At-Home Support for Children with ADHD Featuring Dr. Kimberly Harrison
At-Home Support for Children with ADHD Featuring Dr. Kimberly Harrison
Do you ever wonder why your child with ADHD has trouble getting started on chores or homework? Have you noticed that they get off track when following seemingly simple instructions? Or does preparing to leave your house in the morning often feel chaotic? Clinical Psychologist, Dr. Kimberly Harrison discusses why individuals with ADHD operate differently and how parents can best support them. Additionally, she provides advice on how to help get things done more efficiently, so everyone can start enjoying more peace and harmony in the home.
This episode includes questions submitted by parents of children who have ADHD. If you are interested these Q&A type discussions, be sure to check out The Parish School’s Adult Education series for more live events.
About Dr. Harrison
Dr. Kimberly B. Harrison is a clinical psychologist who diagnoses, treats and does research with persons who have ADHD. She is passionate about helping parents and children discover their personal giftedness and develop ways to use these strengths to overcome areas of deficit.
Hello, and welcome to Unbabbled. A podcast that navigates the world of special education, communication, delays, and learning differences. We are your hosts, Stephanie Landis and Meredith Krimmell, and we're certified speech-language pathologists who spend our days at The Parish School in Houston, helping children find their voices and connect with the world around them. Do you ever wonder why your child with ADHD has trouble getting started on chores or homework? Is it chaotic getting out of the house in the morning? In this episode, Dr. Kimberly Harrison discusses the neurological reasons why individuals with ADHD operate in different ways and what caregivers can do to start enjoying more peace and harmony at home. She also discusses the sweet spot of providing structure to support, but not doing too much too for your child and hindering progress in the long run. This is a recording from a live adult education event. That includes questions and answers from parents who ask what many of us are wondering. If you're interested in this Q and A type discussions, be sure to check out The Parish School's adult education series for more live events. We hope you find some great ideas to put in place in your home.
Good evening, everyone. My name is Amy Lerman. I'm a speech-language pathologist and community outreach for the Parish School. It is my pleasure to welcome you here tonight for our March adult webinar with Dr. Harrison. Dr. Harrison has been in private practice in the Houston area since 2012. She founded the Cognitive Group in 2016. She provides individual and group therapy and psychoeducational testing services. She is also an in-demand speaker known for her talks on ADHD, Autism spectrum disorder, classroom management, emotional regulation, adulting skills, and the psychoeducational testing process. She is an active researcher in the fields of ADHD, transition to adulthood and autism spectrum disorder. Dr. Harrison is passionate about helping parents and children get to the root issues that are causing difficulty at home and in school. Before we get started, just a couple housekeeping things. While Dr. Harrison is speaking tonight, please feel free to direct your questions into the chat button at the bottom of your screen. Dr. Harrison will be answering some questions during her talk and the bulk of the questions will also be addressed at the end of her talk. We are so happy that you guys are here tonight. Thank you for coming and Dr. Harrison, I am going to spotlight you and have you take it away. Thank you so much for being here.
Dr. Harrison (00:03:01):
Thank you for that wonderful introduction, Amy. I am thrilled. Well tonight, we are going to talk about parenting children with ADHD. We're going to talk about what is this thing? So many people have so many different perspectives, and I don't think there's wrong perspectives. Uh, but as a researcher and as a clinician, someone who does diagnosing and, and looking at the long history that ADHD has in our culture and cultures around the world, um, I've, I've kind of put together, um, some of the, the, um, most important factors that seem to come up when I talk to people. And, um, I just encourage everyone to, um, take this information, add it to the literature that you've collected. If you are parents or a parent of a child with ADHD, then you already have your own library because the truth of the matter is every child is different and ADHD is just kind of an umbrella term that covers a lot of different things, and some of them will fit your child.
Dr. Harrison (00:04:14):
Some of them won't fit your child. So we'll talk about some of the common, um, similarities and differences among presentations, but, um, in the end, remember, this is to add to your library and hopefully will help you in, um, helping your child be just become the best that they can be. And you'll see, a lot of my work is based on strengths and using the strengths, uh, to shore up anything that might be getting in the way. So we'll start off. Um, a lot of people come in and say, no, I have ADD. I know I have ADHD. Um, what are these terms? What do they mean? So I think a little clarification as a clinical psychologist, uh, I, uh, diagnose in the book that gives us the list of names. It's called the DSM 5 Diagnostic and Statistical Manual fifth edition. And the DSM 5 says that there is only one label.
Dr. Harrison (00:05:12):
Believe it or not, there's only one label. It is attention deficit, hyperactivity disorder, which we all nickname ADHD, but there's three types. And so under that umbrella, you can have predominantly hyperactive, impulsive type or predominantly inattentive type. That's the kind that a lot of people refer to as ADD. Um, the reality is most people have the combined type, believe it or not, the most rare is the hyperactive impulsive type without inattention within just the pure hyperactive impulsive. That's only about 2%, 2.3%, I think is the latest step of individuals with ADHD. So there's usually that combination. Um, if your child, a learning disability, uh, then the chances of having the predominantly inattentive type is much higher that tends to pair and be correlated with learning disabilities. And also there are many gender studies that showed that, uh, females tend to have more of the inattentive type.
Dr. Harrison (00:06:17):
Um, there's a lot of interesting, uh, research currently, uh, going on because there are so many cultural influences with all of that as well. So, but that's a talk for another day. Um, the, the thing I like everyone to, um, remember as we go through this ADHD is a neuro-biological disorder, not a behavioral problem. Um, obviously there are some behaviors that result, but we want to focus on the neuro-biological issues and I'll be going into some detail. I hope in a, uh, in a user-friendly kind of way. One of the things I've tried to do over the years is take all of this psychobabble and neuro-psych stuff and package it in a way that we can have regular conversations about it. So here's some factoids, current statistics from the Center of Disease Control, um, which will, by the way, be changing as soon as the new census is published.
Dr. Harrison (00:07:13):
So these stats are based on the last available census. And so we'll see a change in them, but prevalence is about 5.3%. Uh, but Russell Barkley, who's kind of our guru in the field of ADHD and research says that probably about 11% have clinical features, which are impairing. Um, boys are currently diagnosed about three times more often than girls and girls most often have that inattentive type and fly under the radar, uh, tend to not be the hyperactive, uh, have the hyperactive behavioral problems a lot of times. So, you know, they're not getting a lot of attention, but they may be lost in, in the, um, the, what I call the playground of the mind. Uh, and, but sitting there smiling and nobody would know, uh, the inattentive type in both girls and boys often does not get noticed until schoolwork becomes more complex. And so a younger child now, in fact, I've had in the last two weeks, probably five different families of middle schoolers who said, but I didn't, they didn't have this, you know, problem with schoolwork.
Dr. Harrison (00:08:22):
They earned great grades in elementary school. So I just don't understand why they can't do it well, that's because a bright child often can plug in in the classroom and doesn't have to study a whole lot, can just earn good grades and do all right. But then once there's that element of studying, um, at an intensive level using the working memory, which we'll talk about the impact of processing speed and timing, all of that, then, uh, it becomes problematic for, for some children. And that's why it's often diagnosed a little bit later. Um, the hyperactive symptoms, obviously they're noted right away. You can, you know, be in a classroom of kindergartners or first graders, and you can see the children who are garnering most of the attention and say, okay, wait a minute. There's there's overactivity there. Um, now this is something that a lot of people aren't, don't quite know, um, that there's actual data on, but parents will tell me there's just something they're just, they just seem younger or less mature, or, you know, we have, but another child who was able to, you know, get up and get dressed in the morning and get out of the house without a problem.
Dr. Harrison (00:09:36):
And it just seems like there, you know, and then I hear the word should a lot, you know, Oh, they should be able to do this. Right. I don't know why they're not so sure. Um, the, uh, they have about a two to year, uh, two to three-year delay in executive functioning. And when you look at neuroimaging, um, the gray matter of the brain, the fiber optics of the brain are actually just a little bit thinner in children with ADHD. Now they grow at a normal rate. This is not brain damage. I don't want you guys to panic. It's just, it starts off thinner and it grows at a normal rate, but it's, it's about two to three years thinner than someone without ADHD. And this governs, um, the executive functions. So what are the executive functions? Well, self-management to time , initiating, getting started on things, and we're going to look at why these things are so difficult.
Dr. Harrison (00:10:35):
Um, and I hope this will enlighten you as to, Oh, what's behind it. And then what can we do about it? Because in this talk, we're also going to have a lot of focus on what do you do, right? But right now we're just identifying what is this? So initiating, planning and organizing, uh, which includes planning and organizing of the thinking and problem solving, um, working memory, which is a part of, uh, cognitive flexibility using what, you know, showing what, you know. Um, often I have parents say, you know, my child studied, I studied with them. They knew all of this information last night. And then they came home in tears today because on the test, they just couldn't come up with the answers, but I know they knew it. Um, and so that's part of that working memory system, organizations of materials, shifting from task to task, stopping one thing, starting another.
Dr. Harrison (00:11:31):
So here's the dilemma, a dilemma for parents, dilemma for teachers, you're trying to help them become more independent. Um, student with ADHD might not be developmentally ready without significant scaffolding. And think about this. I hope I hope you all will keep this, this image. Um, scaffolding is what's put alongside something that's being built, right? Um, or construction of some sort. So scaffolding comes up. Scaffolding is not the building and scaffolding isn't going to do the long-term work of the building, but it comes alongside to support and to make sure that things are going in the right direction. And so kids with ADHD need a little extra support to make sure they're going in the right direction.
Dr. Harrison, can I interrupt you for a moment, please? It looks like we have a question here. And the question is, will that part of the brain ever quote, catch up? Will it always be delayed?
Dr. Harrison (00:12:38):
Great question. No, it catches up. It catches up at onset of the adult brain. Now doesn't mean that ADHD goes away. Although in about half, half statistically, the major symptoms minimize enough that they don't impact the individual in adulthood about 50% do, but then the gray matter sorts out. Great question. Thank you. You're welcome. Um, so the question is how to help your child become successful without enabling, right? That word enabling is, is, is not, is a yucky word in my, my world. We don't want to do things for them or, um, contribute to their being helpless. Um, the bar must be consistently raised, so meet your child where they are, but help them be prepared to master new tasks.
Dr. Harrison (00:13:34):
So assist don't enable. I want everybody to say it with me. You're all in your own homes now, but let's say assist don't enable, right? That's what we want to make sure we are assisting, helping a child over a barrier is sometimes needed. Uh, so, um, you can set reminders. You can give a step-by-step instructions, break it down instead of just one big blob of, and, you know, clean your room, clean your rooms, a nightmare to children with ADHD. It's, there's a hundred steps involved in clean your room. What do you mean do your homework? That's another one of those as a big blob of things that they have to figure out step-by-step so pick up 10 pair of socks and then let's, let's, uh, go, uh, uh, throw the comforter over the bed and put the water bottles in the trash, in the recycling and cetera.
Dr. Harrison (00:14:26):
Um, so lowering the bar does not help in the long run. And I want to give you a visual for this. So let's say there's a barrier or a little hurdle, kind of like, um, jumping horses, equestrian, uh, in the question world we see, and there's a little, there's a little bar that that's, uh, about here in your child's legs are a little too short and you're saying, okay, look, we're going to jump over this, but your child's legs are a little too short. Well, you don't want to lower the bar so that they can step over it. You want to keep the bar where it is, but maybe help them get over it. And then the more they feel the exhilaration of getting over that high bar, that little, um, place, that's a stretch. They develop confidence. They develop resilience. It's motivating when you lower the bar, it's, de-motivating lowering the bar, tells a child. I don't think you can do this. So I'm just going to fix this. You don't have to, you don't have to try hard. They see you got to be careful. Don't enable, provide the least amount of assistance to help the child become successful and then withdraw your help little by little as they master the new task.
Dr. Harrison (00:15:44):
So we're going to talk a lot now about these executive function deficits. What are they and how do they show up? We had that nice little list, but now let's dig into them a bit before we do, did we have any questions, Amy, that this would be an appropriate time for
Not right now, but I really enjoyed what you had to say about giving. So breaking it down and giving something specific to do that really speaks to me as a speech language pathologist and as a parent. So thank you.
Dr. Harrison (00:16:17):
You're welcome. Yeah, it's, it's critical. It's critical. Um, now, first of all, with executive function deficits, we've got to remember, I'm going to say this several times tonight. This is not bad behavior. The result of ADHD is often some bad behavior, but it's not willful misbehavior, a child with a broken leg who can't run fast. They're not penalized for slowness. Rather they're given support, they're given crutches or they're allowed to walk around the track or whatever instead of have to run on. The more often that a child is told that he or she is bad, the greater, the chance of emotional deaths, uh, deregulate, dysregulation, and low self-esteem as they grow older. Um, you know, I've have heartbreaking stories as I'm sure you guys have, have your own that you've you've encountered. Um, but one of the things that I always have to stop and pause, um, when I, when I first meet a family, I get a chart, right?
Dr. Harrison (00:17:19):
My, my office manager, hands me a chart with the child's name on it. And then we have any of our basic intake information. And usually I meet the parents first, but my, my moment, um, of, of absolute bliss is when I look at the name on the chart. And it's very rare that I don't think to myself what a lovely name, you know, there's a lot of lovely names out there. Um, and as a parent myself, I think about going through the process of how you pick that name and when you hold that child for the first time and you look at their sweet little face, and usually you've got like their little hand clenched around your finger or something when they're newborns and you call them by name the very first time. And just think about that for a moment that, that soft voice in that absolute inexpressible joy.
Dr. Harrison (00:18:22):
And as you share that name with others and people say, wow, that's a really cool name. Where did you come up with that name? And so that child's name was born in beauty, in grace and love and affection. Well, just think about, let's say a five or six year old, and the only time they really hear their name anymore is when someone's telling them don't or stop, or why are you doing that? Or you're in trouble. Right. Just think about the shift of how that child feels about their name versus what you intended. And so, um, I ask everyone tonight to make sure to honor the name. Now behavior is behavior, but it's not the person. And so we, we want to make sure to separate that out. Um, low self-esteem, um, is prevalent in children with ADHD and teenagers, with ADHD and adults with ADHD. Um, they've heard their name spoken, um, in non loving ways more than they've heard it spoken in love.
Dr. Harrison (00:19:39):
Now this next part, I'll get off my soap box. The name thing, it just tugs at me up. Sorry. Um, but this next thing is also super important when we look at what do we do. So I'll be referring back to this next. It's just a little innocuous bullet point right here. But, um, it's really important that child with ADHD has to move, has to talk. This is not optional guys. It's part of the disorder. They have to move. They have to talk. And note, I said, have to, right now, if a person is more inattentive, the interesting part is the moving and talking is often on the inside. And so the talking is that stream of consciousness than the daydream. You'll hear me in a minute. We're talking about the wagon wheel, that circular thinking, and the words might not be coming out of the mouth, but make no mistake. It's talking inside the head and the movement might be subtle. I had someone just today who said my child has to chew. Gum, has to chew gum. Doesn't have the big body movements, but has to have the jaw move or the shaky leg. Right. Or there's all kinds of stuff. So it may be big moving and talking. It may be very quiet and more internalized moving and talking, but it's part of the disorder.
Dr. Harrison (00:21:11):
Let's look at, uh, uh, we have a question. Do we want to stop before I go to this next slide?
Yes, we do. A question just came in is the, have to move and have to talk a must companion or it, or some children moves a lot and some talks nonstop.
Dr. Harrison (00:21:37):
Yeah. So it's, it's a spectrum and you'll have it. You'll have it all, but look for it. And when we get to this next section in a few minutes about what do you do? You'll see that incorporating very subtle ways that they can emote and that they can, um, move, uh, will help them study better, will help them behave better. Um, there, there are many things, so it's, uh, you'll see some who talk more than move more. Some who move more than talk more is a great question. Uh, I'll begin, uh, where I'll end, where I began in the beginning where I said every child is so different and it is a block. Yeah. Okay. So the ADHD switch, um, this is not something you'll see in a textbook. I made it up and I made this slide, right. So I just want to tell you tell you that upfront, but I made it up based on research and based on years of trying to figure out how to explain in a fairly simplistic way what's going on with attention deficit.
Dr. Harrison (00:22:42):
And so the first thing is to understand that it starts as a sensory processing disorder. Now I know Amy, you, you, you know all about this, this stuff. Um, we, um, we start with sensory processing now, not every sensory processing disorder is ADHD, right? So not, you don't confuse the two, but ADHD starts as a sensory issue. And that's because as little bodies are growing and developing in the preschool years, if they have attention deficit, there is one or more pathway that is either too big, too wide or too narrow. And that is what triggers, um, eventually what becomes ADHD with learning. Now we don't diagnose kids with ADHD, usually when they're super young, because it could just be sensory. It could just be that their sensory systems are developing and it's not ADHD, or it could be any number of other things. So not all of the sensory issues or ADHD for kids with ADHD will have some sensory issues.
Dr. Harrison (00:23:49):
And you may or may not notice it unless you're looking. A lot of times when we go back through the developmental history and the parents will say, well, yeah, they, um, you know, wouldn't wear socks with lines in the more, um, they had eczema. Um, now not everybody who has eczema has ADHD, but a larger proportion of children with ADHD, have eczema as young children. Um, there's, there's lots of little things that when you look back, Oh, there's one of the sensory things. Or they don't like the birthday party noise. Like they're perfectly social, great, you know, fun kids. But when they walk into a birthday party, they put their hands over their ears or have a little mini panic attack. Well, what does this have to do with ADHD? What is this? Well, that's where it starts. You have either wider or narrower pathway, all data that hits the human brain has to come somewhere and guess where it comes through the vehicle is the sensory system.
Dr. Harrison (00:24:45):
We see something hear, taste, touch, or smell. And that's how information from the environment comes into our brain. Our brain has to decide whether we pay attention to it or not. So the first stop of all that information was not the first first stop. But in general, when we talk about attention is the executive function up here in your prefrontal cortex. There's millions of circuits, all electronic circuits, and they're all trying to help, uh, make sense of the data. So I think it's kind of like a switch. When the sensory information comes in, your brain says, pay attention to it. Don't pay attention to it, pay attention to it, don't pay attention to it. And the coolness of the human brain is that the data is really neutral. Um, so you can see behind me, I have this kind of creamy white wall, right?
Dr. Harrison (00:25:36):
Well, I didn't think about white walls and I bet none of you were thinking about the white walls, but if you, um, if, uh, we're having a conversation, we're not gonna think about the white walls, unless I mentioned it now you're looking at the white walls, right. But, um, when I was building out my office space and I had the contractor in here and they put up like five different swatches of creamy whites, and I had to look at them and I had to pay attention to them. And boy, I could tell you all sorts of nuances about this color of white after I went through that. And that's because my brain knew that it needed to pay attention to that. After I made the decision, I'm in this office all the time. Now I don't really look at the color of the walls. And most people don't either, but when I needed to pay attention, I did so pay attention.
Dr. Harrison (00:26:26):
Don't pay attention. Well, think about the hyperactive child for a second. The hyperactive child is taking in too much from at least one of the sensory reports, usually several. And so you might have, um, the hyperactive child who actually feels intensely the feeling of their bottom on the chair, those nerves and everything. And it's just like, wow, I've got to, I've got to, you know, wiggle around because I am, I am feeling that even if they don't consciously think they feel it there's an over stimulation for movement or sometimes the too bright or too loud. Um, and so you look at all of these tastes, we have a lot of tastes sensitivities and the brain has to decide, do I pay attention? Do I not pay attention? Now, after that happens, then the information goes to wherever it's supposed to go most of the time.
Dr. Harrison (00:27:24):
And that's where we get into this thing called processing. So processing go with me for a moment back in time to your high school science class. And we have the atom, you remember the atom and you got, what is this? The proton, right? And then you got the neutron just hangs out there looking cool. And then you got the electron. He does it all the work, zoom, zoom, zoom, zoom, zoom. Well, so when this, this switch, uh, allows the information to go through, it is being processed now in a typical brain, you've got all these millions of circuits firing all the time and things are going, zoom, zoom, zoom, zoom, zoom, zoom. But when you have attention deficit, the path is not as smooth. And that's because one of the other neuro-biological features of attention deficit is that there's an underproduction of some of your neuro-transmitters namely dopamine and norepinephrine and dopamine and norepinephrine.
Dr. Harrison (00:28:26):
They help give the juice to the electrons, right. They fuel the switch. And so instead of zoom, zoom, zoom, you have zoom, pause, zoom, pause, zoom pause, pause. It's an erratic pattern usually. And it's not an every circuit at every moment, but it's enough that every time there's a pause there, that data communication bit, that little piece of data drops into the black hole of the brain. And that my friends is inattention never to be recovered again. So it's kind of like if we've all had these cell phone calls where we're, you know, talking to someone and uh, we go and we're in the car and we drive under a bridge and we lose a word. Right. And it's like, yeah, I know I went to, and it was so fun. Right. And so we're not gonna get hung up on it unless we're supposed to meet them at that place.
Dr. Harrison (00:29:21):
We just didn't hear. Um, but we, we kind of keep the conversation going and it's not a big deal. And so kids with ADHD, I want to tell you, they are working so much harder than everyone else because their brains are always trying to make up where they left off. And it's usually just a nanometer, just a tiny little bit, the more severe the ADHD, the more often this happens. And that's why we have these questionnaires when we were trying to diagnose, to find out how often do things happen. Um, is it like all the time the child's missing, you know, beats? Or is it just, you know, when things get super boring, we're gonna talk about boring and just a second. Um, but, um, that's what processing is. So zoom caused zoom, pause or zoom, zoom, zoom that's processing. And so whenever you hear about ADHD, you're usually having conversations about processing speed or ability to process information.
Dr. Harrison (00:30:22):
And, um, that's because the electrons are not functioning properly. Um, there's three major parts of the brain that, um, are involved in all of this. You have the learning center, and that's why sometimes we have problems with reading, writing, or math, sometimes a full on disability, sometimes not a full on disability that half the time, there's a pretty significant gap in, um, in the, um, learning domain. Another domain that's impaired is the motor cortex. Um, sometimes you have hyper motor and that can be a great thing. Some of our, um, uh, more Olympic athletes have ADHD than the general population. And so sometimes there's hyper motor, sometimes there's hypo motor, which is the, you know, classically the stinky handwriting. Um, but you can see it in all sorts of show up in all sorts of ways.
Can I jump in here? I had another question and that is, should children with ADHD get more sleep since their brains are always going and trying to catch up,
Dr. Harrison (00:31:28):
Oh, sleep Oh that we could have well, other series on sleep because often sleep is disrupted because their brains quite often don't shut down. And I usually see two extremes. I see some kids who they are so exhausted at the end of the day crash, and they are out, they are just big lumps of, uh, you know, clay just lying in the bed or laying in the bed. They're just so tired. But then I have others who they can't stop the overstimulated brain. And so should they get more sleep? That's I think more of an individual question. Um, I have, I have a whole other series of talks on sleep and, um, we are a sleep deprived nation. And so you can Google, um, and I can give you some general rules of thumb, but is he better just Google the, um, how much sleep does a person need?
Dr. Harrison (00:32:27):
And you'll find that the average child is about an hour deprived. Uh, the average preteen is about an hour and a half deprived. The average teenager is about two hours deprived, and the average adult is about an hour and a half deprived. So, uh, kids with ADHD fit in that range, we're all sleep deprived. I'm sad to report and you guys know it because it's quarter of eight Tuesday night and you're, you know, gosh, I'm hanging in there right. Then I can, I can, I can feel the vibes that you're all just there hanging in there and, um, is because we're, we are tired. We are. Um, and then you had stress. That's a whole other thing. Okay. So, um, the third part of the brain, so we have the learning center, you have the motor cortex back in here, and then the third part is in your subcortex, there's a little gizmo in there called the amygdala that that's your emotion, regulation, um, center, especially as just little binary, um, fear sensors, where it's, it starts and does most of its work be afraid.
Dr. Harrison (00:33:35):
Don't be afraid. Should I run from the tiger or not? You know, it's, it's helped us stay alive for, you know, since the beginning of time, but that wonky processing. He hits the amygdala. And more often than in the normative population, it triggers, um, the, um, the amygdala to say, Oh, I need to be anxious about something. And it then connects to the autonomic nervous system, giving the child a little shot of adrenaline, and that puts them into fight flight or freeze. Again, we can, uh, talk about anxiety in detail, but most kids with ADHD, um, experience more anxiety than you would imagine. It's very common, not often, well, sometimes anxiety disorder levels, but, um, most often just in those little, uh, little moments that happen when the, you know, just think about it, you you've lost the thought and you were trying to hold it.
Dr. Harrison (00:34:30):
And so your body gives you a shot of adrenaline and adrenaline. The first thing it does is it shuts down your logic, so your concentration goes away. And so a lot of these meltdowns that are, uh, parents will report, um, they're actually a little panic attacks. Um, and so, um, fight flight or freeze, remember those things, okay, let's go on. Now. This is the other thing that I think is really important. We're, I'm gonna kind of speed up a little bit so that we can get through, um, and, and get into the, what do we do, but ladders and wagon wheels is the other thing that, um, I've developed to try to explain approach to task. Since the very beginning of time we had linear thinkers and we had circular thinkers. In the beginning, my estimation is that we had way more circular thinkers.
Dr. Harrison (00:35:18):
The ladders were more of the hunters, the task-oriented, uh, people, they had a job to do both and styles of thought helped us stay alive as humans in the early days. And, um, the ladders, uh, let's say their other hunters. They knew where to start. They looked for a track, they followed the track and we're quiet. Um, they were gone sometimes for days at a time and they didn't come back till the job was done. The wagon wheels. On the other hand, they did everything else. So these were more creative people. They had to invent things and problem solve in the moment and just kind of say, let's do this more impulsively, figure out what to do. They tended to be more relational, um, in some outwardly social and some just more quietly intuitive, um, understanding how others felt because they were together in the human collective.
Dr. Harrison (00:36:11):
Um, these were the multitaskers. So maybe one moment they'd be collecting berries and the next moment, uh, inventing fire and, you know, so on and so forth. And the thing that triggered them in their, their quest for, um, multitasking was whatever needed to be done, what was ever in their face. So you fast forward through any society. I love to look at the Greeks and the Romans. Um, you see this everywhere though, across, across the world. Um, the, the Romans, the ancient Romans who we esteemed for giving us many things, they had road systems and Aqua duct systems and the school system that we still use today, which is first grade, second grade, third grade, and keep going, uh, very linear, the Greeks, the ancient Greeks and their philosophies gave us depth and breadth of knowledge that we still study. And it's amazing when you, when you think about how they thought about things, well, how did they do stuff?
Dr. Harrison (00:37:12):
Well, school was not like the Roman school was, you went to places like the Acropolis in your community, and you got in groups of two and three and four social groups, and you argued about stuff. You wrestled ideas. You figured out new ways to think about things. And if you didn't like what your group was doing, you just switched groups or switch topics. And it was very freeform. And you did it your whole life. You didn't just graduate. Um, well you fast forward to a Western society. Well, I think about 90% of us now can live on the ladder. We might not like it. This has nothing to do with pleasure guys, but we get up, we get dressed, we go to school, we go to work, we do our homework, we do it right. We might complain about it. We might love it, but we do.
Dr. Harrison (00:37:59):
It leaves about 10% over here. And I remember that step 5.3% of the US population has ADHD. And then I put in there another 5% or so that are just true creatives, entrepreneurs, people who can't do things on the ladder. It's just their brains don't work that way. Well, here's a couple things. When we start thinking about what to do, if we have our ADH, our little wagon wheels, or if we're a wagon wheel ourself, you have to remember that when there's something new in the environment, that's more interesting. Our brain naturally switches tasks. So wagon wheels have a hard time move staying on track. If it's boring. Now, if it's interesting. Yes. Can we all say video games and social media and all that cool stuff. If it's interesting, then they hyper-focus hyper-focus is the evil twin of inattention. And so, um, one of the things that we have to help them do is know what to focus on.
Dr. Harrison (00:39:01):
Remember that scaffolding. Now look here at the ladder. Let's talk about initiating. It's very clear where you start. When you're a ladder, you start at the beginning, you do your homework, you clean your room, you do whatever. If you're a wagon wheel. Oh my gosh, guys, look, where do you start? You could start here. You could start here and sequencing, Oh my gosh. If you're a wagon wheel, you can go backwards. You can go across, you can go back and forth, back and forth, back and forth. Sequencing is very difficult for the child with ADHD. So remember the wagon wheel and the ladder, um, other issues, um, that emotional regulation that we've talked about. Now, you start to understand the behavioral regulation. Um, it's hard to know which way to go, what to do, motor skills, self-management to time that wagon wheel can go in any direction.
Dr. Harrison (00:39:56):
That time is linear. Time is a ladder right now, starting to all of this, to come into play here. Anything boring is hard to start to that's where they need scaffolding. Where do you help you help with the boring stuff or better yet? Make boring things interesting. Planning, organizing problem solving. Now start looking at it in terms of the wagon wheel, right? Oh my goodness. We start seeing all of this is tough. If you have older kids writing an essay, that's answering a prompt question. Five paragraphs, right? Stay on track. Just think about what, how we teach essay writing it's ladder world. So one of the first things I do when I have a child who doesn't know how to write an essay is we do story mapping. Story mapping. Circular is fabulous. If you don't know what story mapping is, look it up. It's great stuff.
Dr. Harrison (00:40:55):
Preparing a schedule. Schedules are linear. Yes, they are. So help make it an active interactive schedule sequencing. We've talked about that, um, working memory after they've studied and it's not sticking. So how you study guys is key. Use flashcards to break it down individually. Remember the wagon wheels, individual spokes, incorporate movement, be creative, make songs or cheers, for rote learning, right? These are things that enhance working memory. Notice, cheers and songs. Gotta talk, gotta move. Now you're starting to pair the have tos with the need tos. Gotta move, gotta talk. A flashcard where you have an individual factoid is so much better for focus than a study guide. Why? Because our brain focuses on what's interesting. What's interesting to the brain, something it's seen before. So you have a middle school student or a high school student, and they have these wonderful study guides. They're looking at the things they know they filled in all the blanks. They need to look at the things they know, and then they say, got it. I studied. And guess what? They show up for the test. And they are absolutely shocked that there are things that they don't remember being on the study guide. So you have to break it down into individual factor points.
Dr. Harrison have got a great question here. It says, how do you help a child with ADHD when you have ADHD yourself? That's the first question.
Dr. Harrison (00:42:45):
It guess what? It's usually genetic stuff. Chances of someone in the immediate family having ADHD is pretty great. Um, so, um, I wouldn't imagine most of you have been on a plane at some point, I'm going to say, put on your oxygen mask first, um, as a wagon wheel, you're going to be the best person to understand as a wagon wheel, you may be the worst person to help. And so do your part with understanding, or if you've learned strategies, I've met some parents and some older siblings, they've got it down. They know how to operate. And, you know, you can't say this is the way I do it because a wagon wheel rejects it immediately. When wheel is unique, creative, independent, you know, we do our own thing, right? So you can't tell a wagon wheel, that's how you do it. We say, Ooh, let's brainstorm.
Dr. Harrison (00:43:39):
Maybe we could, I don't know, like use flashcards and, um, run back and forth, uh, to the fence and take them on the fence and go, they get them in and find answers. What do you think? And then the wagon wheel will then give you an even better idea, but you're, you're, you're heading them in the right direction. Um, so yeah, you have to know your strengths and weaknesses, uh, and then partner up, uh, with, uh, someone who, and by the way, in most, um, relationships, a wagon wheel will tend to meet up with a ladder. And, um, and so there's usually a ladder somewhere, lurking in the background, usually very frustrated, but although back in the wheels and, um, and so you give everyone their own roles and responsibilities.
We've got one more question. And that is, how do you tell the difference between enabling and supporting?
Dr. Harrison (00:44:36):
Yeah. Enabling is if you're doing more of the work than the child is
Dr. Harrison (00:44:43):
Supporting is, Hey, the kid's doing it and you're just there to, you know, help keep them on track. The moment you cross that line and you're doing the work, or you're giving them like nine of the 10 words in the sentence that they need.
Okay, thank you.
Dr. Harrison (00:45:01):
Sure. Um, organization materials is tough. Ladders have a system, right? Um, if you look at backpacks, lockers, bedrooms, look for that circular pattern. That's almost always a circular pattern. A wagon wheels, classically have stacks. And quite often they know what's, what's in there. Wagon wheels are, are very intuitive and they know a lot. And if you mess with their stuff, if you're a ladder, do not organize their stuff, help them come up with a system that works. Clear bins, to put things in dresser drawers, they are disaster for a wagon wheel. They are hidden. All the stuff is hidden, and then they can't find their stuff. And so you wonder why there's piles everywhere. Well, at least they can see. So if you want organization without the chaos, but you want your wagon wheel to operate, have places where they can see things. Um, and the new system will only work.
Dr. Harrison (00:45:58):
If it works for the person who uses it, I'm going to speed through these next couple real quick, and then we'll have all the time for questions. We're, we're kind of getting down there. Um, shifting from task to task is difficult, and there's often these emotional reactions, right? Because they're hyper-focused, and you're ripping them out of whatever they were hyper-focused on. Um, and hyper-focused, by the way, is the evil twin of inattention. Um, and so you want to help give heads up and whenever possible, have the child have their own ways of reminding, um, I use you guys know these things, grab it real quick, the time timer, I'm sure you guys have them all over the school, um, make time visible. Yes. I think this is critical for our kids with ADHD
That's goes off.
Dr. Harrison (00:46:49):
Um, and so help them have ways to make time visible for themselves. Multi-step processes. We've talked about that. Do your homework, wash the dishes, clean your room. That is, that's a big hornet's nest and you got to help sort that out a bit. Um, so what can a parent do? Well, first of all, you know, partner with your school, if it's schoolwork related, find out what the school needs and expects and talk about the, the issues that need to be addressed. Um, make sure you're consistent at home in school. Consistency is the place where I see more people get off track. Um, when you change something in one environment, then change it in the other. So if you're using the planner is required at school, then make sure the parent is checking the planner at home. If you are expecting homework, um, all goes out on Monday night and is turn back in on Friday, then make sure everybody knows.
Dr. Harrison (00:47:49):
That means we're breaking. We need to break it down a little bit at a time. These big clumps of homework are really nice because you can, um, retrofitted into your schedules. But at the same time, a lot of families don't realize it really means that the scaffolding needs to be every night, um, to, um, make sure they stay on track. So, uh, you know, make sure you're consistent, um, and continually re raise the bar. Of course, you know, if you're at Parish School, um, they're helping with academic accommodations . If you're in other environments and, um, you're not sure what you can do, then talk to your, your school, talk to the, um, counseling or advising department, whatever your school has, and, um, see if what's needed to meet criteria for those accommodations. Uh, they can really help. That's helping the child over the board. Remember, um, some elementary students need behavior charts to stay on track.
Dr. Harrison (00:48:49):
I think they're personally a pain in the neck, um, because we, we start with them and everybody has really great whew thoughts about it, but then, you know, they're hard to keep up. Um, but there are some fun ones that I've put my favorite book, um, Reem on behavior charts at the end of this as a resource behavior charts and beyond, and then you make the kid do all the work. So like my favorite one in there is you have a child draw a picture, and then you cut it into like 20 little pieces. And, um, this can be at home or it can be at school. And then every time the child performs a wanted behavior, does something, they get to get one piece of their picture back. And then they just, you know, glue, stick it onto a piece of construction paper until they get their picture back.
Dr. Harrison (00:49:36):
And then they have the reward of their picture. You can even have little, uh, construction, paper frames or something. So behavior charts and beyond has all kinds of cool stuff like that. And they're kind of time-limited with a beginning, a middle and the end. So you're not, um, in the, the walk of shame with every parent or teacher who started a sticker program and sort of let it trail off and then feels bad about it five years later. Um, so have time limited ways to improve behavior, um, positive reinforcers work, five to sign five to seven times better than consequences. So remember that, catching them doing something right, and saying good job, at a boy way to go. I'm proud of you. It doesn't have to be a big deal of positive reinforcers acknowledgement that they did something right. Um, many of our students have difficulty with auditory processing, so long lectures like this one, they, you know, and if you have ADHD, I apologize.
Dr. Harrison (00:50:34):
You're probably zoned out. Um, that's why we try to have pictures and other fun things. Um, but it's that mom, mom, mom thing, Charlie Brown teachers. Um, so you want to break up talking points with five to 10 seconds breaks. Okay. Everybody stand up, clap your hands, sit back down. That's a break. A break is not a new activity, a break isn't let's play video games for a half an hour. A break is just brief and gets the brain and body shaking up. Remember, gotta move, gotta talk, give them an opportunity to move and talk, or they're going to do it. And it's going to disrupt things. Have the child repeat back to make sure that they've heard you again, got to talk, um, have them repeat key facts or write them down. Um, make sure auditory instructions have written counterparts and the kids can do this themselves.
Dr. Harrison (00:51:27):
Most of them, even young children can draw a picture. You, what am I supposed to do? And they might do a scribble and say, yeah, that's me folding the towel. Um, it doesn't have to be fancy. With studying. Remember chunking the small bites, the index cards. We've talked about that. Um, have, have your child give you a summary of what they've read. There's the inspiration.com has story mapping a wonderful app that you can use incorporate pictures and videos. Remember anything boring is death to the ADHD brain. So it's okay to spool up a YouTube for five minutes on ancient artifacts of China before you you're a fifth grader dives into the social studies chapter. It's okay. It may not have all the information of the social studies chapter, but all of a sudden the brain's got some movement and some color and there's interest being built.
Dr. Harrison (00:52:19):
Read the summary of the chapter. First use movement, walk around and, and, uh, you know, to talk about what they just read after they've read a paragraph, tell me about it and stand up, get away from the desk and move around. Um, homework. Um, one of the big things is turning it in forgetting to turn it in. So work it out with the teacher. If your child's, um, fiber optics are not as developed, let's say they're in sixth grade, but they have fourth grade fiber optics. They're not quite ready for independent, um, management of all of their stuff. So come up with a plan that they can succeed. Have a study buddy system, if things are left at school or stay in close communication, obviously with the teacher, um, check for the online stuff, we've gotten so good about that this year and have written directions, um, breaks five to 10 seconds must involve physical movement.
Dr. Harrison (00:53:14):
You can have the child imagine, Oh, there's a rubber band attached to my back into the chair. And so I'm going to stand up and do a jumping Jack or clap my hands, but that rubber band is going to snap down and they've loved that image by the way. Oh, you know, they'll go all kinds of silly, crazy with it. Use timers for breaks. We have a one-minute break. We have a three-minute break and never electronics during breaks breaks are physical brief, very brief time limited. Um, with organization. Okay. Here's this is gold. I know we're running out of time, but I got to give you this as gold. Um, the backpack, if they carry backpacks, right, empty them every day, that big black hole, the great big one where the permission slips and stuff gets stuck in the bottom. Yeah. Every day it takes less than 30 seconds to empty your backpack every day and do it with your child at the kitchen table.
Dr. Harrison (00:54:05):
And this is through middle school, high school, or start resenting it. But during middle school, empty it every day, clear out bins, clear, have clear bins, have open cubbies and, um, have ways to break down the kind of organizational tasks. This is, this is way, this is a way you help them over the more, um, parents you got this, you just do. Um, here's some resources for you. There's that behavior chart, book, time timer, Russell Barkley. He's definitely a go-to, um, in the field. And so hopefully some of those will be helpful. And here's my information. Um, you can always shoot me an email. Um, I return emails usually between five and seven in the morning. So when you wake up, you'll have a nice little answer and send it to me the night before. Um, so we've got questions. Uh, what kinds of, I'm going to stop screen share if I can
Thank you so much. We do have questions. One of the questions is with more than one child with ADHD alone, um, to help in this way with their homework. Once they hit middle, you know, who has the time, once they hit middle and high school and how do parents help and not sink in the process.
Dr. Harrison (00:55:23):
And that's where if you have, if you're on the elementary side, you set up little by little, the structure for middle and high schoolers. It's, it's hard. And I'll tell you what I have kids. And I'm looking at all their screens and varied, uh, assignments that are three deep in different windows and, and all of that. Um, so you have to have the master system and, uh, the best practice that, that I've learned from my families in that, uh, the people who are doing this, uh, day in day out is, um, have a night of the week or a morning of the week. We pick a time and you dedicate a half an hour to that child Sunday evening. Sometimes it is good in some families, uh, Saturday morning and have a big board. I am a fan of whiteboard. If you come here to my education center, you'll see it's lined with whiteboards.
Dr. Harrison (00:56:18):
And, um, we talk about this month, this week today, and we have the long-term assignments on the month at the big ones, not every single thing, but I have a book report due in three weeks. I have, um, a math test, a big unit test in two weeks. Um, and this week, everything that's on this month should be detailed out this school week. Like I'm going to do, I'm going to do unit three of the math, and I'm going to read 50 pages of the book for the book report, right? So everything there has something there. And then today you come in after school and then you start with a clean slate and you put the homework of the day, whatever's new. And, um, and then you take something from this week and you do something. Now you might say on a real busy day, I'm not going to read for the book report today, but you'll look at it and you make that choice rather than ignore it.
Dr. Harrison (00:57:13):
And so parents for middle school and high schoolers, that 30 minutes strategy meeting once a week, where you make the schedule visible, you make time visible is what you're doing. That then set your child up for success. And then all you have to do is check in periodically through the week. Hey, how's that book report coming? That was what three seconds. Right? And you don't have to think about, do they have a book report or not because it's in your face, hidden things, hidden schedules, hidden clothes, anything hidden does not work well in an ADHD.
We've got a question here. That's been uploaded a couple of times it says, so one thing that was not really addressed is medication, while I recognize that this is not a diagnosis, we have a five-year-old and we've had multiple people tell us he needs to be medicated. What are your thoughts? And when do you seriously consider this?
Dr. Harrison (00:58:16):
So medication for ADHD, um, is statistically effective about 85% of the time. It's the most stimulant medication is the most effective medication that we have in the world of medicine. 85% is huge. Uh, that said, I am a psychologist, not a psychiatrist for a reason. I'm the everything, but medicine and putting medicine in your babies is, uh, it's a, it's a tough choice. And so I focus on all the other stuff, but when do you know when the child is not thriving? Are they not learning? Are they so disruptive to themselves or others that they are socially ostracized? Or are they not able to function at home? Are they having meltdowns over and over? And over those little panic attacks we talked about, um, are they so frustrated with themselves or others at home at school that they they're not feeling good about themselves? Is their name being used in ways more and more and more on their self-esteem is going down. There's a lot of reasons. And, um, stay in touch with your school. That that's the number one thing. You may have enough data at home, but the teacher will tell you if there's trouble with learning or socializing, they have the Petri dish and trust your school. I can't say that enough. Not because this is sponsored by school. I tell people that every day, your school, your teacher knows they have the Petri dish.
Thank you. Can you speak to any statistics on population of ADHD, children who are, and are not medicated to help? Let me see. You kind of just spoke to this, it this, how long are children typically on meds? Can you suggest studies that tend to support either way? Or did you kind of already addressed this?
Dr. Harrison (01:00:18):
Yeah, I mean, as far as the literature I'd have to get out of my I've got tons and tons of stuff there. The classic studies are called MTA studies. They're in there, I think six iteration now over the last 30 years. Um, so MTA, um, just those letters all have MTA are good ones, um, that talk about treatment and efficacy of medications, but there's a lot more Barkley. Russell Barkley has lots of stuff. Um, medication needs usually change over time. And by the time the students in high school, they need to be a big part of the plan.
Yeah. Okay. Here's one are electronics bad for young children with ADHD. Is it too much stimulation? Okay.
Dr. Harrison (01:01:04):
So electronics in large amounts are terrible for every human. End of story. Children with ADHD have extra problems because of their ability to hyper-focus and electronics. Very, you've got your cell phone. I'm just about in a couple months, you'll probably see stuff. I'll be doing a lot of media blitz. I'm finishing a, um, uh, an online parenting workshop of three sessions in half of the second session is all about screen time parents.
Wow. That is outstanding. So many of us need that.
Dr. Harrison (01:01:45):
Yeah, but man, let me just say one thing about it. When you play a video game, the part of your brain that lights up. When you look at spec imaging is the same part of the brain that lights up with hypnosis. There's a sense of peace time management just completely goes out the window. Can you see how this is exacerbated? And then when you pull them out, you're pulling them out of a hypnotic trance. And that's why our kids get mean and ugly when we pull them out. And some adults. wow, let's see.
Um, I would love good ideas of how to help our mornings be calmer. I have a three year old, a five-year-old and a seven-year-old to get ready in the mornings, along with myself, my seven year old wakes up a huge ball of energy, running, dancing, singing, distracting the other two. I hate to say it, but I hate the mornings. And I don't know what to do.
Dr. Harrison (01:02:47):
Says every parent in an ADH family ever. Yes. Um, it, and here's the thing. Look at what we talked about. Self-management and time planning and organizing, breaking down big tasks, get ready. Oh my gosh. That's my clean your room. So having a checklist for all, having a specific, um, uh, morning checklist, having preparation the night before and kids as young as four, pick out their clothes, even three-year-old sometimes they'll be like ballerina tutus or something, but, um, they, they got their clothes the night before their backpack can be by the door. Um, they can have everything ready, fancy breakfast, you know, of course we don't need that. Nice sometimes, but save that for special days, you know. Pop Tarts were all with the multivitamin. Um, what, what will your children eat? Right. Um, what I think we overthink the things that make life more complicated to have a plan in place have as much done the night before and be ready to just rock and roll. Some kids sleep in their school uniforms. Sorry they do. Um, because getting up and getting dressed is too much. Okay. So just put fresh clothes on in the evening and let the guilt turn to the of the off position, do what works to make your mornings, um, wonderful. And they can be. Checklists simple, like five steps, not big, um, are very effective for a lot of kids with ADHD. If they make them themselves, if you make them print them off the computer, they'll never look at them.
Dr. Harrison, I want to respect your time and we have already gone over. So let's go ahead and take one more question and I will read this one here for you. How much does the child's early environment? First three years contribute to ADHD in children. Do you find that many adopted children have ADHD because of early childhood trauma?
Dr. Harrison (01:05:01):
Oh, that's a big question. So, um, nature versus nurture. So we know most ADHD is genetically transmitted and that's the way most of it happens, but there are ancillary ways of there are some environmental issues. There are, um, you know, children born addicted to substances, tend to have, um, uh, forms of ADHD. Um, children exposed to toxins sometimes have, uh, forms of ADHD. So there, there are other, I don't wanna it's it's, it's very, very complex once you get past the genetic part. So the genetic part is the biggest part. So before age three, um, unless they're in, you know, uh, what I call a dramatic environment where something is, is really, um, um, uh, way, way off balance. Um, it's typically genetic now adopted children who were adopted, um, it's, it's the same kind of thing, but more prevalent. Well, so if you think about all the things that contribute to attention deficit and all of the behavioral issues that stem from it, who is more likely to, as an adult have difficulty parenting or difficult.
Dr. Harrison (01:06:24):
So there is a higher percentage of adoptive children with ADHD, but that usually goes back to genetics, but then there's, there's also all of those other comorbid issues. So before age three, what you want to do is, is keep an eye on sensory, remember the early stuff and helping them, um, learn to manage themselves and manage their environment. And if you have a child who is having, uh, just a tremendously difficult time, self-regulating you want to help them with that? It doesn't mean they have ADHD, but they might. Um, and some children I live, I guess we can end on this one last little comment here. Um, most preschoolers have executive function, disruption. That's why circle time works good. That's why very short bursts of activity work. And why would I say something outrageous like that at the end of this talk on ADHD? Well, it's because of brain development up until age six, all of this stuff in the prefrontal cortex is just growing and developing and you go through stages where you're getting long-term memory and then those little pathways are pruned. And then you get the working memory to develop in your body and brain are all different places. So it's very normal for a preschooler to act like they have ADHD and they don't have it. It's just because they all have it. So
This is great. Okay. You sound, thank you, Dr. Harrison, thank you so much for joining us this evening. We are just so thankful for our relationship that we have built with you. And, um, you really, really gave of yourself this evening. I know I can speak for everyone that was here. It, um, it really resonates when we are looking at ADHD as a neuro-biological, um, and not a behavior, yes, behaviors result from this, but really, um, all of the encouragement that you gave us, like parents, you've got this, we need to hear that and breaking things down and, um, helping us come up with practical applications to support our children. That is so valuable. We thank you.
Dr. Harrison (01:08:51):
You're welcome. It's my pleasure. And now we can all just wind down the evening. I am so impressed that so many of you came. Thank you.
And thank you. And for everyone who attended this evening, I think that that is so amazing that your support system is so wide and here at the Parish School, it is our pleasure to support our community through outreach. And that is absolutely what we are about. If you would like to hear more in adult education, you can look forward to our monthly webinars. Next. We will be welcoming Dr. Emily Gutierrez, and she will be speaking on neuro-nutrition. Thank you again for coming this evening. We will see you next time. Dr. Harrison, thank you so much. We'll talk to you soon.
Thank you for listening to the Unbabbled podcast. For more information on today's episode, please see our episode description for more information on The Parish School, visit parishschool.org. If you're not already, don't forget to subscribe to the Unbabbled podcast on your app of choice. And if you like what you're hearing, be sure to leave a rating and review a special thank you to Stig Daniels. Amanda Arnold, Stella Limuel, and Molly Weisselberg for their hard work behind the scenes. Thanks again for listening.