Has your child received a diagnosis of ADHD? They’re not alone. CDC data from 2016-2019 shows that 6 million children ages 3-17 have an ADHD diagnosis. That’s almost 10% of the population in that age range.
Because these numbers are so high and consistently rising, there has been sustained worry about ADHD being overdiagnosed in kids who are simply exhibiting age-appropriate behaviors such as trouble sitting still.
At the same time, advocates say that ADHD is actually being underdiagnosed in some groups of children, such as girls, potentially because they don’t exhibit the same hyperactive symptoms that many boys do, which we are quicker to attribute to ADHD. Girls tend to be diagnosed later than boys. Women who didn’t receive their diagnosis until they were adults have expressed frustration that they had to wait so long to get the treatment they needed.
Because ADHD is a neurological condition, it is different from other medical diagnoses common to childhood. An ear infection, for example, is something that you want to treat in order to make it go away. But you can’t get rid of ADHD; it’s how your child’s brain is wired.
When separated from stigma, having a diagnosis can come as a relief. It also opens doors to medical and educational services that can help your child struggle less. So while parents can view an ADHD diagnosis as an opportunity rather than a setback, it’s often a challenge to communicate this nuance to a child.
HuffPost asked medical professionals who work with kids who have ADHD how they talk about the diagnosis with their patients and their families.
Frame it as a difference, not a disorder.
“The first thing that I always say is that everybody’s brain works a little bit differently and everybody learns a little bit differently,” Dr. Janine Zee-Cheng, a pediatrician who practices in Indiana, told HuffPost.
Zee-Cheng tells patients to imagine their brain as an engine that runs at its own unique speed.
“If your engine runs high, there’s nothing wrong with that. It’s just that maybe it’s running a little too high for sitting in school and being still.” Other signs of an engine running on high might include fast-moving thoughts and talkativeness.
Dr. Larry Mitnaul, a child and adult certified psychiatrist who practices in Kansas, says that he always leads with the child’s strengths: “I describe how distraction and ‘jumping into action’ are great qualities,” Mitnaul told HuffPost.
He continues by explaining that “their unique strength in these areas can make certain activities feel harder to them than their peers.” He might mention focusing on adults’ instructions or staying in their seats at school. Mitnaul then tells the patient, “We have a term to describe brains that work this way.”
Mitnaul says he also sometimes compares the child’s strengths to a superpower, like Elsa from “Frozen” or The Hulk, which “we can help them learn to manage and use for good in the world.”
Dr. Helen Egger, a child psychiatrist and co-founder of the online pediatric mental health provider Little Otter, agrees that it’s important to emphasize what a child’s strengths are. “Many children with ADHD have strengths in social skills, and creativity, and are adventurous,” she told HuffPost. Even traits that could be seen in a negative light, like squirming or fidgeting, could be recast in a more positive way. You could instead describe a child as “bouncy,” for example.
It’s also important to remind kids that there is so much more to them than their ADHD symptoms. “We focus on distinguishing between the diagnosis and the child,” said Egger. “ADHD is something that the child has, but it doesn’t define who they are.”
“When we help our kids understand that every single brain is unique and different (including our own brains as parents), it takes away the stigma of a child thinking something is wrong with them.”
The Childhood Collective is a group of two child psychologists and a speech-language pathologist specialized in ADHD. Katie Severson, the speech-language pathologist, told HuffPost that they also emphasize the idea of ADHD as a difference that is helpful to know about.
ADHD is a term “to describe the way their brain works. It’s not ‘bad’ or ‘wrong,’ but different! And this helps us better understand them and why some things come easily for them and why other things may be more challenging,” said Severson.
Using your child’s specific experiences can be helpful. Severson suggests saying things like, “For some kids, like you, focusing on boring or hard tasks is really, really hard. But you may find it really easy to focus on video games or things you love,” or, “Your brain and body really love to move! You know how you like to stand while you color or do homework? For some kids with ADHD, moving while they work can help them focus.”
Severson also recommends ADHD expert Dr. Edward Hallowell’s description of ADHD as “a turbo charged mind — like a Ferrari engine, but the brakes of a bicycle.”
“This helps kids understand why their brain can feel like it’s moving so quickly, while also being unable to stop themselves from doing things impulsively ... and reaffirms that we know they don’t want to be ‘bad,’ but impulsive things do happen with ADHD brains,” said Severson.
Egger extends the famous Ferrari metaphor into the realm of treatment. She offers: “Most people can’t just jump into a race car and drive it well and safely without training and practice. So, the driver of your race car brain needs special strategies and support to learn how to drive and stay in control of the race car. Caregivers and teachers are like the pit crew that help keep the race car running smoothly!”
Have an ongoing series of conversations, and broaden your focus from only ADHD.
Instead of explaining everything about ADHD in one fell swoop, focus on having brief, meaningful conversations about the many ways that people’s brains are different. You can use yourself as an example, mentioning that you need to take notes or draw a diagram in order to understand something, for example, because that’s the way your brain works.
“By talking regularly about our own brains and our kids’ brains, we can have open dialogue about where they really shine, where they might need more support, and what is or isn’t working for them. When we help our kids understand that every single brain is unique and different (including our own brains as parents), it takes away the stigma of a child thinking something is wrong with them,” explained Severson.
Explain that medication is to help them, not “fix” them.
Zee-Cheng uses a lemonade metaphor to talk about medication with her patients. Most kids understand what lemonade is supposed to taste like, and that it’s made from sugar, water and lemon juice. But it’s not just about having those three ingredients. You could drink a big glass of water with some lemon juice and a few grains of sugar, but it won’t taste as good as when the ingredients are more optimally proportioned.
“When you have ADHD, the chemicals in your brain are kind of like that lemonade, they’re not present in the right proportions,” she said. “When we give medication for ADHD, then all we’re doing is bringing all of the ingredients into the right quantities.”
It’s not about fundamentally changing who your child is but shifting things around to help make certain experiences easier for them.
Another metaphor she uses when talking about medication is footwear for mountain climbing: “Some people have hiking boots already and they walk up the mountain with no problem. Some people are wearing flip-flops — it’s still possible to walk up the mountain, but it’s really tough. So we’re giving you a pair of shoes that is a little bit better so you can get up the mountain the same way that your peers do.”
Ask for help.
You and your child deserve time with an expert who has a deep understanding of ADHD and experience talking about it with people of all ages. If they don’t offer, ask your doctor or therapist to meet with you and your child together to talk about the diagnosis and come up with an action plan.
This way, “the family gets to ask questions together and receive a common language that they can use at home and perhaps school or other parts of the community,” said Mitnaul.
There are lots of resources out there to help you understand ADHD and advocate for your child, including Understood.org, ADDitute magazine, and CHADD. Mitnaul recommends the book “Taking Charge of ADHD.”
Children’s picture books can reflect your child’s experience so they feel less alone and help them understand their condition. There are many, including “Cory Stories,” “Get Ready for Jetty” — which features a girl — and “This Morning Sam Went To Mars.” The Childhood Collective recommends “My Busy Busy Brain” — which also features a girl — and “The Boy With the Faster Brain.”