Dr Sharon Saline - Children with ADHD, Anxiety and Learning Differences

Dr. Sharon Saline speaks passionately with Mike Christian about children living with ADHD, anxiety, and learning differences.

Episode Transcript

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The following broadcast is paid for byWhat's at Risk. This is What's at
Risk with Mike Christian on WBZ,Boston's news radio. Hi, I'm Mike
Christian, your host for What's atRisk. On tonight's edition, Doctor Sharon

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Saline speaks passionately about children living withADHD, anxiety, and other learning differences.
In our second segment, Bob Crawford, longtime basis with the Avid Brothers,
talks about his love of history andin particular his popular podcast founding son
John Quincy's America. Doctor Sharon Salinemaintains a busy psychotherapy practice working with children,

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teens, families, and adults withADHD and other mental health issues.
She has spoken and conducted workshops nationallyand inner nationally on ADHD and the adolescent
brain. She is also the authorof What Your adh Child Wishes You Knew?
Working together to empower kids for successin school and life with ADHD and

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other diagnoses on the rise, Today'syouth are experiencing chronic levels of anxiety and
depression. It's more important than everto make sure neurodivergent children feel supported and
understood. It's all well, helloeveryone, We're here with Sharon Selaine.

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She's an award winning author and licensedclinical psychologist with over thirty years of experience.
She's a top expert on ADHD,anxiety, learning differences, and mental
health challenges. Sharon, how youdoing. I'm doing very well today.
How are you great? It's reallygreat to have you. Thank you for
joining us. Maybe a good placeto start it would be just for you

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to tell us about your background andmaybe your journey in life to this point
and what you're up to. Ofcourse, thank you for asking, and
it is a real pleasure to behere. I'm a clinical psychologist and I
have been drawn to working with peoplewith ADHD for pretty much my whole career.
And I didn't really understand why Iwas drawn to these people until my

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nephew was diagnosed with ADHD, andthen his father, my brother, was
diagnosed with ADHD. And then Istarted looking around at the family and I'm
like, oh, okay, thingsare falling into place here. These are
I am drawn to working with peoplewith ADHD. They're smart, creative,

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funny, spontaneous. A lot ofthem have a theater background like I do,
which is fun, but there's away in which they are also hard
on themselves and feel like people don'treally understand how their brain works and struggle
with having compassion for themselves in havinga neurodivergent brain. And so that's really

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why this work drew me, Andthen there was a certain family familiarity to
it maybe for the listeners and fromyour perspective as an expert, What exactly
is ADHD and what are some ofits causes? Oh, short question,
long answer right. Attention deficit hyperactivitydisorder is a chronic condition that has to

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do with how a person regulates theirattention. Recently, what's been added to
that has to do with their emotions, and that their ability to manage their
executive functioning skill deficits or weaknesses whichcome along with having ADHD is frequently more

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severe than we see in neurotypical folks. There are different types of ADHD.
There's hyperactive, impulsive, there's inattentive, and then there's a combination, which
is a combination of both. Sothere's a kind of a sense where for
people with ADHD that they have thisinconsistency and motivation which is most frustrating to

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them because they can pay attention andbe really interested and focused on something that
just grabs them, that is compelling, that they're passionate about, and then
they are going to struggle with thingsthat they don't have a lot of interest
in. And so we know thatinterest foster's motivation, and this is part
of the challenge of living with ADHD, is the inconsistency in motivation and also

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the challenges with self regulation. Isthere a physical difference in the brains of
people that have ADHD versus those thatdon't of it? That's a good question.
You know, there is some researchthat indicates parts of the brains of
people with ADHD are a little bitsmaller. And these areas have to do

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with, for example, though acorpus colosum, which is the super highway
of the brain that connects the leftand right hemispheres and has to do with
sequencing and the integration of details,the right side of the prefrontal cortex,
so right above your right eyebrow.I guess, which has to do with
managing emotions. And we've found thatthere are there can be like sometimes the

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volume of the brain might be alittle bit smaller, and also the amygdala
the fight flight or freeze could bea little bit smaller. And the memory
capacity might be a little bit smaller. So there are some biological issues that
come with having ADHD, which isreally important for people to understand when you're

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talking about ADHD, because a lotof people still think of it as laziness
or something that's made up. Andit's really been around in medical literature since
the seventeen hundreds. People had startedto notice it. And if there's a
physical difference, do young people,you know, maybe grow out of it?
Does the brain change over time?Is they mature? How does that

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all work? Well, what's interestingwhen we think about it is that it's
not that the brain doesn't mature.It matures more slowly, up to about
three years delay in people with ADHD. And someone will ask, well,
does that mean my brain isn't functioning, And my answer is no, it's
just that it takes a little bitlonger for the connections between the different regions

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of the brain to really fall intoplace, and if you have ADHD,
some of those connections, the communicationbetween different areas of the brain is naturally
a little bit weaker, particularly alongwhat we call the dopamine pathway, which
is a neurotransmitter that is involved inpleasure reward motivation and neuropein effhorn, which

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is a neuro transmitter that's involved insleep, alertness, focus and things like
that. And we hear a lotabout neurodiversity and those that whole spectrum of
things. Is there a relationship betweenautism and ADHD? Excellent question. So
actually, neurodiversity is kind of tome, it's like the overarching umbrilla,

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and underneath that we have neurodivergence andneurotypical And this was a sort of laid
out by a woman named Judy Singerin the late nineties. Neurotypical is are
people who don't have any of thefollowing generally autism, learning disabilities ADHD,

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mental health issues, physical disability,those kinds of things. And so there
is a difference between neurodivergent brains andbrains. And one of the things that's
challenging for somebody who has ADHD oris or is on the autism spectrum or

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is the learning disability, is whatit's like to live in a world not
designed for a neuro divergent brain.So about fifty percent of children and teens
whose primary diagnosis is on the autismspectrum have ADHD, but only about fourteen
percent of kids whose primary diagnosis isADHD have autism, and interestingly enough,

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researchers at the University of Pennsylvania foundthat if a child's primary diagnosis is autism
and their secondary diagnosis is ADHD,even if they don't meet the full criteria
for ADHD, treating kids with ADHDmedications who fit that profile improves they're not

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just their abilities to focus and concentrateand attend, but it reduces some of
the symptoms of autism. That's reallyinteresting. I hadn't heard that before.
You mentioned the term executive function,and maybe just for the listeners, we
might just define that a little bitand talk about how that's a part of

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ADHD and the part that's impacted byADHD. Of course i'd be happy to.
And if you're not driving in yourcar, maybe take your hand and
put it right on your forehead,because behind your forehead is really the prefront
is really what is the command centerof the brain that we call the prefrontal
cortex, and executive functioning skills connectprioritize, and integrate cognitive functions with emotions,

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with physical movement a moment by moment, and so what I like the
analogy I like to think about isand I'm going to date myself here.
Imagine the Beatles are in the AbbeyRoads studio, John Paul, Ringo and
George and they're with instruments, andthey might have a guest or two playing

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extra percussion or something. And inthe studio we have the sound engineers.
We have vocal engineers for each membersof the band. We have engineers for
each of the instruments that the membersof the band are playing. We have
engineers who are dealing with the overalltone, et cetera, et cetera.
Those sound engineers are like the executivefunctioning skills in our brain, but instead

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of dealing with music, they're dealingwith output related to organization, prioritizing,
initiation, self regulation, working memory, sustained attention, etc. Etc.
It's really interesting. You've written abook maybe books on giving advice to parents
that have children that have ADHD.What is some of that advice that you've

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given through your books and through yourlectures. Thank you so much for asking.
My philosophy, I call it thefive sees of ADHD approach. The
five seeds of ADHD are self control. We adults need to manage ourselves first
before we attempt to assist our kidsin managing themselves. When adults are just

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regulated, it's very difficult for ourkids with ADHD and probably kids without it,
to stay regulated themselves. So wereally want to manage ourselves and look
at what is triggering us, butalso what is triggering our kids. The
second SEE is compassion, meeting kidswhere they are, not where we think
they should be based on their age, their height, their weight, what

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their cognitive testing shows. Compassion isthis ability not just for us to imagine
what it's like to walk a dayin the shoes of our kids, but
also to treat ourselves with kindness,because parenting kids with ADHD is very challenging.
The third C is collaboration, whichis working together with your child for

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solutions to problems. These are kidswho spend a lot of time listening to
what other people think they should bedoing and how they should be doing it,
and they're not super keen on thatbecause they feel like their brains and
what makes sense to them either ofthose issues is not being considered, and

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so we really increase the rate ofparticipation and buy in by including children and
teens in coming up with solutions.So, for example, what is the
routine going to be when you gethome from school? I can tell you
what I think you need to do, but I actually would be more I

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would be better served, our familywould be better served if I ask you,
you know, what do you thinkwould help us? You argue less
when you get home from school?And what is a routine that would make
sense for your brain? And ifyou're taking medication while the medication is still
in your brain, so that's collaboration. Consistency is the fourth sea, and
it's not about perfection. It's aboutsteadiness doing something more often than not.

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And this is also about efforting forour kids. Efforting is a word,
yes I made up, but it'sbecause for neurodivergent folks, trying is usually
occupies one aspect of how a personfunctions cognition, emotion, something physiological or

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physical. For kids with ADHD,when attempting to do something, it usually
is efforting because it is involving allthree of those aspects your mind, your
body, and your emotions. Andthen the last sea is celebration, which
doesn't mean you bake the cake foryour child because they clear the table,

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but it's about validating and noticing theirefforts, even if they don't result in
the accomplishment, but that they're trying. For example, I noticed that you
tried really hard not to hit yoursister when she was pinching you and kept
pinching you, and you told herto stop, and she did it,
and you told her to stop again, and she didn't, and then you

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hit her. So that was progress. I noticed that. I see that,
And for a lot of these kidswho hear many more negative comments than
positive ones, their self esteem isquite low, and so we want to
reverse that process of really having predominantlynegative comments by balancing it with some positive

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ones. I think a lot ofthat advice is good for any kids,
any parents raising anything. To behonest, Yes, I mean it's hard
enough raising children, whether they're livingwith ADHD or not living with ADHD.
I've got two questions related to this. They have to be able to manage
them themselves and be in a positionsort of mentally and spiritually and physically to

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be able to work with these youngpeople that are maybe a little more challenged
because of the ADHD. What advicedo you give them for themselves, for
their own self care. If you'restruggling to manage yourself, I encourage you
to do three things. One exercise. Exercise is good for everybody. It's
particularly good for people with ADHD,whether you're nine or fifty nine, because

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the endorphins in the brain really helpbalance the brain in some way that I
don't fully understand because I'm not aneuros neurologist, but they're very good and
doctor John Rady and doctor Edward Hallowellhave written a lot about the benefits of
exercise. The second thing would beto figure out what self care is for

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you. You know, when you'retriggered, what are you going to do
to kind of settle and slow down? So you know what's a sign that
you're Is it not in your stomach, tightness in your chest, maybe you're
clenching your jaw, And what's goingto help you recalibrate. For a lot
of parents, go to the bathroom, close the door, wash your hands,

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splash some water on yourself, lookat yourself in the mirror, and
say something encouraging like Wow, thisis one of those moments I wish I
wasn't having. I'm but I'm goingto get through it because I get through
it. And then the third thingis don't be afraid ask for help.
Find a therapist or a coach whounderstands ADHD and the challenges of parenting ADHD.
We know from research that anywhere fromforty five to maybe fifty five or

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fifty seven percent of adults with ADHDhave a child with ADHD. And sometimes
what happens is the child gets diagnosedMike, and then the adult realizes,
Oh, this sounds like me too, right, so get support for yourself.
Yeah, yeah, I was justgoing to ask that question. Is

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ADHD hereditary? It obviously is,or that wouldn't be you wouldn't have a
status you just referenced. It's themost inherited mental health condition. Yeah.
So you often have parents living withADHD caring for children living with ADHD,
and the parents may or may notknow it. In fact, I don't
want to be shamelessly self promoting,but here we go. I'm doing a

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webinar in a couple of weeks.You can go to my website Wwwdr Sharonsoline
dot com. Parenting Kids with ADHDwhen you've got it yourself. So it
would be something to be very usefulfor people. What about the young people
themselves. You just mentioned deficit framingthat, oh, that kid's got ADHD

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or there's something wrong with them,and they're looked at as something. They're
not defined by their positive attributes.They're defined by their the fact that they
have ADHD. How do you workwith them or do you work with them
to be able to reconcile? Howpeople pursued them with being able to function
I shouldn't say in a normal way, but just being able to function in

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a more peaceful way in their ownlives. This is my mission in life,
Mike. I didn't realize that,but I'm glad. This is very
passionate. This is my mission inlife. People have many misconceptions about ADHD,
and what happens is that these arekids who hear negative comments a lot.

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In fact, I will tell youI've traveled all around the world and
I'll ask them for every one positivecomment, how many negatives do you think
that you hear per day? Andthe answers anywhere from five to fifty if
they include what they tell themselves.This is tragic for me. Doctor John
Gottman and his colleagues have found thatthe ideal positivity of ratio in relationships should

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be five positives for one negative,so we are way out of balance here.
I think it's important for people tounderstand that we are all uniquely wired
and that one type of processing isn'tbetter or worse than something else, it's
just different. And one of myclients even says, and this is a

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quote in my book, I don'tbelieve you know. I don't like the
word disability because it means you havean unability to do things, and I
think that's not true. You alwayshave an ability to do something, to
try it. And so we wantto work with kids to help them discover
a talent and interest, a passion, something that they feel really good about

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themselves doing, so that then thatpart will grow and nurture a sense of
self esteem. And we have foundthat many, many people, particularly children
and teens who have ADHD or neurodivergent, have what we call a negative mindset,
a fixed mindset, and that meansthat this is who I am.

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I can't do things, it's notgoing to change. I mean, I
expect failure. That's what happens tome. And we want to nurture a
growth mindset right that I actually cantry something different and see what happens.
It might work out great, I'lldo it again. It may not work
out. That's okay, that's partof being human. I'll regroup, get

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some help and try it again.And this is why it is so important
for us to nurture that kind ofgrowth mindset in children, teens and adults
with ADHD, because there's often alot of shame about being different that started
as a child with those negative commentsand has continued through adulthood. And then

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that's great advice. I think youmentioned at the beginning about young people with
ADHD. They may be more creative, they may be more focused on the
arts and excel at the arts.It's very many places that they would excel
because of having ADHD. Frankly,how are you able to get young people
to look at it from that perspective? And our society has to look at

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it that way too, because ofthis deficit framing that you were just talking
about. Often it puts young peoplethat are living with ADHD in a difficult
position because they have to make acomeback from being viewed negatively presenting themselves with
the assets that they have. Buthow do you think about that? I
think that the fundamentals of a growthmindset actually dovetail well with your question.

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A growth mindset includes islands of competency, areas where you feel like you know
what you're doing and you do itwell. So identifying what these are nurturing
them and having kids themselves be ableto feel pride in those aspects of themselves
that could then be transferred in someway to the areas where they're struggling.

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The second aspect of a growth mindsetas a charismatic adult. So this isn't
Beyonce or Adam Sandler or anybody likethat. This is actually a person you
know who believes in you, whoyou feel safe with, who you feel
understands your brain. Many kids withADHD give up on themselves because either they

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receive messages from adults I don't understandyou, I don't know how to help
you, and then they go astep further and say I'm not worth helping,
I'm unhelpable, or they give upbecause they've encountered failure and they don't
know how to change how they approachthings so that they're not expecting failure.

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It's a negative expectancy. And thenyou know the third aspect of a growth
mindset is really being able to trythings and see what happens, and to
understand that making mistakes is part ofbeing human. I'm living and I'm learning.
That's the mentality that we want.I want to leave you with one

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last question. Your insights and youradvice have been so spot on. I
think in the topic that we've beentalking about ADHD, we're living in a
very fragile time in the world,and there's a lot of anxiety, and
that's an area that you focus inon all the time, mental health and
anxiety. What about some tips forthe rest of us in terms of how
to get through this very difficult timethat we're in. This is a very

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difficult time in the world, andanxiety is rampant for everybody. And so
what we want to try to dois change our relationship to anxiety rather than
trying to eradicate the anxiety. We'renot going to eradicate the anxiety. It's
partially how we're wired. It keptus safe through the millennia, right,

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But what we can do is changeour relationship to anxiety. Anxiety says blah
blah blah, and you're not goingto be able to handle it. What
we want to do instead is toidentify a goal. I want to do
something, and so I'm willing totake a risk in this particular way.
We want to talk back to thatworry monster or that anxiety voice in our

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heads that says you can't handle it, and say, actually I can,
because I did at this time.We have to recall incidents when we were
successful, when we triumphed in spiteof fear or worry. It helps if
we focus on controlling what we cancontrol. Well, Sharon, thank you
for your passionate insights and great adviceto all of us, and I appreciate

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you coming on the show. Thankyou so much for having me. It's
such a pleasure. We'll be rightback after the news at the bottom of
the hour.