We delve into Attention Deficit Hyperactivity Disorder or ‘ADHD’. This episode explores diagnosis, practical strategies for managing symptoms, and creating supportive environments for children with ADHD. We'll discuss different types of ADHD, the importance of realistic expectations, and setting achievable goals. Whether you're a parent, educator, or simply curious about ADHD, this episode offers valuable insights and actionable tips. Tune in and join the conversation!

Contact Andrew:

https://being-comfortably-uncomfortable.captivate.fm/bcu

Acknowledgements:

This podcast is produced by CommTogether - podcasts done for you!

Anthony Perl: In this episode, Andrew Greenfield looks at the subject of ADHD, how you gain a diagnosis, and what that actually means. It's an important one for parents, so stay tuned. I'm Anthony Perl, and you're listening to the Being Comfortably Uncomfortable podcast.

Andrew, I wanted to ask you about ADHD and ADD, right? Two particular, um, things that we hear a lot about. Explain to me what difference is because I know parents hear that terminology around, but I don't think they really understand it all that well and get the differences between the two. Yeah. And

Andrew Greenfield: again, um, often we're talking about ADHD and a versus ADD in the, we talked about the DSM five that I talked about not that long ago when you talk about specific learning disorder and you have to fulfill certain criteria to meet the disorder.

It's the same with ADHD. Now officially it's called attention deficit hyperactivity disorder, ADHD. That's what it's called. But with ADHD you can have three different subtype. So there's purely the inattentive type. Where you can't pay attention and focus and it's not necessarily that obvious. You can have the purely hyperactive impulsive type where you have difficulty physically sitting still.

You're very impulsive with your thoughts and your actions, which is obviously more obvious. looking at the child. Um, and you can have a combined type. So more often than not, when people talk about ADD, they're more often talking about without the hyperactivity, but officially the terminology is ADHD. That can be with or without the hyperactivity, or it can be combined inattentiveness and the hyperactive, the hyperactive impulsivity, or just the hyperactive impulsivity on its own.

So it's those three separate subtypes, but, um, there is no difference necessarily officially between ADHD and ADD besides, depends what you're talking about, depends which subtypes you're talking about. And I think that's, um, that's the distinction. So, you know, it's generally known as ADD and that's it.

That's the official term is ADHD with, and which subtypes.

Anthony Perl: I'm, I'm interested in your professional opinion on this because I hear, you know, ADHD thrown around a lot, almost in a self diagnostic fashion, people said, Oh, yes, that's what, that's the reason why, I mean, how difficult is it actually to properly diagnose and, you know, and, and how useful is it, I suppose, the second part of the question with people doing that kind of self diagnosis.

Andrew Greenfield: Yeah. And, um, you know, it's like doing an IQ test. You go on online and you do what's called an IQ test. Well, an an actual formal IQ test, for example, has to be one-on-one. It has this, you know, it has to be, um, the, the examiner has to get certain key measures. Same with A DHD. You can fulfill a a, a checklist online, and it might come up with some sort of criteria for A DHD, but is that the official diagnostic criteria according to the actual DSM five, which is the.

the holy grail of criteria. No, most likely not. So we've got to make sure that anyone make talking about or thinking about the diagnosis. It has to be done properly by the most by the appropriate people, whether it's a child psychologist, whether it's a pediatrician, whether it's a psychiatrist, they're the ones that were trained in the actual diagnostic criteria.

So I think we can all and you have to meet six out of the nine criteria for it to be significant. There is certain age limits that you have to go by. Um, you have to have had symptoms by a certain age with these with ADHD. Um, it has to be persistent. It has to be consistent in lots of different environments.

So it's, you know, there are strict criteria that have to be met in order to come up with an actual diagnosis. But at the moment it is symptom based. It is symptom based and it is subjective based on, you know, writing questionnaires that we get parents and teachers to fill out for I guess up to 18 and then at once you're an adult, it becomes there is self, um, rating questionnaires that somebody fills out as well.

So, and obviously we look at the background and the history and more often than not, we'll do a psychometric assessment that will help gather a whole lot of information. So it's a combination of all of those factors. Um, there are a whole lot of other measures that people use. Sometimes. People use what's called the continuous performance task, which is a little test on the computer and you've got to press a button every time you see a certain number or something comes up, um, that can be useful.

In some respects, there's a whole lot of other range of assessment tools that some people use. There is no one ADHD test. You can't do a blood test. You can't do a brain scan necessarily. Um, there are certain markers of, uh, of, uh, you know, of the neuros. There are certain neuro, neurobiological markers that can be used, but unfortunately not going to routinely do a CT scan on any, um, on any one particular person because it's just not.

It's not going to happen. It's not, it's not viable. So, um, it's not reasonable to do that. So we have to use, it is subjective to some degree, but there are certain criteria that have to be met. And it's a combination of factors that people should look at, not just yes or no, or not just a tick box. And that's it.

Anthony Perl: So I suppose the next part of the equation is then, okay, you've got an official assessment. What, what does it actually mean, um, you know, for, for you as a, as a parent and indeed for the child?

Andrew Greenfield: Yeah. So once, once someone has a diagnosis, um, uh, through whichever measure, um, they had, there are a few different ways of moving forward.

Um, one way is to go and say developmental pediatrician. Or a specialist developmental pediatrician or psychiatrist. And I guess what they do, what we don't do, is they deal with the medical side of things. And they may do blood tests that look at iron levels, or they may talk about medications, if that's appropriate, stimulant medications.

Um, that's what psychologists don't deal with. We don't deal with medications. So that's one possibility. Um, obviously, the other thing that can be done, and more often than done, is behavioural strategies and techniques. And I would be working with the parents and the child in combination of together and separately as to what they can do and what are some specific strategies that they could work on as well.

And it's about

Anthony Perl: which brings me to the into. It brings me into that whole idea of what you were talking about it, you know, the reason for the name of the show being be uncomfortably comfortable. I mean, I suppose that's the question is what does it mean for the child when they're when they're diagnosed with, with ADHD, how much does the diagnosis help them in knowing and and how do they cope with how they're feeling?

Andrew Greenfield: Yeah, so ADHD is a, is a deficit. ADHD is a deficit of a drug in the brain. And Um, it's not necessarily a child's fault. Um, they haven't caused anything, they haven't anything. So more often than not, they will take maybe stimulant medication, which increases the production of the drug in the brain to the normal levels.

So that's one part the medication can play, but at the same time, they have to be able to come up with strategies to be able to help them focus and concentrate and organise themselves. And more often than not, when they are disorganised or they can't focus, they feel a bit uncomfortable. And that's part of it.

Even ADHD is associated with being a bit, you have to learn to be a little bit uncomfortable. Cause that's just part of our personality. That's just part of who we are. So even with ADHD, that's really important to learn to be okay. It's not a criticism. It's not a negative. And a lot of the times we actually talk about ADHD as being a superpower.

Being a little bit impulsive can, it's not a bad thing. It just means that as long as you're taking healthy risks and not stupid risks, that can be a positive. Often more people, people with ADHD are often more creative. And they're more likely to be able to take, um, to be able to think outside the box. So, it can be a superpower.

And I think it's important to be able to teach kids to be able to look at it as if it can be a superpower. It can be a positive. We don't want it to be used as an excuse as to why you can't do things. Because you, it's important to get kids to be able to take control over what they can control. Um, and yes, if you have difficulty in a certain area with maybe organisational skills or focus and concentration, there are, you know, there are things that you can do to be able to help you help with that.

And, you know, once we're an adult, we can get somebody else to organise ourselves to organise our diary, or we can hire someone to do that. Um, so there, you know, we don't always have to be the best at all, be the best at doing all of that. Um, it's important to be able to learn to live with who you are and what you're, what you've got and you know, but you can improve on certain areas as well and that's part of why we do that original psychometric assessment to find out if there is an area that needs improving.

And there are things that can be done to be able to improve on key areas.

Anthony Perl: I love what you said about treating it as a superpower. Um, because it, it, these sorts of things, you know, whatever it is that who you are as a personality should be taken, um, advantage of. And I know, you know, In a business sense, you know, and most business people out there will be very familiar with a whole series of different, uh, personality type tests that can be done these days and how you should be mixing this person, that person.

And I think being self aware, uh, of where you are from a, from a child, from a child onwards, um, can be something you can really use to, to heighten your career, to heighten what you. What you can do and what you love doing.

Andrew Greenfield: Yeah, absolutely. We've got to be out there. Everyone's got different strengths and weaknesses and different learning styles, and we don't have to be any particular one style.

Um, and it's important to be able to embrace what you, what you do have. Um, as I said, the area, you know, you can have different deficits in certain areas and we can work on that and, and, and that's great. Um, but we've got to embrace what it is that we can do as well and, and, and, and, and, and use that as best as we can.

Yeah. And

I

Anthony Perl: think that's an important point as well. It is about setting those expectations. And I think that is that part of the strategy that you would work together with a parent and with the child on how do I, actually make sure that we're taking advantage of, um, you know, of what the superpower is, but also not limiting being

Andrew Greenfield: limited by that.

Yeah, absolutely. I think we've got to be sensible in terms of that. And we'd, we may have limitations in terms of what we can do. And we need to acknowledge that and say, well, if we can't sit down and focus, got very difficulty focusing. for long periods of time. Well, let's not focus for long periods of time and maybe sit down, work for 20 minutes, get up, have a break for five minutes, work for another 20 minutes.

So there are certain organisational strategies that we can use. Um, if, if, if that's the way that we learn, some people might be able to sit down for half an hour and that's great. Um, so we've got to be able to try and brainstorm with parents and their child and figure out the way that they learn the best based on all the information that we have.

And a lot of that information may come from a psychometric assessment. It may come from a specific diagnosis. It may just come by saying a child prefers to work a certain way and that's okay as well. So we've got to, anytime I'm looking at any, any profile, cognitive profile or psychometric assessment, I've got to take all of that information to account, not just focus on one bit and another bit.

Um, and even is, is yes, you can improve the areas that need to be able to be improved. And there's a whole lot of different strategies, um, that can be used. But at the same time, I often say within a school environment, They're not necessarily going to wait until you improve that area of weakness because that might take a few months.

It might take, it's a process that takes time. So what they need to be able to do is also focus on, well, be realistic and say, well, except that's the way that it is, and not necessarily get a child to rely on, on their poor working memory, for example, or on their processing speed and learn to accept it and have strategies to help them around that.

And I think eventually when

I was gonna say eventually when they're when they're in year 11 year 12, you can have special provisions, in some cases where you can have extra time or. You can have a reader or a writer, depending on what your strengths and weaknesses are, it's not that easy to get these days, but we're trying to basically get every child to perform to the best of their ability, uh, and make it as fair and reasonable as possible.

Anthony Perl: I think, uh, what you've summed up there as well as how important it is going back to the beginning of this little discussion is that, Uh, getting a proper diagnosis and developing those strategies is super critical. It's not something to be afraid of. It is something that, uh, there's a process and there's a real advantage in following

Andrew Greenfield: that.

Yeah, absolutely. Absolutely. And it often, uh, ADHD, for example. There's often there are comorbid factors, so there are often other factors that go that go along with something, someone has ADHD, they might have a ADHD and they have a learning difficulty, they might have a language difficulty, um, they might have issues with anxiety.

So often it's, it's, it's not just the one factor, it can be complicated where a child has difficulties in a whole range of different areas, and then we have to try and make sure that we're accommodating for all of those factors as well. So. It can be quite complex, and it's not just a yes, no answer that we're coming up with.

Um, but at the same time, it is, as in coming up with a specific diagnosis, there are certain criteria that have to be followed, and there's a process that has to be followed, um, as well. And that's really important to make sure that it's done appropriately, properly by the appropriate professional as well.

Anthony Perl: Thanks for your company, and please see the show notes for how to get in contact with Andrew Greenfield, and don't forget to subscribe for future episodes.

Andrew Greenfield: And remember, it's important to learn how to be comfortably uncomfortable some of the time.