Child Mental Health for Pediatric Clinicians

55. What Parents wish you knew about ADHD with Ashley and Lauren

• Elise Fallucco • Episode 55

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What do parents wish *all* clinicians knew about raising kids with ADHD? How can we ask more effective questions to learn about how ADHD symptoms are affecting a child's life at home and at school? We answer these questions and more in Part 3 of Child Mental Health talks w/ Parents about ADHD with Ashley and Lauren!

00:00 Advice for Parents and Clinicians

01:12 Advice for Clinicians from Ashley

05:17 The Importance of Community and Support

05:17 Navigating ADHD as a Parent

08:58 Advice for Parents and Clinicians

10:10 Encouragement for Parents to Seek Diagnosis and Treatment

10:10 The Role of Medication in ADHD Treatment

13:08 Conclusion and Final Thoughts



Check out our website PsychEd4Peds.com for more resources.
Follow us on Instagram @psyched4peds

Dr. Elise Fallucco:

Welcome back to Child Mental Health for Pediatric Clinicians, the podcast formerly known as Psyched for peds. I'm your host, Dr. Elise Fallucco, child psychiatrist, and mom. I am so excited about today's episode, which is part three in our series of child mental health talks with parents, where we go behind the scenes and really learn more about what it's like to be a parent and to raise kids with. A DHD, and in this episode, parents, Ashley and Lauren talk to us about what they wish that all clinicians knew, and in fact that all parents knew about raising kids with a DHD. And through this conversation we're gonna learn what we as clinicians can do to better be able to untangle A DHD in families. Also, we're gonna be able to learn about what it is like from their perspective to come and see us and talk about A DHD. Finally, we'll close with some practical tips about things that we can do that can help all patients and families with A DHD. So without further ado, let's continue the conversation with Ashley and Lauren. So what do each of you wish that everybody knew about A DHD?

Ashley:

I think for clinicians, I would say, I just hope that you can ask the questions to get at the root of all these things, because a lot of times, pediatricians or other doctors hand over to parents this paper assessment, but there's so much more to these than what's in those questions, and you don't really get at. What those things are, unless you're asking really varied in diverse questions about home life and school life and really trying to build out this picture of the kids. So communication with the parents, communication with the kids. And then I think also communication with each other to the extent that that's possible. Because sometimes the different doctors are also not talking to one another. So there isn't this whole of care approach where they know what the pediatrician is doing with the child or the psychiatrist doesn't know what they're doing with the child. I guess better comms all around.

Dr. Elise Fallucco:

Let me, you said a lot of really good things. Let me just summarize those to make sure I understand them. One of the things you talked about in, in your advice for clinicians would be, don't just rely on paper assessments. Yes. By which, I think you're referring to the Vanderbilt or the Connors or whichever, parent report, teacher report, potentially self-report rating tools. Make sure in your clinical interview. You're asking more about what is your home life like, what is school life like? And you guys even gave some great clues about ask about how hard is it for people to follow two or three step commands? What is the morning routine like if you ask your child to go brush her teeth and or, do a larger task, clean up your room, how hard is that?

Ashley:

Yeah, exactly. And I think sometimes even what you just said about asking questions about what's your home life like? That's such a big and broad question, and I think a lot of people might just answer it like, oh, our home life is great, and so to the extent that a clinician can really dig in with specific examples where the parent might be able to more directly relate to that example and then say, oh yeah, that's something I see in my home. So as many vignettes that the provider might be able to give to help a parent understand that, okay, this resonates with me, and that's what we're dealing with here.

Lauren:

I also think it's important because parents don't always recognize the accommodations that they naturally just put in for their children because maybe they only have one child who has a DHD and they don't see that what a typical child's behavior is. And so they are constantly scaffolding and supporting their child at home, and they're not aware that, oh, their child is functioning at this level because they're given support that they might need in other scenarios.

Dr. Elise Fallucco:

You bring up an excellent clinical point. We really need to keep in mind that kids may be doing well because of parents scaffolding, so it may be helpful to ask parents, do you feel like you have to work hard for things to go well for your child? In other words, do you have to do more preparation or put in a lot of effort to support that child? and another part of what you were saying, Ashley, is that it's so important for us as clinicians to make sure that we are working in partnership with all the other clinicians who are also taking care of our patients or these children. And this is a hidden signal to all of my child psychiatry friends. I know in our field there's been a lot of barriers to being able to share records with referring providers due to concerns about the sensitivity of the nature of the things we discuss often in our office. And so what I would just strongly encourage all of us to ask parents permission to be able to share basic information like what meds they're on and what their leading diagnoses are with referring positions. And just get in the routine habit of sharing this information.'Cause it can only help the kid. Yeah. Shifting to you, Lauren, what do you wish that everybody knew about A DHD?

Lauren:

Number one, for parents, I really would want everyone to know that you're not alone in navigating all of this. That is by and large, that is a huge feeling that I had, that felt overwhelming. And. More and more that I talk to other parents, they are just like, how do I do this? What do I do? They feel like, oh, I have to reinvent the wheel. I have to figure this all out on my own. And that's really not the case. And that's why we started this mental health and neurodiversity PTA committee, was to let everybody know you're not alone. You don't have to do it all by yourself. And a lot of times there is that one parent that's the caregiver and the leader in all of these things, and they're having to educate their spouse or their partner. And that can be overwhelming. And so I would say number one, takeaway. You're not alone. Find yourself a community, whether it is in person or online. There are so many resources. We actually can provide you with a link to our resources. And I think your podcast is on our list actually. What? So there are podcasts, there are books, all kinds of things. So find yourself a community because that has been one of the, saving graces in navigating this whole neurodiversity thing for us.

Dr. Elise Fallucco:

we would love to share those resources with our listeners, and we'll be happy to put that on our website at psyched P-S-Y-C-H-E-D, the number four peds.com.

Lauren:

The other thing is that A DHD I guess like autism is also a spectrum. It looks different in every kid. So you might have a kid that, shows up with the stereotypical, things that you think of with A DHD or you might have somebody who is internalizing a lot and is what you're seeing is anxiety. One of the first things I did was to listen to podcasts like yours and read books and articles and just educate yourself on what it can look like. Those are my big takeaways.

Dr. Elise Fallucco:

Excellent. That you're not alone. Find a community of people who are going through it with you.'cause it can be really intense and overwhelming. And then your other point was really great about how A DHD looks differently in every kid. There's a lot of heterogeneity, and for some people, their A DHD symptoms may not be captured as well by some of the Vanderbilt or Connor's forms, and it may take more of a clinical interview to get at the different symptoms and to learn what the parents are really seeing at home.

Lauren:

-Yes.

Dr. Elise Fallucco:

It's so helpful to hear your perspective about what it's like to go see a clinician about your child's A DHD. And I have to tell you, as a clinician, for us, A DHD sometimes feels like bread and butter, like something that we deal with very often and that we're very comfortable with. And it's a really helpful reminder that the families that we're taking care of this is far from bread and butter or ordinary, and this is something that's really impacting their lives. And so one of the things we as clinicians can do is to remind parents that they're not alone, that there's a lot of resources, available in this journey. And to be able to share resources with parents about books or about local support groups or about national organizations like Chad, C-H-A-D-D, that offer support for families and people with A DHD, So Ashley, you talked about advice for clinicians, but what advice would you have for other parents who are raising kids with A-D-H-D-I?

Ashley:

For parents, I would say I wish that they knew diagnosing neurodivergent kids is a journey. It's not a quick thing that happens with a diagnosis because there are so many different symptoms, so many comorbid situations, right? And you're just constantly trying to figure out all these pieces of the puzzle. Just be patient. Give yourself grace as you navigate it, hang in there. And I think the other thing I would say for parents is just really advocate for your kids. Because a lot of times navigating this journey will be dissected into different paths where. You may be talking to your pediatrician on one path, and then you might be talking to a therapist on another path. And then you might be talking to a psychiatrist on a third path, and then the administrators at school, which is the fourth path. And they may not all talk to one another or have the whole picture. And so it's your job to really do the research, talk to other parents who might be going through this, talk to your kids and then use all of that knowledge to be the advocate for your children. So the other thing I would say to parents is don't be afraid. What I mean by that is don't be afraid to chase a diagnosis if you think something may be different about your kid. I think with the mental health stigma that has been around for a number of years, there are some parents who don't want to hear that there's something different about their kids, or they also have an inkling that something is there, but they're like, oh, I'll check it out later. So for example, I have a friend who. Has a DHD herself. Her one child was recently diagnosed and she sees a little bit of her, a little bit of a DHD in her second child. But she said, oh, she gets good grade grades at school and she has no problems. And I looked at her and I said, why wouldn't you get your child tested if you know that you have it, your other child has it and it runs in families, it's hereditary and you know that kids can mask it in school. Just go ahead and get the testing now. And then she looked at me and she's yeah, you're right. Why am I waiting for two more years? Which is a totally arbitrary thing to do. So don't be afraid to chase that kind of information down and the diagnoses down, but also don't be afraid to try medicine. I think that is very scary for parents and it was also scary for me and my husband. We were hesitant to start our kids on medicine, especially at such a young age. But it has made such a difference in how our kids can function and live their lives and be happy. And the way somebody described it to me was, if you have another medical problem, if you have a problem with your heart, you are going to take medicine for your heart. If you have diabetes, you are going to take medicine to treat that diabetes. It's the same thing with neurodivergent issues and A DHD. There is something in your brain, chemicals are off. Take the medicine to help with that. And the worst case scenario is you try medicine. And if you don't like it, if you feel awful about it, if your kid turns into something you know that is not reflective of who your child is, you can stop it. You can put your kid on a medicine for a week and then take them off. So give it a chance if you think it will give your kids a chance at a better life.

Dr. Elise Fallucco:

Ooh. So I love that.

Lauren:

Yeah.

Dr. Elise Fallucco:

We've,

Lauren:

We've struggled with my daughter also. she won't take medicines. she was like hiding her medication. I found them in a game. I was on vacation. I had brought the game with me and my friend who's a pediatrician was like, why is there a Zoloft in? And I was like, oh yeah, and so I keep finding them random places, like in a drawer or like Monopoly with a bunch of Zoloft Monopoly would make me wanna take Zoloft. I don't like Monopoly. Yeah.

Dr. Elise Fallucco:

That, that's an indication of health. Okay. Let's do our wrap up. Thank you both for sharing your personal experiences as parents, taking care of four kids with a DHD between the two of you and all of the ups and downs of the journey of getting, understanding what's going on with your kids. Getting a diagnosis and then going through the process of trying to figure out how to holistically treat them. How to support them in school and home, at home socially, and how to help them shine and not have to feel like they need to mask their symptoms or to be somebody who they're not. So thank you both so much.

Ashley:

Thanks for having us.

Lauren:

Yeah, we really appreciate it. It's been fun.

Dr. Elise Fallucco:

And to summarize some of the tips for pediatric clinicians, number one, interprofessional collaboration is key. While our schedules are beyond busy, we need to try to make time to reach out to the pediatric clinicians who are part of the team that's caring for our patients and try to coordinate care. And at a very minimum, seek parental permission to be able to share our notes or even a list of diagnoses and meds with the other clinicians taking care of our patients. The other thing that I took away from this podcast was it's so helpful to be reminded that parents and families are navigating a really challenging and sometimes overwhelming road. And that part of our job, or part of our opportunity is to be able to remind parents that they are not alone and to encourage them to reach out and find a community of other parents. Maybe they don't have a cool neuro diversity support group at their local elementary school, but there are other resources like the National Group, Chad, C-H-A-D-D, or books or podcasts or various websites. Sites that can help them as they're navigating this journey. As I mentioned before, we'll have a brief list of A DHD books, websites, and resources for families on our website, psyched for peds.com. And for listeners who've already signed up to be a friend and colleague of the podcast on our website, we'll go ahead and email you these resources as a part of our regular newsletter. Finally, I just wanna say. Huge thank you to Ashley and Lauren for sharing their insider's view of the joys and challenges of raising kids with A DHD, and thanks so much to our listeners. Look forward to seeing you next time. I.