How can we raise our kids with ADHD to become mentally healthy and successful adults. We talk with Dr. Edward (Ned) Hallowell, is a board-certified child and adult psychiatrist, a NY Times bestselling author, and a leading authority in the field of ADHD. He authored the groundbreaking book on ADHD, Driven to Distraction, and has written several other books on ADHD, including a newly released e-book co-authored with Lisa Schuman titled: ADHD and Adoption. He was a Harvard Medical School faculty member for 21 year, and is the Founder of The Hallowell Centers.Support the show
* Note that this is an automatic transcription, please forgive the errors.
Nice to be with you,
a disclosure upfront. I am the parent of four by Birth and Adoption, and two of my kids have a DHD and your basic approach, which I'm not trying to summarize your work into distill it into one sentence. But part of that what your approach is that I appreciated his apparent so much on used as a guiding principle was that a T H D is less of a disorder and Maura of a trait and that we can parent towards that. I found that so helpful, and we're gonna be talking about that today, and I think it will infuse our discussion. Such refuses your your work. In general, I'd like to start with part one on understanding a DHD. So let's begin by asking, what is a DHD? And if you could also just include some of the typical symptoms, although I'll admit that most of our audience will be well familiar with a DHD and its symptoms.
Well, attention deficit hyperactivity disorder, which I should quickly add, is a terrible term because it doesn't describe the condition at all. Uh, it's not a deficit of attention, and I don't see it as a disorder. I see it. It's a trait is a genetically transmitted condition composed of positives and negatives. The positives, which never get included in most descriptions, are our originality creativity. Think outside the box entrepreneurialism. Most entrepreneurs have this. Ah, tremendous imagination. Tremendous spirit, generosity, sparkle, charisma. Ah, strong will to the point. Usually being stubborn, Think outside the box independent minded All of the all of those positives you can't buy and you can't teach. And then on the flip side on the troublesome side, trouble focusing when you're not interested. People with a d d pay super attention when they're interested and when they're not interested, they're mine. Doesn't go empty. That's why deficit is such a misnomer. They're mine goes elsewhere. Their mind wanders. Theeighty mind is like a toddler on a picnic. It goes wherever curiosity leads. It's driven by curiosity, and it has no regard for danger or authority. It simply goes wherever curiosity leads it. So you have this wandering mind. Ah, and then trouble with so called executive function. Trouble with planning, organizing, prioritizing, being on time. Uh, you know, getting getting things together, straightening up your room, straightening up your backpack, straightening up the, uh you know, your closet, whatever your desk, whatever the whatever. The the thing that needs to be organized might happen to be including your own mind. Uh, so so There's a lot of Ah ah, lot of disorganization, a lot of chaos and out of that chaos so often wonderful, wonderful new inventions emerged. But there's a lot of, ah, a lot of, you know, lectures and storm and wrong about getting organized, which is hard for people to do. A tendency toward impulsive behavior, trouble following through trouble, following directions, sequential directions, um, and so living up to potential because performances inconsistent because focuses inconsistent. And so you get a sort of a picket fence pattern of grades A's and these days and EPPS, A's and D's and people attribute it to inconsistent effort has nothing to do with that. It's been consistent focus. So it's a wonderfully interesting condition composed of tremendous positives and significant negatives, and I explain it to kids and say, You've got a Ferrari engine for a brain. You've got away powerful brain, but you have bicycle brakes and i'ma break specialist. So my job is to strengthen those brakes and once you strengthen the brakes, you're a champion in the euro champion in the making. But until you strengthen those breaks, you're in danger. You can crash, you can fail. You could get into
drive your parents crazy
drug and and then, as you get older, your risk for serious trouble. I mean, the prisons are full of people with undiagnosed untreated 80 D, and so are the holes of the addicted and the unemployed, so it's important to take it seriously. But if you do take it seriously, tremendous success can be in the cards for you
are adopted or foster kids more prone to a th ng.
About 40% of the adopted population has the condition, and again, that's because of the genetics. People who give their kids up for adoption or more likely to have it themselves, um, impulsive behavior. And and so the statistics in the adopted population of at 40% way higher than the average monthly in the average population, it's about 10%.
So one of the questions we often get from parents and this is particularly from parents who have adopted or foster Children at an older age. It's the symptoms of a child who is experienced trauma and the symptoms of a DHD are often overlapping or they seem to be from the parents standpoint. So how do we tell whether our Children's behaviour is a result of a DHD or the trauma name
exposed. You can't at first glance because the dissociated state of post traumatic stress disorder and the distracted state of a DHD are indistinguishable. So the But the ultimately the way you tell them apart is by history. And ah, the people, often with PTSD won't give you the full history because they can't or it's repressed or they're afraid to on dso uh, and and often people with a DHD, you won't give you the whole history because they can't. They're terrible historians. They don't remember. So you're you know, you're you're going with basically what your eyes tell you and what teachers tell you and what others tell you. And, um, uh, good news is that people who have a DHD tend to be quite positive, quite upbeat. They have a sparkle. They have a light heart. They have, ah, positive energy about him. Have people with PTSD that's often not the case. They have, ah, very dark spot to them in a then, and that's another way you can tell them apart now. As I said, they often occur in the same person because
I'm just going to say it's not They're not mutually schools.
No, no, in fact, that it is a great overlap. Because if you have a PhD, uh, your provocative you you know, you you are someone who could provoke adults to abuse you. Not that that's an excuse for an adult to abuse you, but the kids kids with a DHD are way more abused than average Children throughout history. These are the battered Children. These are the Children who were beaten and and sometimes killed because of their reckless, uncontrollable behavior. And and so they are way more likely to be traumatized and and, uh, sexually, physically abused or neglected. People want to avoid them and cast them aside, cast into the side of the road back when that was actually done. These are the kids. They're just ditched abandon. So, you know, unfortunately, what they have going for them is they tend to be tenacious. They tend to be incredibly resilient. They we, I should say, because I have it myself. We bounce back, You know, we we keep on ticking. You knock us down nine times, we bounce back for the 10th. Mean it. It's There's a great bounce back bounce back it. This built into us.
Now this talk about diagnosing and treating a DHD. It seems to me that kids with a DHD are so very often misunderstood by the important dolts adults in their lives teachers, coaches, scout leaders. And it's important that we as parents, not be a part of that group. And we want to avoid the they learned helplessness, which occurs when the child has seen himself fail over and over and over again, and it begins to perceive themselves as a failure. And then it becomes a self fulfilling prophecy. So you talk a lot about the importance of early diagnosis in intervention. So if a parent has a child that they, they think could be a DHD, how did they go about getting a good diagnosis?
Well, you know, im not to sound flippant, but it's the truth. You go see a good doctor now. It doesn't have to be the specialty. Doesn't matter. The ones who have the most training our child psychiatrists, but they're very hard to find.
Yeah, there. It's a very underpopulated specialty. Yeah, So most people end up seeing their pediatrician now, a lot of pediatricians don't have time. A lot of pediatricians don't have the training. So So it's hit or miss. You know whether they can do a good job or not. Ah, psychologists can diagnose it. Family physicians can diagnose it. Uh, your social workers congee. I Agnos it. What you want to do is see someone who has made it kind of a subspecialty of theirs. You want to see someone and preferably see someone who takes a strength based approach. The kind of approach I take where, where you're saying, you know, this is not a disorder, but a trade, and if you manage it right, you could become a winner. Which is the truth, by the way. That's not blowing smoke. I mean, that's the truth Picket line. I could fill many buildings with spectacularly successful people who have this. So So you want to see someone who's gonna give you that approach rather than the negative drumbeat of the deficit disorder And you poor thing, you should breathe loss of the things you wish you had all this guy's stuff. So So so. But But the credential the person has doesn't matter. It's the experience the person has asked around Ascot. The school, if you're a pediatrician, really doesn't have a lot of experience that all he can do is prescribe medication. Ask him to refer you to someone who could do more than that. It's worth doing the legwork to find someone because, you know, like, is not you're gonna be consulting with this professional for many years. A DHD doesn't just go away, and you want that person to be on your team part of your team for years to come.
Yeah, I'm glad you mentioned that A. D H D is not something that you outgrow unnecessarily or even usually lets gonna move to talking about treating. Let's start, although not necessarily a treatment per se. Let's start and talk about. We get this question all the time. Are there certain diets? Are certain foods to either include or exclude? We hear a lot about sugar we hear a lot about through dies, and things such as that. What's the research show? As far as lifestyle changes, which would include diet but but also include exercise sleeping things such as that as far as helping Children radiates
well, you know, healthy is good and unhealthy is bad. Basically. So, networks, um, some people have found gluten free works wonders, but not for everybody. Some people have found lack toes free works wonders, but not for everybody. So, you know, be your own experimental animal. Uh, in general, the less sugar the better S o if you can cut back on sugar candy that refined sugar. You know, birthday parties can be holy hell, uh, soda pop. You might as well eliminate that even fruit juices air. Just sort of a lot of empty calories with sugar. So if you can eliminate fruit juices and soda pop and Gatorade and that kind of thing, you know, try toe, try to get rid of sugar as much as you can.
Okay. I've read one time about increasing protein. That increasing protein was effective for Children with a D h d.
Yeah. I mean, in general, you want to have protein in your breakfast so your blood sugar doesn't drop in the middle of the morning, So don't just have a straight carb breakfast. Don't just have a bagel and run at the door, have a bagel with smoked salmon, or have a bagel on duh. Uh, I don't know about a high protein diet. Then you get into sort of opinions and there's no there's no, you know, solid research, this solid research behind Ah, low sugar. And there certainly are sections of the A D D. Population where gluten free or lacked us free Make a huge difference. Okay. And then and then stay away from junk food is another one that we can take to the bank. Uh, basically, whole foods are good for you. And, you know, processed foods are bad for you. So you know, we all know that I mean, I'm just stating the obvious, but but the more you can stick with that, the better off you'll be. And then certainly it does not really under the heading of nutrition, but it's a hugely important point. Substance use an addiction is 5 to 10 times more common in the A. D. D population, and we're talking about a tremendous risk that you want to be aware of from early on. And one of the addictive one of the addicting substances is sugar. So, you know, the kids can get it to candy and cake and sweets and carbs. and obesity is a really problem.
And his obesity of a problem or that is not infrequent are more common in the 80 HDP
because they're so active, you know, they're so active. But eating too much sugar is
okay. All right, Now let's talk about the big question that I'm sure you've heard 1000 times to Medicaid or not to medicate. Um, so what does the research show as faras medication in general?
Yeah. This is one of those weird situations where what the research shows and what the population believes are completely at odds. Population believes medication is dangerous. It should be a last resort. And basically I never go there. The research shows just the opposite. The research shows medication used properly is very safe. And, uh, it's it's, you know, godson. And it's just amazing how how, for reasons we can speculate on how diametrically opposed the the general population is to the research that the side effects people ought to worry about are the side effects of not taking medication, not the side effects of the medication. When used properly, medication is very safe and very effective. It works. About 80% of the time. In my own case, it does not work. I have a d D. And medication does not work for me. But my three Children, who are now 30 27 24 have been on it since early in elementary school, and it works wonders for them. They all inherited by 80 d, and they all thrive on stimulant medication.
What about the age of the child? I know a lot of parents I feel like they could diagnose or have there are actually have had their child diagnosed at a very young age. We're talking pre school age and and but worry about starting a child on medication that young. So at what age? Well,
I usually don't start medication until age five or six, but genetically speaking, you can start them sooner. If if they've got, you know, life threatening, impulsive, hyperactive behavior, running out into the streets and jumping out of second floor windows and that kind of
stuff. Yeah, okay. And that used to be that we would talk about you would read about taking a medication holiday or going off the meds in the summer toe, let their body readjust, or whatever is that still the current thought or no,
you can do that. Uh, there's a tiny subset of of kids who will experience a tiny amount of growth suppression if they stay on stimulant medication year round. We're talking tiny amount in total, about 1/2 an inch. To avoid that, you can stop the medication during the summer and during school vacations. Um, but there's no reason you need to other than that, other than to see if you still need the medication. So you know a D D doesn't go away on weekends and during the summer. So you know, if you if you drive real benefit from it, I take it you know you're around.
And the idea that for many people a DHD will continue to exist and be a factor in their life well into adulthood. And the concern for some is that should I be on this medication for life? What's the research show on that?
Yeah, take it. As long as it's useful, there's there's no evidence there that there are any long term side effects now. We don't have long term studies, so we can't say for sure that there are no long term side effects. But there's no reason to believe that there are, and we certainly certainly have long term studies with another stimulant, namely, Captain. The whole world is caffeinated, so
raising my hand right here tell me
to. It's my medication of choice. So yeah,
my medication of George. Well, Mina's well, uh, all right, so that it's taking medication. There is no reason there. Another concern we hear from parents is that their Children may be more prone to substance abuse issues if they've been on a stimulant medication most of their life thoughts on that.
The exact opposite is true again. The exact opposite, uh, substance abuse is, it said. It's 5 to 10 times more common in people with a PhD if you take stimulant medication that dramatically reduces that risk. So far from being a gateway drug stimulant medication closes the gateway again. The general public has the completely the wrong idea. If you want to reduce the risk of your child becoming addicted or developing a bad habit, one of the best ways to do that is to get him on stimulant medication.
And is that because they experience? I mean part one of The reasons people turn to substances is, too to make up for a feeling inadequate scene. Oh, it's
not that it's not that it's by. There's a it is the taking the right medication. You don't feel the need to take the wrong medication. It's not that stimulant medication makes up for a feeling of inadequacy the way you for a drug might. It's that stimulant medication fills a certain neuro transmitter. Need that you then don't need to try to replace with euphoric drugs.
Okay, let me pause here to remind everyone that this show is underwritten by the jockey being Family Foundation. And they want all adoption agencies to know that they have a program that packed program for newly adopted gift agencies. Need only apply in order to have their newly adoptive families receive. Her Children received backpack. It has initials and broad re on a child, and it has a bear blanket inside. It also has a parent full of information to help adoptive parents. It's free for adoption agencies. It's free for families. You need only go to the jockey being family website and sign up under their backpack program. All right now, moving on to parenting challenges with raising a child with a d. H d. I can, uh, speak for myself. And I certainly know that managing expectations as a parent was a was a big part of something that I needed to learn and also to stop comparing my child and, quite frankly, myself, toe other parents. And their what seemed to me at the time, of course, was perfect Children. Um, so we as parents, have some the work that we could do on our own. But parenting kiddos with a d. H. D. Did this present some challenges? So we've asked our audience what some of the bigger challenges, more frustrating challenges that they face is, and not surprisingly, number one with self control. So what are some things that you could say to parents on how to help Children with a D H d Do a better job at self control?
Well, uh, the obvious factors again, structure matters a lot. You know, having a structured setting at home structure at school rules, predictable rules, getting enough sleep, getting enough exercise, huge sleep exercise matter. A great deal eating, eating properly, you know too much sugar. Absolutely set some kids off and then medication. When medication works, it strengthens your brakes, you know? And so, um, self control depends on all of those learning learning how to, uh, learning how to pause before you act. And that's, you know, it takes top. You can't strengthen your brakes and 1/2 an hour, but the factors that I just mentioned are the most powerful.
Okay, um, another challenge parenting challenge is for lack of better words. Stick to witness how to help our kids stick to an activity and finding that you know that balance between encouraging a child to persist and letting them letting him if it's not a fit, then letting him let go.
Well, I think once you start something, you think one of the things that you need parents for us to say, you gotta you gotta stick with it. So unless it's an obvious bad Manche, you know you start piano, you've got to stick with it for six months and you can't quit. And not quitting is a good message to give kids
and for some kids with a DHD, that's a message that needs to be sent because it's easy for the win their attention leaves to want to quit, right? Well, that leads into a, uh, the perennial favorite. Why can my child focus forever on a video game? But we'll take three hours to do a 30 minute homework, asshole.
And it's Or they can focus for hours on any number of things. Anything that combines structure, novelty and motivation. Those three factors they'll get focused on. And and, uh, homework just doesn't. Okay, But if they were, if they're lucky enough to respond well to medication than homework Good. Uh, you know, So So you know, the the, uh, the the way to make homework engaging other than medication is to have a tutor to break it up into chunks. Um, but but the simplest and easiest way to do it is to make sure you have medication coverage when you're doing your homework. And again, this is This is a reason why parents, you know, really should consider medication to do not my medication, unless it's unless it's against. Your religion is just Ah, it doesn't make any sense to me not to give a trial of medication. Um, you know, medication won't always work, but when it does work. It's so safe. And it's so effective that, um I don't understand why people won't do it.
So it's getting kind of in summary medication are at least a trial of medication because it's effective, I think, he said, 80% of the time, Uh, setting up external structures, uh, having a routine, having a predictable routine within your family, um, focusing on protein at breakfast or least have some former protein and then eating. We all know what relatively healthy eating there were to be fanatical, but but relatively healthy eating, um, and then adequate exercise and sleep. Those were kind of the to summarize for a
lot of not not too much screen time. Watch out for that.
Oh, yeah, Good point. Okay, so and then and then limit screen time. And that some combination of or all of those will go a long way towards helping with the parenting challenges of a child with a DHD. Okay, Excellent. Um, that at the time we have left, I really want to spend some time talking about what it feels to me is at the heart it of the strength based approach. I think that is, is so necessary, and I want to do it shot out for untold er book that you were co author Ron called positively a d d and talking about, uh, looking at all the people in this world who have accomplished amazing things and it could be worked, you could use it with your child. So one thing that I wanted to start, which was how do we talk with our kids? And I would assume it is important to you. And you talk about the telling a kid about the Ferrari brain and that his parents were here to help them increase their brakes or work on their breaks. Um, at what age did you start talking with Children and explaining that they have a d h
d o a. Soon as they can understand? You know, four year old who's running around tearing things up? You say you've got a racecar brain, you know, instead of you're a bad boy. Say you've got a racecar brain with bicycle brakes. And so when he bumps into something or kick somebody or throws something, you say your brakes are failing you and said there's no shame in that. You avoid shaming him But at the same time you've intervened. You said We gotta work on this. Your brakes are failing. We need to work on your break. So you explain it to them. Is early is he can understand English. You don't use the term a DHD. It's a terrible term. It's inaccurate. It doesn't explain what the condition is all about that you want to explain that he does have this this difference, which is managed properly. It's a wonderful difference. It's like he's got a superpower.
I think that's that. That's the heart of it is focusing on the fact that this is a strength now, if not managed. You know, it
was a terrible curse. If you don't know that's what makes it unique. I mean, there's nothing quite like that that it could be, Ah, wonderful asset or it could be a terrible curse.
And that's the challenge of parents that is our job. A parent of a child with a D. H D. It's our job to help our child see it and help ourselves see it both. I would add, uh as, uh, you say something in one of your books about viewing a child with a D h d is like a gift wrapped, wrapped up gift.
I tell you, I don't treat disabilities that unwrap gif ts
Yes, I love that. And the gifts were trying to unwrap our creativity, originality, thinking out of the box Theobald ity that got a box Be intuitive. Ah, persistence all, all of all of those things. So how can we help parents shit their mentality towards say, Yeah, it's all good to say you're unwrapping a gift, but right now this gift is driving me bananas.
The ones that were gonna return the gift.
Yeah. Where's the return section, please? Yeah, what can we do to help parents getting away? What you're saying is it's a mental shift from a parent standpoint.
Well, you know what my first rule is? Never worry alone. Talk to other parents, you know, have books. You know, it's not easy raising a child who has this condition. My wife, Sue and I have done it three times now, and ah, you know, it's labor intensive. They don't do stuff that comes easily to some kids. Just doesn't to these kids getting dressed in the morning. What could be easier than that for these guys could be a total ordeal. Yeah, you know. And, uh so So what's easy for most kids is really hard for these kids on the other end. What's really hard for most kids, like being ultra creative and coming up with new ideas? These kids, it's natural, comes naturally to them. So in the long run, they're better off being ableto have the kind of minds that have. But in the short run its stuff and particularly cuff on parents,
are there any good Children's books that you know of? I mentioned positively a d D. I don't know if that would actually be a Children's book. It's a book for parents to be able to read, to talk to their Children about the positive aspects and the positive number of them wonderful people who have done amazing things who have a th day any other, their Children's books that, you know, uh, that would be helpful for Children, for parents, to Rita kids.
Well, my book, a walk in the rain with the brain it is a is a good one for little kids. It's not about a D d per se, but it's about brain differences.
Yeah, that's part of it. It's treating this as opposed to a disorder as just a different type of brain. Okay, Excellent. Um, and, uh, any parting words for parents who are a TTE this point looking for the return counter to for their gift of a child with They did.
Well, you know, it's all gonna work out, is, you know, just hang in there. I never worry alone. There's tremendous power in sharing your concerns with other people. Get on a chat room, join a group, talked up. Mother's talked about the fathers, talk to teachers, talk to other people, keep your sense of humor. Uh, I mean, and let's face it, you can't return your child, so it's not an option, so Oh, you know, Okay, you're you're you're stuck with the child and, um uh, you know, love the child you've got, you know, don't waste time wishing you had a different child
and don't come out here. Yeah,
love the child you've got. And next thing you know, this child that you might think is defective turns into the most incredible wonderful child use you've ever could imagine.
And I would add that if identified your day and there's gonna be pretty predictable places. You used the example of getting dressed, and that is certainly one of them. Well, then dress that specific problem. Say okay, Every morning we have it takes you 30 minutes to get dressed, and then we're shoving breakfast in you as you walk out the door. More running. At this point, I'm yelling at you. All right, So you, as a parent can then say Alright, what could we do, too? Simple fight. I know of parents who have their Children dress for school and sleep in their clothes. And then that of the problem. I know others who lay out clothes downstairs in an environment where parents are so the child will have to get dressed. Where parents there to keep encouraging them. And the clothes is already picked out. They're not alone. And not in an environment that is more usually distractive. Uh, so there's just think those are just two examples are near
our daughter. We gotta flying alarm clock because she so she had to get out of bed and catch the alarm clock.
Oh, wow. That would, um I could use that right now. No, Uh, at that point, it would become a game for at least one of mine with a DHD, so that wouldn't have worked. But But the point is, be creative, rupture on and go back to the things you mentioned before. And I don't
feel bad if you get exasperated. You know, it is labor intensive. It really is. And just never worry alone. You know, I have someone you can call up. You won't believe what happened. Day. I think I'm gonna lose my mind. That's fine. The
one I really feel sorry for is your wife Sue. Because she had three kids and a husband. She was product. I'm assuming she doesn't have aviation.
Doesn't she? Doesn't. She's amazing. She's She's truly amazing. She
should be the one writing the books on how to survive with or exactly should. For people who are bouncing off the walls when abi to dok. Well, thank you so much, Dr Ned Hallowell, for being with us today to talk about raising a child with a t h e into a healthy and successful adulthood. And from what you're saying, it is not only possible, but with the right attitude of these kids turn into amazing adults. Sure, I could say that for for mine as well, so Yeah. Well, thank you so much. I appreciate my pleasure. Keep in mind that the opinion shared here are those of the guests and do not necessarily reflect the position of creating a family, our partners, or are under arrives. Also, the information given in this interview is General Liszt. Understand how it applies to your specific situation. You need to work with your adoption professional and to our audience. Thank you for joining us, and I will see you next week.