Tips for Living with ADHD | Pediatric Neurologist Dr. Sarah Cheyette

Living with ADHD

This Facebook Live chat about Living with ADHD was a Q&A session with Doctor Sarah Cheyette of the Bay area.

dr sarah cheyette

Sarah Cheyette, MD, graduated from Princeton University, and then UCLA Medical School. She did a fellowship in pediatric neurology and has been in private practice since then. She treats kids and young adults with ADHD, not just with medication but also with non-medication strategies such as those she outlined in her book, ADHD and the Focused Mind. She brings a powerful professional perspective on the benefits and limitations of ADHD medication, and the many behavioral adaptations young people with ADHD must embrace to thrive with their condition. She and her husband have four kids and live in the San Francisco Bay Area.

Here are the resources she talked about today, including information on the two books she has written.

You can watch the video of our chat here.

ADHD & The Focused Mind: A Guide to Giving Your ADHD Child Focus, Discipline & Self-Confidence
28 Reviews
ADHD & The Focused Mind: A Guide to Giving Your ADHD Child Focus, Discipline & Self-Confidence
  • Cheyette MD, Sarah (Author)
  • English (Publication Language)
  • 256 Pages - 02/15/2016 (Publication Date) - Square One (Publisher)
Winning with ADHD: A Playbook for Teens and Young Adults with Attention Deficit/Hyperactivity Disorder (The Instant Help Solutions Series)
44 Reviews
Winning with ADHD: A Playbook for Teens and Young Adults with Attention Deficit/Hyperactivity Disorder (The Instant Help Solutions Series)
  • Friedman, Grace (Author)
  • English (Publication Language)
  • 192 Pages - 04/01/2019 (Publication Date) - Instant Help (Publisher)

ADHD FAQs with a Pediatric Neurologist

LL: Okay. We are live. Great. Thanks for joining us everyone today. I am here with dr Sarah Shay yet. I’m going to let her introduce herself in a minute. I’m going to give this a minute to show up in a few feeds on Facebook. Well there we are. Good.

SC: Okay.

LL: It is closed captioned live on Facebook. If you’re watching, those of you and I get asked this all the time. Yes, it will be available to watch later. It will stay on the Facebook page forever and I also download the video and upload it to YouTube so it will be there. but if you do have to leave early for some reason, you can catch it there. I also transcribe it for hearing impaired viewers, so, okay, great. We have a few dozen people on already, so let me introduce Dr Sarah Cheyette. She is a pediatric neurologist, so I was interested in having her on. Neurology is one of my favorites. It’s my favorite specialty. I think out of all the, my son has a very large team, but neurology is definitely my favorite and the ones I see the most frequently unfortunately. But she doesn’t specialize in seizures. She specializes in ADHD and in fact she’s published two books on ADHD.

LL: One she wrote with a karate master and you can ask her more about that and it’s called ADHD and the focused mind. And her second book is called winning with ADHD. And as always, if you have questions you can put them in the comment section. and we’re going to keep, please keep your questions focused to dr Shea and ADHD and kind of on topic. I’m not going to be answering any general IEP or five Oh four questions today during this talk. but we’ll do that in future office hours as I do. So today she and I are going to talk about, making connections with our ADHD kids and some activities to build up their skills during the summer. she and I were talking before this broadcast before we went live and talking about, you know, there’s really going to be a covert slides, so we’re going to have to talk about that. So, okay. Welcoming.

SC: Absolutely. It’s, it’s, I want to first thank you for having me on the show, Lisa. I enjoyed our chat beforehand and obviously pediatric neurology is gotta be everyone’s favorite specialty. You have wonderful taste. And, although I am sorry that you had to make the acquaintance with, at least one team of pediatric neurologist. yeah, I do a lot of work with ADHD and some pediatric neurologists do that and some don’t. this is, ADHD is a brain thing, so I feel like I can, and I really liked to, I came at it through more traditional pediatric neurology type of things in that, headaches, can sometimes be caused by the stress of school and, and that can be caused by ADHD. And so, I kind of fell into ADHD that way. I have four kids myself and, you know, they all get distracted. So my kids range from age. well Jackie’s going to be, eight this summer and my oldest is turning 23, so kind of a spread. But, I love kids obviously. Okay. So let’s get into that a little bit. Cause I think when we talk about

Do you need a neurologist for ADHD?

LL: ADHD, you know, a lot of even parents, they may not have a neurologist on their team for the ADHD. It seems to go more the educational route or maybe a counselor, psychiatrist, psychology, kind of. You don’t often hear about, parents adding a neurologist to the mix. So you want to talk about that and you know, advantages and all that.

SC: Yes, absolutely. So, neurologists do or pediatric neurologists do, do a lot of work with kids with autism and so autism and ADHD overlap in many ways. And I’ve written a blog on that. There are, genes in common with both of them and the symptoms are in common with both of them. And recently the DSM guide, which is a handbook to diagnosis, has allowed for co-diagnosis of both ADHD and autism. So you might have, if you have a high functioning autistic kid or another autistic kid, you might’ve met a pediatric neurologist through that way, and because of the symptom overlap, we might treat your kid with medication or deal with ADHD in certain ways. Psychiatrists also deal with autism and ADHD and they may make the diagnosis, a psychiatrist, or a pediatric neurologist, we can prescribe medication because of the MD part of it. Psychologists may be very helpful or other mental health professionals. It could be a MD or you know, whatever the degree. But they may also be very helpful in managing the behavior, but they can’t do the medication. It’s really confusing for parents to know who to turn to. And you might start by asking your pediatrician who does the ADHD and what aspect of it you want to work with.

LL: Okay. great. Alright, we have some questions coming in before we get to those quickly before we go to our main part. Julie and I know this is a common one. Kenneth’s child grew out of ADHD. She’s saying her child got the diagnosis around 10 or 11. She’s always felt it’s been autism. but he’s not hyper anymore.

What is ADHD? Can you grow out of it?

SC: Isn’t that great So, I’m going to just start by clarifying a little bit about what ADHD is. So we’re all talking about the same thing. First of all, there is confusion between the add and ADHD. So the first one add is like ADHD without the hyperactivity, but it’s no longer a diagnosis that you’ll hear from professionals. Basically. They changed it. I don’t think it’s a good idea, but they did it. they changed it. So everything is Ady is called ADHD now. And some people with ADHD are hyper and some people with ADHD are not hyper. Okay. So from here on in, I just want everyone to understand that I’ll be using the term ADHD, although a lot of the kids I deal with, they should be more hyper. You know, they’re, they’re, they’re, they’re more inattentive. so, and I also want to make the point that we all have times when we’re not focused and we all have times when we’re focused.


SC: And ADHD is no different in that respect. Focusing means that your brain automatically pays attention to one thing and doesn’t pay attention to other things that it could. It could. So like for example, Lisa, right now I’m paying attention to you and I’m not paying attention to my dog who warmed his way into the room and I’m trying not to pay attention to the right side of the screen that’s flashing. But I’m focusing on you and I’m not thinking about all the other things in my life, which there are millions, when I’m not focused, I might start by thinking with you or I might start by looking at you and thinking about you. But then, okay, my dog’s agitating to get out and you know, the screen is flashing. I’m so glad people are watching with comments and blah, blah, blah. You know, like my brain may hop from thing to thing.

SC: So to answer the question throughout your son’s whole life, just like your life, there are going to be times when you’re focused in times when you’re not focused. that doesn’t change. ADHD is diagnosed when you’re not focused. So much of the time that it’s a problem. So, you know, although your son, may have times when he’s not focused, it sounds like it’s not that big of a problem for him anymore. And I wouldn’t focus on the diagnosis. The part of ADHD tends to get better over time. Okay. So, you see really hyper little kids, but you don’t see that many hyper adults. You might see some fidgeting, but not sort of the, I can’t sit still. and of course, it will depend on what people do. Right. So there are times when your son’s going to be in doing things he doesn’t want to do or doesn’t like to do or not. Interesting. And you might see the inattentiveness more than, Hmm.

LL: Okay. I’m learning a lot myself. okay. Hi, Robert. Robert. Oh, he’s just saying why he’s here. and Robert joys, he’s joining us very early. I know from past videos, he’s actually in Hawaii, so, he’s an adult living with ADHD. let’s see. Can you talk about the irrational temper and decision making with ADA, with ASD and ADHD

ADHD and Anxiety

SC: Sure. So, that comes from a lot of different things. One of the features of ADHD is impulsiveness. Impulsive myth. Newness means you do something without thinking about it, without planning it out. Some of that is good. You know, people who start a company, they have to kind of leap in, right But some of it is not good. And, people who are impulsive, they get angry quickly, boom, they don’t think it through. They don’t think, maybe I shouldn’t be angry. Maybe they didn’t mean that. They just go straight to straight to, straight to, anger and reaction or reaction, whatever it is, the impulsive decision. And, the thing about it is that if your brain sees lots of different things all at once, instead of prioritizing the one thing over the other things, for one thing, it’s very overwhelming for a lot of people.

SC: And they respond to that with anxiety. And people who are anxious often have a more hair-trigger decision-making. and you know, if you see lots of different things, it can also be harder to make a decision. So, you know, you just sort of pick one thing. So there’s a lot, there’s a lot that goes into that very excellent question. Okay. does it kinda diet and help ADHD That’s a common one, right So the so there was for many years, thought of ADHD is not something biological, but it’s something that, you know, poor mothering and other, you know, it’s all the mother’s fault type of thing. And diet was raised as a possibility because of everyone’s kind of observation that sugar and hyper may go together when it’s been studied. sugar, not a major culprit in ADHD.

Are all kids with ADHD hyperactive?

LL: Maybe those kids are more hyper at the birthday parties cause there’s a lot of sugar and, and excitement at birthday parties. But, there’s been some studies that have implicated red dyes or other artificial dyes, but I don’t think that’s a major part of this. I do think that starting the day with breakfast, which feeds your brain is helpful. So don’t we all get more irrational and anxious and hangry when we don’t have the right food in our bodies And that is your brain talking. Your brain is the most metabolically active part of your body. So pound for pound, it uses more energy than your muscles. Overall. You have more pounds of muscles than brains, but it’s important to give your brain the right food. So I, I don’t know that I would put, an already difficult kid on a super restrictive diet. I think I would focus on good, healthy habits. Okay. okay. Before we get to some of the questions we’re in touch a little bit about,

LL: Of course we’re here in the pandemic, and we’re on shutdown, locked down wherever you want to call it. my state’s on lockdown, we’re under stay at home orders until next Friday. at least. so all these kids we have with ADHD, and I know many, many States and districts have already said that ESY is going to be virtual. It’s not going to be in person ESY. So what can parents do with this covid slide or over the summer, you know

SC: Yeah. Preventing regression. Yes. And of course, it depends on the age and the developmental state of your kid. but, and, and you know, many of us, myself included, are also trying to hold down full-time jobs. while balancing all of a sudden I have eight hours or more of childcare and, you know, many moms take that on more than dads. just because of, well, lots of different things I’m sure. But I just wanted to shout out to all the moms there as well as all the dads who are taking out on the childcare with their jobs. Cause it’s, it’s really hard to do that. we’re also in shutdown lockdown, whatever quarantine, I don’t know what you want to call it, but, I’m trying to take the opportunity to develop connections with my kids. Like okay. for ADHD, a lot of kids feel very isolated and, they feel very, you know, they get a lot of negatives.

ADHD and Positive Feedback

SC: the optimal ratio of positives to negatives is that you’re supposed to hear about four positives for every negative. So if you say to me, you were late and, but you know, you should save for positive things to balance it out, but I’m glad you’re here and we’re gonna have a great time and I hope that everyone enjoys it or whatever it is. ADHD kids here closer to 20 negative things for every one positive that they hear and what a way to grow up in. Well, that is really terrible because then they develop this concept in their, in their own brains, a self-image of somebody who’s lazy, who doesn’t achieve, who doesn’t want to do things. and then they become that person, right So it’s a negative cycle. If you have a bad outcome, then you go, Whoa, I must be that person that sort of validates your sense of self as negative and then you, you’re going to have another bad outcome because somebody who’s bad at something doesn’t try hard.

SC: And every mistake is used to validate yourself as a, as a bad or lazy person. So, dr Hallowell, who’s one of the, you know, real, grows and pioneers in ADHD treatment talks in his books about the importance of the connection of being just being there for your kids. not trying to shape their behavior but just to do something together. And there’s a lot of activities that you can do on lockdown that just develop a connection. eating is one, I’m sure everyone doing a lot of that. Yeah. Quarantine 15 and all that and you know, just sort of sitting next to somebody and, and even if they’re mad at you or whatever, just talking about food is always fun. Baking is an activity that a lot of people enjoy doing. And then to counteract that, you know, some, some families have exercise together and that’s, that’s a time for connection.

Making a Connection with your ADHD child.

SC: So being out in nature, meaning taking a walk around the block, is a real relaxing things for people. And, if that’s something you can do with your kid, that’s great. My son is 15, just turned 16. And you know, many teenage boys, not all, but many are in the grunting phase of their existence. And, he is too, it’s rare to get a whole sentence out of his mouth, but sometimes we walk the dogs together and you know, I don’t really try to talk to him, but just kind of being near him as good. some people are into music, you know, you can connect by learning ukuleles together online. There’s so many YouTube videos on how to do stuff. and if you have a kid who can manipulate all the YouTube stuff, they’re going to feel great showing you how to do stuff.

SC: So, you know, there may be some really cost-effective things that you guys can learn together. I know that the dojo where my kids go to karate and, you know, I wrote a book with the teacher there. you know, they made the point that it’s hard to do team sports these days, but you can do martial arts online. And so that’s another thing, in my family, my husband does that with the kids. And it’s a big connection. There’s archery, there’s, you know, you could rig up some fencing thing, learning to program on computers. I mean, like who, who wouldn’t want to learn that good. There’s a lot of things that you can do that you’re near somebody that you’re not trying to make them into something but you can both enjoy together and that would be really helpful so that later on you can use that connection in order to impart some wisdom to

Addressing ADHD issues on a 504/IEP

LL: Great ideas. okay. So let’s talk a minute about comorbid conditions. I know in my experience as an IEP and 504 advocate with parents, you know, I often use the phrase ADHD rarely travels alone. either quite often comorbid conditions. How can a parent like piece out what, where the issues are, and what to address? And you know, our specific question from, from one of our viewers is, if it’s a comorbid condition that is typically something you don’t medicate for, like dyslexia, how do you know what, you know, should you be medicating or are you considering medication or not

SC: Right So I think the best way to do this is to think about the symptoms rather than your diagnostic list. Like your child is not a diagnostic list. Your child is not a collection of diagnoses. Basically, your child may have difficulties with attention, difficulties with reading, difficulties with socialization, and those traits can be overlapped in different conditions. Now as an IEP or five Oh four advocate, it’s more important to have, okay, this, that the other thing, because that’s the language, the school’s talk. So the diagnosis is useful, but your brain doesn’t like have different compartments for this or the other thing, it kind of all works together. So if you have difficulties with your brain recognizing letters and letter sounds as in dyslexia, you have to know that that means that reading’s going to be hard for your kid. So your kid may have anxiety about reading. And your kid also may have in attention for reading cause it’s so hard to, and so trying to figure out what is going on rather than which diagnosis is there, is often really more helpful on a practical basis.

LL: Okay. Yeah. That’s, yeah, identifying the needs and that’s, that’s great. That’s typically the advice I give to parents as you know, it’s about what needs they have.

SC: Yes, exactly. So, you know, it’s, it’s never just one thing, but, if, you know, if your child has difficulty with socialization, the attention to do that is often going to be, problematic. Right. So we all want to avoid things that we don’t like to do. Yep. okay, another question, as a pediatric neurologist,

ADHD Awareness among IEP Teams

LL: How do you educate individuals who have not seen or interacted with a person with ADHD and how do you offer better awareness even among educators who are not being properly trained about the different challenges with ADHD

SC: that was difficult. So that’s why I, that’s why I wanted to start by talking about what ADHD was because I’m sure all of your listeners and, viewers, I guess I should say, come to this with different ideas about what ADHD is not the least of which a lot of people just all over the place rolling their eyes and saying, Oh, ADHD moment. So, you know, I try to use practical down to earth language so everyone is understanding what things are, what is happening. Hey, let me get rid of the dog. Sorry about that. That’s all right. Do it. so you know, again, the diagnosis of things can change over time. The diagnosis of ADHD now is different from, you know, where it was many years ago and it will be different in the future. So trying to get away from the language that is confusing, to so many people would be really helpful.

LL: Yeah. It would be. I, yeah, I think, and that’s why I always often tell parents to focus on the areas of need and not the diagnosis. Because when, even when you have that label, whether it be autism, ADHD, everybody gets a picture in their mind.

SC: That’s exactly it. Of the last person you saw with autism or ADHD, right It’s like, okay, then we go to the autism or ADHD playbook and do this, that and the other thing. And that I, you know, I’ve yet to meet two children who were exactly the same or two adults who were exactly the same. And we, we all, it’s not just a diagnosis, but it, you know, what goes into functioning is how people think of themselves, how they’ve been treated over time. you know, what they believe is possible. Their, their hopes and their view of the future is really important as to how they’re going to do. And so even if there are two kids with ADHD or autism or whatever it is, then you know, their individual experiences, how much anxiety they have, they’re just, just, just sort of natural tendency. So some people are naturally very organized. They’re going to do better even if they’re inattentive, because life’s easier when you’re actually organized. So, you know, there’s so many factors that go into the outcome. It’s important to consider the whole person. Right.

LL: Jessica, your questions I’m going to skip over your questions. We actually had an executive function coach on yesterday. so we did a whole hour just on executive functions. So, I’ll let dr Shea if she wants to say something briefly about executive functioning, go ahead. But we’re not going to get too much into that cause like I said, if you look on yesterdays, Facebook live is a whole hour on it. do you want to just mention it for a minute

SC: Sure. Executive functioning is sort of like the mom part of your brain that says, do this now, do this later, finish that. don’t do that. so, you know, that’s basically it. And like I was just saying, executive functioning and organization are somewhat synonymous, not perfectly. And, you know, your child is going to do better and feel better if they can get some degree of organization because that will, will help them function better. So doing that to some degree, you know, not alphabetizing their sweaters or whatever. That doesn’t have to be crazy, but trying not to spend so much time frustrated with missing things or losing things is, is helpful.

LL: Is it Possible to figure out what makes a child have an extreme attention deficit, for example, why they keep drifting or what, you know, like this. What causes those neurons to keep firing so to speak

SC: Yes. Great question. So, you know, in terms of what causes this ADHD is felt to be genetic, some of the genes are known and some of them are probably not known. And how the genes work together with every other thing is really unknown. And, so I, I’m sure someday we’ll be able to like run your blood through the machine and really tell you what causes this. In addition to genetic causes, there can be, you know, environmental causes, difficult births or pregnancies, you know, deprivation, emotional issues. There’s, there’s a lot of causes why some people are more severe. We, we can’t really tell you that some of the genes involved have to do with, dopamine processing. And that’s dopamine is one of the chemicals involved in the reward part of your brain. So, you know, ADHD kids do respond differently to rewards than, than some other, other people. But also, you know, think about the things that make you less attentive over time. If you’re tired, if you’re bored, if you’re hungry, if you’re depressed, if you’re worried, all of those things can contribute to why a given person is inattentive at a particular time. Hmm,

LL: Okay. Yeah. And then sometimes I think we expect the kids to really behave better than what we are not necessarily behave and perform at a different level, better, higher level than what adults perform. Cause you know, we’re allowed to have bad days. So there’s a lot of days, you know, we’re not a lot, but days where you say, I just really can’t, you know, I had planned to do this chore today and it’s a nonpreferred item, you know, and we say, Oh, you know what I’m going to put it off for a day.

SC: And that’s why some adults do better. And that you can think of that as outgrowing. Although like I said, we all have the capability to be inattentive. So, you know, as a kid, everyone has to do everything the same way, the same time consistently, at least in the previous life that we had at school. And that is another plus of this time at home in that you do have more, leeway for getting things done. And, I, you know, now that I’m home with my, youngest and I’m looking at the stuff they have to do at school, I’m like, God, this is really boring and you know, I’m like, eh, don’t do that. You don’t have to do that. And so, you know, I think as an adult you have more flexibility and you are able to choose things that you like to do more in general.

SC: On the other hand, the consequences of uncontrolled, the ADHD as an adult are worse. So if you have, ADHD as a kid and you don’t turn in your homework, okay, everyone’s mad at you, you get a zero or whatever it is as an adult, if you don’t turn in your taxes, you know, bad things happen there. If you don’t turn in your stuff at work, you get fired. There is no food on the table, you know, if you don’t listen to people, okay, your parents are mad at you. But as an adult, my goodness, you know, you got divorces and, and you know, just major things. So there’s a lot of, benefit in addressing this earlier rather than later. Yep. Okay. All right. So,

What Medications Work for ADHD?

LL: I’m going to tread lightly on this next one because I know I don’t expect you to give medical advice online and certainly don’t expect you to give advice about prescriptions online. but the question is, does Adderall really help So maybe, I don’t know if you want to give your opinion on, on medicating overall, you know. Yeah, yeah. So,

SC: So, you’re right. I can’t give anybody medical advice online, but I can speak in and, just like everything, Adderall helps some people and doesn’t help other people. And, but for some people, it is amazing and life-changing. I have seen F students become A students and more importantly because like who cares about grades and when you’re in seventh grade, like do you know the grades I got in seventh grade, but I don’t know. Nobody knows. Nobody cares either. So it’s not the grades, but when you do well, you walk around, you’re proud of yourself, everybody recognizes you as excellent. So yes, Adderall can do that for some people. And for most of these medications, you know, there are, you know, it’s a biological thing that’s going on in your brain and it would make sense that some medications can help. There are some people who seem to do well with any medication that they take and there are other people who are extremely sensitive and have every side of a side effect on every medication. Then I try them on. and certainly I as the author of two books on the non-medication strategies, I really believe that those aren’t important too. But yes, Adderall can be life-changing or Focalin or Vyvanse or you know, any of these medications.

LL: Right. And I think that goes, I mean, that goes for any, I mean, chemotherapy works for some cancer patients and others. It’s not, you know, it’s, it’s an anxiety and depression and I can’t even pick Tyler. Like for me, Tylenol makes the headache worse. I don’t, I have, you know, who knows why, but it does

SC: Individual, you know, everyone’s always asking me for the medication that does all of the good and none of the bad. And if I had that, my job would be the, I’d be like open up, but it’s not so easy, unfortunately. Yeah.

LL: okay. Kathy, we already touched on that question a couple minutes ago. I hope he caught it. Robert, again as a member of IEP teams, Oh,

LL: Oh, whoops. He’s just giving me a compliment. Well, thank you. Not a question.

SC:You can read that one aloud if you want. We have time.

LL: I have noticed different studies or trials being performed on it in individuals with ADHD by neurologists, but it usually is only offered for individuals under the age of 12. Is there a specific reason that they focus on younger kids and ignore individuals over that age

SC: Well, that’s a great question and I don’t know if I really know the answer to that because I don’t do those trials. But one thing I will say is that over the age of 12, there gets to be a lot of complicated emotional stuff that goes along with ADHD. It’s sort of like teenager-hood magnified and you know, when people are anxious or depressed or otherwise emotional, it makes it harder to be rational. So basically you can think of your brain is having two parts. One part is the emotional part and you know, fill in the blanks, emotional, angry, sad, whatever, worried. And the other part is the thinking part of your brain and the emotional part of your brain has a physical connection to your thinking part of your brain. And it, it turns it off. That’s probably from the days of the saber tooth, tiger, tiger, you know, like, danger.

SC: Is that really a tiger You know, they, your brain didn’t want you to overthink that. So, but what this means is that when you’re really worried about something, it’s hard to think about it in a rational think straight about it. you know, like for me, when my older kids were starting to take planes and go places by themselves, I’d be like, Oh my God, the plane is gonna crash. You know and as soon as they landed and texted me, they were fine. I’d be like, yeah, of course, they’re probably safer in a plane than anywhere else, you know, the planes never crash, blah, blah, blah, or almost never and all that stuff. But while I’m emotional about it, I, it’s hard for me to think rationally about it. And so, you know, when you get to be over 12, there’s definitely more emotional stuff and more sort of baggage from the previous seven, eight, nine years of having all that 20 to one negative statement that we talked about earlier.

LL: Yeah. And I as a parent who has, pursued many, clinical trials for my son. what a lot of people don’t realize when you do a clinical trial, you can’t change anything at all. Like you can’t change like very specific, right

SC:Yeah. It’s very specific.

LL: And you, you agree that you’re not going to change anything else about your child’s life during the clinical trial and that might be easier to control under age 12.

SC: You know, just on a physical level, the brain of a child is physically completely different from the brain of an adult. I mean, if you are, if you ever look at, look at it, I mean, it’s, it’s not just that it’s a smaller adult brain, but it’s physically different than myelination. All the different things in it are not little adults. And once kids start talking, I think people start expecting, that them to be little adults and they really have different perspectives on things. And one thing that’s helpful is trying to see things from your child’s point of view. So, you know, we’re all like, you gotta do your homework because you know, you will never get to college and you know, you’re, you’re going to turn into an irresponsible surfer dude beach, the I am on the West coast, right?

SC: I don’t know what people turn into in Philadelphia, but be all that isn’t me, but you know, we have all this like blah, blah blah, blah blah. Here’s the, you know, you of course we want you to be a responsible person and the child is sitting there going like, why do I have to do this homework It’s like really dumb and why do I have to do dumb things And so, you know, kind of turning it from the assignment, it’s not about the assignment. That’s something that an adult can help a child do, but you really have to kind of understand things from your child’s point of view. Yeah.

LL: okay, before I get to Jim’s question about another non-medication question. Julie asked about your books. I mentioned them at the beginning. I’ll say them again right now. the one is called ADHD, ADHD, and the focused mind. And the second one is called winning with ADHD. And as always, when we wrap up this talk later today or tomorrow, I send out an email to everybody. I put it on Facebook, I tweeted out, I put it in the group, I put it everywhere with links of where to get her books. and of course if you’re watching us right now, you can see her name over there on, oops, there

LL: Over there. on the side you can see how to spell her name if you want to look her up on Amazon.

SC: Yeah, my books are available on Amazon and also they’re available in audio because I recorded them, with my coauthors. so audiobooks are available as well, wherever you get audiobooks and, like audible or whatever. so I have two books. One is the first one is ADHD. In the focused mind, I’ll mention my husband who’s a psychiatrist as a coauthor. as well as, like my kids have been taking karate from Peter Johnson, who’s my other co-author for many years. And that book started because, you know, when I’d be the mom and I hear Pete yelling at the kids, Hey, focus your eyes, focus your mind, you know, all the things that they were learning in karate. Those were really helpful things for the rest of their life.

SC: And that’s kind of how the idea of the book was generated. And we talk about how the athletic techniques that, you know, world-class athletes as well as seventh-grade players, use are really helpful in terms of focusing in school and at home. And so, it’s all about the non-medication strategies, although again, there’s a little chapter in the back about medications which can be helpful. it’s the only book in history written by a pediatric neurologist, a psychiatrist and karate, that one and my other book. And so that’s a book that’s mainly for parents. the other book, winning with ADHD is written with a lovely young woman named grace Freedman and she has a site called Addy, She talks to ADHD teens in their language. My kids were very, very clear that my language. But so that book is a mainly at middle and high school students and told from the perspective of somebody who had been there herself with an assist from me.

LL: So, okay, so going into another non-medication idea, CBT, and your thoughts on that cognitive. Half the time I’m asked about CBD and about CBT, cognitive behavioral therapy. And so, that’s, that’s the one you asked about, right So, you know, that is a therapy for people who can reason out, you know, kind of like, here’s what I want to do. It’s helpful for setting goals and if you have a clear goal that helps your focus, if you know how to get to your goal, the CBT is what will help you kind of take the steps to go from point a to point B. And so it can be very helpful for kids. Some kids are not motivated to go to therapy and I can understand that. But the same kids who have coaches and other, you know, adults in their lives that help them, you know, it’s, it’s very similar to having a therapist.

SC: So if you have a kid who won’t go to therapy, you can certainly, mentioned to them that, you know, they have a soccer coach, they have a tennis coach, they have a whatever coach and what’s the difference And it’s hard for them to name that. Sometimes it’s not helpful or oftentimes I would say it’s not helpful to do coaching for the kids themselves, particularly younger kids. I think their parent coaching is more helpful. There’s a site called impact ADHD and they have something called sanity school and I refer a lot of people over to them because they have excellent and very cost-effective parent coaching available. You could also work with psychologists or therapists locally. No.

LL: Good. and again, I will include all these resources with whatever links to whatever she mentioned. when I send it all out. let’s see. Joanne’s asking about Anxiety and ADHD and tell me the difference. We talked a little bit about comorbid conditions, but you want to touch on anxiety and ADHD specifically

SC: Yeah, that’s a great question because anxiety is one of the most common emotional things involved with ADHD. Like I said earlier in the broadcast, you know when your brain is sort of seeing lots of different things, it’s the same feeling you get when you get back from vacation and there’s like all these million things that you have to do and everything’s yelling, do me, do me, do me, do me, do me. And then you wind up, doing little parts of everything and you don’t get anything done. And so you never get that good job because, you know, it was like me last Sunday, I had a million things that I wanted to do and I did a little of this and did a little of that. And at the end of the day I was working, I, believe me, I wasn’t sitting around but nothing got done.

SC: And I have my same to-do list to do, you know, for this weekend. So that’s a real anxiety-provoking situation. So anxiety is often found with ADHD and like I said, also earlier when you’re anxious it’s harder to focus and when it’s harder to focus it makes you more anxious. So it’s really difficult. Anxiety can mimic or worsen ADHD in other words. And sometimes it is hard to know if you’re choosing medication or a route for therapy. What do you do first You know, sometimes, sometimes it’s helpful to go back, you know, in, in younger kids before they were, let me rephrase that. Before they, got anxious, they may have had significant difficulties focusing. And in that case, knowing what came first can sometimes help you as a target for therapy.

ADHD in Girls vs Boys

LL: can you talk a little bit about the difference between ADHD in girls and boys and some of the differences and maybe clinical signs that you see that are different Maybe they’re not different. Maybe that’s a myth.

SC: I, I may be getting too old fashioned, but I do think that there are differences in girls and boys brains. my older daughters may argue that one is, you know, that is this true genetic or is this from being raised with cultural cues And I’m not going to get into that at this point. But you know, girls I would say tend to be more quiet and girls tend to be more organized. These are general statements. so it’s one of those things where, when you’re more quiet and you’re more organized, you’re going to get noticed as having ADHD a little bit later in life. So, you know, towards middle school more typically for girls than you know, five-year-old running around boy, you know, crazy kids. So, I think it is different and, and I do believe that that as a culture, we do treat girls somewhat differently from boys. And, those differences can play a role in as to when somebody is, ADHD becomes an issue.

LL: Okay. is this an executive function or is this just not related and perhaps maybe some overlapping or co-morbid odd, but is it a trait that a child with ADHD has difficulty understanding, taking responsibility

SC: I think that a common thing, it’s hard to know what’s the chicken and what’s the egg there. So if you take responsibility for something, you are more likely to be focused on it if you have ownership of the goal. So that is one thing that you know, really will translate from sports to real life. So, or not real-life sports is real life, but you know, translate from sports to non-sports aspects of your life. So if somebody told you you need to run a mile in six minutes but you didn’t really want to and it wasn’t your thing and it wasn’t your goal, you’re never going to do it. But if you decide that this is your mission in life, then you know, you can do pretty much anything. There’s a great YouTube video out there called, I can’t, that’s like five, four. The guy is five, four and he teaches himself how to dunk a basketball.

SC: Any are five-five. Anyways, I’ll help you find it. If you can’t find it, it’s an awesome video. so, I guess what I’m trying to say is that, if you take responsibility, you’re going to get more focused. But a lot of people won’t take responsibility if they don’t believe they can do something if they’ve had failures in, in that before. So one of the things you can do this summer to get back to one of the original things we were going to talk about is, is giving your child responsibility. And that would be different responsibilities depending on the age and the developmental level of the child. But I, you know, I think, I just read little house on the Prairie to my youngest and my goodness, giving responsibility to kids was done back then. You know, and now we’re like, okay, your responsibility is your school and your homework. It’s like, no, you live in a house with other people and you have responsibilities. And so I firmly believe that responsibilities will help build self-esteem. And self-esteem will help build your focus. So depending on your job or depending on your kid’s age, you know, having them find some sort of job, they can do this pandemic summer, you know, chores around the house. Maybe there’s something that needs building or some construction thing. If your child is appropriate for that, that you may do with them. Boy, wouldn’t that be great

LL: I live near many Amish, so I still see a lot of kids and I tell my kids often like, I’m going to drop you off the farm cause you know, they haven’t been out there harvesting and plowing and all kinds of things.

SC: I’m not advocating, you know, child slave labor, but I am just making the point that our kids are more capable than we are often treating them. And you know, we want people who take risks that society needs people who take responsibility and who look for ways to contribute.

LL: Right. Okay. So let’s wrap up where we have about 10 minutes left. what are, you know, what’s your takeaway message for parents this summer What I mean What, what would you like to impart on a ton of IEP and 504 parents,

SC: Right. Of course. So, you know, education during the last, is it 76 days of quarantine. It feels like a hundred.

LL: Pennsylvania. at least for Pennsylvania.

SC: Yeah, yeah. No, I think it’s all pretty close. But you know, I don’t know about you, but, the schooling, the academic part of schooling has been not so great, during the pandemic. for younger kids, I don’t even think it’s that important. They need to learn some basics, but, you know, a lot of what they are doing in class is not necessarily crucial. but one thing you can do this summer is work on skills that you will need in the future. So, you know, if your child has some, executive functioning things, you know, you can always do some planning together this summer. So we’re going to cook something, you know, can you make a list.

SC: What do you, what do you think we need to get from the store in terms of planning your time You know, first thing in the morning, what are we going to do today You know, let’s make a schedule, let’s put some times on the schedule and those skills will help your child non-pandemic times and in whatever else that they want to do. Another thing is, I think that you know, obviously, we’re all going to be on the internet for the rest of our lives, but it doesn’t have to be continuous. So, having some limitations to electronics is a part of focusing and a part of, you know, hopefully, it’s going to be a part of your summer. I totally get it when you’re trying to get work done and your child is in the background here, take the tablet. I get it.

SC: I totally, totally have been there. But you know, electronics, are designed to grab our attention and keep it and the rest of the world is not that way. So, you know, we, we get used to a certain amount of stimulation from electronics and then when you look away, it’s like, wait a second, I cannot swipe my teacher out of the picture. And you know, everything else feels slower. And again, if you have a child who has a difference in their dopamine processing, that could get to be very important. So learning how to find rewards in something that’s slower paced. You know, we’ve been doing some board games here that’s pretty fun. And you know, reading chess, all these other skills are things that can be done. Pandemic or no pandemic. Yeah. Okay. Great. Well, thank you so much for being on today. Thanks for having me, Lisa. I want to recap her books,

LL: ADHD and the focused mind and winning with ADHD. and again, I will send out links to everything to where to find her and where to find her books and everything else. Thank you so much.

SC: Thanks for having me. I’ve really enjoyed talking to you and I’m so glad that people put on so many good comments and so many good questions.

LL: Yeah, they did. I have a very engaged group and they’re always trying to learn more, which, which I love.

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