Kristin Sanchez has to set an alarm to remember to feed her kids. “It sounds terrible, I know. But it’s the honest truth,” she says. Kristin has two children with attention deficit hyperactivity disorder (ADHD), and she has adult ADHD.
It means that organizing, planning, time management and seeing tasks through doesn’t come naturally. Trying to keep her own life together is hard enough; teaching her kids to be organized and mustering the persistence to deal with other issues tied to their ADHD feels nearly impossible.
This morning, her son, Preston, age 13, disappeared after breakfast. After calling him eight times, she sprinted up the stairs, abruptly ending a phone conversation. Preston was in his pajamas playing with the dog. His sister, Gracieann, age 10, threw a tantrum in her underwear because she couldn't find her favourite dress. They needed to get out the door for school.
“I’m mad because they’re not doing what they should be, and I’m not either. It’s like, why can’t you just get it together and do what normal moms do?” says Sanchez against a backdrop of laundry stacked down the hall.
She’s already worrying about dinner and homework. For the ADHD brain, things like planning a meal and time-managing the execution of that meal are no small task. And the kids, who’ve already had to work much harder than their peers just to follow lessons in class, are typically exhausted by the time they get home and need to do homework. Plus, any meds they take to help them focus are most likely wearing off by late afternoon.
Kristin’s family scenario is not unusual. Studies show that ADHD runs in families. In twins, 70 to 80 percent of the time, if one has it, so does the other. And some research reports that nearly a third of kids diagnosed continue to live with the disorder as adults, so it’s common for both a parent and kid to have it.
This is why Stacey Bélanger, a paediatrician at Sainte-Justine Hospital in Montreal, does not simply treat her child patients with ADHD but pays close attention to parents too. Many have symptoms of ADHD, but usually haven't been diagnosed until after Bélanger takes a fairly extensive family history, sees the pattern and recommends they get assessed.
“The parent is the most important person in this child’s life. If his or her ADHD is not addressed, it will, of course, affect the child’s response to interventions,” she says.
Once parents learn they too are affected, they are typically relieved. “Now they understand and can face it,” says Bélanger. She includes parents in the treatment plan, recommending they go with their kids to workshops and/or group therapy. She sometimes refers them to support groups or programs to help with organizational skills. And she has access to plenty of books and videos to help along the way. “They learn not only to understand and parent their children, but how to manage their own ADHD,” says Bélanger.
Guilt is a problem, often because of issues with impulse control; parents tend to say and do things they regret later, says Diane Brunette, a Burlington-based certified ADHD coach to parents and children. She knows from first-hand experience: The mother of four now-grown kids with ADHD learned in her late 30s that she had the disorder too.
Parents remorsefully confide in her that they have hit their children, or stepped in to stop their kids from spatting only to get pulled in and start screaming too. “They feel horrible. But if you start to ruminate, you often end up doubting your parenting skills, when your instincts are usually right,” says Brunette.
She recommends that parents “pause before acting. Take deep breaths and ask yourself: What am I thinking? What am I feeling? What am I doing? Is this what I really want to do? Imagine yourself doing what you wish you had done. In time, it will become easier to actually accomplish.”
Terry Matlen, a licensed clinical social worker in Detroit, sees many scenarios where parents and children have different types of ADHD, which further complicates family dynamics. For example, a mom with inattentive ADHD may feel overwhelmed by her hyperactive child. One craves quiet and calm; the other craves movement and noise. “Asking the hyperactive child to sit and read a book is like asking the inattentive parent to go skydiving,” says Matlen.
Brunette recalls that her youngest would rather sit still, while she always wanted to be in motion. But they talked things through and found ways to compromise. “I would sit with her and watch a movie, though sometimes I’d have to get on the treadmill [while]. Then later she would have to come out walking with me.”
It helps for the whole family to be on a regular schedule, says Doron Almagor, a child and adolescent psychiatrist and chair of the Canadian ADHD Resource Alliance (CADDRA). Therapists can work with families to set up scheduling systems, reward systems or cues, cutting down on the stress of managing the day to day, he says.
Practicing these strategies as a family is important, says Heidi Bernhardt, executive director of the Center for ADHD Awareness Canada (CADDAC), a national education and advocacy group. “We have families who, on Sunday afternoons, will make a game of practicing getting ready for school. Eventually the routine becomes a habit and makes it easier for the entire family,” she says.
Brunette suggests keeping to-do lists on an erasable board or large piece of paper stuck to the wall. “In between trying to accomplish tasks, take a break—put the music on and dance,” she says. “And break things down into steps. Don’t try to clean the whole room at once; that’s too overwhelming,”
Dealing with school is typically the toughest hurdle. For children, it’s hard to meet teacher’s expectations. For parents, there are other issues. “It’s hard for them to advocate, to know how to file school reports and to be able to access them when they need them,” says Bernhardt. “We have a presentation to explain the special education process, so they go into this knowing how the system works. We break it down in steps and give templates.”
“They are trying hard to be the best parent and fear they will mess their kids up,” says Brunette. “But they just have to change expectations of their child and themselves, and change their parenting somewhat. With good management skills, their children will be OK, and so will they.”