Dr. Jessica Nouhavandi sat down with three experts—Dr. Stacy Haynes, Dr. Jessica Myszak, Gabriel Villarreal—to better understand how ADHD affects children. Read on to get their thoughts and tips for parents of children with ADHD during this difficult time.
How do you tell the difference between typical behavior for a developing child and ADHD symptoms?
DR. JESSICA MYSZAK: Sometimes it can be challenging to tell the difference between what is typical for a child versus what is ADHD. The DSM5 lists criteria for an ADHD diagnosis, but many of the symptoms can be typical in some settings. For example, depending on age and the activity, it is perfectly normal for a child to have difficulty finishing some tasks, daydream, or have difficulty waiting for their turn. The key is that, with ADHD, the symptoms must be a major problem and they must occur in at least two different settings, such as at home and school.
DR. STACY HAYNES: I always say they are like the energizer bunny, always on the move. Children with ADHD usually have difficulty following directions, managing time, being organized, and managing friendships. They have trouble focusing and often do not finish tasks.
GABRIEL VILLARREAL: Depending on the child, there might be more or less self-control, and we might not see the ADHDer always acting out to the same intensity. Additionally, the ADHDer has little control over themselves and these behaviors when young, and without practice, will not have control as they get older either.
What is your approach to ADHD treatment for children?
DR. MYSZAK: Very young children are not able to manage these techniques on their own, so they depend on parents and teachers to adapt to the environment for them. As children mature, they can learn to incorporate these strategies and techniques into their work (i.e., making lists, scheduling tasks, choosing a helpful environment for work, etc.). Children must first learn to self-monitor their attention before they can improve it, so the first step is often teaching children to notice if they are paying attention.
DR. HAYNES: I use Collaborative and Proactive Solutions by Dr. Ross Greene. This approach recognizes the skills a child is missing, like Executive Functioning skills, and works with the child to create solutions to help them succeed in environments that demand those skills.
VILLARREAL: I was diagnosed with ADHD when I was 8 years old. My approach to ADHD in my practice is strengths-based; ADHDers have superpowers neurotypical people don’t have. Once you find those superpowers and teach children how to use them, life, school, and relationships become a bit easier.
What is your opinion on prescription ADHD medications for children with ADHD? What are your thoughts on stimulant medications (like Adderall) versus non-stimulant ones (like Strattera)?
DR. MYSZAK: Many children benefit from ADHD medications, but they are not right for everyone. I often recommend that parents try behavioral and teaching strategies first. Some children will do great with these adaptations, but for some, it is not enough. If children are significantly struggling in class, or their behavior or self-esteem is a significant problem due to their ADHD symptoms, I think medications are worth considering. Some parents worry about over-medicating their children, and it is important to note that the right ADHD medication should not turn your child into a zombie, but it may help them be much more successful, both academically and socially.
DR. HAYNES: Medication works differently in children based on their biology. Parents will often have to try several medications before finding the one that works for their child.
VILLARREAL: If it works, keep doing it. If not, don’t. Only 20% of all ADHDers in the world are non-responders to medication, so the issue isn’t medication vs non-medication or stimulant vs non-stimulant, rather, it should be: Are we giving the proper medication dosage for the particular child? Good enough is not good enough!
What are some of the biggest challenges parents of children with ADHD face?
DR. MYSZAK: ADHD symptoms can be very challenging for parents. Many of the behaviors, like impulsivity, constantly being on the go, and not following instructions, can create friction at home. These behaviors can sometimes look like laziness or willful bad behavior, which can be especially frustrating for parents.
DR. HAYNES: Some of the biggest challenges parents face is managing the behaviors. Many parents face isolation as their child is not easy to babysit or to have playdates with. School is [also] extremely difficult for parents as they are often called to meetings due to their child’s behavior in school.
VILLARREAL: Too many people have opinions about ADHD that are just not true, old stereotypes, myths, or outright lies. These opinions come from family, friends, teachers, and yes even pediatricians and counselors. Seek out the specialist—take everyone else with a grain of salt.
Many parents find themselves working from home because of COVID. What tips do you have for managing children with ADHD during this time?
DR. MYSZAK: Working from home with a child with ADHD can be difficult to manage. Set up clear expectations and structure so your child knows when it is okay to interrupt and when it is not. If there are two parents in the home, planning times when each parent is the point of contact for the children can be helpful, so each parent gets some uninterrupted work time.
DR. HAYNES: Parents should carve out time for themselves throughout the day. We are all dealing with work and school. Children during COVID need parents to understand that learning at home is new to everyone. Parents should [also] look at their work week and try to manage their schedules around their child’s. Students with ADHD will benefit from having parents be available to help to stay on track throughout the day. Parents can assign work areas for children that are less likely to be disturbed by others.
VILLARREAL: The single best thing to manage ADHD is exercise. If you and your child are not exercising, you are leaving the cheapest and best medicine on the table. Depending on the age, exercise can look like games, free play, outside time, or structured workouts. If possible, start and end the school day with exercise, whatever that looks like for your family.
Many children are forced to do remote learning due to COVID. What unique challenges might this cause for a child with ADHD? And what are some possible coping strategies, or ways in which parents can support their children with this challenge?
DR. MYSZAK: This is a challenging time for all children and families with the transition to distance learning. While every child is different, parents should notice what is going well and try to do more of it. If particular methods of teaching or school activities are not going well, find ways to change or adapt it. Essentially, do more of what works, and also encourage kids to get away from their screens as much as possible.
DR. HAYNES: Remote learning is hard for children who benefit from engagement in learning as many children with ADHD do. Students may need help with organization skills and learning how to check emails each day for directions on work. I suggest children use fidgets like fidget spinners or even small toys like legos/clay while sitting at the computer. Parents can get wobble seats and allow children to get up/or stand up during instruction.
VILLARREAL: The challenges abound for remote learning and ADHDers. Learning time should be short, separated with movement breaks, and done standing or on the move. Supporting your child emotionally, and maintaining a loving relationship right now should supersede school. Too many children have developed anxiety or depressive symptoms or disorders as a result of COVID, and [that] compounded with even worse learning standards [is] leading to contentious times between parents and their children.
Any other suggestions or tips for parents of children with ADHD?
DR. MYSZAK: Searching out parent groups on Facebook and checking out books, such as Smart but Scattered, by Dawson and Guare, can be helpful. Many of the challenges you are facing are things that parents have dealt with before, so you can often find some great suggestions and ideas from others.
DR. HAYNES: Make sure children are taking medication as prescribed while they are home for school instruction. Children benefit from movement. Chunking work time can help everyone. Keep to the same routine as if they were in school. Keeping a bedtime that allows for at least 8-10 hours of sleep. Watch excessive snacking and eating foods with sugar/sweets while they are home.
VILLARREAL: Play with your kids, exercise, take walks, have fun with your kids. The side-effects of all of those things might just be a stronger bond with your child, less resentment, more patience (with each other), understanding, and above all love.
Dr. Stacy Haynes, Ed.D., LPC, ACS is the owner and clinical director of Little Hands Family Services in NJ. Dr. Haynes is the author of two-time award-winning book Powerful Peaceful Parenting: Guiding Children, Changing Lives and is a certified provider of Collaborative and Proactive Solutions, an evidence-based treatment approach working with children with emotional and behavioral challenges. Her website is https://www.littlehandsservices.com/.
Dr. Jessica Myszak is a psychologist in Glenview, Illinois. She recently started a private practice and is currently offering psychological evaluations and behavioral therapy over telehealth. You can learn more about Dr. Myszak at https://helpandhealingcenter.com
Gabriel Villarreal is a Licensed Professional Counselor in the state of Virginia. He owns LostBoys Strength & Conditioning, the only gym that offers to coach children with special needs such as ADHD, ASD, Depression, Anxiety, and other mental health disorders. Additionally, with his private practice, ADHD Counseling in the Roanoke Valley he coaches the only class in the country specifically for ADHDers, designed to give them the medicine exercise offers. Gabriel is an expert in the topic of exercise and mental health, is routinely asked to speak to gyms, coaches, athletes, and educators, in the Roanoke Valley and beyond, on all things exercise and mental health. His website is roanokeADHD.com.
Interviews have been edited for length and clarity.