When I realized my son needed help cultivating and sustaining friendships, I looked for a social skills program but found nothing specifically for boys with ADHD. There were plenty of these groups in our area, but most featured well-meaning female clinicians or guidance counselors teaching formal etiquette and scripted communication that did not resemble the way boys talk to each other. “How are you doing today?” “What are your hobbies?” When boys speak in that way, as my son had done at wrestling practice, it comes across as inauthentic. I know this because I was a boy, and I’ve worked with hundreds throughout my career as a school social worker, therapist, and camp director who runs programs for boys with ADHD.

When kids with ADHD struggle socially, their inability to read social cues isn’t the problem. Instead, they more likely have lagging and inconsistent use of social executive function (SEF) skills, which we use to understand others’ thoughts and feelings. These SEF skills help us know how we’re coming across to others, how to read a room (or situational awareness), how to initiate and end conversations, and how to use humor appropriately.

Building Boys’ Social Savvy

When fathers call me about their son’s social difficulties, they tend to talk much more than mothers do, perhaps because this is the first time they’re speaking to another man about this challenge. During these conversations, I find that most parents don’t see the connection between ADHD and lagging social skills. (In fact, I’ve heard a lot lately about kids who were misdiagnosed with autism because of their difficulty with SEF.) I explain the important role that male role models play in helping boys improve SEF skills; and the differentiated and valuable perspective they bring to their sons because they understand how boys’ friendships evolve and how boys communicate when adults aren’t around.

I want each father to understand that his son’s emotional awkwardness, and difficulty understanding how he’s coming across to others, is neither a choice nor apathy. These are skills he is still developing, and he is most likely several years behind his peers’ emotional maturity because ADHD is an executive function developmental delay.

[Download: Solving Behavior Problems Rooted in Executive Function Deficits]

When boys with ADHD struggle socially, their fathers often resort to lecturing, telling their sons what they’re doing wrong. In turn, their sons typically become argumentative or defensive because they truly don’t understand how they’re coming across to their peers. The defensiveness is often a result of their shame, knowing that they have a harder time connecting with their peers but not knowing why.

Tips for Dads

Here are a few tactics for dads, and other male role models, to help boys improve socially:

Cite successes. ADHD brains live in the present. Kids do not think about how to cultivate and sustain friendships when they’re not around their peers. Point out situations when your child showed another boy that he wanted to be friends and kept that friendship going.

Describe healthy friendships. Say what it means to be a good friend as well as when to end friendships that have become hurtful. Many of the boys I’ve worked with were quick to latch on to other boys who showed interest in them. I’ve seen boys cling to friendships when they’re not being treated well out of desperation for friends, or for inclusion in a peer group. In my school-year programs and in summer camp, I share stories about when I was growing up to give the boys examples of good friends I’ve had, and times I’ve had to cut off a friendship.

[Read: Help Your Child Forge Lasting Friendships]

Raise awareness of patterns. Teach boys to understand how they come across to others. In Socially Smarter, my parent training program to build SEF, I depict a sequence of events: your child’s words, another person’s response to those words, and your child’s thoughts and feelings about their peer’s response. Parents can discuss why the interaction worked, or didn’t work, and how future communications can be improved.

Teach tolerance. Being part of a peer group means being flexible. If your child is invited to go bowling, he should go, even if he doesn’t like bowling. He was invited because someone wants to spend time with him. If he says “no” whenever he doesn’t like the activity, he may stop getting invited to outings because the other kids might assume he’s not interested in spending time with them.

Give praise. Kids can’t learn what they should be doing if we don’t praise them for what they’re doing well. That’s why it’s important to offer recognition of and praise for behaviors we do want, such as thinking about others, being flexible, and putting effort into social relationships.

The ADHD executive function liabilities are not gender-specific. Girls with ADHD struggle too. But I don’t teach girls because I did not have the experience of growing up female.

Just as girls need friendships with girls, boys need friendships with boys. They do not need social skills groups or role playing; research shows that clinic-based social skills groups offer no benefit to kids with ADHD. Boys need male role models to help them understand social communication and how friendships evolve between males.

Social Skills & ADHD: Next Steps

• Download: Questions to Get Your Child Talking
• Watch: The Social Lives of Boys with ADHD
• Read: What Parents Misunderstand About Executive Function
• Read: 10 Hard (But Essential) Truths for Dads of Boys with ADHD

Ryan Wexelblatt, LCSW, is a licensed clinical social worker, former school social worker, and father to a son with ADHD. He creates content at the ADHD Dude YouTube channel. Learn more at www.adhddude.com.

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“In his senior year, my son started drinking, doing drugs, and not going to school,” says Vogel, who lives near Washington, D.C. “They didn’t let him graduate. My kids were all suffering.”

*Vogel and Silverman asked that their names be changed.

Nicole Kear is Consumer Health Editor at ADDitude.

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#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share. However, all products linked in the ADDitude Store have been independently selected by our editors and/or recommended by our readers. Prices are accurate and items in stock as of time of publication

“Dopamine fasting” is a buzzy term for the practice of temporarily abstaining from stimulation — via smartphones, social media, video games, and other platforms that deliver reliable dopamine hits — to feel more pleasure later. Here, psychologist Wes Crenshaw, Ph.D., weighs in on the Silicon Valley and TikTok trend that is gaining momentum, particularly among people in their 20s who have ADHD.

Q: People say they go on a dopamine fast or digital detox to “reset their dopamine levels” so that they will feel heightened pleasure when they return to their screens and other forms of stimulation. Does this work?

Our minds are so habituated to a heightened level of engagement from near-constant phone or computer interaction that taking a pause seems wise. But when it comes to video games, TikTok, and other high-dopamine-hit engagements, doing a “fast” isn’t the way to go because you’re not really changing anything about your brain. It’s better to moderate your device usage to have an effect that’s less negative than stopping cold.

[Read: “My Phone Was My Drug”]

Q: Can a digital detox help your brain overcome addictions to compulsive behaviors like checking social media and high levels of stimulus delivered via texts and alerts?

The idea of using abstinence to address addiction is not supported by research. And it’s not a practical solution for behaviors integral to functioning in the modern world, such as using social media and texting. These tools, when used in moderation, are a regular part of modern life. But when these devices draw you away from more necessary activities, or impair your ability to do daily tasks, they become destructive.

I have college-age clients who put their phones in timed lock boxes for, say, three hours during their study time. Once the box is locked, there’s no opening it without a sledgehammer. This technique is referred to as “precommitment,” and in my experience, it is much more effective than other phone apps.

Q: Can individuals exert control over their dopamine levels or is sensitivity to stimulation just baked into your DNA?

[Read: “I Need a Digital Detox. How Do I Break a Social-Media Habit?”]

The timed lock box is a good example of exerting control, except you’re not really controlling your dopamine; you’re moderating your behavior. That’s about the best anyone can do. Another kind of moderation is setting an alarm to signal when it’s time to exit a game or social media, or shutting down the Internet at 10pm to avoid interrupting sleep with multiple dopamine hits.

Q: Are there risks associated with dopamine fasting? Should people be trying it?

I think the risk is that you constantly feel uncomfortable. Unfortunately, feeling uncomfortable is exactly what a lot of people are trying to escape with so-called addictions. They want things that are easy, fun, and stimulating to their brains instead of the tedium of getting business done.

Dopamine Fasting and ADHD: Next Steps

• Read: Wasting Time on Social Media? 6 Ways to Stop ADHD Brains from Doom Scrolling
• Read: Hooked on Social Media? How to Break the Habit
• Read: My ADD Sabotages My Social Skills Online

Carole Fleck is Editor-in-Chief of ADDitude.

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If someone doesn’t value spending time with me as much as I value spending time with them, I feel rejected. Last month, I said to one of my closest friends that I would like to hang out with him more like we used to. He said that he was cool with the way things are. This hurts a lot. What can I do to make this less painful?”

When teens with ADHD struggle with rejection sensitive dysphoria, it affects their relationships — and their self-esteem. Often, they don’t know how to cope with their intense emotions and, feeling overwhelmed, they may lash out at friends and/or family members.

[Read: Why ADD Makes You Feel. So. Much.]

One of my teen clients told me: “When I come home from school, sometimes I just can’t hold it all together. I yell at my mom and then I feel bad afterward, but I know that I can’t get kicked out of my family.” Other kids will withdraw quietly into their rooms and swallow their pain. As parents, there’s a fine line between supporting your adolescent in managing their big feelings and intervening to diminish their distress.

While some ADHD non-stimulant medications or antidepressants, such as SSRIs, can reduce sensitivity and overwhelm, the following behavioral tools can be very effective to quiet the inner critic, shift perspectives, and develop self-confidence.

Sharon Saline, Psy.D., a licensed clinical psychologist, is an expert in how ADHD, learning disabilities, and mental health issues affect children, teens, and families. She is the author of What Your ADHD Child Wishes You Knew.

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ADHD Family Coach Leslie Josel, of Order Out of Chaos, will answer questions from ADDitude readers about everything from paper clutter to disaster-zone bedrooms and from mastering to-do lists to arriving on time every time.

Submit your questions to the ADHD Family Coach here!

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May 1, 2023

Hormonal fluctuations worsen symptoms of attention deficit hyperactivity disorder (ADHD) for men and women alike, and the severity grows more pronounced with age, according to a recent ADDitude survey of 1,829 adults with ADHD. Across genders, ADDitude readers almost equally cited progressively more debilitating challenges during the marked hormonal shifts of puberty, pregnancy, postpartum (the time after childbirth), perimenopause, menopause, and andropause (often called male menopause).

These findings suggest that the traditional view of ADHD — as a childhood disorder that resolves after puberty — was entirely backward.

In reality, both women and men with ADHD report the greatest symptom severity from ages 50 to 59 — during menopause and andropause, respectively. On a scale of 1 (minor impact) to 5 (life-altering), ADHD symptoms from age 50 to 59 earned a 4.24 rating from women and a 4.14 rating from men. In contrast, symptoms during childhood earned ratings of 2.79 and 2.9, respectively. Fading memories, late diagnoses, and recency, or availability bias, may factor into these ratings, but the stories shared by ADDitude readers support the idea that ADHD grows more pronounced — not less — with age.

“The reason so many women are not diagnosed until menopause and beyond is because estrogen falls, leaving our brains when we need it more than ever,” wrote one Californian diagnosed with ADHD at age 62. “Estrogen and dopamine go hand in hand — or, rather, synapse to receptor! Whatever dopamine you have in the center of your brain needs estrogen to get it moving to the frontal lobe, where executive function takes place. It’s a travesty that menopausal women are typically left to feel like we have finally lost our minds.”

Another interesting survey finding that contrasts with traditional thinking: The rate of inattentive-type ADHD was nearly identical across genders, impacting 36.6% of women and 37.9% of men.

[Get This Free Download: Hormones & ADHD in Women]

Both genders share more in common than we might have imagined, however distinct and important differences do exist. For one, women with ADHD are far more likely to experience debilitating comorbidities. According to the ADDitude survey:

• Anxiety affected 77.6% of women surveyed (with an average age of 46.4) and 68.9% of men surveyed (with an average age of 47).
• Depression impacted 67.9% of women and 61.3% of men.
• Migraines were cited by 25.8% of women and 13.4% of men.
• Eating disorders affected 16.5% of women and 7.9 percent of men.

Other important gender differences influenced by hormonal spikes and dips were revealed in the ADDitude survey.

Hormonal Changes: ADHD in Puberty

Men said their ADHD showed up in puberty, when testosterone production increases nearly 30-fold¹, by way of the following:

• Academic performance issues: 61%
• Anger or hostile behavior: 49%
• Risk-taking behavior 42%

[Read: Boys 2 Men — When ADHD and Puberty Collide]

For women with ADHD, adolescence was marked by the following:

• Feelings of sadness or depression: 70%
• Rejection sensitive dysphoria: 63%
• Greater worry or anxiety: 58%

A staggering two-thirds of women surveyed said they have experienced premenstrual syndrome (PMS) and/or premenstrual dysphoria disorder (PMDD) — well over the  prevalence of PMS and PMDD in the general population.² Survey takers said they experiences the following PMS and PMDD symptoms:

• Irritability: 80%
• Mood swings: 79%
• Cramps or discomfort 79%
• Tension/anxiety: 68%
• Lack of focus/concentration: 66%

“For me, PMDD meant suicidal ideation, increased meltdowns and shutdowns, a decrease in emotional regulation, extreme sensitivity to rejection, and intrusive thoughts,” said a 39-year-old woman diagnosed with ADHD, anxiety, and autism.

Women also were more likely to report social anxiety, self-harm, and eating disorders in adolescence. “I didn’t show any signs of ADHD or major depressive disorder until I started menstruating. Then all hell broke loose,” said a 41-year-female diagnosed just two years ago.

Men were more likely to report illegal drug use, hypersexuality, and anger-management problems in adolescence than were women. Testosterone levels typically reach their peak around age 20, when challenges shift to procrastination, emotional dysregulation, and relationship problems, according to the ADDitude survey.

“I have always had procrastination and time-management issues, but porn and masturbation became my dopamine release in adolescence, and after the pleasure, it became exhausting,” wrote one 31-year-old male with combined-type ADHD. “It’s been almost 20 years, but my porn addiction hasn’t gone despite trying in multiple ways.”

Hormonal Changes: ADHD in Pregnancy

During pregnancy, a woman will produce more estrogen and progesterone than she will throughout the rest of her life. For 20% of women surveyed, heightened hormones during pregnancy brought greater focus, drive, organization, and sleep.

“My sleep problems completely resolved in pregnancy (I was able to fall asleep easily at a ‘normal’ time and wake up when needed in the morning),” said one 34-year-old woman in the UK. “I was able to focus and felt the most productive I’ve ever felt in my life.”

But 44% of women said they noticed no difference in ADHD symptoms during pregnancy, perhaps because spiking hormone levels were offset by discontinued stimulant medication use (98% of women said they stopped treatment in pregnancy). Another 36% of ADDitude readers said their ADHD symptoms worsened in pregnancy with exhaustion, poor memory, emotional dysregulation, and sensitivity topping the list.

[Free ADDitude Webinar: ADHD, Pregnancy, and Motherhood]

Hormonal Changes: Postpartum and ADHD

Estrogen and progesterone fall off a cliff following childbirth, contributing to postpartum depression in roughly 15% of women.³ Among our survey takers, the rate of self-reported postpartum depression skyrockets to 61%. ADDitude readers reported that symptoms of postpartum depression lasted roughly one year, and included the following:

• Crying spells: 76%
• Feelings of worthlessness, shame, guilt, or inadequacy: 72%
• Mood swings: 66%
• Irritability: 62%
• Lack of concentration: 58%
• Sleep problems: 57%

“It still makes me sad, nearly 20 years later,” said one 49-year-old woman with inattentive ADHD who suffered postpartum depression. “I didn’t want to hold my child and actively sought to hand him off to others in the early weeks. I felt strongly that I wanted a redo, that this wasn’t what I had expected…. I still feel robbed of that miraculous time, but my son and I are closer now than ever — he’s awesome and gives great hugs. Maybe that makes up for it a little.”

Almost half of ADDitude survey respondents said they were not offered any treatment for their postpartum depression, while 41% were prescribed antidepressants and 20% received therapy. “I thought I was a bad mom for feeling how I did, so I masked my issues,” said one 50-year-old mother with ADHD in Colorado.

“The nurses I spoke to did not recognize my postpartum depression and told me it was probably a normal hormonal drop, but things never improved,” said a 36-year-old mother in Pennsylvania.

Hormonal Changes: ADHD in Menopause and Andropause

In 2022, ADDitude fielded a survey of nearly 4,000 women regarding ADHD symptoms in menopause, when production of both estrogen and progesterone drop. It found, among other things, that 70% of women said ADHD had a “life-altering” impact in their 40s and 50s — a finding echoed in the latest ADDitude survey, which found that half of women called ADHD “extremely severe” in menopause.

The most debilitating symptoms during menopause, they said, were the following:

• Procrastination and time management: 79%
• Working memory problems: 74%
• Feelings of overwhelm: 72%
• Greater disorganization: 70%

“Menopause coincided with my ADHD diagnosis, starting medication for ADHD, 1-on-1 and group therapy, and I have better coping strategies now than I have ever had,” said a 55-year-old woman diagnosed with ADHD four years ago. “The sadness is still there, for what I have lost and my struggles, but I feel I have developed wisdom, self-acceptance, and awareness.”

In men, testosterone levels gradually drop with age, triggering andropause in their 40s and 50s. Nearly three-quarters of ADDitude survey respondents aged 40 and older said they have experienced andropause, which heightened these symptoms:

• Procrastination and time management: 79%
• Feelings of sadness and/or depression: 70%
• Work performance issues: 68%
• Working memory problems: 67%

For many, it was difficult to assign blame to dwindling testosterone, or one of many other life factors during this life stage — namely, divorce, the death of parents, the loss of a job, other health problems, or decades of low self-esteem and a feeling of failure.

“My anger at the world increased and I always felt unsettled,” said one 61-year-old man about how andropause impacted his mental health. “I experienced drug use and fear of sexual failure. I was either bored of things or obsessing on things, feeling frustrated, and intensely trying to please people.”

“In my 40s and 50s, I started to feel an accumulation of self-doubt as I questioned why I was not successful and why I was so self-isolating. I was just not feeling good about myself,” said a 58-year-old male who noticed signs of stress, anxiety, and physical deterioration that led him to seek a diagnosis late in life. “This carried a heavy burden of not feeling pride or confidence in myself, of not liking who I had become, and of never being able to let go of my failures to move on.”

Hormonal Changes and ADHD: Next Steps

• Free Download: Menopause & ADHD — Treatments & Interventions
• Read: Perimenopause Problems — How Changing Hormones Exacerbate ADHD Symptoms
• Read: Inside the Aging ADHD Brain
• Resource Hub: The Ages & Stages of ADHD

Anni Layne Rodgers is general manager at ADDitude.

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Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Sources

¹ Nottelmann, E. D., Susman, E. J., Inoff-Germain, G., Cutler, G. B., Jr, Loriaux, D. L., & Chrousos, G. P. (1987). Developmental processes in early adolescence: relationships between adolescent adjustment problems and chronologic age, pubertal stage, and puberty-related serum hormone levels. The journal of pediatrics, 110(3), 473–480. https://doi.org/10.1016/s0022-3476(87)80521-8

² Clark, K., Fowler Braga, S., Dalton, E. (2021). PMS and pmdd: Overview and current treatment approaches. US Pharm, 46(9), 21-25. Retrieved from https://www.uspharmacist.com/article/pms-and-pmdd-overview-and-current-treatment-approaches

³ [1] Bauman, B. L., Ko, J. Y., Cox, S., D’Angelo Mph, D. V., Warner, L., Folger, S., Tevendale, H. D., Coy, K. C., Harrison, L., & Barfield, W. D. (2020). Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression – United States, 2018. MMWR. Morbidity and mortality weekly report, 69(19), 575–581. https://doi.org/10.15585/mmwr.mm6919a2

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Educators today understand how a student’s behaviors related to ADHD manifest in the classroom much better than their counterparts did 25 years ago. But too many teachers still fail to recognize the academic and social struggles that can plague students with ADHD inside and outside the classroom.

For many students with ADHD, it’s difficult to imagine anything worse than a contemporary classroom: six-hour days filled with expectations of sitting still, following endless instructions, completing tedious tasks, and navigating social situations. It’s not surprising, then, that academic outcomes for some of these students are worse than they are for students without ADHD.

For too long, educators have focused almost exclusively on reducing symptoms (e.g., fidgeting, interrupting, losing focus) in the classroom, but this approach does not necessarily improve a child’s academic outcomes. Evidence-based interventions and supports to reduce specific ADHD-associated impairments and to build adaptive functional skills are needed for long-term academic success — but not always provided in IEPs and 504 Plans. Approaches to improve a student’s social relationships with peers are often left out of such accommodations, but they are equally important to a child’s success.

In this webinar, educators and caregivers will learn:

• How the core features of ADHD are often magnified by the expectations in classrooms, and how this makes it harder for students to experience success in school
• About the limitations of some approaches that focus exclusively on a student’s symptom management and ignore other areas of impairments
• About strategies, supports, and approaches that can help students with ADHD flourish

Have a question for our expert? There will be an opportunity to post questions for the presenter during the live webinar.

Meet the Expert Speaker:

Gregory A. Fabiano, Ph.D., is a professor of Psychology at Florida International University. His interests include evidence-based assessments and treatments for children with ADHD.  He is the author of two books, Interventions for Disruptive Behavior Disorders: Strategies to Support Success; Daily Behavior Report Cards: An Evidence-Based System of Assessment and Intervention. (#CommissionsEarned) Dr. Fabiano is also the developer of a Massive Open Online Course entitled “Everyday Strategies for ADHD” that has been completed by more than 6,500 online students across six continents. A cross-cutting theme throughout his work is developing intervention programs that are effective for children and families within the contexts of their everyday environments. Dr. Fabiano’s work has been continuously funded by federal agencies and foundations since 2006. In 2007, Dr. Fabiano was nominated by the Department of Education and invited to the White House to receive the Presidential Early Career Award for Scientists and Engineers, the nation’s highest honor for early career investigators.

#CommissionsEarned As an Amazon Associate, ADDitude earns a commission from qualifying purchases made by ADDitude readers on the affiliate links we share.

Certificate of Attendance: For information on how to purchase the certificate of attendance option (cost $10), register for the webinar, then look for instructions in the email you’ll receive one hour after it ends. The certificate of attendance link will also be available here, on the webinar replay page, several hours after the live webinar. ADDitude does not offer CEU credits.

Closed captions available.

Like most moms, I can clearly recall the moment my baby was first placed into my arms. It was real… She was here! Ten fingers, ten toes, bright eyes, and a cute little mouth with pink, bowed lips. She was perfect. My urge to protect her and offer her the happiest life possible was immediate.

Looking back, almost 15 years later, I can see I was brimming with the idealism innate to most all new parents. Our babies often represent a fresh start, a clean and bright beginning. The hopes we project onto them are inevitable. But life almost always has other plans.

Releasing the Myth of the Perfect Childhood

When my daughter was 2, I realized that I needed to leave my marriage. I left with no savings, assets, or job. When she was 4, my mother had a massive brain hemorrhage. After my mother died, my stepfather was in an accident and required care before eventually also dying. I battled through graduate school during this time.

I noticed that my daughter was unique as she reached school age. She was brilliant, verbose, and creative, but also different in her behaviors. She began to have massive meltdowns after school every day — tears, tantrums on the floor, and generally losing her shit, especially if homework was on the table.

Though she was extremely bright and an early reader, tearing through Harry Potter books in second grade, she also struggled in the classroom. It was hard for her stay on task, and she got out of her seat during lessons. I struggled to reconcile how my child, who was reading at an adult level and had unusually mature social insights, could also be so messy, irritable, disruptive, and so often unable to focus. As I searched myself and the world for an answer, I took the road we so often do as mothers. I blamed myself. Even my experience as a therapist and years of studying child psychology couldn’t help with the huge blind spot I had when it came to my own kid.

[Read: Why ADHD in Girls Is Often Overlooked]

Maybe it was because of the divorce — or because of my grief. Maybe I had spent too much time studying. I read to her every night, but maybe if I had focused more on math, she would be doing better with it. Essentially, I blamed myself for everything.

Consulting the Experts

As I tried to gather more info from “the experts,” I felt even worse. Seasoned parents told me that my daughter was disrespectful and needed a firm hand. School meetings, where I faced a row of teachers telling me about behavioral issues, left me feeling as though I was on trial. Even meeting with child therapists for consults confused me, since they’d only tell me that my daughter was precocious and creative and seemed to have a high IQ, but they did not otherwise offer any concrete help.

I pushed my daughter into martial arts, amped up her nutrition, discussed her ongoing issues with my mental health colleagues, and tried different therapists. Deep down, I saw her struggles as my own shortcomings. I was exhausted — and it didn’t help that she slept erratically.

Without answers, my daughter’s struggles worsened. Things had spiraled into a hatred for school, difficulty with activity transitions, trouble with organizational tasks, panic attacks, and even thoughts of self-harm.

[Read: 5 Things Every Doctor (and Parent) Should Know about Girls and ADHD]

It was our pediatric primary care provider who finally brought up ADHD. Could it really be that my daughter’s brain just needed some extra dopamine? ADHD ran in my family and in her father’s family as well. I began to wonder what a pediatric ADHD prescription would do.

As it turned out, it did a lot. Once we found the right medication and dose, the world opened up for my daughter. Her anxiety quieted. Her focus improved. Thoughts of self-harm and panic attacks receded. What’s more, she he was having fun. Life wasn’t a constantly overwhelming battle. We could both breathe.

Advocating for Girls with ADHD

I wondered why my daughter’s diagnosis had been so hard to arrive at and why it had taken so long, even for me, a mom and a trauma-informed therapist with a clinical degree. As I reviewed research on ADHD, things became clearer.

We often think of wild and unruly boys when we picture ADHD. The reality is that many girls are also silently suffering with ADHD without any understanding or support. That’s why ADHD is more commonly diagnosed in boys and is often underdiagnosed in girls. Educator and medical provider bias may also contribute to this.

Girls are more often misdiagnosed (or only diagnosed) with depression or anxiety. Socialization patterns may also be a factor. Some researchers theorize that girls are more likely to “mask” ADHD symptoms. This is particularly concerning, because research indicates that ADHD in girls is correlated with more severe pathologies such as self-harm and major depression. These unique risks mean that our girls are in danger if an ADHD diagnosis is missed or delayed.

Today, my daughter is thriving. In my clinical work, I now advocate for girls to be automatically screened for ADHD if they are struggling with what seems like anxiety or mood dysregulation. I wish I had the information I have now when my daughter was in her early grade school years. I’m grateful, however, that I now have the awareness to fight for her and for other girls.

Girls’ Mental Health and ADHD: Next Steps

• Self-Test: ADHD Symptoms in Women and Girls
• Read: Stop the Cycle of Shame for Girls with ADHD
• Read: I Searched So Hard for ADHD That I Missed All the Signs

SUPPORT ADDITUDE
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When your teen opens up, try to determine whether she just wants a safe space to vent or she is uncertain and seeking guidance. Knowing is half the battle. A teenager’s primary job is to move away from their parents little by little to eventually become fully independent. Teens are a lot like toddlers—venturing farther from you to test their independence, but still requiring support as they face a host of dangers they don’t understand. Your role is to encourage safe exploration and stand by.

You can do this by listening reflectively and asking thoughtful questions. Your best strategies will be to reflect on what you’re hearing, to be honest about your own uncertainty, and to ask what she needs. If she does want guidance, be sure to keep your advice simple, brief, and nonjudgmental.

[Download: Free Parenting Guide for ADHD Caregivers]

You might say something along these lines:

• “It sounds like this situation with Suzie is really frustrating. I have some thoughts about how you might handle it, but I’m not sure that’s what you want right now.”
• “Seems like you’re facing a tough choice. What would be the positives if you made choice A? What about B? Are there any negatives to either choice?”
• “Gosh, that is a dilemma. How would you feel if you didn’t (do the thing, say the thing)?”
• “I see how much thought you’re giving to this, and I get how challenging this must be. What does your gut say?”

Walking alongside her as she thinks about and solves her own problems is far more powerful, and supportive of a growth mindset, than is solving the problems for her. But don’t be surprised if she resists answering your questions. If her response is a sigh and an eyeroll, show your reflective listening with responses like, “I get it. Wow, that’s hard.”

Remember to acknowledge her thoughtfulness, as praise is scarce for many teens who have ADHD. You might say, “Thanks for including me as you think this through. I’m really impressed by how you’re handling it.” For a teen who struggles (and let’s face it: what teen doesn’t?), knowing you’re her ally, confidante, and biggest cheerleader can be the best scaffold in the world.

Parenting Teens with ADHD: Next Steps

• Download: Questions to Get Your Child Talking
• Read: “When Fixing His Problems Didn’t Fix Anything, I Finally Learned to Listen.”
• Read: Don’t Freak Out! And 13 More Rules for Navigating Teen Behavior Challenges

Merriam Sarcia Saunders, LMFT, is a licensed psychotherapist working with parents who have children with ADHD. She is the author of five books on ADHD and the creator of the on-demand course, How to Parent ADHD: 5 Steps to the Relationship You Want with Your ADHD Child.

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April 24, 2023

One in four middle and high school students has reported abusing prescription stimulant medications used to treat ADHD, according to a cross-sectional study recently published in the journal JAMA Network Open. ¹ Non-medical use of prescription stimulants among teens remains more prevalent than misuse of other prescription drugs, including opioids and benzodiazepines, the research found.

According to researchers at the University of Michigan, students who used marijuana in the past 30 days were four times more likely to abuse ADHD medications than teens who did not use cannabis. In addition, stimulant drug abuse was 36% more likely to occur in schools with a large population of students with stimulant medication prescriptions to treat ADHD than it was in schools with fewer students using prescription stimulants like Adderall or Ritalin. (Studies have shown that one in every nine high school seniors reported taking prescribed stimulants for ADHD.) (², ³)

According to the research, other factors associated with increased rates of stimulant drug abuse included:

• Schools located in suburban, non-Northeastern regions of the U.S.
• Schools with a high proportion of parents with a college degree
• Schools with a higher proportion of white students
• Schools with a medium amount of binge drinking among students (10%-19% of the total student body)

Prolonged stimulant abuse, researchers said, can lead to several detrimental health effects, including cardiovascular conditions, depression, anxiety, seizures, overdoses, psychosis, and stimulant use disorder.

“The key takeaway here is not that we need to lessen prescribing stimulants for students who need them, but that we need better ways to store, monitor, and screen for stimulant access and use among youth to prevent misuse,” said study author Sean Esteban McCabe, Ph.D.

For the study, the University of Michigan research team analyzed data collected between 2005 and 2020 by Monitoring the Future, a National Institute of Drug Abuse (NIDA) multi-cohort survey that measures drug and alcohol use among adolescents nationwide. More than 230,000 teens in grades 8, 10, and 12 from 3,284 secondary schools participated in the survey.

Dangers of Stimulant Misuse

Counterfeit Medication

Demand for prescribed stimulants to treat ADHD symptoms increased substantially from 2020 to 2021, a recent U.S. Centers for Disease Control and Prevention (CDC) report found. According to the CDC report, prescription stimulant fills were highest among males and females aged 5–19 and 15–24 years, respectively. ⁴

Previous studies have reported that more than half of adolescents who misuse prescription stimulants get the medication for free from friends or relatives. ⁵ However, illicit medications are increasingly obtained via online drug markets and social media referrals, making it harder to differentiate real and counterfeit medications. ⁶

“The drug supply has rapidly changed,” said National Institute on Drug Abuse Director Nora Volkow in a press release about the study. “What looks like medications — bought online or shared among friends or family members — can contain fentanyl or other potent illicit substances that can result in overdoses. It’s important to raise awareness of these new risks for teens.”

Students who use counterfeit medications often believe they are obtaining the actual medication as dispensed by a pharmacist, explained Kevin Antshel, Ph.D., professor of psychology at Syracuse University. “However, students obtaining counterfeit medications may purchase a product that is laced with potentially lethal amounts of drugs, usually fentanyl or methamphetamine,” Antshel said. “Fentanyl is especially concerning. A lethal dose of fentanyl is roughly the size of a few grains of salt.”

In May 2022, two Ohio State students died from suspected use of counterfeit stimulant medication laced with a synthetic opioid.

Drug Diversion

The University of Michigan researchers recommended that caregivers educate teens about the consequences of drug diversion (selling or sharing prescribed medications). “Nearly a quarter of adolescents who are prescribed stimulant therapy will be approached to divert their stimulant medications by their peers before the completion of high school (and more than half [54%] during college),” they wrote. ⁷, ⁸

Theresa E. Laurie Maitland, Ph.D., coordinator of the Academic Success Program for Students with learning differences and ADHD at the University of North Carolina, Chapel Hill, learned first-hand how widespread medication diversion is on college campuses.

“I asked a graduating senior if he had any advice for me. He said, ‘There’s one topic I wish you’d talk about with all students taking ADHD medication: How to handle the demand they will face to give away or sell their pills!’

“I was shocked but hid my reaction and listened attentively,” she said. “The student had been open about stimulant use, and the news spread quickly among his peers and classmates. He was often approached to sell or hand over ‘just one pill.’”

The FDA classifies stimulants as Schedule II controlled substances. Most state laws follow federal laws, with criminal penalties for possession without a prescription.

“Even if no money is exchanged, sharing your medication is, technically, ‘dealing drugs,’ and anyone who expects you to do it isn’t a true friend,” said Susan Yellin, Esq., Director of Advocacy and Transition Services at The Yellin Center for Mind, Brain, and Education in New York.

How Parents Can Help Teens

“The diversion of stimulant medication has serious legal and health risks for undiagnosed students and major personal, legal, and financial consequences for teens diagnosed with ADHD,” Maitland said. “We must inform those with ADHD about this important issue.”

Maitland offered the following suggestions to caregivers and teens:

1. Talk to Family Physicians
“For middle and high school students, doctors can provide printed or video material explaining the legal and health risks associated with sharing or selling stimulants,” she said.

2. Value Your ADHD Diagnosis
It’s important that adolescents understand and accept their ADHD diagnosis, and that parents include them in healthcare decisions. “When students accept their diagnoses and value their medication, they have no desire to give or sell their pills to others,” Maitland said.

3. Use Discretion
Teens must store their ADHD medications in a lockbox or other secure device. They should also use discretion when sharing information about their stimulant use. “Many students have told me it is best not to discuss one’s stimulant use until they make friends (or maybe not at all),” Maitland said.

4. Foster Open Dialogue
Parents should talk with their children about the health and legal risks of misusing, sharing, or selling medication and potential scenarios they may encounter.

Teens can even role-play what to say if a family member, friend, or stranger asks them for pills. “Have teenagers rehearse several scripts to prepare them to say ‘no’ and to deal with pressure,” Maitland said.

Most importantly, Maitland continued, “Young people need to know they can turn to us in awkward situations and talk with us about something they regret having done.”

Sources

¹McCabe, S.E., Schulenberg, J.E., Wilens, T.E., Schepis, T.S., McCabe, V.V., and Veliz, P.T. (2023). Prescription Stimulant Medical and Nonmedical Use Among US Secondary School Students, 2005 to 2020. JAMA Netw Open. (4):e238707. doi:10.1001/jamanetworkopen.2023.8707

²Garfield, C.F., Dorsey, E.R., Zhu, S., et al. (2012) Trends in Attention Deficit Hyperactivity Disorder Ambulatory Diagnosis and Medical Treatment in the United States, 2000-2010. Acad Pediatr. 12(2):110-116. https://pubmed.ncbi.nlm.nih.gov/22326727/

³Xu, G., Strathearn, L., Liu, B., Yang, B., and Bao, W. (2018) Twenty-Year Trends in Diagnosed Attention-Deficit/Hyperactivity Disorder Among US Children and Adolescents, 1997-2016. JAMA Netw Open. 1(4):e181471. https://10.1001/jamanetworkopen.2018.1471

⁴Danielson, M.L., Bohm, M.K., Newsome, K., et al. (2023). Trends in Stimulant Prescription Fills Among Commercially Insured Children and Adults — United States, 2016–2021. MMWR Morb Mortal Wkly Rep 2023;72:327–332. https://doi.org/10.15585/mmwr.mm7213a1

⁵Compton, W.M., Han, B., Blanco, C., Johnson, K., Jones, C.M. (2018) Prevalence and Correlates of Prescription Stimulant Use, Misuse, Use Disorders, and Motivations for Misuse Among Adults in the United States. Am J Psychiatry. 175(8):741-755. https://doi.org/10.1176/appi.ajp.2018.17091048

⁶Moyle, L., Childs, A., Coomber, R., and Barratt, M.J. (2019). #Drugsforsale: An Exploration of the Use of Social Media and Encrypted Messaging Apps to Supply and Access Drugs. Int J Drug Policy. 63:101-110. https://doi.org/10.1016/j.drugpo.2018.08.005

⁷McCabe, S.E., Teter, C.J., and Boyd C.J. (2006). Medical Use, Illicit Use, and Diversion of Abusable Prescription Drugs. J Am Coll Health. 54(5):269-278. https://doi.org/10.3200/JACH.54.5.269-278

⁸McCabe, S.E., West, B.T., Teter, C.J., Ross-Durow, P., Young, A., and Boyd, C.J. (2011). Characteristics Associated with the Diversion of Controlled Medications Among Adolescents. Drug Alcohol Depend. 118(2-3):452-458. https://doi.org/10.1016/j.drugalcdep.2011.05.004

As The Washington Post recently reported, the Adderall shortage is causing disruptive and frustrating ripples in the academic and social lives of students with ADHD.

New limits on controlled drug supplies, paired with increased demand for that supply and lingering supply chain disruptions, have touched millions of patients prescribed ADHD stimulant medication. The medication shortage, now entering its eighth month, has had a jarring effect on families, especially the parents who are expected to manage their kids’ modified treatment plans and adapt to the pain points of tracking down and trying out new medication options.

Recently, ADDitude asked parents and teachers: Have you noticed the impact of the ongoing Adderall shortage on any of your students’ school and homework performance? Their classroom behavior?

Their answers point to a domino effect wherein the Adderall shortage has caused constrictions in other medications’ supplies. The cost of alternative, name-brand drugs can run significantly higher than Adderall, causing a financial burden that not every family can sustain.

Inadequate medication coverage is causing some children to experience behavioral problems in the classroom. Some students are not consequently showing up for school, or they’re being kept home, according to caregivers, roughly half of whom also have ADHD. Adults who relied on Adderall, including teachers, say they are struggling to attend to their own responsibilities — many of which directly impact their kids. That includes getting to school on time, reviewing homework, and sticking to a consistent routine.

[Download: Free Parenting Guide for Caregivers with ADHD]

The Adderall shortage may be temporary, but the repercussions could have a lasting emotional, social, and academic impact on developing kids. Hear what caregivers had to say about the Adderall shortage, below, and contribute your experience in the Comments section, above.

Adderall Shortage: Impact on Students with ADHD

“Some children who had used Adderall in the past have been changed to a different medication. The interruptions, resets, and resumption of new medications is noticeable in the classroom. Management tools and strategies are very helpful at these times.” — Jo Ann, Missouri

“The Adderall shortage is creating huge anxiety in my daughter, which leads to migraines. She does not function as well on other medications.” — Lisa, New York

“We couldn’t get the medications we needed, and had to get Vyvanse. It’s working, but the first fill was $400 with insurance. Not everyone can bear that, which may stop people from taking their medications at all. Neither of our two kids can do homework well without ADHD medications.” — An ADDitude reader

[Read: Could You Be Saving Money On Your ADHD Medication? Find Out Here]

“I am a teacher who has ADHD. For myself, luckily, I haven’t experienced a shortage for the slow-release Adderall, yet. For my students, absolutely. I noticed a huge increase in the number of students who fail to turn in assignments on time or fail to come to school.” — Noelle, New York

“We were briefly affected by the Concerta shortage prior to Adderall and, yes, it was difficult. My son relies on his daily medication to function. If I cannot give it to him, I will keep him home from school because I cannot send him into battle without the proper weapons to be successful. During those few months, I had to be proactive in contacting different pharmacies within short periods of time. I was also prepared to pay for the name brand out of pocket if we could not access the generic, as insurance would not cover the name brand.” — Amanda, North Carolina

“I have not noticed this, but the high cost of Vyvanse has definitely affected some of the lower-income high school students that I teach. Many lower-income families simply cannot afford it and are forced to use a drug that is less effective.” — Donna, Texas

“As a person, I need my Adderall to function. As a mom, I need my Adderall to support my kids. The shortage has left me unable to drive for field trips, get my kids to school on time, or even get out of bed at times.” — Lacey, California

“I am not always made aware if/when my students are on medications and/or when they stop, start, or change. However, I have observed changes in certain students’ behaviors (e.g. increased inattention, increased physical impulsivity).” — Theresa, Georgia

“As a teacher, it is a difficult (and blurry) line when it comes to medications and students. I have to assume a lot of students are medicated, but because their parents have not shared this with the school, I may not know for certain. And even if the information has been shared with the school, that doesn’t mean I am privy to that information as a classroom teacher. So, at this moment, I really don’t know if there are students who are being impacted by the Adderall shortage. What I know is that personally I am, and it makes my days very difficult.” — Brianna, Iowa

“My 14-year-old son started a generic Concerta this year for the first time. A few weeks ago, I couldn’t find a pharmacy to fill the generic. Eventually, I figured out that my insurer’s online pharmacy could fill a brand name Concerta prescription. In the meantime, about three weeks went by when my son struggled more with homework and tests. I am told the Concerta shortage is a result of Adderall patients seeking alternatives.” — An ADDitude reader

“Our oldest son with ADHD is already out of college and working. I know the shortage has affected his ability to feel like he’s performing well at his new job. He’s developed other strategies that he’s implementing (through years of CBT), but I have noticed that things seem to be more of a struggle than they were a year ago for him.” — Jenny, South Carolina

“I am a preschool teacher; my students are largely unmedicated. However, the shortage has affected my co-workers and some of the parents of my students in a noticeable manner. One parent-teacher conference devolved into hysterical laughter because everyone forgot all the important paperwork. I’m lucky I found a non-stimulant option for myself.” — Holly, Washington

“I am no longer a teacher, but I can say that for me, personally, I am having a hard time completing any tasks, and I am surprised I am even completing this task right now. I suppose it’s because I have other, what I might consider more important things to do, and answering this question is a distraction.” — Marisa, Georgia

“I was worried for my son, but his psychiatrist worked out other medication options with him.” — Cathy, California

Adderall Shortage: Next Steps

• Download: ADHD Medication Tracking Log
• Read: What Do You Mean You’re All Out?
• Read: A Patient’s Guide to Overcoming ADHD Medication Disruptions

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Hi Procrastinating Mom,

As an ADHD student coach for teens and college students, I have worked with kids labeled “procrastinators” or called lazy, weak, and even stupid (I hate all those words!) for as long as they can remember. I routinely challenge those students’ parents — and the students themselves — to look at “procrastination” through a different lens.

Here’s the definition I use when coaching my student clients and their parents:

Procrastination is the act of putting something off or not doing something despite knowing that a negative consequence is likely to happen.

When we describe procrastination, we often leave off the second part of my definition — knowing a negative consequence is likely to happen.

Delaying something (particularly from someone else’s point of view) doesn’t necessarily make your son a procrastinator. Think about it: We all put off things occasionally; we say we’ll do it later; we don’t always finish what we start. When that happens, there’s often no horrible, earth-shattering, life-is-over consequence. This is important for students with ADHD to hear.

[Free Download: How to Focus (When Your Brain Says ‘No!’)]

Why Procrastination Works for ADHD Brains

Waiting until the last minute works for some students with ADHD and executive functioning challenges. A looming deadline activates and jumpstarts their engines, making them uber-focused on completing their work with their creative juices flowing freely.

Procrastination may be a hard pill to swallow for parents who get things done two weeks in advance (I’m like this.), but that doesn’t mean it’s ineffective or bad. When my son was younger, I had to remember that he worked best as a “last minute kind of guy,” and getting him to do things way in advance stunted his creativity and productivity. It made the work harder for him and the tension in our house harder for me. (I’m not proud.)

I constantly hear from my students that they feel powerless and want control over their time and tasks. In other words, they want agency as to when and how they accomplish their work. Remember, getting motivated to do what someone else determines is important or timely is truly difficult for all of us — even more so if that structure clearly doesn’t work for you.

A Different View of Procrastination

Let me share one story to illustrate my point.

Many years ago, I was parent coaching a mom of a 16-year-old, who shared with me a conversation she had with her son that changed her mindset and how she viewed her son’s “perceived procrastination.”

[Self-Test: Does My Child Have ADHD?]

It was Thursday afternoon, and he had a short paper due by Monday at 11:59 p.m. He didn’t feel the urgency to work on it during the weekday, although he had free afternoons. He was planning to write it on Sunday morning. It was his only assignment that weekend, and he liked knowing his deadline loomed close. The paper didn’t require research, just reflection, and he was confident that this plan worked best for him. His mom voiced her frustration repeatedly as he tried to explain his thought process. After a bit of back and forth, her son quietly said, “You can yell at me all you want at midnight on Monday if my paper isn’t done. But not a minute before.”

Quite powerful, no?

Here’s my advice: Allow your son to trust his instincts. Give him the choice and control to make his own decisions and let him lead the way. You’ll know — and he’ll know — if it’s the right path.

Good luck!

Procrastination: Next Steps

• Read: Why Procrastination Is OK
• Read: Procrastination Guide for Parents
• Download: 5 Powerful Brain Hacks for Focus & Productivity
• Watch: This Video Explains How to Combat Procrastination

ADHD Family Coach Leslie Josel, of Order Out of Chaos, will answer questions from ADDitude readers about everything from paper clutter to disaster-zone bedrooms and from mastering to-do lists to arriving on time every time.

Submit your questions to the ADHD Family Coach here!

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Molly Seidel is one of only three American women to medal in the Olympics in one of the most brutal of events, the marathon. Even with all her triumphs in competition, perhaps what is even more remarkable about Molly is her candor and courage in discussing and addressing a series of mental health challenges.

Molly Seidel was diagnosed with obsessive-compulsive disorder (OCD) while studying and competing as a Division I athlete at the University of Notre Dame. She continued to compete through college, winning several NCAA championships, before seeking treatment for eating disorders. It wasn’t until years later — after medaling at the Tokyo Olympics in 2021 and finishing fourth with a personal best in the 2021 NYC Marathon — that Molly discovered the root source of her ongoing mental health challenges: attention deficit hyperactivity disorder (ADHD).

“When I speak publicly about being diagnosed with ADHD and get absolutely flamed online for it, it’s frustrating and a little bit heart breaking sometimes because I know there are other people out there who are dealing with this,” Molly said in a recent conversation with WebMD. “One of the reasons that I didn’t get help earlier, when I was in high school or in college, is because I didn’t have the role models speaking out about this. Everybody who was at the pro level running then seemed like these perfect people, and I was like, Why doesn’t my brain work?”

“I do think we’re getting to a point where there is a lot more acceptance,” said Molly, who suffered a race-ending hip injury during the 2022 Boston Marathon. “I think the Tokyo Olympics was this watershed moment for mental health, but there is still so much stigma and so much hatred out there that we need to be aware of… Athletes are real people with real mental health issues.”

Read the full transcript of this video interview with Molly Seidel on Medscape.

Whether your child is attending a specialty, day, or overnight camp, the path to success begins well before they step foot on camp grounds. Beyond packing the essentials, you can do a lot to mentally and emotionally prepare your camper for the experience ahead, especially if your child is nervous and/or going to an overnight camp for the first time.

But your child isn’t the only one who needs to prepare. You do, too. Setting up your kid for a summer of growth means taking a step back to let them experience camp as fully and as independently as possible.

Follow these steps to get your child ready for an unforgettable summer camp experience.

1. Tour the Camp and Meet the Staff

Most day and overnight camps offer open houses. If you or your child didn’t get a feel for the camp’s physical space before signing up for camp, try to squeeze this in before camp starts, especially if your child is feeling anxious. Your child can also meet staff members along the way — another plus. Most camps publish photos of the layout and of staff on their websites or social channels, so be sure to check those out, too.

An open house my offer your child a chance to meet a helpful point person, like a guidance counselor or a unit leader, to whom they can speak if they need help during their time at camp.

[Haven’t Signed Up for Camp Yet? Ask These 6 Questions to a Prospective Camp]

2. Review Camp Chores and Duties

Be sure to inquire about the camp’s expectations for chores and/or cleanup, especially if your child is staying at an overnight camp. Ask, “What happens during bunk cleanup, and what skills my child work on before they head to camp so they can participate in cleanup time?”

Even if your child does work on these skills in advance, please know that camps understand and expect that many campers will need help performing chores and cleanup activities.

3. Understand How the Camp Manages Medication

Tell the camp about your child’s medication needs and ask how they’ll ensure a steady and reliable medication schedule. Many overnight camps have campers’ medications pre-packaged and sent directly to camp to easily dispense and manage by the time camp starts.

If you’re thinking of an ADHD medication vacation for your child during camp, think again. Like school, camp makes many demands that require your child’s full attention and symptom control. As a camp director, I can’t tell you how many times I’ve seen kids’ camp experiences not go as planned because their parents decided to give them a medication break. Avoid making medication adjustments right before camp starts or during camp, too. Bottom line: Camp is not the time for a medication vacation.

[Read: Skill-Building Ideas from ADHD Camps]

4. Respect the Camp-to-Home Communication Policy

If your child is attending a day camp, be sure to only contact the camp when absolutely necessary. Avoid helicopter parenting. Camps can tell — and do not appreciate it — when parents try to micromanage their child’s camp experience. (Read more about this in section seven below.) If you do need get in touch with a day camp, expect to speak to a member of the camp’s administrative staff, not to the camp’s counselors (who may be high school or college-age teens or young adults).

Many overnight camps allow campers to phone home only after their first week, when campers have adjusted to the new experience and overcome homesickness. Review this policy with your child and set ground rules (if they aren’t laid out in camp policies) about how often you’ll keep in touch. On your end, respect the camp’s communication policies, too. Do not call the camp demanding to speak with your child.

Many overnight camps also require campers to write home. Do not be alarmed if your child complains of their camp experience in their letters, especially if they weren’t thrilled about attending camp. As a child, even I used to write negative letters home at the beginning of overnight camp. Why? Because I was uncomfortable and I wanted my parents to worry about me. (My parents never responded to these negative letters.) But I always got through it — and your child will, too.

5. Remind Your Child to Drink Water

If your child takes stimulant medication, remember that dehydration is a common side effect, which can be of particular concern during summer camp. Let the camp know of this so they can help your child stay hydrated. It’s also good to check in with your child before they leave for camp; remind them that headaches, crankiness, and/or tiredness could all be signs that they need to drink more water.  Insulated water bottles that keep water cold for hours are particularly useful at camp. (Just don’t buy an expensive one in case your child loses it.)

6. Set Clear Expectations

The camp experience is, at least in part, about learning how to be part of a group. That said, your child should arrive at camp with the following expectations:

• They will take part in activities and interact with other kids. Encourage your child to join activities they find fun and interesting, and let the camp know ahead of time if your child needs a bit of nudging to participate. (The camp shouldn’t force your child to join everything, but it’s also not a good idea for your child to be allowed to sit out of all events.)
• They will not be on their device during the camp day. Be sure to talk to your child ahead of time about the camp’s electronics policy, especially if unplugging from devices is already a battle.
• Camp is a learning experience… and not all learning experiences are comfortable. Camps strive to create a positive experience for all, but problems and conflict may still arise. Some campers may not get along, or there might be misunderstandings. Rather than tell your child that camp is utopia, keep it realistic by saying that things may come up and, if they do, there’s always someone at camp they can go to if they need help.

7. Reassure Your Child — and Yourself — That They’ll Do Well at Camp

In my time as a camp director, I’ve seen firsthand how some parents — unable to allow their child to have an independent experience at camp — end up sabotaging their child’s camp experience altogether.

If you want your child to do well in camp, convey your confidence in their ability to succeed in a new environment, even if they don’t feel confident about going to camp, and especially if you are anxious or worried for them.

• Avoid saying things like, “If you don’t like it, you don’t have to stay.” Rescuing your child from the temporary discomfort of a new experience robs them of the opportunity to grow and learn about their abilities. Your child is resilient; lean into this truth to set them up for success.
• Don’t make your child feel guilty for going to camp. Repeatedly saying things like “I can’t wait until you’re home” could make your child feel guilty for having an independent experience. At all costs, do not make your child feel responsible for any difficult feelings you may be having about their camp experience.
• Focus on the positive. Ask, “What was fun at camp today?” or “What activities did you do?” instead of fishing for the negatives with questions like, “Was anybody mean to you today?” or “What bad things did you not like doing at camp?” Focusing on the negative will only teach your child to do the same.
• What if things don’t work out? Have a backup plan for the summer if you have concerns about your child’s camp experience. Should your initial plans fall apart, explain to your child that not every camp will be a perfect fit, and that there’s always next summer to try again.

Summer Camp Tips: Next Steps

• Free Download: A Sample Letter to Introduce Your Child to Camp Counselors
• Read: The Complete ADHD Camp Guide
• Read: How to Help Your Child Make Friends & Fully Participate in Summer Camp

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “Choosing the Best Summer Camps for Your ADHD Child: A Guide for Parents [Video Replay & Podcast #442] with Ryan Wexelblatt, LCSW, which was broadcast on February 16, 2023.