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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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
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.

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.

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.

Trichotillomania (i.e. hair pulling) and dermatillomania (i.e. skin picking) disorders—also known as body-focused repetitive behaviors, or BFRBs—are seldom discussed openly. Though BFRBs are relatively common, people struggling with them feel ashamed and misunderstood. Behavioral treatment for BFRBs is available and effective. Learn how they are treated and how parents can support their children.

In this webinar, caregivers will learn:

• What defines a BFRB: How they are diagnosed and what to know about these misunderstood childhood disorders
• About the current functional model for understanding why people pull their hair and/or pick their skin
• About ways parents can effectively and lovingly support their child with a BFRB
• The current best practice treatment approaches for BFRBs

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

More on BFRBs in Children with ADHD

• Download: Is It More Than Just ADHD?
• Read: Understanding Body-Focused Repetitive Behaviors in Children
• Read: Trichotillomania, ADHD, and My Daughter — How It Got Better

Obtain a Certificate of Attendance

If you attended the live webinar on May 4, 2023, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker:

Suzanne Mouton-Odum, Ph.D., is a licensed psychologist and a leader in the field of Body Focused Repetitive Behaviors, Anxiety Disorders, and Obsessive Compulsive and Related Disorders. She has served on the Scientific Advisory Board for the TLC Foundation for BFRBs for over 20 years and has published several books and numerous journal articles in the BFRB space. In addition to doing research and writing about BFRBs and the treatment thereof, Dr. Mouton-Odum has treated hundreds of individuals with BFRBs and their families.

Recently, Dr. Mouton-Odum and other co-authors published a clinician guide for the treatment of people with BFRBs with Cambridge University Press. She is the President of PsycTech, LLC, the Founder and Director of Psychology Houston, PC: The Center for Cognitive Behavioral Treatment, Vice-Chair of the TLC Foundation for BFRBs Scientific Advisory Board, and Clinical Assistant Professor at Baylor College of Medicine. In total, Dr. Mouton-Odum has published five books: Out of the Rabbit Hole: A Road Map to Freedom from OCD; A Parent Guide to Hair Pulling Disorder: Effective Parenting Strategies for Children with Trichotillomania; Psychological Interventions for Children with Sensory Dysregulation; Helping Your Child with Sensory Regulation; and Comprehensive Behavioral Treatment of Body Focused Repetitive Behaviors (in press).(#CommissionsEarned)

#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.

Webinar Sponsor

The sponsor of this ADDitude webinar is…

Play Attention: NASA Inspired technology that improves executive function & self-regulation. For over 25 years PLAY ATTENTION has been helping children and adults thrive and succeed. Tufts University School of Medicine found Play Attention significantly improved attention, executive function, academic performance and behavioral control of ADHD students. Your program will include a Lifetime Membership and a Personal Executive Function Coach to customize your plan along the way. Home and professional programs available. Call 828-676-2240 or click here to schedule your free 1:1 consultation! | www.playattention.com

ADDitude thanks our sponsors for supporting our webinars. Sponsorship has no influence on speaker selection or webinar content.

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In ADHD grandfamilies, grandparents are raising or helping to raise their grandchildren for a variety of reasons — while simultaneously learning how to parent and support a neurodivergent child, often for the first time. So much has changed in our understanding of ADHD and its comorbidities, and grandparents are working hard to catch up and help out.

If your grandchild has ADHD, you likely struggle with kickstarting the morning routine, tackling and turning in homework, doing chores, and even sitting at the dinner table. Navigating your role as a grandparent—whether you’re raising your grandchild or just contributing to childcare—requires patience and energy when your grandchild presents with inattentive, hyperactive and/or impulsive behavior.

In this webinar, grandparents will learn:

• About the three presentations of ADHD and how each can affect a child’s life at home, at school, and in peer relationships
• About evidence-based behavior management strategies to improve interactions with your grandchild
• How to address everyday struggles, such as getting ready in the morning, starting and completing homework, following directions, and balancing screen time
• How to avoid common pitfalls, such as yelling and using escalating threats

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

More on ADHD Grandfamilies

• Download: 3 Rules for Organizing Your Child (or Grandchild)
• Read: “Let Me Tell You How ADHD Runs in My Family”
• Read: A Strong Foundation

Obtain a Certificate of Attendance

If you attended the live webinar on April 26, 2023, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker:

Caroline Mendel, Psy.D., is the Senior Director of Clinical Services for School and Community Programs and a psychologist in the ADHD and Behavior Disorders Center at the Child Mind Institute. She specializes in the assessment and treatment of youth with ADHD, disruptive behavior, and other co-occurring conditions. She is skilled in behavioral parent training approaches and is a certified parent-child interaction therapy (PCIT) therapist. She also has experience providing evidence-based interventions including cognitive-behavioral therapy (CBT), interpersonal psychotherapy (IPT), and dialectical behavior therapy (DBT).

Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
Apple Podcasts | Google Podcasts | Spotify | Google Play | Amazon Music | RadioPublic | Pocket Casts | iHeartRADIO | Stitcher

When a child feels secure in their caregivers’ love and encouragement, strong self-confidence and self-esteem naturally follow suit. When a child’s ADHD is fully recognized and understood, that is when their strengths get unlocked and futures become clear. How do you get from here to there? One step at a time.

Step One: Learn Everything About ADHD

ADHD is like an iceberg. The complexities beneath its surface (including its high co-occurrence with other conditions) are seldom recognized and often criticized unfairly, leading many children with ADHD to develop damaging self-beliefs. They are not lazy or unmotivated or slow; they have a unique neurological footprint. Understanding and communicating that is key.

ADHD and Executive Function Deficits

ADHD impairs executive function — the brain skills we use to succeed in school, work, and other realms of life. You and your child must understand that deficits in executive skills makes it difficult to…

• …be on time
• …get started on tasks
• …juggle information in the mind
• …initiate work independently
• …set priorities
• …be organized
• …complete long-term projects
• …submit work on time
• …remain calm in stressful situations

ADHD and Delayed Maturity

Maturation of the ADHD brain lags about three to five years behind that of the non-ADHD brain.¹ The delay affects the brain’s prefrontal regions, which control the aforementioned executive functions and other important cognitive processes. What does this mean? You need to adjust your expectations about your middle schooler or high schooler in comparison to their peers. Developmentally, your 14-year-old’s “executive age” may be closer to 11 or 12 years old, for example. As is the case for many people with ADHD, your child might experience a maturation spurt in their early 20s as the brain continues to develop.

[Get This Free Download: Explaining the ADHD Iceberg to Teachers]

Learning Challenges

As many as 45% of children with ADHD have a learning difference like dyslexia, dyscalculia, dysgraphia, or another condition that requires academic supports.²  It’s also common for students with ADHD to have learning challenges that affect written expression, memorization of facts, reading comprehension, complex multi-step math, and other areas. Be sure that your child understands how both their ADHD and learning differences show up in the classroom.

As you teach your child about ADHD, be sure to separate them from the condition. Depersonalize ADHD when you approach your child; educate and give your child a choice. Say something like “People with ADHD have trouble getting started, and I’ve noticed that sometimes that’s a challenge for you.”

Step Two: Establish Learning Habits for Ongoing Support

From disorganization to tardiness, the challenges that children and young teens face in middle and high school are essentially the same challenges that exist in college and at work. Identify your child’s unique learning and executive function challenges early on so that they can receive accommodations and practice using appropriate tools and compensatory strategies in school and beyond.

Bolster Executive Function Skills

For Help with Task Initiation

• Use timers, alerts, or verbal reminders to indicate that it’s time to start. Present these tools as choices to your child to increase compliance. Say, “Do you want to set a timer to start your homework or do you want me to remind you to get started?” Perhaps you may even have to sit with your child to help them get started.
• Review the instructions together. Have your child contact a classmate if the assignment is unclear.
• Start with physical activity. Some children focus better while moving, so let your child walk around and read if it helps with task initiation.
• Work in 10-20 minute chunks with breaks in between so that your child can reenergize their brain. This helps make the task feel less overwhelming.

[Read: Where Do I Start?!? How to Organize and Initiate a Big Project]

For Help with Time Awareness

• Externalize time. Use devices and tools like smartwatches, wrist devices, analog clocks, visual timers, smartphones, paper calendars, and white boards as appropriate to make time (an abstract concept) and important events (due dates, extracurriculars, etc.) stand out visually.
• Practice time estimation. Ask your child how long they think a task like homework will take them. Record their answer and compare it to the actual time to gauge and enhance their time awareness. Typically, students are surprised that the work takes less time than they predicted. Similarly, ask your child how long they think it takes to get to their first class of the day on time. Make sure your child accounts for things like getting ready, traffic, parking the car, walking to the building, going to their locker, saying hello to friends, and “oops” time.
• Schedule backwards. Make it a habit to start with the end in mind as a best planning practice. Scheduling backwards for a long-term school project, for example, will help your child see how far in advance they must start working.
• Ask others for help staying on task. Teachers, for example, can gently redirect your child if they get distracted. You can also ask a classmate to help keep your child on task with a signal.

To Enhance Working Memory and Help Your Child Remember

• Link new with old. Tie in new material to your child’s prior knowledge to reinforce learning.
• Information in multiple formats — posters, photos, video, hands-on projects, texts, graphic organizers, maps, and other mediums and tools — help to convey information.
• “Read to the clip.” Place a paper clip after every 8 to 10 pages of a long reading assignment, and have your child read until they get to the clip. This will segment the text and give your child time to digest information. Also, consider having your child write key text points on sticky notes as they read.
• Talk about it. The more your child talks about what they learned, the more likely they are to remember it.
• Use mnemonics. Set new information to the tune of your child’s favorite song, a rhyme, or an acronym. Humor helps jog memory, too.
• Short water and snack breaks give your child’s brain time to reenergize and reengage with information.
• Allow fidgeting or some movement to enhance concentration. The more difficult the task, the more movement required.

To Stay Organized

• A planner or organizer, whether digital or paper, is a must for all students.
• Color-code and use different folders for each class.
• Do a weekly bookbag cleanup together. Sort through papers and don’t throw out any documents until the end of the year, just in case they are needed.
• Keep a launch pad — a single place for your child’s bookbag, school supplies, and other must-haves — by the door. Place completed work and book bags on the launch pad the night before.
• Establish a homework routine. Agree on a start time and location. (Present them as choices to your child.) Double check assignments wherever they are posted (on paper, text, apps, the school’s online portal, etc.)
• Divide long-term projects into small segments to keep your child engaged. If possible, have the teacher assign due dates to the smaller segments and grade them.
• Monitor your child’s progress on homework and long-term projects for additional support.
• Ask the teacher for a sample of a completed long-term assignment for your child’s reference.

For Effective Studying

• Practice exams are great for previewing questions and concepts.
• Distributed study sessions will always be better than cramming. Your child should spend about 15 minutes reviewing for a test the night prior.
• Moderate exercise prior to studying can prime your child’s brain for maximum focus and retention.
• Slowly sipping a sugary drink can boost alertness as your child’s studies.

Step Three: Explore a Variety of Careers and Interests

Expose your child to as many careers as you can while they are in middle school and high school.

• Follow your child’s interests and skills. Seek lessons in music, acting, art, sports, robotics, gaming, and other activities they enjoy. You want your child to gravitate to a career that aligns with their best self.
• Match your teen to a summer job or a volunteer (shadow) position that aligns with their interests.
• Investigate the school’s career and college resources like career interest inventories/aptitude tests, career days, counseling services, transition plans, etc.

What to Do After High School? Don’t Fear the Gap Year

Many students with ADHD and learning differences rush into college without a clear path. As a result of this premature launch, they flounder and may ultimately drop out. A gap year can help your child plan out their future, increase their confidence, and seamlessly transition to a new, challenging environment. Most teens and young adults go to college within a year of the gap year experience, and colleges are eager to admit students with such experience.

If a gap year is the best option for your child, work together to create a structured gap year plan. Your child’s gap year may involve taking one community college or technical class, and working part-time or volunteering in a field of interest, for example. Ultimately, the goal is to help your child identify a career path.

Step Four: Prioritize a Positive Parent-Child Relationship

Experiencing success in school does wonders for a child, but grades don’t necessarily predict success in life. More often, happiness and wellbeing flow from a positive parent-child relationship.

• Protect and treasure your relationship with your child. Focus on the good and elevate your child’s strengths. Give yourself an attitude check-up if you are fixating on negatives.
• Manage your expectations. You will have to support your child longer than other caregivers, but it’s what your child needs. Give yourself permission to be involved and to do whatever it takes to help your child succeed. Be patient as you give your child the gift of time to help them become more and reach their full potential. By working together, you will get there.

What to Do After High School: Next Steps

• Free Download: 8 Ways to Strengthen Your Teen’s Executive Function Skills
• Read: How to Shepherd — Not Carry — Your Child Toward Fulfillment
• Read: The 4-Year College Track is Not Right for Everyone

The content for this article was derived, in part, from the ADDitude ADHD Experts webinar titled, “Getting Ready to Launch: Setting Up Middle and High School Students for Success and Independence” [Video Replay & Podcast #425],” with Chris Dendy, M.S., which was broadcast on October 13, 2022.

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.

Sources

¹ Shaw, P., Eckstrand, K., Sharp, W., Blumenthal, J., Lerch, J. P., Greenstein, D., Clasen, L., Evans, A., Giedd, J., & Rapoport, J. L. (2007). Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proceedings of the National Academy of Sciences of the United States of America, 104(49), 19649–19654. https://doi.org/10.1073/pnas.0707741104

² DuPaul, G. J., Gormley, M. J., & Laracy, S. D. (2013). Comorbidity of LD and ADHD: implications of DSM-5 for assessment and treatment. Journal of Learning Disabilities, 46(1), 43–51. https://doi.org/10.1177/0022219412464351

February 21, 2023

Teen girls in the U.S. are “engulfed in a growing wave of sadness, violence and trauma,” according to a report released last week by the Centers for Disease Control and Prevention (CDC) that found alarming increases in rates of rape, depression, suicidality, and cyberbullying among adolescents.¹ “The numbers are unprecedented,” said Kathleen Ethier, director of the CDC’s Division of Adolescent and School Health. “Our young people are in crisis.”

The CDC report echoes findings from a 2022 ADDitude survey of 1,187 caregivers, which found that an astounding 75% of adolescent girls with ADHD also have anxiety, 54% suffer from depression, more than 14% have a sleep disorder, and nearly 12% report an eating disorder — more than three times the national average for neurotypical women.

“The kids are not alright. Not at all,” wrote one ADDitude reader who works as a youth therapist.

[The ADHD Symptom Test for Teen Girls]

The CDC report, based on the most recent Youth Risk Behavior Survey, included a nationally representative sample of students in public and private high schools, and it found that adolescent health risks have ballooned to levels never seen before—especially for girls. Its findings include the following:

• Nearly 60% of teen girls reported persistent feelings of sadness and hopelessness during the past year, double the rate reported 10 years ago, and twice the rate in boys. For LGBTQ+ teens, this number jumped to a startling 70%.
• 1 in 3 of girls seriously considered attempting suicide during the past year, up nearly 60% from a decade ago.
• At least 1 in 10 girls attempted suicide in the past year. Among LGBTQ+ youth, the number was more than 1 in 5.

Girls with combined type ADHD are 3 to 4 times more likely to attempt suicide than are their neurotypical peers, and they are 2.5 times more likely to engage in non-suicidal self-injuring behavior, said Stephen Hinshaw, Ph.D., in an ADDitude webinar titled, “Girls and Women with ADHD.” The 2022 ADDitude survey found that 18% of girls with ADHD had engaged in self-harm in the past two or three years, as opposed to 9% of boys; it did not specifically ask about suicidality, however anecdotal reports from caregivers are both frequent and frightening.

“A few years ago, I would have been shocked by these numbers,” said one mom of a teen daughter recently diagnosed with ADHD. “But in 2021 my girl was admitted to a clinic for suicidal ideation. She is still here and working on her mental health daily.”

Only 6% of caregivers rated their adolescents’ mental health as “very good” in the ADDitude mental health survey. Contributing to elevated rates of depression, self-harm, and suicidality among teen girls with ADHD are poor response inhibition and peer victimization, as well as a history of maltreatment, such as physical abuse, sexual abuse, or neglect, Hinshaw said.

“I can’t tell you how many mums are holding their girls tight as they self-harm their way through adolescence,” wrote one ADDitude reader in Canada.

[ADHD and Self-Harm: How to Help the Girls Who Suffer Most]

“We are gaslighted, misdiagnosed, or expected to suck it up,” wrote an ADDitude reader on Instagram. “The wait times for help are not OK, and once you finally do get ‘help,’ they barely listen or dismiss your concerns.”

Sexual Violence at an All-Time High

Among the CDC report’s more distressing findings was a stark increase in sexual violence among teen girls. It found the following:

• 1 in 5 girls recently experienced sexual violence
• 14% have been forced to have sex, an increase of 27% over the past 2 years
• For American Indian or Alaska Native girls, that number jumped to 18%, and for LGBTQ+ teens, it was 20%

“For every 10 teenage girls you know, at least one of them, and probably more, has been raped,” Ethier said during a press briefing.

The prevalence of sexual violence causes significant and understandable anxiety. According to the ADDitude survey, 20% of girls expressed anxiety about physical or sexual assault, as opposed to 7% of boys.

The CDC’s study reflects this anxiety, reporting that:

• 10% of girls did not go to school in the past 30 days because of safety concerns, nearly double the rate from 10 years ago; the same was true for 7% of boys.
• School avoidance rates were higher among LGBTQ+ students, at 14%; American Indian and Alaska students, at 13%; and Black students at 12%.

The prefrontal cortex in a developing brain is especially sensitive to the effects of stress and “children with ADHD may be even more sensitive to the effects of traumatic stress,” said Cheryl Chase, Ph.D., in her ADDitude webinar, “How Stress and Trauma Affect Brain Development.” In other words, the trauma of sexual violence leaves lasting scars.

The mother of a girl with ADHD explained the long-term implications of a sexual assault on her daughter’s health and well-being four year after the attack: “When she was a freshman in college this past year, she was re-triggered while in public talking to a boy who touched her inappropriately without her consent.”

Cyberbullying Twice as Likely for Girls

Whether in school or online, girls are more likely to be victims of bullying, according to the CDC report.

• 1 in 5 girls said they were bullied through texting and social media, almost double the percentage of boys who were cyberbullied
• In school, 17% of girls and 13% of boys reported experiencing bullying in school over the past year

Among teens with ADHD, the rates of bullying are much higher. According to ADDitude survey respondents, 60% of girls with ADHD have been bullied at school, 58% on social media and 44% in text messages.

“We know that kids who are neurodiverse are often seen as peculiar and different,” explained Sharon Saline, Ph.D. “You miss social clues, you blurt things out, and chances are you’re more likely to experience bullying and be socially excluded.”

This was the case for the daughter of an ADDitude reader in Wisconsin: “Bullying has been around my daughter’s lack of age-appropriate social insight and her emotional reactivity. Girls exclude her from group texts. Friends screenshot the negative posts others create about her, and she then ruminates until her mood totally plunges.”

Bullying is a widespread problem, and so is the response (or lack thereof) from most schools;  72% of ADDitude survey respondents who reported that their kids were the victims of bullying also said they were dissatisfied with the school’s response.

“The lack of help in the public school system is so disappointing,” wrote an ADDitude reader on Instagram. “They claim to not be tolerant of bullying, yet anytime you seek help you’re met with nothing but rotating doors and promises of help that go undone.”

Substance Use Higher in Girls

Teen girls are more likely to use alcohol, marijuana, vaping, and illicit drugs, according to the CDC.

• Alcohol: 27% of teen girls reported drinking in the last month vs 19% of boys
• Vaping: 21% of girls reported vaping in the last month vs 15% of boys
• Illicit drugs: 15% of girls reported ever using illicit drugs vs 12% of boys
• Misuse of prescription opioids: 15% of girls reporting ever misusing opioids vs 10% of boys

“ADHD affects substance abuse in both children and adults,” explained Walt Karniski, M.D., in a recent ADDitude webinar on ADHD medication. “Children with ADHD are more likely to smoke and to begin smoking at younger ages. They’re more likely to use alcohol at younger ages and more likely to abuse alcohol as adults.”

“A Level of Distress that Calls on Us to Act”

In the introduction to its 89-page report, the CDC authors clearly state its takeaway: “Young people in the U.S. are collectively experiencing a level of distress that calls on us to act.”  The CDC urges schools to act swiftly and thoughtfully for maximum impact.

“Schools play an integral role in promoting wellness and connectedness, and facilitating protective factors among students,” said Anna King, president of the National PTA. Specifically, the report highlights the importance of implementing quality health education, connecting young people to needed services, and making school environments safer and more supportive.

“It’s about time someone noticed, besides all the struggling parents and kids,” wrote one ADDitude reader in New York.

How Can Parents Protect Their Kids?

Keep lines of communication open

“As girls reach the teen years, they naturally want to emancipate from adult control,” Chase says. “But teens’ brains have more ‘accelerators’ than ‘brakes,’ so they need a loving, interested adult to guide them.” This is doubly true for teens with ADHD, whose executive function weaknesses may exacerbate impulse control. So, how do you stay connected with a teen who seems intent on pushing you away?

• Prioritize a positive relationship

Sources for conflict between adolescents and parents abound, but Saline advises that parents pick their battles. “Your Number One agenda item as the parent of a teen is maintaining a positive connection,” Saline says. “So that they will come and talk to you if they need help.”

To build that connection, Chase emphasizes the importance of unstructured time together. “Going for walks, grabbing a smoothie together, playing a game,” she suggests. “Time just to ‘be’ and if they want to talk, they can.” Don’t wait for your teen to reach out to you. Be proactive, and invite them to do something low-key and stress-free every week or two.

• Make communication routine

When teens push back against their parents, seeking autonomy and space, anxious parents often ask a lot of questions, which can make teens feel hounded, Saline says. Keep communication open without putting teens in the hot seat by making conversations routine. Saline suggests instituting a family-wide practice of sharing one “happy” and one “crappy” thing that happened during the day — at dinner or in the car ride home. If it’s a daily practice in which everyone participates, your daughter won’t feel singled out.

• Actively listen, rather than offer unsolicited advice

When your child share experiences with you, practice active listening to ensure the communication continues. Allow your child tell their story, uninterrupted, and follow up with reflective statements, like “I think I’m hearing you say…”  Avoid swooping in with unsolicited advice — that’s the fastest way to get a teen to shut down, according to Chase and Saline.

Help your daughter find treatment

Depression, anxiety, trauma, and self-harm are all treatable, and a mental health professional can help you figure out what avenue of treatment to pursue. If you sense something’s persistently troubling your teen, Chase urges you not to wait to find them a therapist. “It’s like going to the dentist with a toothache,” she explains. “It doesn’t mean they are broken.”

Cognitive behavioral therapy, dialectical behavior therapy, and medication are among the most common interventions. If trauma is involved, consider somatic therapy, which increases awareness of the sensations in the body as a form of healing.

If your child has ADHD, consider that ADHD treatment may decrease their risk for other challenges. Hinshaw says that treating ADHD can decrease rates of suicidality in teens. “Treatment is a huge antidote to internalization, self-stigma, and the belief that there’s something wrong with you,” he explains. In addition, multiple research studies have indicated that children and adults with ADHD who are taking stimulant medication are less likely to engage in substance use than are their untreated peers.

Get Help

Suicide &Crisis Lifeline: Call or Text 988
988lifeline.org

National Sexual Assault Helpline: 1-800-656-HOPE

National Substance Abuse Helpline: 1-800-662-HELP

Stop Bullying

Mental Health in Teens: Next Steps

• Read: Special 2022 Mental Health Report from ADDitude
• Read: Compare & Despair: Social Media & Mental Health Concerns in Teens with ADHD
• Self-Test: Signs of Depression in Teens
• Learn: Nearly One in Four Women with ADHD Has Attempted Suicide

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.

Source

¹Centers for Disease Control and Prevention (2023). U.S. Teen Girls Experiencing Increased Sadness and Violence. Youth Risk Behavior Survey cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2023_508.pdf

Intense children exhibit intense, often problematic, behavior with a frequency and severity that impacts everyone. Exhausted parents field regular phone calls from school administrators, frustrated teachers feel punishment (or leaving the profession) is their only option, and medical professionals assume medication is the only approach that truly works. No one benefits, certainly not the child.

Enter the Nurtured Heart Approach, a parent behavior training program developed from therapist Howard Glasser’s work with the most challenging and intense children. School and treatment centers report that it not only positively transforms “difficult” behaviors, but the Nurtured Heart Approach benefits all children by enabling and teaching adults how to channel their intensity into great qualities of character and leadership.

In this webinar, you will:

• Understand the dynamics of intense children and how to inspire success and greatness
• Understand why, despite sincere intention, conventional methods of parenting, education, and treatment often backfire with intense and challenging children
• Learn a methodology for inspiring success that is more powerful and encompassing than traditional approaches
• Understand how to uphold a great level of limits and accountability while avoiding the traps that make consequences backfire

Watch the Video Replay

Enter your email address in the box above labeled “Video Replay + Slide Access” to watch the video replay (closed captions available) and download the slide presentation.

Download or Stream the Podcast Audio

Click the play button below to listen to this episode directly in your browser, click the symbol to download to listen later, or open in your podcasts app: Apple Podcasts; Google Podcasts; Stitcher; Spotify; Amazon Music; iHeartRADIO.

More on Positive Parenting and ADHD

• Download: Questions to Get Your Child Talking
• Read: “My Child Resists Everything! Will He Ever Open Up to New Experiences?”
• Read: Positive Charge: How to Reinforce Good Behavior

Obtain a Certificate of Attendance

If you attended the live webinar on March 29, 2023, watched the video replay, or listened to the podcast, you may purchase a certificate of attendance option (cost: $10). Note: ADDitude does not offer CEU credits. Click here to purchase the certificate of attendance option »

Meet the Expert Speaker:

Creator of the Nurtured Heart Approach, Howard Glasser works in family treatment, clinical studies, and educational leadership. His formal studies, along with direct experience with the most intense and challenging children, form the basis of this approach. He has been referred to as one of the most influential persons working to reduce children’s reliance on psychiatric medications.

Howard is the author of 15 books, including Transforming the Difficult Child, a longstanding bestseller on intense and challenging children. (#CommissionsEarned)

Howard teaches Nurtured Heart Approach Certification Training Intensives at the Nurtured Heart Institute, the University of Arizona’s Integrative Medicine Program, and at the Zuckerman School of Public Health.

#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.

Listener Testimonials

“As a heart-centered practitioner, I appreciated this approach!”

“Glasser got to the core of the parent-child relationship in such a beautiful and compelling way.”

“Excellent presentation. I was affirmed in some of my current practices with my 5th & 6th grade classroom & want to explore this approach further!”

“Thank you! So rich and helpful.”

“Thank you, Howard was fantastic. Lots to think about, and to redirect the focus is something I’m going to try starting now! Inner wealth… I love this idea.”

Follow ADDitude’s full ADHD Experts Podcast in your podcasts app:
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ADHD and dyslexia commonly appear together and are highly treatable. Ultimately, the way in which you talk to your child about these conditions will depend on their age. But for all ages, you’ll want to nurture strengths, instill a growth mindset, and show unconditional love and support.

Talking with Younger Kids

• Explain what dyslexia and ADHD mean. Emphasize that everyone’s brain is different. For example, some people have a passion for art, others for nature and the outdoors. Young children are likely already aware of their reading challenges and other areas where they struggle, so it’s best to focus on neurodiversity and inherent differences. Let them know that dyslexia won’t prevent them from being terrific at school and at activities outside of school.
• Lead with your child’s strengths. Support their interests and notice where they shine. Are they great with pets? Maybe they’re a wonderful sibling? Ask them what they enjoy; their answers might surprise you.

[Watch: When Dyslexia and ADHD Overlap]

Talking with Tweens and Teens

• Be honest. I’m not afraid to tell my patients at this age that co-occurring dyslexia and ADHD means they’ll have to work a bit harder than their peers. Explain that they might have trouble reading or copying teachers’ instructions from the board. They might need to accept extra tutoring or classroom supports. Honesty about these challenges will validate your child’s experiences and reduce shame.
• Be optimistic. Help your child understand that dyslexia is not a sign of lower intelligence. Assure your child that you and their teachers will work to support them and help them succeed.
• Maintain perspective. Remind your child that there is more to them than ADHD and dyslexia. They are not defined by these conditions, but by who they are as individuals. Involve them in activities they’ll enjoy, such as Scouts, sports, or volunteering, to offset the pressures of school.
• Boost self-esteem. Encourage your teen to join a support group that helps connect them to peers with shared experiences. Your child will be able to talk openly about their challenges with others who simply get it, and this will do wonders for their self-confidence.

[ADDitude Directory: Find a Specialist Near You]

Ways to Encourage Reading

• Listen to audiobooks and have your child read along with them.
• Identify books your child might like, such as graphic novels or books about topics that interest them.
• Read a book together and take turns reading out loud.
• Use spell-check or online dictionaries to help with homework if permitted.
• Use apps that make decoding words into a game.

Talking About Dyslexia: Next Steps

• Download: Signs of Dyslexia at Every Age
  
• Read: The Best Way to Explain Learning Disabilities to Your Child
• Read: Famous People with Dyslexia, Dyscalculia & Other Learning Differences

Cheryl Chase, Ph.D., is a clinical psychologist in Independence, Ohio. She specializes in the diagnostic and neuropsychological assessment of certain conditions affecting children, adolescents, and young adults.

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.

In one of my earliest memories, I’m at a restaurant with my parents talking excitedly about something, only to be sharply shushed. “Listen!” my parents say to me. “Do you hear anyone else talking as loudly as you are?”

It was the first time I learned that I was expected to behave like everyone else, and that I was falling short at that. That same lesson would show up throughout my childhood; I was in constant trouble at home for doing things that felt out of my control — things I would only realize many years later were symptoms of undiagnosed ADHD. It was the same situation in school, except the color of my skin made me an even larger target.

A Visible Minority with Undiagnosed ADHD

At an ultra-white French-immersion school in a primarily white city in Canada, I was already different enough. Undiagnosed ADHD only amplified my otherness.

I was told my hair was “not normal,” so my mother straightened it with harsh chemicals. I looked slightly more palatable, but I paid a high price by damaging my hair and scalp.

I will never forget the day we were instructed to draw portraits. One of my classmates looked at the dark face I drew and said, “Eww, why would you make your person brown?” I heard comments like these all the time.

[Read: “I Could Have Been Myself for So Much Longer”]

Every stereotype I didn’t fulfill was an excuse for more mockery. I cannot count the number of times I’ve been at the receiving end of comments about my lack of rhythm or inability to dance. (I later learned that clumsiness is common in ADHD.) I still remember my teammates’ disappointment when I failed to live up to the expectation that my Blackness would make me automatically good at sports. (In retrospect, I can see that failure in athletics was less about raw ability and more about my inability to understand the rules of any sport.)

My peers called me “weird” because I struggled to read social cues. My teachers frequently relocated my desk to the hallway to stop me from talking to my classmates, or to drown out the sound of my voice, as I often had to read aloud to myself to understand the material.

Why My ADHD Was Overlooked

It’s said that children with ADHD receive 20,000 negative messages about themselves by age 10 — likely far more than their neurotypical counterparts. This negative messaging did not abate as I got older. Undiagnosed ADHD in high school meant I rushed through assignments, crammed for tests, and often lost my schoolwork. My friends teased me for being “random” and hinted that I was of lower intelligence due to my struggles in school. And as a visible minority, my teachers and others were quick to view me as rebellious, lazy, irresponsible, messy, and rude — and couldn’t fathom that I was struggling with a neurodevelopmental condition.

ADHD is highly hereditary and (while far be it from me to diagnose others) my parents, also distracted and forgetful, didn’t see anything “off” about the challenges I faced just to manage everyday life. My academic career was certainly not helped by the fact that they couldn’t help me keep track of my assignments, or drop me off at school on time.

[Read: Why ADHD Is Different for People of Color]

I know stigma in my community partially explains why I didn’t receive help early on. My family also saw mental health issues as spiritual problems to be prayed about, not as problems that required medical treatment. General distrust of the medical system, which has historically been discriminatory and harmful toward visible minorities, was also a factor.

Older, Wiser, and Hopeful

As an adult — and finally armed with the knowledge of my diagnosis — I may be wiser and more capable, but the challenges of being a neurodivergent person of color are ever present. Some people perceive me as too loud, talkative, irresponsible, lazy, or “out there.” I still hear ignorant comments about my ethnic background, and I’ve been the victim of racial stereotyping and discrimination at work. I’ve also been dismissed from positions after I disclosed my ADHD diagnosis.

Experiencing double discrimination is not easy. Still, I have hope that current and future generations will work to ensure that people like me are given the same opportunities that others have, from early diagnosis and treatment to unconditional acceptance and respect.

Racial Discrimination and Undiagnosed ADHD: Next Steps

• Read: Why We Must Achieve Equitable ADHD Care for African American and Latinx Children
• Read: We Need to Talk About ADHD Stigma in BIPOC Communities
• Read: Having “The Talk” with Black Children Impacted by ADHD and Race
• Read: The Ultimate ADD Accommodation — Ending the Systemic Oppression That Leaves Me Unbelieved, Untrusted, Unsupported

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.