• Alana Stern

ADHD Diagnosis - Now What?

Updated: Jan 30

In Memory of Hayley Sevitz Varenberg

Dedication

On 22 December , the first night of Chanukah, the world lost a flame and got a little darker. 35-year-old Hayley Varenberg (ז''ל) tragically lost her life in a bus accident near the airport here in Israel. I knew Hayley as a student and chanicha. I remember her as a lively and friendly girl with a big and sparkly personality, never afraid to be herself. She had this admirable presence and confidence about her.

I shared these memories with Pauline, Hayley’s mother, at the shiva. Knowing that I am an ADHD coach, Pauline mentioned that Hayley had ADHD and that, on receiving the diagnosis, she remembers being given a very helpful pamphlet on parenting an ADHD child. So it is to honor the memory of the spirited and lively Hayley that I write this parenting guide.


My Child has ADHD - What's Next ?


Receiving the news of your child’s diagnosis can set off a variety of emotions. You may feel overwhelmed with what to do and where to start. You may feel relief that there is an explanation for your child’s behavior and that his/her challenges are not due to bad parenting on your part. You may feel angry that this was not picked up sooner, or sad at the loss of the possibility of “normalcy”.

There is no cure for ADHD and you generally don’t outgrow it, but you can learn to cope with it and to compensate for your difficulties. There are things you can do to support your child’s weaknesses. Moreover, every child has his or her own unique set of strengths that can be harnessed so that your child can not only get by, but actually thrive.

Below are my 5 action steps to take following diagnosis.


1. Educate Yourselves


Read up all you can on the ADHD condition. If using the web, be sure to use reputable sites. There is a lot of misinformation out there. Get my list of recommended resources

here. In Israel there is a great Facebook support resource called

Navigating ADHD for Anglos in Israel.

Or join other support groups for parents of children with ADHD. Most HMOs offer parenting classes (הדרכת הורים) for parents of newly diagnosed children.


2. Educate your Child


Talk to your child about his/her condition – I like to tell kids with ADHD that their brain works differently than the kind of brain that the classroom was designed for. Albert Einstein said, “Everyone’s a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.” Everyone is good at something.

I also love this idea from

Dr. Edward Hallowell : I tell them they have a race car brain, but with bicycle brakes (even with inattentive ADHD, previously called ADD, the hyperactivity and impulsivity can be on the inside, feeling like a busy brain that you sturggle to control). Race cars are amazing in their speed and strength, but with bicycle brakes, it’s going to be very difficult to control the car and get it to go where you want it to go.

Many ADHD symptoms can actually have a flip side and can be positive in certain situations. Hyperactivity can be re-framed as energy. Distraction can be re-framed as curiosity. And to quote Dr. Hallowell, “What is creativity, but impulsivity gone right? You can’t plan to be creative.” Impulsivity can be useful as quick thinking in an emergency. Risk-taking can be courage in some instances. Simply google a list of celebrities that have ADHD, and show your child. A lot of these people have not only learned to support their weaknesses, but they have managed to harness their condition to their advantage.


3. Modify Behavior


For children under the age of 11-12, we are talking here about parent behavior. It starts with you! If you can learn more effective ways to preempt or react to your child, your child will respond more positively, and his/her behavior will improve. The parenting classes mentioned above train you on effective parenting behaviors. You can also consult with a counselor, therapist or parenting coach specializing in ADHD.

If your child is over the age of 11-12, they can learn on their own how to change what they do to be more effective. CBT is an action-based therapy that helps your child think in ways that can change behavior for the better (For example, to improve sibling conflict or school anxiety). ADHD coaching can teach your child life skills like time management and organization. Coaching also teaches your child how to go after a goal, like getting better grades or improving behavior in class.


4. Medicate?

Let me start this section by saying that ADHD is a biological, brain-based condition. It is not a disorder of behavior. Medication can help regulate the chemicals that are out of whack in an ADHD brain. ADHD scientist and expert Prof. Dr. Russell Barkley says that giving your child ADHD medication is akin to giving glasses to a child with impaired eyesight, or insulin to a diabetic. Stimulant medication has been proven to show improvement in the core symptoms of ADHD – reducing distractibility, hyperactivity and impulsivity.


However, if you come away with one thing from this article, please be aware that “the pills are not the skills”. Just like glasses won’t change your child’s actual eyes, medication is not going to “cure” your child. It can make schooling and socializing a lot easier, keeping your child’s self-esteem intact. But there are skills that your child will greatly benefit from that medication cannot give them, like prioritization and planning, organization and time management. Research has shown that a combination of medication and one of the behavior interventions above is most effective.

Because these medications can have side effects, they are not recommended in all cases of ADHD diagnoses.


Here are signs that a trial of medication is worth considering:

  • When ADHD is making it difficult for your child to make or keep friends.

  • When the attention disorder begins to affect self-esteem – your child is bothered by low grades or negative attention from a teacher. If your child starts to make a lot of negative comments about him/herself, medication might improve self-esteem.

  • When ADHD interferes directly with your child’s ability to learn. They may struggle to focus in class and finish their work, they may be too impulsive to be thorough with their working.

  • When the amount of effort required for your child to control his/her distractibility, impulsivity, or motor activity is great enough to affect overall emotional adjustment. (Dawson, Peg. Smart but Scattered: The Revolutionary "Executive Skills" Approach to Helping Kids Reach Their Potential (pp. 287-288). Guilford Publications.)

It is also important to note that getting medication right is a process of trial and error. Your child’s doctor will most likely start your child on the smallest dose and see how that works for a week before increasing. Know that each person’s brain metabolizes drugs differently and that the ideal dose for your child does not have much to do with his/her weight. In addition, every person reacts differently to every type of drug. You friend's child will tolerate a drug differently to you child.

There are a few types of stimulant medications for ADHD. These are generally the first line of treatment. However, know that if you have gone through the stimulants (Ritalin, Focalin, Concerta, Attent, Vyvanse, Adderall) without positive effects, there are also non-stimulants such as Strattera that can help. Prof. Barkley’s book,

Taking Charge of ADHD: The Complete, Autoritative Guide for Parents has a comprehensive explanation of how each medication works.


Most medications come with a few side effects. Some disappear after about a week and some don’t. You will have to decide which your child can tolerate. The Facebook support group mentioned above is full of support and suggestions from other parents on how to manage and tolerate various side effects. For example, people share healthy, nutrient-packed quick breakfast ideas for kids who lose their appetite on medication.

What really helped me understand the effect of ADHD medication is a classic Hebrew expression: פול גז בנוטרל (full gas in neutral). Taking medication can be like putting your car into drive before stepping on the gas, so that you can actually get somewhere. You still have to do the driving, but with a lot less effort. The effort to keep on par without medication can be like getting out to push a car in neutral up a hill.


5. Accommodate


Accommodations are adaptions that the school makes in order to "level the playing field" for your child, so that they do not need to perform with a handicap. If you suspect your child has learning difficulties, a psycho-didactic evaluation will identify them and recommend official accommodations like more time in tests, or having the questions read aloud. Even without a formal evaluation (which can be costly and, here in Israel, needs to be done in 8th grade for your child to be eligible for them for their matriculation exams) there are informal accommodations you can request for your child, like sitting in the front of class, being allowed to take a photo of the homework board or being allowed short breaks.


The Most Important Thing


If you take just one thing away from this guide, remember this: No one knows your child better than you do and you are far from helpless in what I see as one of the most important goals of parenting: Getting your child to adulthood with their self-esteem intact.

According to Time Magazine, children with ADHD get 1-2 negative interactions per minute. Leading ADHD experts estimate that by the age of 12, children with ADHD would have received 20000 more negative messages than children without ADHD.

But don’t despair! You can counter this negativity by sending your child positive messages, as many as possible, in a variety of ways. Parenting author

Barbara Colorosso

talks about six life messages we should give to our children. Here they are:

Print them out and stick them on the fridge. Every day, think of something you can do to send your child one of these messages.

Remember those extensive lists of celebrities with ADHD I mentioned? If you can support your child’s weaknesses while helping him/her discover and develop his/her strengths, there is no reason your child’s name can’t be right up there with the rest of the people who have learned to use ADHD to their advantage.

Below is a comprehensive guide for parents from one of the most repultable websites on ADHD and learning difficulties.

https://www.understood.org/en/learning-thinking-differences/child-learning-disabilities/add-adhd/my-child-was-just-diagnosed-with-adhd-now-what

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