Deborah Howell (Host): The landscape of ADHD can be quite complex and require strategies, just ask any family dealing with this challenge. Welcome. I'm Deborah Howell. And today, we'll offer up some tips on how families can create a supportive environment for children with ADHD and help them channel their energy in different ways.

Our guest is Dr. Leslie Young, a board-certified pediatrician who's been at Memorial Care Medical Group Lakewood since February of 2024. Hello, Dr. Young. So glad you're with us today.

Dr. Leslie Young: Thank you, Deborah. I'm glad you joined the discussion.

Host: Yes. Now, can you please explain to us what ADHD is and how it manifests in children?

Dr. Leslie Young: So, ADHD, interestingly, it's an acronym. It stands for attention deficit hyperactivity disorder. And this acronym doesn't really correctly describe what essentially ADHD is. More so, ADHD is not about a deficit in attention. ADHD is more about a lack of control or reduced control over attention, impulses, and emotions.

Host: Okay. That makes perfect sense. Now, some well-known symptoms in kids with ADHD include constant fidgeting and inability to sit still. Are there any other symptoms parents should look for?

Dr. Leslie Young: Yes. Some of the prominent signs are not directly addressed by the acronym. So for example, a lot of times parents or teachers will notice that there is very inconsistent children's performance, whether academically or involving self-controlled behavior. Some days they're very much in control, other days they seem to fall apart and things are very challenging. Another thing that sometimes parents have noticed that it may be easy for children with ADHD to make friends. But a lot of times, it's hard for children to maintain that friendship.

Host: I see. Because they're inconsistent in their behavior?

Dr. Leslie Young: Inconsistent. Also, sometimes they're overly exuberant when they're interacting with their friends, so their friends can feel overwhelmed by their excitement and exuberance.

Host: That's just too, too much. Okay. Do you see behaviors that stem from ADHD prominent in younger kids or older kids?

Dr. Leslie Young: ADHD tends to affect children differently depending on their age and setting. I would say in younger children, it tends to affect them in the social setting more because academics is not as rigorous yet. And in older children, it tends to affect their academics, because that's the main focus of their school lives and what's expected of them.

Host: Yeah. And by younger and older, can you give us an age range?

Dr. Leslie Young: Oh, I would say age six or so. Under age six, it can be more of a behavioral issue. Over age of six, when academics has become the focus of their school life, then it becomes an issue with their academic performance.

Host: And are there different types of ADHD? And if so, how do they differ?

Dr. Leslie Young: Yes. So, officially, ADHD is described as three different types. In the past, prior to 1994, there was a term called ADD and ADHD, but now everything falls under the ADHD category. But the ADHD is dividing through three different subtypes. The first type is called ADHD predominantly inattentive type. The second type is called ADHD predominantly hyperactive-impulsive type. The third type is called ADHD combined type. And the distinction between these three types is rather kind of arbitrary. Based on words that you're hearing, the description is that if the symptoms is primarily affecting a child predominantly involving their control of attention, then it fits into the first category. But if it's primarily involving their reduced control of their impulses, then they tend to fall in the second category. Of course, the combined type involves it affecting in both settings, but the distinction is not very strict. It can be fluid depending on sometimes a child can be diagnosed as the hyperactive-impulsive type when they're younger, and then they tend to fall into the inattentive type when they get older.

Host: I see. And what do you say when parents say, yeah, people say, don't worry, you know, they'll grow out of it?

Dr. Leslie Young: Well, I would say every parent is their child's expert because they spend more time with I would be cautious to listen to advice from anyone else. If they know that their child is suffering and things are a lot more difficult because of their symptoms, they should really seek out intervention to help their children instead of listening to other people.

Host: And when you say intervention, are you talking medical intervention, social intervention?

Dr. Leslie Young: First of all, I would solicit if the teacher hasn't put in their feedback regarding how their children's performing in the school setting, they should ask the teacher how that's affecting their children in that setting. Secondly, once they have all the input from different people, then they should approach a medical professional who is experienced at helping and treating and diagnosing children with ADHD.

Host: Got it. Dr. Young, what are some of the biggest challenges children with ADHD face day to day?

Dr. Leslie Young: I would say just managing their own frustration. I think a lot of times people tend to forget that children, they're not in control of their attention and their impulses. It makes things harder for other people around them, but most of all, it makes their own life very difficult. So, dealing with their own disappointment.

And over a long period of time, anxiety could become a significant issue because if these children can't even predict how they're going to perform throughout the day, they feel the sense of lack of control makes them very anxious. So, anxiety could be a very prominent symptom. And also, it can affect their self-esteem and confidence. Of course, if they're not confident in doing something, they can be afraid to even try. And that's when it comes to the biggest barrier.

Host: Now, for parents and families just starting to learn about ADHD, what advice would you give them to help manage this journey?

Dr. Leslie Young: I would really understand the very essence of ADHD and try to put themselves in their children's shoes, because I've seen a lot of caregivers who tend to kind of put the fault on the children in saying they're not necessarily living up to their potential, they're lazy, they're not trying hard enough, or they're not taking things seriously. But I would say that children, just like adults, we never intend to do poorly on something. We never intend to not put their best foot forward. So, the parents should put themselves in their children's shoes. They understand that their children are trying hard, and a lot of times it still comes up short. And that sympathy will send a message to the children that, "Oh, this, person understands what I'm going through," and then they can trust and rely on these caregivers and parents and teachers to help them.

Host: Patience and empathy. We've been talking mostly about the school environment, but how can parents create a more ADHD-friendly environment at home?

Dr. Leslie Young: So, a significant part of ADHD is the lack of control. So, providing a schedule and a structure at home is very important. It may seem incongruent because if the child is already disorganized, it seems more difficult to fit them into a schedule, more rigid structure. But usually, children with ADHD tend to thrive on structure. So, I would say even on non-school days, try to have a schedule, you know, wake up the same time every day, eating breakfast and have certain play time, some downtime and then time for studying and work on academics. That's very important. Lists can be very helpful too. And these lists, you can put them on the refrigerator with dry erase marker, and the child should take an important role in checking things off on the list and managing the list themselves.

Host: That's a great idea. All right. Now, let's talk about some effective strategies or tools that parents can use to help their child stay organized and focused, especially after summer's over and kids head back to school.

Dr. Leslie Young: I would even say during the summer, it may be a good time to start, because there are many tools that parents can use. As I already mentioned, lists and schedules and folders, and you can try out different ways, because maybe one way would not work perfectly for your child in the beginning. And the perfect time to kind of experiment with different kinds of approaches is during the summer, and it's important that you establish a schedule during the summer so that they can ease into the school year quickly. It's very important during the school year. A lot of times, children will fall into a different schedule over the weekend versus the weekdays. And this can wreak havoc on their sleep schedule and their ability to wake up and get ready for school. So, I would say work with lists, schedules, and get buy-ins from the children, and experiment during the summer before school starts.

Host: That's a great idea. Now, we touched on this earlier, but how does ADHD affect children socially? And what can be done to help them build stronger relationships?

Dr. Leslie Young: As we all say, practice makes perfect, well, at least makes it better. So, I would put children in different settings that they get to interact with other kids. But when they do so, supervise them from the periphery. So if they become overly exuberant when playing with other children, the parents can step in and say, " Why don't we take a break right now? Why don't we give them a little space?" Do so not in such an intrusive way, but then you can gradually guide their behavior so they can learn from the proper interaction with other children and peers.

Host: I suppose just living with it for all these years and just knowing what makes that child tick can certainly guide you toward the best way to alleviate any situation. So, what role do diet and exercise play in managing ADHD symptoms?

Dr. Leslie Young: I think there's a very common belief that sugar can ramp up ADHD symptoms. Surprisingly, all the scientific studies point that it does not. It doesn't do so otherwise. Not that I recommend a very sugary diet, because children should eat healthy for other reasons too for their overall health. But increased sugar amount of intake doesn't necessarily increase ADHD symptoms. However, exercise plays a very important role in managing ADHD symptoms. Regular aerobic exercise plays a very important part in managing ADHD, and it's been clinically demonstrated that it is a very important factor. Also, it can really help boost a child's confidence, because a lot of people with ADHD are very gifted athletes. So, they can allow that area of their life to set the foundation and build up their confidence, because so many other aspects are more difficult for them.

Host: That's easy to understand, because that's one part of life that is very different from others and you have your whole being involved in it. So, what successful interventions have you seen work in helping a child with ADHD?

Dr. Leslie Young: From several perspectives, at the school setting, I usually will communicate in writing with the school about conveying the message that the student has been diagnosed with ADHD, and there's certain accommodations that makes academic plans and homework more flexible. So, for example, they can turn in their work late by a few days, and they can still get full credit, or they can take the test in a quieter setting, or they may have extended test-taking time.

Another way to help children with ADHD is, of course, most people are aware that medicine plays an important role. And I have seen drastic differences when a child starts on medication. But that's a long discussion, and it's a very personal choice whether some families want to consider using medicine in helping their children.

Host: Can you maybe give us just one example of a child that you've had in your practice whose life was changed for the better through the use of medication?

Dr. Leslie Young: I remember there was a 14-year-old girl who came to see me for ADHD. And after an extensive interview, I found that it was interesting because she was getting A's and B's, and she was captain of the tennis team. And I thought, "Wait, everything seems fine." So, why is there a problem? And I realized that she has two sisters, and they're both on the varsity team, I think for tennis and volleyball, and they're getting straight A's. But my patient, she was only sleeping about two to three hours a night, because it would take her so many hours to complete her homework. So, she's able to perform nearly as well as her sister, but with great sacrifice of her sleep, and she put in so much effort. And when we decided to do a trial of medication, that transformed her life. Because suddenly, she's able to finish her work in less than half the time compared to before. And her grades even shot up too, she was getting straight A's. And she was making more friends. She had more free time. She's just a lot happier. And I think she got into Stanford and she's a student there right now.

Host: That is fantastic. Thank you so much for sharing that example. Where can parents who need assistance go to schedule an appointment for their child, Dr. Young?

Dr. Leslie Young: I've been with Memorial Care. And you can find doctors like me and including myself, you can go to memorialcare.org/mcmg and click on the find a provider button near the top to schedule an appointment.

Host: Well, thank you so much, Dr. Young, for your time and your expertise today. I learned a lot, and we really enjoyed having you on the podcast.

Dr. Leslie Young: Thank you for providing this opportunity to carry on this discussion with everyone.

Host: Thank you again. For more info or to listen to a podcast of this show, please visit memorialcare.org. That's all for this time. I'm Deborah Howell. Have yourself a terrific day.