this is a brain issue. This is an executive functioning issue. It's the brain itself that is lacking. It's not the will of the child. No way.
00:29:03
Speaker
No way. You know, it's not just that they're defiant or that they're, you know, weird or in all the things that the terms that could be used, it's like, no, there's part of their brain, which all kids, by the way, have a part of the, they're all developing, all kids are developing, which is why we see kids start with emotional states and even as adults.
00:29:21
Speaker
But it's just another, it's more difficult. Because there is this big disconnect between these internal states of the dialogue and the assessment. Like that's, wow, I love how you said that. It gives me, I'm visualizing it too. There you go. The working of the brain and the splitting. Oh, it makes so much sense. And now for a short break.
00:29:39
Speaker
So if you're looking for ways to support the show and my YouTube channel, head on over to buy me a copy.com forward slash therapy for dads. There you can make a one time donation or join the monthly subscription service to support all that I'm doing at the intersection of fatherhood and mental health.
00:29:56
Speaker
and all the proceeds go right back into all the work that I'm doing, into production, and to continue to grow the show to bring on new guests. So again, head on over to buymeacoffee.com forward slash therapy for dads. Thanks and let's get back to the show.
00:30:12
Speaker
And so, let's say, you know, your parents, they're seeing this, now what? So, they see these things, they're noticing some stuff. What is a typical standard step to take if they're like, hmm, maybe? What would they do? Yeah. So, obviously, you know, you want to have these conversations with your pediatrician and with your doctors to figure out if medication is the right route. What are the right therapies?
00:30:37
Speaker
There's a lot of stigma around ADHD medications, of course, because they're abused by college students and things like that. And there's also so many different medications and different dosages, and it's hard to figure it out. It can affect sleep. It can affect appetite. But ADHD medication is one of the most researched medications in psychiatry. So the medications are legit. They are beneficial. It's just a matter of time of finding the best one and the right
Parenting Strategies for ADHD Support
00:31:04
Speaker
dosage.
00:31:04
Speaker
So definitely talk to your doctors about that. But in the home, really the most important thing for parents to do is it's so important to have structure, accountability, and expectations in the home. That is the most important thing. So there's lots of research and benefits into authoritative parenting for kids with ADHD in terms of helping them to grow up
00:31:27
Speaker
and be independent and have positive relationships. I don't like that term authoritative parenting because it's so close to authoritarian parenting which is basically, you know, which is just, you know, abusive basically. But authoritative parenting, I call it democratic parenting or reciprocal parenting.
00:31:50
Speaker
Because when you really look at what authoritative parenting is, is it's, hey, let's talk about this. Let's have a conversation. Let's come up with a plan. Let's sit down and let's figure things out. It's having high expectations and being there for the student and open communication, open expectations. And the last thing, the biggest mistake I see parents make
00:32:12
Speaker
is giving their kids open access to screens and games. So this term open access is the most important thing. So basically you give them an Xbox, you give them a PlayStation, you give them a Nintendo Switch, you give them a cell phone and it's just theirs and they can play it whenever they want. It's in their room, their controllers are there and it's up to them. The kid decides when they play, when they do homework and that's it.
00:32:39
Speaker
And we have to remember, these kids have great difficulty self-regulating, self-motivating, self-evaluating.
00:32:45
Speaker
They can't, you know, 10 times out of 10, they're going to choose that video game over homework, over going outside, over calling a friend, all of those things. Cause it's easy, you know, video game, you know, playing a video game is like going to a casino for someone with gambling addiction. It's the same thing. It's the exact same. Yeah. It's the exact same thing. It's like a gambling addiction and it's, you know, they're in control. They're getting constant dopamine drip and they'll play.
00:33:11
Speaker
those video games for hours and hours and hours. They'll be on TikTok and social media and YouTube. They'll watch videos of someone else playing a video game for hours and hours. And they're loving it. And then by the time they're done, all of those positive endorphins and positive chemicals of the brain are depleted and they're irritable for the rest of the evening. They go to school the next day and they can't maintain attention because the only thing that can stimulate their brain are these screens.
00:33:40
Speaker
So screens are really dangerous to these kids, and we have to be very open and honest about that. You know, screens have become such a big part of our lives where it's almost like a stigma to say something negative about them. You know, let the kid have a laptop. Let him have a phone. If he doesn't have a phone, he won't fit in socially. He'll be alienated, all these things. We have to be honest about how dangerous screens are, especially for kids with executive functioning delays.
00:34:04
Speaker
So making sure you don't have open access screens and games and you have screen time limits on the phone. That's the most important thing is only allow games, only allow preferred tasks.
00:34:18
Speaker
after non-preferred is completed first. Have that structure where it's non-preferred before preferred. Don't allow them to just be able to download any app and play games on their phones all day or watch YouTube videos all day. Have them have roles in the house where they're cooking, they're cleaning, they're walking the dog, they're exercising. Kids with ADHD thrive under roles and jobs where they can become competent
00:34:46
Speaker
and build confidence, you want them to start packing their own lunch and cleaning their own room and, uh, you know, interacting with the, you know, have family game night, all these different things. Uh, so you want to have roles in the house. You want to have responsibility. You want to have accountability.
00:35:03
Speaker
And parents, you want to make sure that you allow your child to struggle sometimes. Let's allow them to learn from natural consequences. The school has to be able to hold the kid accountable to missing homework, late assignments. That can't all fall on the parents' shoulders. The teachers and the schools have to hold the kids accountable as well.
00:35:25
Speaker
in terms of getting things done on time and all of that so having structure having accountability making sure they're having exercise making sure they're having varied experiences you know we don't want these kids coming home from school everyday coming home and staying home coming home and staying home.
00:35:42
Speaker
Like when you start to notice, hey, Monday through Friday and even Saturday and Sunday look exactly the same for my son. He spends all day in the basement. He plays games. He comes upstairs to eat every now and then. That's not really what we want. We want them to go outside and exercise and interact with people face to face. So make it make sure they're having varied experiences. Their days look different. They're going out in the community and they have real interpersonal relationships. Online relationships are not real relationships.
00:36:11
Speaker
They need face-to-face relationships. It's not all on Discord and Snapchat and texting and FaceTime. They need to go out and play with people in real life.
00:36:21
Speaker
Yeah, and what they need to do too is once they get to talk to a pediatrician, once they understand this, once they have structure and the kind of the democratic parenting or authoritative democratic like having these conversations, having limits and rules, giving jobs, giving roles, I mean, these are all things that get them engaged. These are all things that help their brain really, really what I'm hearing is helping their brain provide some boundaries for their brain to kind of develop in a way that they still have freedom
00:36:49
Speaker
they still have decision power and yet within these limitations to help them. It's like we're helping guide his parents to keep them kind of from kind of way helping build structure in their brain is what I'm kind of seeing it as or hearing it as. It's like we're trying to kind of help that kind of fill in the gaps where the brain is lacking by doing these different things and by helping out by okay we're not just gonna sit here doing the screen and do this every day but we're gonna build structure and give it to help that part of the brain grow.
00:37:13
Speaker
So, anything they need to do with the school, like if parents don't know, what do I do with the school? He's got ADHD, what do I need to do?
00:37:19
Speaker
Of course, yeah. So there's going to have to be a school evaluation done to determine if this student needs an IEP where they're getting federally mandated services or a 504 where they're getting basic accommodations.
Educational Plans: Balancing Support and Independence
00:37:33
Speaker
So it's very important that it's an IEP or a 504 that goes off of this research on ADHD. So what I see with a lot of IEPs and 504s is it puts all of the responsibility and all of the accountability onto the teacher.
00:37:47
Speaker
The teacher has to make sure that the student is doing these things. So we need to think about how prompt dependent is this student and how independent is this student. So part of ADHD is you are significantly delayed in your independent skills and you are too prompt dependent. You're not ready to go off to college and live an independent life because you're so used to being prompted by your teachers and prompted by adults.
00:38:15
Speaker
And if it wasn't for your parents doing so much behind the scenes, and if it wasn't for your teachers doing so much for you at school, you would completely flounder and fall apart. And then these kids go off to college and they fall apart the first semester because they're so prompt dependent on their IEP or their 504. So it's super important that the IEP and the 504 put their responsibility on the student. And it's fading adult prompts over time. And this all depends on the individual, the severity,
00:38:43
Speaker
you know, what exactly is lacking, what we're talking about. It's individual based, it's experience based. But we have to remember that we're focusing on getting them ready for life after the IEP. IEPs are not lifelong. IEPs don't last forever. 504s don't last forever. And colleges may say they have great supports.
00:39:03
Speaker
They have an office of disability services. They have counseling. They have all these things. But most of the time, those things really fall short and are nothing like what a high school can offer. And America recently now leads the world in first semester college dropouts. And a lot of these kids had IEPs, 504s, and did really well academically because of the heavy supports
00:39:29
Speaker
of the IEP and the 504. But once that document goes away and they go to college, they can't be successful. So it's very important that it's not just these external accommodations, giving them preferential seating, giving them extra time, giving them ability to take tests in a separate room. These are all good things, great. And some of those things can transfer to college. But we also have to recognize that we also have skills we have to strengthen, skills we have to develop.
00:39:58
Speaker
So it can't just be accommodations, accommodations. It also has to be teaching the student to gain these skills themselves, self-advocate, self-regulate, self-motivate, gaining these internal skills so that they're successful once those documents go away.
00:40:15
Speaker
and
00:40:34
Speaker
I would say parents have actually been trained based on experience to actually do the opposite. Parents now have, due to this system, this broken system, it's not the parents' fault, parents have been trained to go into these IEP and 504 meetings thinking they have to fight. They have to fight with this team and fight with the team and make sure they get as many accommodations as possible, as many resources as possible.
00:41:00
Speaker
You know, nothing can be on the child's shoulders and has to be on the school's shoulders. And we know how, you know, teachers tend to get blamed for a lot of things and schools get blamed. You know, there's especially nowadays with lots of turnover and, you know, lack of resources and funding with schools and all those sorts of things. It's not so much give my kid every accommodation in the book, give him everything, give him everything. He's really struggling. He hates school. He has anxiety. He has all these things.
00:41:29
Speaker
It's not just accommodations. Yes, that's a short-term fix, giving him these accommodations. But we have to think big picture. What do we do when these documents go away? How are we developing these skills now so that he's okay when he or she ages out of this document? So it's not just getting every accommodation in the book, getting every therapy in the book, getting every resource in the book. Yes, those things are good in the short-term.
00:41:57
Speaker
But we also have to start to think about, OK, where is the responsibility? Where is the accountability on the student to start to show that they can do these things on their own without adult support?
00:42:11
Speaker
And I see that too sometimes often is kids with ADHD, they get the IV and they also throw them in therapy. I get a lot of kids coming in for therapy. They need everything. They need mental health, they need this, they need this. So they have all these things.
00:42:29
Speaker
and hearing what you say is we gotta prep them for post high school and how do we start to build these skills? How do we start to, yes, maybe they need, you know, they might need medication, they might need this IP, they might need a 504. Some of them might need some mental health therapy because of the anxiety or because of the depression. And to treat that, because I can treat the anxiety, I can help build some skills and CBT, you know, different techniques to help challenge our thoughts, to kind of think differently in learning techniques, I could do things like that.
00:42:56
Speaker
But I'm wondering from your expertise and what you've seen and what you do, what are some practical things you are teaching the parents or the student or the kid to build that skill? Not to give away all that you do, because obviously you have a practice that you do, but I'm wondering what are a few couple things that you try to help practically to help them build that skill so they can be more successful?
00:43:20
Speaker
Well, number one is there has to be some type of practice and exercise towards the skills of internal language, the foundational skills of ADHD and executive functions. So nonverbal working memory and verbal working memory.
00:43:36
Speaker
visual imagery and self-talk making mental movies and talking to your brain those skills have to be worked on period that's super important you know visualizing the future learning from the past stopping the ability like we always hear that phrase stop and think and that's really what kids ADHD don't do but that's such a vague simplistic thing it's really stop
00:43:59
Speaker
pause, visualize, talk to your brain, and then act. So whether it's, like you said, some mindfulness. Mindfulness is great. Kids' yoga is great, depending on ages and the individual, of course. But there has to be practice on teaching these kids to stop, visualize, and talk to their brains. That's number one.
00:44:18
Speaker
Really, number two is teaching these kids to set goals. Set goals, track the goals and hold themselves accountable and see if they're successful or not. That's so important. What you see with IEPs and 504s is it's always the teacher or the therapist or the school staff who
00:44:41
Speaker
knows what the goals are, keeps the data, tracks the goals. When it gets to be a high school student, why aren't they taking the data? Why aren't they tracking the goals? Why aren't they making the goals? They should be attending the 504 meetings. They should be hearing the feedback from the teachers. They should be setting their own goals. Really, what I've seen a lot of successful schools do is
00:45:02
Speaker
They'll have the student meet with their counselor, their teacher, whoever it may be, wherever they have the most positive relationship with. Meet with them on a Monday, set goals for the week, review the week, track things, write in the agenda, fill things in, preview the entire week, make predictions, visualize the week, talk to yourself, create some self-talk scripts for when things come up.
00:45:24
Speaker
Then on Friday, review all of the predictions, review the goals, take data, see where they were successful, where they weren't successful, what ended up being better than they expected, what was worse than they expected, having that person to hold them accountable, and then it fading back over time. We're talking maximum support in September and then minimum support in May or June.
00:45:48
Speaker
So, you know, having a positive relationship with the school staff is really important. You know, relationships first, of course, with these kids, and engagement first, motivation first. You know, executive functions are not developed by sitting at a table and doing worksheets. You know, you have to have a relationship. You have to do these internal practices.
00:46:07
Speaker
but having the ability for the student to really understand what goals are, what they're working towards, the cause and effect between their choices and their behaviors, and how it impacts the goals.
Developing Self-Awareness and Coping Strategies
00:46:18
Speaker
It's a process, and it's a marathon, not a sprint.
00:46:21
Speaker
And would that be the same thing with the, you know, this just sounds like more of the academic side. What about the behavioral side? What would be a practical thing with that, with some of the behaviors, the, you know, the reciprocal play or conversation or maybe awareness, like would it be similar or something different you would do there?
00:46:40
Speaker
Yeah, so what we see in the schools is we see kids having these behaviors and adults tend to step in and talk to them and throw language at them and talk to them to calm them down and to suppress the behaviors as quickly as possible to make life easier for everybody. So that is part of prompt dependence. So these kids are getting dysregulated.
00:47:01
Speaker
And the teachers have to come in and squash it and end it and take care of it as quickly as possible. But really what we want is for this student to be able to regulate their emotions on their own without an adult having to step in. Because let's be honest, every kid, every teen, every adult gets dysregulated and pissed off by people every day. It happens all the time. But it's OK for a
00:47:24
Speaker
for a three-year-old to cry on the floor and kick and scream but teens and adults can't do that because we can regulate our emotions and cope and deal with those things. So we need the child to work on developing their own safety plan, their own self-talk.
00:47:44
Speaker
So, hey, and help them to have the self-awareness and the self-recognition that, okay, I'm starting to get a little elevated. I'm starting to get angry. I'm starting to get frustrated. This person's upsetting me. I don't feel so good right now. What can I do? Can I go get a drink of water? Can I go talk to a teacher? Can I walk away? Can I go listen to music? Can I do all of those things? And schools need to be accommodating to those things, to kids to take a break. For kids to
00:48:12
Speaker
to self-advocate and take a break instead of responding to a negative peer or a negative situation or a negative stimuli is an incredibly positive thing. That's great. The ability to take a break, take a sensory break, do what you need to do, whatever it is, whatever works for that unique individual, that's great.
00:48:31
Speaker
But the goal is for that student to do that, recognize their emotions, start to recognize when they're leaving baseline, they're getting angry, they're getting frustrated, and then following the safety plan on their own without a visual, without a prompt, without an adult. And if they're doing that on their own, that's the ultimate goal.
00:48:49
Speaker
Mm-hmm. You mentioned quickly this and it's something that gosh now it's not going backwards in the questioning, but you said sensory. Yeah. Can you speak more to that quickly? Is it sensory where you see with kids with ADHD where they can have like sensory overload where they kind of get drained like is that
00:49:05
Speaker
Did you see that often with kids with ADHD? Yeah, it certainly can. Not every kid with ADHD has that, but some of them certainly can. And, you know, this is the whole thing with ADHD is often comorbid with other things. So this is all part of having a very comprehensive and in-depth evaluation.
00:49:21
Speaker
So, if there is someone that has auditory sensitivity, overall tactile sensitivity, whatever it is, it's very important to have that in-depth evaluation to figure that out. So, they can get easily overwhelmed in certain situations and that's due to the lack of the internal self-coping skills and all those sorts of things. So, really figuring out where the sensory issues lie and how that can be treated with the appropriate clinician.
00:49:47
Speaker
is super important and that's something that should absolutely be in an IEP or a 504 because that's a daily struggle this student is dealing with that's internal that we don't know unless we dig deep. Yeah and where were parents get tested for that if they felt there was also a sensory issue? Is that also through the pediatrician or someone else? That can be through an occupational therapist so occupational therapy can certainly do that definitely talk to your pediatrician first so they can you know lead you in the right direction and schools can do that evaluation as well.
00:50:15
Speaker
Yeah. Okay. That's because I've seen that too with kids with sensory issues where I feel like there's, they get overwhelmed and it's like, you gave the analogy before of like, if they're on YouTube all day, you know, and they're already drained. So now that now they're expected to perform or be engaging, but they're even more, they're farther away now.
00:50:30
Speaker
but I feel like I've seen kids too where they're in an environment where certain stimuli just kind of drains their emotional tank more. So now they're just done. And then they also have that disconnect between that internal self-talk and everything else. So it's like on top of just that, it's like they're also drained over here more so and they need to recharge and so it's kind of both and. So I have seen that and you're right, it's a spectrum.
00:50:55
Speaker
And you can probably speak to this too quickly. ADHD is a spectrum or EFDD, right? EFDD, that's the term. Yeah, yeah. It's a spectrum of severity where you got mild all the way to severe. Absolutely, you got it. Yeah, that's exactly what it is. It's a spectrum and one of the best ways to describe it is you meet one kid with ADHD, you meet one kid with ADHD, period.
00:51:19
Speaker
So there's no two kids with ADHD that are exactly alike period. I don't care if it's hyperactive only, inattentive only, whatever it is. Every single kid with ADHD is different and you have to approach it based on interests, relationships, experiences, case history, family values, and really understanding what the family goals are for the student.
00:51:42
Speaker
So that's super, super important. And basically as a clinician, if you're treating someone with ADHD or executive functioning challenges, you have to approach it from understanding what are their strengths, what are their areas of need, and what makes this person motivated, what makes this person engaged.
00:52:01
Speaker
video games. That's often the thing. That's pretty much it. You got it. But the number one thing is the best clinicians are the ones who can improvise on the spot and keep a student incredibly motivated, keep them engaged, keep them laughing. And you have to give them a fresh, unique experience.
00:52:22
Speaker
They're at school all day where basically every class follows this lecture-listen model. Every once in a while there's project-based learning or group learning or a field trip or recess, whatever. But basically every class is sitting at your desk, listen, take notes, and take a test next week. And then they go home and they play games and they're on games all day and they eat dinner and they go to sleep.
00:52:44
Speaker
So if you're able to give them something novel, something different, something engaging, get them moving, get them up, get them out of their seats, and get them engaging in a positive way, then you're going to be onto something. Yeah. So it sounds like a traditional model. And again, this is not unfortunate. Teachers are overworked.
00:53:00
Speaker
They have a lot on their plate, they're trying to wrangle, you know, 30, 40, 50 kids with an array of needs. So it's definitely not only the teacher, but I think I also understand typical, our traditional schooling that, you know, lecture, note-taking, it doesn't always, it's not the really best for every student, especially probably kids with EFDD. Oh, absolutely.
00:53:24
Speaker
But we live in a world where that's the primary kind of model of learning is this kind of sit, sit. You know, it's just sit, sit, sit, sit. It's the same thing all day. And so it can make sense why those kids struggle more because it's not novel enough. It's not, the learning is too rigid and too mundane over and over and over and over and over for years, that that's what it is. And we know that that actually, even the research shows, my wife was a teacher for a number of years, that then all kids will learn that way.
00:53:53
Speaker
This is not the best way for a lot of people. Like we need to do things differently, but this is just, this is the structure we live in. And so we, certain people learn really, really well in this model, um, that, that really excel in this typical model, but the, you know, a lot that don't, but they're kind of trying to fit into this mold. And I know kids at the EFDD or ADHD, um, more, I think have a different, more difficult time because
00:54:18
Speaker
they need more of that variance, that novelty to kind of change things up, to move, to do things differently, maybe to stand in the back, or even teachers who have this awareness, who are better trained to understand, can help, you know, maybe let the kid have a little more freedom to do the things differently, because they're still engaging and learning, as long as it's not disrupting the class, right? That they can maybe stand up. In fact, I heard of a teacher, like, yeah, I had some kids, but I let them stand, and I'd give them a corner to go into, I'd give them a thing,
00:54:43
Speaker
different things they can do to communicate when they if they can't sit if they're if they're being overwhelmed in their brain, I Am understanding with the student I could help them in the in vivo in the in the moment To stay engaged by changing things up for them knowing that that's what they need to be successful And so I think that you're right that that comes from a good clinician good a good teacher who's aware but I think the problem is well the whole reason why we had this episode is I think there's a lot of misunderstanding misconceptions and lack of education and
00:55:09
Speaker
Absolutely. And this is a big picture issue. When you look at the laws that have been passed about education and the way things are in this country with standardized testing and school competition and the way teachers are evaluated, teachers now have to teach to the test.
Educational System Challenges for ADHD Students
00:55:26
Speaker
And these standardized test scores reflect on teacher performance, which is absolutely ridiculous.
00:55:32
Speaker
So teachers can no longer be creative and teach the way they want to teach and show their passion. All of the fun and the love and the relationships and the play and the fun has been completely sucked out of teaching by politicians on both sides of the aisle. So it's completely ridiculous. And you look at what other countries are doing, like Finland, who are number one in the world in education, it's more project-based learning and community-based learning. And teachers are highly respected there and paid well.
00:55:59
Speaker
uh so you know teachers are the last people we need to blame they're the ones that are that chose that profession and are on the front lines and with these kids every day and it's terrible some of the things that they have to go through but you know there's lots of research on project-based learning and group-based learning and
00:56:16
Speaker
going out in the community and interacting with some community leaders and things like that. And this lecture-listen model and standardized test scores are, you know, they're BS, let's be honest. It's completely ridiculous. You know, SAT scores, ACT scores, state testing, federal testing.
00:56:33
Speaker
It's a joke. It's an absolute joke. They're not focused on the true skills that matter, executive function skills and life skills, independent skills, social skills. It's finding the area of a circle and the area of a triangle and knowing your civil war facts and things like that. These things are not truly beneficial long-term to the health and wellness of this child, but it's important for standardized testing and they're easily measured and that's all we care about.
00:57:01
Speaker
So there's a lot of problems in education and that's just one of them. Wait, your SAT scores, you don't use them this day in all that you do? You don't use those scores? No, oh yeah. I have them in my wallet just to show everybody. Thank you. And here's what I got, everybody. Yeah, here's what I got. I'm 35 and here's my SAT scores. Yeah, gosh, that's so funny. Well, one final question as we close up. We're coming up on the hour. Where can we find you? How can we get your resources? Where are you at?
00:57:31
Speaker
Sure. My website is grownowadhd.com. Check me out there. You can fill out the information on the website and that directly sends me an email and then we can chat on the phone. Yes, you will chat directly with me. I don't have a receptionist or anything like that. You will talk to me directly on the phone. Definitely check that out. On Instagram, it's at grownowadhd.com.
00:57:55
Speaker
Also on Facebook and YouTube and those things but definitely check me out on Instagram Follow me there and shoot me a DM and I would love to if anyone who took the time to listen to this And enjoyed it. I would love to chat with you one-on-one. So reach out and we could definitely have a conversation
00:58:11
Speaker
Yeah, and for as far as any resources that you would say, I know you mentioned Attitude Mag, which is a great website, ADDitude, right? Mag.com is a great one. Anything else that you would plug quickly for resources or on your website if you have a resource list?
00:58:27
Speaker
Yeah, definitely check out your local Chad chapter. So Chad is like your national organization, children and adults with ADD and it has different chapters based on the county and the location you're in. So find your local Chad, they're a great resource. Watch Dr. Russell Barkley's videos on YouTube, read his books.
00:58:47
Speaker
Sarah Ward, the fellow speech and language pathologist at EFpractice.com. I love her work. If you're a parent of a child with ADHD or you're a teacher, start to educate yourself on really what this disorder is. It's a shame that it's not a bigger part of master's level training or bachelor's level training.
00:59:09
Speaker
but try to find that information and read some of the great books out there and watch the YouTube videos. Podcasts like this, of course, are very helpful. Yeah. Well, Michael, I appreciate your time. I appreciate your expertise, your sharing, your just kind of openness and just directness and education. So I appreciate you and I'm so glad we finally got to do this. I can't wait to share this.
00:59:33
Speaker
And yeah, I think we may need to have a follow-up on some more specifics. I'm sure I'll get some people talking to me about this episode and some other things that just due to time, couldn't ask that I wanted to go deeper in. But I think this is, there's so much meat in this episode. So much just like, oh yeah, this makes so much sense. And again, I thank you so much for your time and yeah, have a great rest of your day over there in Philly. Absolutely. Thank you, Travis. Thank you. See you.
01:00:03
Speaker
Thanks for joining and listening today. Please leave a comment and review the show. Dads are tough, but not tough enough to do this fatherhood thing alone.