FINAL_The Gaming Paradox: Your Kid Can Focus on That, But Still Have ADHD. (Here's Why) with Dr. Fox

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[00:00:24] Welcome back to Kids these Days. Insights for every stage of Child and Family development. I'm Dr. Courtney Lynn, licensed psychologist and owner of Integrated Behavioral Health. Today we are tackling a topic riddled with outdated assumptions and frustrating myths. We are talking about A DHD. If you're a parent who has ever thought my child can hyperfocus on video games, so they can't possibly have a DHD, this episode is for you.

[00:00:49] I'm thrilled to introduce our guest, Dr. Stephanie Fox, the founding psychologist at Four Corner Psychological Services. Dr. Fox specializes in comprehensive evaluations for A [00:01:00] DHD, autism and learning disabilities. Her expertise is vital, but what makes her perspective so powerful is that she is also an A DH ADHD, or who is diagnosed in adulthood.

[00:01:11] Dr. Fox, thank you for joining me. We are ready to cut through the confusion and educate parents about the true face of A DHD, the struggle for executive function and the silent success stories.

[00:01:23] Courtney: Hi, Dr. Fox. How's it going?

[00:01:26] Stephanie: Hi. It's going. I'm excited to be joining you today in your inaugural season.

[00:01:31] Courtney: Yes, I'm so excited to have you. I feel like you are such an expert in all things assessment and evaluation that I am really excited to get your perspective.

[00:01:41] Stephanie: Great. Thanks for having me.

[00:01:43] Courtney: Yeah. So let's just jump right in with. The most common thing I hear from parents, I know we're gonna talk about A DHD myths today and kind of bust some of those myths.

[00:01:54] Courtney: So one of the things that I hear the most common is if my child can focus [00:02:00] for eight hours a day on video games, they can't possibly have a DHD. So what is your perspective and what are your thoughts on that?

[00:02:11] Stephanie: Absolutely. Come to bust the myth. , , A DHD is so misunderstood as a diagnosis and I'm really excited to get the chance to, you know, add some light to some of these things. And yes, attention deficit is in the name. But a DHD is. So much more complex than that. It's actually a disorder of what's called executive functioning.

[00:02:31] Stephanie: Or sometimes you'll hear ef what is that? Those are the management tools of our brain. It helps us with getting going in the day, being able to make a plan, being able to be prepared, be organized, keep track of time, right? All those really important things, and attention is one of them. And so with A DHD, what you have is not.

[00:02:53] Stephanie: A lack of regulation abilities, but difficulties with doing that [00:03:00] regulation. So that means that. It's not an issue of being unable to focus. It's an issue of being able to control your focus. Most of the times we think about us not focusing, but it can also include focusing too much, particularly on things that are stimulating and reinforcing.

[00:03:19] Stephanie: So video games are a big one, right? Shiny. Lots of colors, lots of graphics, lots of interest in movement and things like that. But you could even see kids with a DHD hyperfocus on things like reading, doing arts and crafts, studying a subject that they really like. Like it doesn't just have to be those obvious things.

[00:03:40] Stephanie: And so when I am talking with parents and I'm hearing some of these signs that the executive functioning might not be doing as well as it could. I'll ask about attention, and I very commonly get, no, they actually, I've seen them sit for four hours and work on their scrapbook. That actually tells me probably a DHD is there versus [00:04:00] not.

[00:04:00] Stephanie: Um, For that imbalance that I was just mentioning,

[00:04:03] Courtney: That makes a ton of sense. So what I'm hearing is the name Attention Deficit Hyperactivity Disorder is maybe a little bit misleading and it's really about executive functioning.

[00:04:15] Stephanie: Right. And so our attentional control and our behavioral control, so this would be that hyperactivity impulsivity piece. Can you control yourself from acting right before you think and can you control yourself from being too restless and fidgety? Those are all part of that self-regulating.

[00:04:33] Stephanie: And granted, we don't expect kids to be great at this, right? These are actually the last. Skills in the brain that develop for anybody. , But there is a certain level of functioning and regulation that we would expect. Um, And then when we start to see that diverge a little bit is where I start to wonder about A DHD,

[00:04:50] Courtney: Okay. I've actually heard Dr. Russell Barkley say that executive function self reg. Deficit disorder is probably more of an [00:05:00] accurate description of what we're discussing,

[00:05:03] Stephanie: Absolutely. Yes. And, And Really it was , a few years ago where the phrase executive functioning disorder started popping up on the internet. And so, , I've had more parents call and ask specifically about executive functioning. Not a DHD, but like, I think my kid has executive functioning disorder.

[00:05:21] Stephanie: And to bust that myth, it would probably be the same thing. Although I do wanna be fair and say that executive function can be impacted by other things like autism anxiety and depression, trauma, a brain injury, but most often with , that's specific constellation we're thinking. A DHD.

[00:05:37] Courtney: Yep. Okay. And you said executive functioning, you kind of named a few things, planning, organizing, working, memory. Can you give a few like daily tasks that fall under those things just to maybe bring it to

[00:05:51] Stephanie: Yeah. Yeah, great question. So thinking about like, , a student, let's say maybe like a 12-year-old , being able to kind of get [00:06:00] themselves ready independently in the morning where mom or dad does not have to be coming back in the bedroom multiple times and make sure they've gotten out of bed, that they've started getting dressed, having to remind them so frequently to brush their teeth.

[00:06:11] Stephanie: Like at 12, you probably should be able to manage some of these things, right? So that's like that task initiation. You know, Just keeping track of time. We still gotta get out the door at this time. Right. , In the classroom this would be, you know, focus and attention do go as part of this. So this could be zoning out.

[00:06:29] Stephanie: But working memory is a part of executive functioning. It's really important for learning because you're taking in information and then you have to hold it there for a minute to be able to do something. So this would be like. You hear the teacher give you a piece of information, you have to hold it long enough to get it down on paper to take notes, or the teacher tells you what chapters you need to read tonight for homework.

[00:06:52] Stephanie: Did you hold onto that? Did you notice it? Did you hold onto it? And then did you write it down in your planner? And then when they get home from school, are they [00:07:00] able to be flexible and transition to, okay, now we're in the home environment. Now it's time to get started on our homework. Are they wandering off And again, do they need mom and dad to really police homework time?

[00:07:13] Stephanie: When they sit down to their homework, can they see that task through to completion or are we getting distracted and starting and stopping? We work on it for five minutes. We get up to get a snack, we come back, we get distracted by what the dog is doing. You know, Those sorts of things. And I guarantee there's a lot of parents list.

[00:07:30] Stephanie: To this thinking, oh my gosh, that is my child. It, again, some of it is a child thing, but this is suggestive that maybe they need a little bit more regulating than their brain is capable of doing on their own.

[00:07:42] Courtney: That is really helpful to kind of have those. Daily task ideas in mind. I was also thinking, I'm curious your thoughts, like a messy room or a messy book bag.

[00:07:54] Stephanie: Totally. Or you know, a common one that I hear is that the homework doesn't get turned [00:08:00] in. It was done the night before, but somewhere between the kitchen counter when I finished it and when I came to class, it has gone missing. Or I forget to turn it in. I have it, but I forgot to turn it in.

[00:08:11] Stephanie: Or these could be kids. I'm always asking parents, especially of younger kids, are they always leaving the water bottle at school? Are they always leaving the sweater at school, right. those sorts of things. Um, But yeah, all of this goes under executive functioning.

[00:08:25] Courtney: . Right. And it isn't necessarily attention, I love that you're connecting those to the real life examples. What are your thoughts? I think as kids get older, so we transition from elementary to middle school to high school, right? The executive function, demand get greater or become greater.

[00:08:43] Courtney: Do you find that? Maybe kids who are doing really well in elementary school and parents are like, no, there really weren't any issues and now they're in middle school and high school. It starts to become more apparent that maybe the executive functioning is a challenge. Yeah.

[00:08:58] Stephanie: A hundred percent. That is such a [00:09:00] common um, kind of timeframe. And sometimes it doesn't even show up until like college or they get out into the working world. I also see adults with A DHD, and so I really have gotten an opportunity to see a lot of different kind of life trajectories. But yeah, elementary school.

[00:09:16] Stephanie: It's very structured. You're always switching between tasks and so you don't have to have sustained attention for very long. It's engaging. It's more fun. You're usually in one classroom all the time, and then middle school and high school, you're transitioning. You've got a locker. You need to know what to bring home.

[00:09:32] Stephanie: You need to know what. Do. There's so much more personal responsibility that's needed and every school's a little bit different in the expectations that they have on, on kids. And the level that they prepare those kids for these advancing grades. And so there might be some variation. But it is not uncommon for me to hear somebody who like is coming and suspecting this for the first time in 10th grade, 11th grade where they managed fine and then now it looks the [00:10:00] responsibilities are different and so their performance is different.

[00:10:03] Courtney: Okay. Yeah, that's helpful to hear, I think especially for parents to know that, kids can cope. And they can develop skills to get by, and there might be a point where it becomes so overwhelming for their executive functioning.

[00:10:17] Stephanie: Exactly, and that's a trajectory that we see more often with girls. Sometimes it's very obvious in elementary school it does stereotypically tend to be a bit more with boys. But again, it's not always. But that is just normally who tends to draw a bit more of a teacher's attention.

[00:10:34] Stephanie: Usually it's a teacher who's bringing concerns to parents or maybe parents are just seeing their kids or. Very unruly at home, right? But those are kind of more of those obvious and extreme examples. And many times you have the opposite, where it's a really lovely child. They are very people pleasing.

[00:10:53] Stephanie: They are favorites of their teachers. They're well-behaved at home. They have some intellectual [00:11:00] abilities to where they're managing the demands. But then once we get to these higher levels of um, skills that are required uh, there starts to be those cracks that are forming. And not every student will bring that forward, right?

[00:11:14] Stephanie: Or maybe they do bring that forward to a parent or a teacher. But they're getting straight A's. So what is the concern? What is there to really look into, right? Oh, you're just being anxious, or, oh, don't worry about it so much or, or you just try harder, right? And then that over time can start to build up and become demoralizing of thinking something is wrong with you or you're not.

[00:11:35] Stephanie: Smart right? Kids really quickly go to that as a, I'm not smart versus it's actually just kind of the way my brain is working. Um, and so, , What we see with girls especially is this stress, this anxiety. Sometimes it's like a really high degree of perfectionism where they're working so hard and they're so conscientious to try to compensate and that's just not sustainable. [00:12:00] Where we're getting, you know, burnout and things like that. And so again, when a parent contacts me and they're describing this presentation in their teenager, again, most often girls, but certainly boys can feel this way too.

[00:12:12] Stephanie: I'm always thinking a DHD is a possibility.

[00:12:16] Courtney: I think you are already transitioning to our second myth, which is perfect. I love the segue. So A DHD is historically associated with. Hyperactive boys who are making fart noises while on the carpet in

[00:12:30] Stephanie: Not the fart noises. Yes

[00:12:33] Courtney: exactly. Leading to an underdiagnosis potentially in girls and women.. I'm curious 'cause I know you've already started to touch on that a little bit. What ways, maybe the symptoms manifest differently that cause them to be missed by parents or teachers and how that, like you said, can maybe lead to misdiagnosis of anxiety or a mood disorder later in life.

[00:12:56] Stephanie: In terms of the differences, it really does look a [00:13:00] lot like what I had just describing, and we don't really have any sort of necessarily. Physiological explanations for these gender differences. Although we do know that the role of hormones and estrogen can kind of impact um, attention and focus.

[00:13:12] Stephanie: So obviously at puberty that things could look different, but more of what we're attributing these gender differences to is the way that we socialize, right? Especially thinking about in a, a binary gender presentation. But, girls really are kind of taught to be, I don't wanna say seen and not heard, but to follow rules, to not rock the boat, to be kind to others.

[00:13:35] Stephanie: It then presents more of a silent. Presentation 'cause they're keeping things to themselves or they're just so enjoyable to be around. Again, it doesn't raise suspicion. And then when boys get to be unruly or maybe they aren't as attentive, cause boys can be missed for this reason too.

[00:13:52] Stephanie: Right. It can be chalked up to, that's just how it goes. Then when we get a little bit older in time. A ton of social comparison [00:14:00] happens. So I work with a lot of students that are in competitive independent schools, and so a lot of people are high achieving. And again, if you're that piece that doesn't fit right, one thing's not like the other, you really start to um, take it as something is wrong with you and develop some of those , internal feelings.

[00:14:18] Stephanie: Boys a little bit more will kind of attribute it to well, that teacher just doesn't like me. Or, you know, I don't like that class anyway. And then there's a little bit more of that clash of oh my gosh, how do I get my teenage boy, you know, going um, whereas teenage girls maybe will suffer in silence a bit more.

[00:14:38] Stephanie: Um, So that can be one difference. Again, you go through adulthood, you're not diagnosed, you are just like stressed out by life. And you're dealing with anxiety and depression and like no one else around you gets why you feel that way, because you're doing so great. Right. Externally. Um, I see that so often with uh, the adult women that I assess for [00:15:00] A DHD as well.

[00:15:01] Courtney: Okay. So some of those perfectionism things like you're saying, we might not be realizing, 'cause the. Are silent that it's such a struggle, and then as they get older, they're may be thinking something is wrong, anxiety, depression, et cetera.

[00:15:17] Stephanie: Yes. May I also jump in and say that another thing that is impacted by executive functioning and that self-regulation is our emotion regulation. So it's not always a suffering in silence. Sometimes it's a very loud expression of emotions. This can go over boys and girls, right?

[00:15:32] Stephanie: It's irritability, it's moodiness, it's, just getting really like panicky and stressed out, right? Or just . Total mood change. And then there's this question from parents of is this a typical teenager thing? Is this just teenager moodiness? Which it could be. But then again, when I'm hearing this really big change in personality and kinda emotional presentation, this is again where I'm thinking about A DHD because the stress has [00:16:00] built and now.

[00:16:01] Stephanie: They're experiencing feelings here, but because they have difficulties regulating how those emotions are dealt with, how they're expressed, they come out really big. But when that happens, there's usually more of this, this push toward well, let's go this therapy route, or let's go the medication route for something psychological, which isn't wrong, but it may be missing Another kind of important contributing.

[00:16:26] Stephanie: Factor to all that emotionality. Um, But you can see where a lot of these roads that we're talking about lead to a lot of mental health, stress and distress for teenagers who aren't diagnosed with A DHD. And the same for adults as well.

[00:16:42] Courtney: Yeah, I'm just really thinking, shout out to all the teenage girls who are navigating hormones and anxiety and A DHD. It's a lot. It's a lot.

[00:16:52] Stephanie: So much. It's so much. Yes. And then layered on with all the other, like social media world stressors. Yeah. So much, So much [00:17:00] that people are having to deal with. And so I tell parents that, when there's this kind of hesitation to think about a DHD or to pursue assessment, it is really a gift that you can do for your children.

[00:17:12] Stephanie: To let them know that they're being seen and you wanna understand them better, and then help them understand themselves better, right? And so then that, when that happens, then you have room to start with , building self-compassion, right? And that understanding and starting to make some changes and accommodating so that you're not experiencing this level of stress.

[00:17:33] Stephanie: Um, So even if it feels kind of like, Ooh, this doesn't feel right, or oh, I don't wanna think about a DHD. The possibility could be there, and it's just the best thing is to be open-minded about it.

[00:17:44] Courtney: Yeah, you bring up a lot of really good points that it can be. Positive, right? It can give more insight to what is going on, especially when you're seeing your child struggle and you want to help them so much and you're doing therapy like you said, and all of these other [00:18:00] things. Getting a big picture of whether or not a DHD is part of the picture can just be so helpful in many different ways.

[00:18:07] Stephanie: Exactly. And I think there's a lot of reliance on teachers and schools to bring concerns to parents. And so, if a student is doing well, that's not gonna really raise concerns and there's not gonna be a lot of urgency on the school and to initiate an evaluation or initiate accommodations or do any of these other things.

[00:18:27] Stephanie: And so, , you know. don't take that as, here's another myth to bus as does not mean not a DHD, right? Both can absolutely co-occur. Um, And so just because everything's copacetic at school again, doesn't preclude the possibility of a diagnosis,

[00:18:46] Courtney: Right, which I think is important to empower parents. They're the ones that are at home that they see, their. Teen daughter or child spending so much time on homework and it being so much and having [00:19:00] these really big emotions, and so parents, can trust that, right? Like they can trust, okay.

[00:19:05] Courtney: Yeah. Teachers are saying that everything is fine at school, but my experience with my child at home is different and that is very valid.

[00:19:14] Stephanie: Very much so. And of course when, when things are taking longer to get done, that interferes with sleep, right? And then the less sleep the kids are getting, the more it exacerbates these symptoms and their psychological function. It, really can spiral not to be fearmongering, but just knowing that these are some possibilities.

[00:19:31] Stephanie: Um, One more point I wanna make about presentations with girls that I think is important is that the hyperactivity piece can look different. There's three different subtypes to a DHD. One is the predominantly inattentive presentation. This is more of that internal, more of that daydreamy focus issues, as well as some of those executive functioning challenges, like getting started with task, being organized, hyperactivity and impulsivity kind of is what it sounds like.

[00:19:57] Stephanie: And I will point out that. [00:20:00] Hyperactivity slash impulsivity. So maybe the hyperactivity isn't there, but the impulsivity is a relevant piece. Um, And then lastly, there's a combined presentation where you can have all of those symptoms. More often girls get diagnosed with that inattentive, A DHD, again, because that's more internal.

[00:20:18] Stephanie: They tend to be more of that daydreamy, whereas boys will get more often diagnosed with that hyperactive, impulsive, or combined. But hyperactivity can show up in girls in just a slightly different way. Big one is chattiness, right? That girl loves to talk. She is a social butterfly. She will go up to anybody.

[00:20:37] Stephanie: She is always getting, you know, corrected for talking in class. Her teacher loves her. She's so smart, but she really needs to just, leave other students alone so they can focus, right? And it's is that a bad thing? No, it's like that's a beautiful quality in a kiddo, but that can be this energy that just needs to come out again in this social manner, which is how girls are [00:21:00] socialized.

[00:21:00] Stephanie: It can also be, the impulsivity can be. Blurting, right? Oh, I've got this thought. I just have to say it right now. Right? I just, I have to raise my hand and I have to make this point. And I had to tell you about what my dog did this weekend, right? It's just like really exciting. That falls under hyperactivity and impulsivity.

[00:21:17] Stephanie: It might not be. Raking the rules or like physically aggressive, but it comes out in that way. I also see girls do a lot more of like doodling or I always get a kick out of going to conferences and people are like, crocheting, right? Or doing like other things where it's yeah, you gotta get that, that um, stimulation out there.

[00:21:39] Stephanie: Um, And so it might just be more. Subtle movement fidgeting is still restlessness. A lot of girls will do like the bouncing the foot or like the bouncing the knee. So just those sorts of signs, even though they're not egregious and maybe not interfering with their life, like they're still part of data collection.

[00:21:57] Courtney: For sure. And impact, [00:22:00] long-term outcomes and trajectory and things. So it is, yeah. I like that you gave those examples, especially the chattiness and how, that is so wonderful and they're so smart and it's so great and also can be a sign of potentially A DHD.

[00:22:15] Stephanie: Totally. Or as younger kids, like they just really liked the active play. Or they were always jumping between activity to activity. Like I always had to keep them busy, right? These sorts of things. Again, subtle, but this is where it's good to have something that's a more of a comprehensive evaluation to be able to listen for these various pieces.

[00:22:37] Courtney: Yeah. Okay. I think that's a good transition to the next myth because. As you're saying that I'm hearing in my mind parents say but I don't want to lose the chattiness and how outgoing they are. Like, I don't wanna lose those things. And it feels like getting a diagnosis of A DHD is filled sometimes with dread and that the child's [00:23:00] life is going to be limited and we don't want them to.

[00:23:02] Courtney: Change or be different. So I am curious how we can reframe this to highlight some of the strengths that, kids and adults with A DHD might have and that it isn't, I guess the myth is it's all dread and finality.

[00:23:19] Stephanie: So now in 2025 is. Probably the best time to be having and di being diagnosed with A DHD. , Because We have a lot more awareness of the diagnosis. We have a lot more treatment options and we have a lot more appreciation for neurodiversity, right? Like we're really starting to recognize.

[00:23:37] Stephanie: Brains are different and they're beautiful, and there's lots of of strengths that come with these different diagnoses. Certainly, unfortunately, our diagnostic criteria is really framed around deficits, right? Which isn't exactly the best way to think about empowering a person. Um, But there are a lot of strengths that come with having a DHD.

[00:23:56] Stephanie: So one of them, again, just so that you see with [00:24:00] with Neurodivergence, is. They're living in a world that is not optimized for their brain and they're persevering, right? And it builds a lot of resilience. It can build a lot of grit. Um, They can be flexible and adaptable for those reasons. Um,, Relatedly people with a DHD can be amazing, creative.

[00:24:19] Stephanie: Problem solvers, right? The ability to notice things that other people may not pick up on or just, in, in terms of this question about can they focus what's,, you know, they overfocus sometimes that hyper focus like lets them see things from a different lens, right? And lets them zero in on things that are really interesting to them.

[00:24:38] Stephanie: And who doesn't want an employee that can spend six hours engaged in something that's like really exciting, right? Um, That's an asset. Sometimes it's not, but it can be an asset, right? The energy enthusiasm that they bring to the jobs when they're in a job that's a good fit. So one thing that I have just seen anecdotally in terms of the success trajectory [00:25:00] for people with A DHD is really the goodness of fit.

[00:25:04] Stephanie: With the path that they take. Most often it's, a professional path, but making sure they're in a job that really aligns with the way that their brain works really highlights their strengths and is rewarding and stimulating that is the best thing for helping to get people out of bed and continue to keep them motivated and continue to succeed at their job as if it's something that.

[00:25:25] Stephanie: They're passionate about. Sometimes I'll see teenagers and college students who wanna go into finance or law or medicine because their parent did it. But if that's not their passion and that that's not what um, is a good fit for them. It's best and more successful for them to go in something that's gonna work for them.

[00:25:45] Stephanie: Maybe they try out a few things before they find the thing. But that's okay because it's really important that they find the thing. There's a couple of professions that I, as. See more often with people with A DHD given [00:26:00] some of those social strengths that we talked about, some people with A DHD can just be the funniest, most entertaining, most enjoyable people to interact with.

[00:26:09] Stephanie: So they do great with sales, right? They do with a great, with things that are like um, public relations, marketing things that are like relationally based careers. But then also given the creative nature that they have. Things like the arts, music. I've worked with some folks who are in like video production, more of media.

[00:26:28] Stephanie: And surprising to me, I find a lot of people that fall into like IT and finance and I'm thinking, whoa, that's a lot of details to keep track of. And whoa, the stakes are really high to not make little mistakes and they just, they love it and they can just get into it and just. Flow. Um, So again, it might not be the career that you expect, but more likely than not, they're gonna find something that's gonna be their jam and that's what's most important.

[00:26:56] Courtney: I love that. I think everyone should operate that way. [00:27:00] Finding what's your jam. Yeah. But it makes so much sense that using all. All of those positive things, the creativity, the problem solving, the ability to hyperfocus on things that you're interested in can actually make for a really successful and rewarding career.

[00:27:16] Courtney: And I can see how when we're trying to fit ourselves in a box, where we think we should do something or think we need to do something, that that also can be challenging to have to do that.

[00:27:29] Stephanie: Absolutely right. This is universal advice, but even more. More true for A DHD and I mean, truly it's been such a pleasure for me over the years to work with adults and just hear their life stories, I mean, every job you can imagine, I've met an adult or assessed an adult with A DHD um, in those, those positions.

[00:27:47] Stephanie: The other thing too that I, wanna mention is the relationship between A DHD and iq. Because even though perhaps a child or a younger person may collapse the challenges they have with [00:28:00] A DHD as being, not intelligent, that's actually not true. There're completely distinct, right?

[00:28:05] Stephanie: There are some cognitive abilities that can be impacted by A DHD, but not everybody with A DHD has the same , profile. Right. So some things that may be weaknesses for one person with A DHD may be strengths for another. And so we can't just make blanket statements. But actually what we have found, a lot of people with A DHD are gifted.

[00:28:25] Stephanie: And so this falls into a category of something that is called twice exceptionality, or two e sometimes it's a two and a little e, and sometimes it's a two with a big E. Are you a little e or a big E person?

[00:28:36] Courtney: I feel like I see little E, but Big E looks better 'cause the two in the E then are the same size. That probably says something about me, but yes, I could. I like the big E, but I've seen little E probably more.

[00:28:48] Stephanie: There you go. Yeah, the little e more often. So if you see that out and about, two E stands for twice exceptional. And it just means that there's two really unique aspects to the way your brain works. You [00:29:00] are very smart, or there's some things that are just very advanced about the way your brain works.

[00:29:04] Stephanie: And then there's other things that have this other kind of. Interesting. , You know, Set of regulatory skills, executive functioning strengths and weaknesses that come with A DHD. And so again, it's important not to collapse A DHD with this means my child isn't smart. This means my child can't succeed academically.

[00:29:24] Stephanie: This means my child will live on my couch forever. Right? This is not what this means. Um, What does change A trajectory is how we respond to the possibility of a DHD.

[00:29:35] Courtney: So on that note, someone's listening and they're like, oh all of these things are ringing true either for myself or for my child. And you're bringing up IQ and all of these other things. So, I know you do a lot of, you know, very comprehensive evaluations. Can you talk about why that's important?

[00:29:52] Courtney: Why getting an evaluation is helpful?

[00:29:55] Stephanie: Yeah, there's a few different directions that parents can go in. I'll start kind of like as a [00:30:00] kid. Perspective first. Um, There's a lot of directions parents can go in. Very often people will go to their pediatrician um, and ask about a DHD and pediatricians will use um,, some rating scales that are called the Vanderbilt.

[00:30:14] Stephanie: , They're not great uh, because they're based off of the diagnostic criteria that we've put together based off of research about. Boys with a DHD. So I am, I'm not sure I've ever seen a girl come up positive from an evaluation with a pediatrician, now that I think about it. So there's opportunities for things to get missed, right?

[00:30:33] Stephanie: We've talked at length about the hidden nature sometimes of A DHD in girls, so that's a possibility, but not necessarily. The best. There's also school evaluations and parents should know that schools cannot diagnose, so they're not necessarily gonna come back with some diagnostic clarity. And schools also can only look at the school environment.

[00:30:54] Stephanie: So how has their learning impacted and what can we do to change or um, [00:31:00] give some special services for that. But as parents, you probably wanna know. What do I do to support them at home? Are there like therapies? Are there medications? What do we do about that? And a school evaluation just can't touch that piece.

[00:31:12] Stephanie: Um, So by having a more comprehensive evaluation with a private evaluator, like a psychologist, we're able to recognize the nuance and the different presentations of A DHD. A DHD very often co-occur with other conditions like anxiety and depression or autism or a learning disability like dyslexia. Um, So it's really important to have an understanding of the full scope of what um, that child is experiencing so it can make really um, effective and accurate uh, intervention recommendations.

[00:31:44] Stephanie: And again, when you have somebody who doesn't have that like slam dunk presentation, so much better to get more, a more complete picture. Especially that focuses more on executive functioning as a whole. Um. The benefit of being diagnosed, I think we've [00:32:00] kind of touched on, is there's a lot of risk to not being diagnosed, right?

[00:32:04] Stephanie: Maybe you're not getting the supports that you really need in school. Maybe you're not getting the private supports you really need. Maybe you're not understanding yourself accurately, you're not understanding your child accurately, and that gives lots of opportunities for. School failures to occur, unnecessary stress to occur, parent child conflict to occur.

[00:32:23] Stephanie: Parents are like, why can't you get this together? And the kid's like, I just can't. Right? There's a lot of conflict that can come with that that maybe could be avoided. And then just as we've talked about things that just could gen then build upon themselves, so it's really valuable when there's a suspicion to add a minimum.

[00:32:40] Stephanie: Just call a psychologist, just talk with someone and say, I'm noticing these things. Am I being, paranoid? Am I just being like too, too you know, worried about this? Or is there actually something to look at? And a good evaluator waiter will be able to walk you through, wow, that really does sound like something, and here's what testing could look like.

[00:32:59] Stephanie: [00:33:00] Or, oh, maybe that actually sounds like anxiety. Instead, maybe we need to look at that. Right. Just to really be able to give you that good guidance.

[00:33:07] Courtney: Right, And I mean, based on everything that we've been talking about, you're exactly right because there's so much overlap between so many things, and a teenage girl might be experiencing a lot of anxiety, you know, and all sorts of things going on. When a psychologist can look at all of those areas and give the comprehensive picture and conceptualization that can then lead to help, right?

[00:33:30] Courtney: And like what supports, you know, kids need, which ultimately, you know, is what a lot of parents wanna do, is be able to help their kids. So getting this full, complete picture allows us to, have the best idea of what's going on at that time so we don't miss something.

[00:33:45] Stephanie: Exactly and having worked with a lot of adults with A DHD, I have this past year have seen people in their sixties for the first time that are like, this has been missed this whole time and they've just been managing and they're exploring this. But I would say in at [00:34:00] least, I don't know, 60% of the evaluations that I do with adults who are getting identified for the first time with A DHD, they cry because it's validating to hear that all the things that they've encountered and they've struggled with are essentially outside of their control, right? Their brain is just the brain that they're born with and that they can start then to feel compassionate toward themselves. But there's also a kind of a grieving process of oh my gosh.

[00:34:27] Stephanie: Could my life have looked different if my parents had just taken me for an evaluation or if they had been open? Right? I hear a lot of times people will say, you know, mental health wasn't something that we openly talked about in our family, or, you know, you just were expected to pull up by the bootstraps and do fine.

[00:34:44] Stephanie: But there can really be this grieving of could I have saved myself some of these years of, of challenges, right? If I had been identified um, you can't go back in time. , Which is why I just really applaud and respect the adults that are pursuing this it's never too late, is what I want [00:35:00] people to know.

[00:35:00] Stephanie: It's so important.

[00:35:02] Courtney: Well, Even that self-compassion I think for parents is so helpful. Right. When they're evaluating, you know, getting evaluation for their teenager and feeling so much grief, thinking back on helping with homework in elementary school and feeling like things could have been different. Having some compassion for themselves too, that, everyone's doing the best that we can and it's hard

[00:35:25] Stephanie: A hundred percent. And I definitely will tell parents that as well. Like, It's never too late. Would it have been better earlier, realistically, in some situations, definitely. But, you know, you're, you're showing up for your kid and yeah. I mean, We are all out there doing our best.

[00:35:41] Stephanie: And it's not an easy time to have kids, to have teenagers to navigate around screens, to navigate around social media. There's so many, expert recommendations out there. And what I always tell families, I will give pages of recommendations for strategies they can try or [00:36:00] resources or interventions.

[00:36:01] Stephanie: But, and I, but I feel like that's probably overwhelming. I just like to be really helpful. Um, But what I tell people is don't feel like you have to take this all in at one time. You don't have to try every strategy at one time. You might find some things don't work for your family, that like maybe research suggests should right.

[00:36:19] Stephanie: You family is unique and you'll know what works for you all. And so I really encourage people to be their own, advocate, right. be their own kind of leader in terms of what's gonna work and what to try. But more than anything, you're gonna do best with more information and more guidance.

[00:36:36] Courtney: Right. Right. So on that note, with all of these myths that we just busted and talking about getting an evaluation, what is one takeaway message that you really want parents to be able to hear?

[00:36:50] Stephanie: Everything that you think you know about A DHD is probably misleading. And it's just,, it's a much more expansive and [00:37:00] complex diagnosis. And some kids with a DHD, they manage their whole life just fine. Um, And other kids are different and we just can't make that prediction. With nothing to go off of. And so the best thing that you can do is can be open to the possibility, explore it as a possibility, and then implement the recommendations if there is a DHD whether that's accommodations, whether that's therapies, whether that's strategies just the open-mindedness I think is what's just so important that I wanna communicate today.

[00:37:34] Courtney: Yes. Thank you so much for your time. This has been wonderful. I'm so glad that we got to talk about all of these myths and really appreciate your expertise and knowledge in this area.

[00:37:45] Stephanie: Thank you. It's my favorite topic. Again, I am so honored to be able to chat about it and I hope I provided some clarity if more questions arise. I love consulting and chatting with families please find me and I'm [00:38:00] happy to chat.

[00:38:01] Courtney: Yes, all of your information will be linked in our show notes, so families will definitely be able to get in contact with you.

[00:38:08] Stephanie: Sounds great. Thank you for having me.

[00:38:10] Courtney: Thank you.

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