In the article “Your Child’s ADHD is and Iceberg,” author Penny Williams compares Attention Deficit Hyperactivity Disorder (ADHD) to an iceberg. In detail, an iceberg has many layers that are not visible to the human eye. Correspondingly, just like an iceberg, one that has ADHD do not have visible symptoms that are easily recognizable. Symptoms such as inattention, impulsivity, and hyperactivity are very important to take notice of. Williams notes that “these traits are too often mistaken for character flaws, personality defects, or moral or ethical deficits. They’re not any of those things.” In this case, it is necessary for parents to pay close attention to their child and be consciously aware of their symptoms. 

Within each layer of ADHD there are the following:

1. Poor Self-Esteem and Self-Confidence Kids who struggle with ADHD may experience poor self-esteem. It is the parent’s job to help their child regain their self-confidence by creating opportunities such as calm environments and activities where your child can excel in.

2. Developmental Delays Williams states that “children with ADHD develop 2-3 years more slowly than their peers.” This can impact their maturity, social skills, executive functioning, emotional dysregulation, and self-regulation. 

3. Inflexibility It is seen that kids with ADHD may be more stubborn than willing. Inflexibility prevents children from being able to manage their emotions: they do not have the skills to notice that their emotions can be changed rather than one way. 

4. Intensity When children's emotional awareness, self-regulation, frustration tolerance increase, it can lead to hypersensitivity that can make them have extreme emotions. When this happens, instead of trying to resolve this intensity and get to the bottom of it, ask your child, “How can I help you?” This will help your child understand that you are there for them and are trying to help them.

5. Emotional Dysregulation Children with ADHD may have a hard time regulating their emotions that’s appropriate for given situation and/or their age. They may have a difficult time with expressing and regulating their emotions at home, to the family, at school, and in social interactions with peers.

6. Co-Existing Conditions According to Penny Williams, “it’s estimated that 50 to 60 percent of individuals with ADHD also have one or more coexisting conditions.” These conditions include mood disorders, anxiety, autism, learning disabilities, functioning deficits, and more. As a parent, it is important to keep and eye out for signs of distress in order to fully understand and help your child effectively. 

7. Skill Deficits Skill deficits are very common for those who have ADHD. Because ADHD is a developmental disorder, kids with ADHD may not have fully developed skills on how to manage and regulate their time, frustrations, plans, emotions, problems, etc. However, these skills can be taught improved over time with a little bit of practice and help from the parents.

8. Executive Functioning Deficits Executive functioning skills such as learning how to manage one’s day, organizing, starting tasks, regulating one’s emotions, and managing one’s time may fall apart if one exhibits executive functioning deficits. As a parent it is dire to identify your child’s level of executive functioning and continue to be flexible when it comes to adapting for areas of weakness in the classroom and at home.

9. Time Blindness People with ADHD may have trouble with the concept of time. For example, 30 min. may feel like forever or just a quick second. People with ADHD may not have an innate sense of what it feels like. William notes that you can tell a child that ”you have until the end of class,” or, “You have one hour,” but that will mean virtually nothing to someone with time blindness. 

10. Meltdowns In order to get what they want, children may throw temper tantrums to get their parents attention. Generally, to get what they want, children may have a meltdown or a tantrum. However, a meltdown is different than a tantrum. In detail, during a meltdown your child is no longer in control of what they are saying or doing. Similarly, a meltdown can be triggered by a tantrum, which usually comes first, along with sensory overload, feeling misunderstood nor heard. During this time your child can not go through their actions and rationalize what they have done. At this time, it is important for you as parents to not give in to what they originally wanted: why they through the temper tantrum and had a meltdown in the person. If you give in, then your child will associate meltdowns as a way to achieve what they want every time, essentially reinforcing the tantrums and meltdowns.

11. School Incompatibility Students with ADHD may have a harder time in school because all assignments are not subjected for their needs. Furthermore, Williams states that in school “students must sit still, be quiet, and remain attentive for long periods of time.” However, kids with ADHD may not handle staying still for long periods of time nor does the teacher realize that it is very difficult for these students. These weaknesses and challenges are rarely considered by teachers and parents.  Your child may not be able to make all of your expectations and that is okay, this is when one needs to be flexible. 

12. Pills Don’t Teach Skills There is not one medication that solves everything: there is no magic pill.  Certain medications may affect one physically on the outside (hyper focus or hyperactivity), but on the contrary, the layers beneath one are yet to be cured with one pop of a pill. In order to get past this, as parents, it is essential to pay attention to your child’s self-esteem and work on building it up with them. To do that, you must focus on your child’s inflexibility, intensity, emotional dysregulation, skill deficits, time blindness, etc.

Focus on looking below the surface and deeper into your child’s everyday actions and emotions. This will not only contribute to the growth of you and your child’s relationship, but their well-being and mental health as well. Williams describes that “these hidden layers are all part of ADHD. Together, they form that beautiful but dangerous iceberg. Others might not see them; you must.” 

For more information on ADHD and its symptoms, please contact us. To learn how we can help you or your child who may be struggling with being successful with ADHD, contact us or visit our website. For more information on therapy, visit Hilber Psychological Services. 

To learn how Neurofeedback can help with the “white-knuckling” experience of ADHD, visit San Diego Center for Neurofeedback, APPC or contact us for for more information.

- Written by Lily Schmitt and Tanya L. Hilber, PsyD

References 

Williams, Penny. “Your Child’s ADHD is an Iceberg.” ADHD Symptoms in Children. ADDitude. Web. 28 Jan. 2019. https://www.additudemag.com/what-is-adhd-symptoms-hidden-parents-educators/

In the article, “How to Help Teenage Girls Reframe Anxiety and Strengthen Resilience,” author Deborah Farmer Kris recounts how rates of anxiety-related disorders in teenage girls have risen. Furthermore, not only can girls get anxious and stressed out easily, but so can any other teenager or adult. This could be because of the environment they are in, denial of their stress and anxiety, lack of sleep, no validation of their emotions, etc. Damour, a psychologist and author of the new book "Under Pressure: Confronting the Epidemic of Stress and Anxiety in Girls," states “some degree of stress and anxiety is not only normal but essential for human growth.”

Through decades of research and working with adolescent girls and their families, Damour observed that “the anxiety that teenagers express is a sign that they are aware of their surroundings, mindful of their growing responsibilities, and frightened of things that are, in fact, scary.” She notes that adults can make a difference by reassuring their child and have an honest conversation with them about their emotions and what is going on in their life that may make them stressed.

Keep in mind that teenagers brains and bodies are still developing and that change can spur stress. Not only physical or emotional change but also the act of continually switching schools, academic workload is increasing, or social relationships are constantly evolving. With this information, parents should continue to support their child but also let them figure it out on their own. “Teenage girls are particularly sensitive to the cues they receive from parents and teachers –  from words to facial expressions. How adults respond to teens’ emotional reactions matters a lot,” said Damour. The growth that they experience on their own will allow them to develop as a person who can withstand these types of stresses in the future and know how to handle them.

It is best not to avoid the anxiety as a whole, but to call it out and realize that one needs help. In this case, parents should stick to the two words that Damour has found helpful: “stinks” and “handle:”

“‘That really stinks’ is a very simple phrase that cuts right through it. It says, ‘I hear you and I’m just going to sit here for a moment and acknowledge that what you are up against isn’t that great.”

Validation and empathy go a long way when it comes to the exact thing that a child wants to hear, that they are being heard and that someone understands what they are going through. If teens realize that some level of stress is inevitable then they can accept it and move on to focus on how they can build in recovery time whether that is by having some downtime or getting more sleep.

Sleep deprivation is one of the simplest explanations for the rise in anxiety-related concerns, Damour said. If your child is getting less than seven or eight hours of sleep then a change needs to be made. Most of the time, teenagers may not be getting enough sleep because they are on their electronics. With the change of turning off social media for the night by putting their device on do not disturb or putting their phone in another room can make all the difference.

Stress and anxiety is part of life. It is not a parents job to get rid of it completely but to help their child get through it by sitting down with them and discussing their feelings. Stress and anxiety do not go away overnight, but with some extra sleep, reflection time, and downtime, teenagers can develop a sense of self on their own and figure it out with some guidance from a parent if needed.

For more information on stress, anxiety, sleep deprivation or how Hilber Psychological Services can help, please contact us and check out Lisa Damour’s book "Under Pressure: Confronting the Epidemic of Stress and Anxiety in Girls.”

-Written by Lily Schmitt and Tanya L. Hilber, PsyD

References

Kris, Deborah Farmer. “How to Help Teenage Girls Reframe Anxiety and Strengthen Resilience.” Mindshift. Web. 12 Feb. 2019. https://www.kqed.org/mindshift/52994/how-to-help-teenage-girls-reframe-anxiety-and-strengthen-resilience

Damour, Lisa. Under Pressure Confronting the Epidemic of Stress and Anxiety in Girls. https://www.amazon.com/gp/product/0399180052?pf_rd_p=f3acc539-5d5f-49a3-89ea-768a917d5900&pf_rd_r=R1KSEQT2AT89FSXWG6K1  

In the article, “New Childhood Anxiety Treatment Focuses on the Parents,” author Matt Kristoffersen discusses how Supportive Parenting for Anxious Childhood Emotions (SPACE) is an alternative to behavioral therapy used to treat childhood anxiety. He acknowledges that it all starts with the parents and how they perceive their child’s anxiety in the given situation.

Stated by the National Institute of Mental Health, “nearly one in three American children will experience at least some kind of anxiety disorder before reaching adulthood.” Although drugs and therapy techniques have shown to be proven successful in the past years, a recent study published in the Journal of the American Academy of Child & Adolescent Psychiatry, promulgates a new technique developed for the parents.

A team of Yale researchers randomly selected 124 children with anxiety and assigned them to a therapy-based group or a parent-only group for 12 weeks. In these meetings they were divided into two groups, one in cognitive behavioral therapy and one in SPACE therapy. They learned how to control their symptoms and confront their fears through therapeutic exposure. The researchers observed that children in the first group never spoke to a therapist about their specific anxiety during the trial. The researchers suggested that parents should support their child in a sense of letting them figure out how to cope with anxiety on their own, by using the SPACE treatment, rather than continuing to oblige to their child’s behavior. For example, “if a child gets anxious when there are guests in the house, parents may stop inviting people over. However, according to the study, children can grow accustomed to these accommodations over time, which can lead to greater difficulty with anxiety later in life.” In this case, parents should take a step back and “replace accommodation with words of support and with expressions of confidence in their children’s abilities to deal with anxiety on their own.”

In the first study administered in 2013, author Lebowitz prompted parents to follow a script of ways to be supportive and reassuring in order to reduce accommodations for their child with anxiety:

“We understand it makes you feel really anxious or afraid,” the script said. “We want you to know that this is perfectly natural and everyone feels afraid some of the time. But we also want you to know that it is our job as your parents to help you get better at things that are hard for you, and we have decided to do exactly that. We are going to be working on this for a while and we know it will probably take time, but we love you too much not to help you when you need help.”

Through SPACE therapy, parents were able to form a much closer relationship with their children than those of the children in the cognitive therapy-based group and help them work on their anxiety problem. Because of this study, “SPACE will provide an alternative for children with anxiety who may not respond well to traditional therapy or who refuse to participate.”

For more information on therapy for anxiety with the parents or the children, or any other therapy, please contact us at Hilber Psychological Services.

-Written by Lily Schmitt and Tanya L. Hilber, PsyD

Reference

Kristoffersen, Matt. “New Childhood Anxiety Treatment Focuses on the Parents.” Yale News. Scitech. Web. 26 March 2019. https://yaledailynews.com/blog/2019/03/26/new-childhood-anxiety-treatment-focuses-on-the-parents/?fbclid=IwAR1_yDjSIF9njsJ6ATplIrWwivPIqbj-OgqtehNYIxvfE85vrVkfTFoOj7k

In the article “Resilient Kids Come From Parents Who Do These 8 Things,” Lizzy Francis recognizes what it takes for children to learn how to be resilient when their parents do the following eight things.

When your child gets frustrated, whether it’s because he or she can’t put together LEGO pieces or does not yet understand a math problem, this is the time to teach your child how to bounce back from being discouraged and how to overcome their struggles. If taught properly, children will understand how to overcome their struggles and how to better handle their stress. When resilience is learned from a young age through numerous lessons, children will be able to manage their stressors better as adults.

According to Amy Morin, LCSW, a psychotherapist and the author of “13 Things Mentally Strong Parents Don’t Do”, she explains in detail of eight common ways parents can raise their children to become resilient.

1. Let Your Child Struggle

As a parent, it is your job to provide a guide for your child to navigate through life. However, this guide will only get them so far in life. It is up to them to take the skills and knowledge that you have taught them into their own hands to practice and be okay with making mistakes along the way. Francis notes that the parents who teach their child that hard work is important and that it may also be difficult to practice are those who raised a well-adjusted child. If they are more well adjusted then they will understand how to cope with stress and persevere through their struggles.

2. Let Your Child Experience Rejection

It is essential for your child to understand the word “no” and what it entails. No matter how much your child may want something or need someone to rely on, it is your job to stick to your word and not give in. Francis insinuates that failure can be one of the greatest life lessons that a child can understand.

3. Don’t condone a Fixed Mentality

It is important for you, as a parent, to not give in to your child’s helplessness. For example, if your child gets a bad grade on a test it is not the teachers fault for not explaining the material well enough, but your child’s responsibility to ask for help if they don’t understand. As much as you would like to take your child’s side, it is important to teach your child that things don’t always work out the way they think they will: that life isn’t fair. This idea will spur their sense of responsibility in order to not be in this situation again. No matter how easy it may be to advocate for your child, it is important to encourage the idea that life isn’t fair and that they are able to advocate for themselves. Don’t condone to letting your child put the blame on someone else.

4. Do More Than Tell Them to ‘Buck Up’ When Struggles Occur

Instead of putting the emotional strain on your child by telling them to just “deal with it,” validate their emotions first and then give them advice on how to get through their struggles. Tell them that you understand where they are coming from to empathize and validate the feelings. If they open up about their feelings to you now, then later in life they will have the confidence to communicate how they feel because they were validated when they were younger.

5. Help your Kids Learn How to Label Their Feelings and Emotions

Help your child feel comfortable expressing their feelings out loud. If they acknowledge their emotions out loud, then they are less likely to act upon them or “show” their feelings. For example, if your child says “I’m mad,” they are less likely to scream at you because words are more powerful communication.

6. Give Your Kids The Tools to Self Soothe

Although coloring books, play-doh, and lotions that smell good may calm some children down, they do not act as stress relievers for everyone. As long as you provide your child with an outlet, such as a sport, active task, or a musical instrument, your child will receive the skills it takes to calm themselves down. Then remind your child that these are helpful when they want to feel better. Not only will they learn how to take responsibility for their feelings, but how to cope with them in the future.

7. Admit Your Mistakes. And Then They Fix Them

Utilize your own mistakes to teach your child how to respond to failures. This will show that even parents make mistakes and that not everyone is perfect. Kids tend to forget this idea and put so much pressure to be as perfect as their parents. But in fact, even the most well-rounded parents tend to mess up sometimes. The important thing to note is that one should own up to their mistakes in front of their child so that they see that you are acknowledging the mistake and then going to fix it.

8. Always Connect Your Kid’s Self Worth to Their Level of Effort

When there is a common outcome that students strive to succeed, some may cheat their way up to the top in order to get that A. The idea is to teach your child that through hard work, practice, and honesty, they will get to the top instead of faking it until they make it. Morin states that “the kid who grows up knowing that it’s all about their effort, rather than their outcome, is going to be more resilient when they fail or when they get rejected.” These children who will grow up to be resilient are not the ones who received the stereotypical feedback of doing a good job because they are a girl or a boy but because they had an awesome support system cheering them on to go the extra length.

Whether your child is a boy or a girl, it is not only what you say to them (for a girl: good job because you studied hard & for a boy: good job because you are smart) it is also how you communicate your feelings in a certain tone and at the right time.

For more information on how to help your children increase their resilience or how to put these above steps into action, please contact us. For more information on therapy, visit FAQ at Hilber Psychological Services.

-Written by Lily Schmitt and Tanya L. Hilber, PsyD

References

Francis, Lizzy. “Resilient Kids Come From Parents Who Do These 8 Things.” Love and Money. Fatherly. Web. 26 Nov. 2018. https://www.fatherly.com/love-money/build-resilient-kids-prepared-for-life/
Morin, A. (2017). 13 Things Mentally Strong Parents Don't Do: Raising Self-Assured Children and Training Their Brains for a Life of Happiness, Meaning, and Success. New York, NY: William Morrow, an imprint of HarperCollins.