Childhood ADHD: How Support Can Help

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If you have a child with ADHD, you know already that life can be a whirlwind. But as you move into the middle school and high school years, it can at times seem even more overwhelming.

"You're navigating puberty hormones on top of everything else, plus there's a real widening gap socially and academically compared to peers without ADHD," says Suzanna Trice, a writing instructor in Peachtree Corners, GA. Trice has a 12-year-old son, Logan, (not his real name), with ADHD.

All of this may sound stressful, but there are things parents can do to make life easier for everyone once their child hits the rocky road of adolescence. This includes everything from parent training to medications to school support. You'll still need to buckle up your seat belt as you embark on this journey, but you'll feel better knowing you have safety measures in place.

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Taking the First Steps

As you go through your child's ADHD journey, there are three important points to keep in mind:

Don't blame yourself. It's important to remember that ADHD is a brain disorder and is often genetic. It doesn't result from poor parenting or a messy house.

Learn about the condition. There's a lot of information about ADHD online, but unfortunately, not all of it is accurate. It can be tricky to figure out what's helpful and what's harmful. Pay close attention to internet sources. Look for websites that have .gov after their name, like cdc.gov, or university resources, which end in ".edu." Another good resource is the nonprofit CHADD (Children and Adults with ADHD), at chadd.org.

Get all the necessary assessments. Your doctor can often make a diagnosis based on symptoms. But to make sure your child gets the right treatment, you need to have the proper evaluations.

What Does an ADHD Evaluation Involve?

Interviews with you and your child and a doctor or ADHD specialist
A review of your family medical history
Parent- and teacher-completed child behavior rating scales
Clinic-based psychological tests
A review of school records
Screening for learning disabilities
Medical, physical, and neurodevelopmental screenings to rule out other conditions. This includes vision and hearing checks.

Health insurance may cover some of these assessments, but not others. You may need to have them done by your local public school district. There could also be other, less expensive options.

"We actually had Logan tested when he was in first grade at the University of Georgia's graduate program, which was much less expensive than going to a private psychologist: $600, versus $4,000," Trice recalls. Since she disagreed with some of the psychological testing, she had him retested a few years later and got what she felt were more accurate results.

Advocating for Your Child at School

If your child has ADHD, it can affect their learning in school. They may find it harder to do well academically than kids without this condition. It could be harder for them to pay attention, sit still, and stay quiet. All of these things can make school settings a real challenge.

Thankfully, parents have the law on their side. The Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973 are designed to ensure that students with disabilities, including ADHD, receive equal access to a free and appropriate public education. To get this process started, you will need to:

If the school decides your child is eligible, it will create either an IEP (Individualized Education Program) or 504 Accommodation plan to meet your child's needs. If the school refuses to evaluate your child, or refuses to provide them with services, you can request a due process hearing to appeal the decision. This step usually involves hiring an advocate or attorney.

It's very important to stay in touch with your child's teachers to get detailed instructions on how they're doing. Angela Stephens of Springfield, MO, remembers being in a sixth-grade meeting for her son Drake, now 22, to talk about his academic performance.

"The teacher showed me an assignment he did in his second period that looked great, then showed me another, similar assignment from sixth period that looked like it had been done by a first grader," she recalls. "I had a moment of panic, and then it hit me: his medication had worn off."

He was able to tweak his dose, which helped solve the problem. But "if I hadn't insisted on those monthly meetings, I wouldn't have caught it," she says now.

Sometimes, kids with ADHD do so well with these school supports that educators automatically assume that they're not needed anymore. That's what happened to Deborah Armstrong, a mom in Greenwich, CT, whose 16-year-old son, David (not his real name), has ADHD.

"When David was in middle school, they wanted to exit him out of special education entirely, which means he would have lost all of his accommodations," she says. Armstrong fought back, and made sure David kept all the supports he needed, which included extra time on tests and preferential seating in the classroom and for SATs. Now, her son is thriving as a junior at Greenwich High School.

Your Daughter With ADHD

Boys are more than twice as likely to be diagnosed with ADHD as girls. But ADHD can be tougher to pick up in females, since they often don't display the same hyperactivity and impulsiveness found in males. But research shows that as girls with ADHD grow older, they may show fewer visible symptoms, but are more at risk than their peers for self-injury and suicide.

"The signs were so subtle -- she might never have gotten diagnosed, since these behaviors weren't getting in the way of her academics, and there were so many more kids in her classroom who were more disruptive."

-- Emma Bouza

"My older daughter's main symptom is actually that she's hyper-focused -- she'd zero in on an assignment or activity she finds interesting and ignore everything else," says Emma Bouza, a mom in Hawarden, IA, whose daughter, Norah, age 14, was diagnosed in 2017.

The main reason she was diagnosed so early, she adds, is because Norah tagged along to an appointment with a developmental pediatrician for Bouza's younger daughter, Ruby, who has Down syndrome.

"The doctor turned to me midway through Ruby's visit and told me to get her evaluated," Bouza recalls. "But the signs were so subtle she occasionally interrupted me during the appointment and fidgeted a bit. She might never have gotten diagnosed, since these behaviors weren't getting in the way of her academics and there were so many more kids in her classroom who were more disruptive."

If Norah hadn't had a diagnosis, Bouza adds, she might have just been dismissed as lazy or unmotivated by teachers. Today, Norah helps keep symptoms under control with medication and one-on-one counseling.

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Helping Your Preteen

Helping Your Teenager

Boost their confidence.

Life with ADHD is a challenge for teens. Make sure they know that you love and support them. Help them identify their strengths and find opportunities to experience success. That may not be at school. It may be through sports, art, or music.

Angela Stephens' son, Drake, for example, discovered a love of theater and acting in high school. "He loved it -- the kid who struggled to focus in a classroom could memorize 6 pages of dialogue in 30 minutes," she says.

Let them find their tribe.

When David Armstrong, 16, returned to his high school in Greenwich after a couple of years of living with his family in Italy, he found it hard to connect with old friends due to difficulties such as being unable to read social cues. After a few months of struggling, he connected with a group of kids, many of whom also have ADHD.

"It helped that they understood some of what I was grappling with, and also they can point out when I do something like talk about an issue a friend doesn't want to discuss," he explains.

"The more anxious a teen with ADHD gets, the less capable their brain becomes to actually learn."

- Penny Williams

See things from their perspective.

Rather than just trying to motivate your kid to do what you want them to do, think about what really motivates the ADHD brain: novelty, urgency, interest, competition, and enjoyment. Then consider some ways to win them over.

For example, if your teen fights you about bedtime, think about what may motivate them. It might be getting to school on time in the morning to talk to their friends. Once you frame it to them in that way, they may come up with the idea themselves that they need to go to bed earlier.

Pre-planning is your friend here as well. Making a nighttime routine will help your teen's brain recognize the cues for sleep and make it easier for them to unwind. Plan to turn off electronic devices that can interfere with the body's sleep rhythms about an hour before it's time to turn in. They can spend that time reading or doing other quiet things as they relax.

Expect resistance to medication.

Nearly half of all kids with ADHD don't take their medications as directed, especially during the teenage years. Sometimes, it's a way to rebel against parents, or they just feel negatively about taking any medicine.

If your child wants to stop, talk to their doctor about a trial period where they stop using them under medical supervision. You can work with your child to set goals and make a plan to help stay on track academically and socially. This could involve things like tutors or behavior interventions.

You also should be specific about what they need to do to stay off of medication, like keep up good grades and behave well at home. If they can't do that, they'll need to go back on medication.

Keep them organized.

When Angela Stephens' son was in high school, she realized that the coding system his teachers had put in place for the labels on his homework folders didn't work: "it was a sea of black," she recalls.

She moved everything to color-coded folders, which helped Drake immensely. She followed up with systems to help him keep track of other items, like his phone, keys, even his passwords.

Let them chart their own path.

"Our culture has a specific path laid out for success, but not all kids are cut out for it," Penny Williams says. "Projecting far in the future can be really hard for kids with ADHD. And the more anxious a teen with ADHD gets, the less capable their brain becomes to actually learn."

Williams' own son is currently living at home and working part time. "He struggled a lot in school, and it was traumatic for him," she says. "He needed to heal from that while he explores different possibilities about what to do next."

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The Value of Therapy

Behavior therapy is a key component in treating ADHD. The goal is to strengthen positive behaviors and get rid of problem ones. There are two main parts:

Parent training.

If your child is younger than 12, it's very important to get this training. Kids aren't mature enough to change their behavior without their parents' help. Parent training involves eight to 16 sessions with a therapist to learn strategies to help your child. You can do it one-on-one or in a group setting with other families. You'll meet with the therapist regularly to keep tabs on progress and to get support.

Child training.

This type of therapy is most useful for kids between the ages of 12 and 17. It teaches skills they can use to help control some of their ADHD symptoms. They may learn strategies to help stay focused and organized, like how to make checklists or daily planners. The therapist can also help them learn to follow rules and directions. Other types, like cognitive behavioral therapy, aren't as useful in kids with ADHD.

Resources for Help

It can be tough to parent a tween or teen with ADHD alone. Here are some resources to turn to:

CHADD Parent to Parent Program

CHADD's online courses include both short video lessons and self-paced online courses to learn strategies to improve life at home and school.

Child Mind Institute

Their Family Research Center provides a complete guide to ADHD in kids.

The Attention Deficit Disorder Association (ADDA)

ADDA offers parent support groups, as well as peer support groups for young adults.

ADDitude Parenting Webinars

These sessions cover the gamut, whether it's helping your kid to remember their homework or ways to bolster social skills.

Reviewed by Daniel Brennan, MD on March 6, 2022

Sources

Suzanna Trice, Peachtree Corners, GA.

Patty Stewart, Atlanta.

Emma Bouza, Hawarden, IA.

Deborah Armstrong, Greenwich, CT.

Angela Stephens, Springfield, MO.

Penny Williams, Arden, NC.

Johns Hopkins Medicine: "Attention-Deficit / Hyperactivity Disorder (ADHD) in Children."

CHADD: "Evaluating for Childhood ADHD," "Parenting Teens with ADHD." "The Special Education Process: A Step by Step Diagram," "Some Quick Tips for Parents," "Create Routines for Smoother Summer Days," "Four Tips to Get Your Child with ADHD to Bed on Time."

Child Mind Institute: "When Both Parent and Child have ADHD," "Childmind Institute: “ADHD in Teenagers."

CDC: "Data and Statistics about ADHD," "Behavior Therapy for ADHD," "Therapy to Improve Children's Mental Health, "Parent Training in Behavior Management for ADHD," "Treatment of ADHD."

Journal of Consulting & Clinical Psychiatry: "Prospective Follow-up of Girls with Attention-deficit/Hyperactivity Disorder into Early Adulthood: Continuing Impairment Includes Elevated Risk for Suicide Attempts and Self-Injury."

NYU Langone Health: "Behavior Therapy for Attention Deficit Hyperactivity Disorder in Children."

State University of New York at Buffalo: "Couples with Children with ADHD at Risk of Higher Divorce Rates, Shorter Marriages."

Medline Plus: "Attention-deficit/hyperactivity disorder."

Mayo Clinic: "5 tips to manage ADHD in children."

Nemours Children's Health: "Parenting a Teen With ADHD."