Elaine Taylor-Klaus

Today, we’re gonna get on our soapbox.

Diane Dempster

Yes. Do we do this very often? I don’t think we do. The backstory on this was that I was on a call with a parent the other day, and I got up on my soapbox because the intro from the parent was something like, “The doctor told me that my kid only has mild to moderate ADHD, so…” right?

The perspective of the parent was, “Well, that’s only a little tiny bit of ADHD. Should I even worry about it? Should I just keep plowing on? What should I do with this kid?”

So I wanna talk about what it really means to have mild to moderate ADHD, if that even is a thing, and then how to support your kids regardless. That’s what I wanna talk about. What about you, Elaine?

Elaine Taylor-Klaus

It’s rare that Diane gets so soapboxy to say, “We gotta talk about this,” cuz usually I’m the one on the soapbox and Diane is trying to mitigate me. So it’s fun for me.

I wanna start by saying, the other thing that came up for me as you were talking, mild to moderate ADHD? Is that like being a little bit pregnant?

Diane Dempster

Yes, that’s exactly what I thought of. Right. So most of you don’t know that Elaine and I have similar backgrounds in lots of ways. We were just doing an interview with somebody, talking about pregnancy and everything, but that’s exactly what I felt when this parent said, “My kid only has mild to moderate ADHD.”

So, wait, let me start with this, because I’m on my soapbox, I always wanna start a soapbox from a place of non-judgment. Right? So I’m gonna downregulate and take a deep breath because it’s frustrating for me, as a parent and as a professional, to hear this. And I also don’t want you as the parents to hear any judgment in this, because I think it’s well-meaning professionals who tell us things that we misunderstand, misinterpret, or don’t know what to do with. So know that I see your heart here.

Elaine Taylor-Klaus

So there is absolutely no judgment here, and that includes no judgment of the professionals, because there is a spectrum of ADHD. Yes, people come in on the mild-to-moderate ADHD range. That would be me.

Diane Dempster

Mm-hmm.

Elaine Taylor-Klaus

Diane might be surprised to hear that. Some people would come in on the moderate to, you can’t see that I’m smirking.

Diane Dempster

And those of you listening to the podcast, those of you watching can see me smirking.

Elaine Taylor-Klaus

Some people are moderate to significant ADHD. The way I like to say it to parents is: if you look at the executive function chart that we teach, there are six areas of executive function that Dr. Tom Brown identified as impacting people with ADHD.

If you’ve got one to three of those, you’re probably mild to moderate. If you’re impacted in three to six of those areas, you’re probably moderate to significant.

Diane Dempster

But wait a second, because that’s actually not my, so check me on this, Elaine, because maybe I don’t have the right information. But that’s actually not the way that the diagnosis process goes, right?

Remember how ADHD gets diagnosed: it’s self-reported, teacher-reported, and parent-reported. So depending on the human filling out the form and how extreme they identify behaviors as being, that’s really gonna define where on the spectrum it lands. Is that not true, Elaine?

Elaine Taylor-Klaus

It’s a yes-and. Right. OK, so part of it is that it’s a process-of-elimination diagnosis, as you describe, and there’s interpretation: where does it show up, how often does it show up, and in how many different aspects of life?

So I’m not actually speaking to the diagnosis itself, because the diagnostic process will lead you to identify somewhere on that spectrum of mild to significant. What I’m saying is, for those of us who are experiencing it, one good way to figure out how intense it feels, what I’ll say to parents sometimes is: “Do you have a mild dose of ADHD, or do you have a healthy, whopping dose of ADHD?”

One way we can tell is that if we’re impacted in all six areas of executive function, chances are you’ve got a pretty significant diagnosis of ADHD. If you’re doing OK in some of them but struggling in others, chances are it’s mild or moderate.

Diane Dempster

Well, and I think that’s the piece of it for me. I wanna go back to this “you can’t be a little bit pregnant” idea. Right?

And I think I wanna throw out the conversation about mild to moderate. Yes, there are people who are impacted in some areas of executive function and not in others. There are some kids who are significantly impacted. I hear this a lot, “My kid doesn’t have any problems at school, but we have all kinds of problems at home.” Or vice versa: the kid has problems at school but not at home.

Part of the challenge in the diagnostic process is that inconsistency is the beast. Yeah. That’s the biggest challenge of ADHD, that it’s inconsistent. So many of these kids are able to mask with their intellect, and I see this a lot in the school environment. Particularly the gifted kids, they’re so smart they “overcome” or accommodate for the executive function challenges by being super smart.

I had a kid who was completely disorganized but could go into an exam and just get a 100 on it because he caught everything in class. You know, it’s the classic zero on homework, 100 on the exam. And sometimes vice versa, again, vice versa. Right.

So I think, for me, the level level set is that you can’t have a small amount of it. It doesn’t necessarily matter whether you have a small amount of ADHD or a lot of ADHD. That language of a “mild to moderate” diagnosis is potentially a misnomer. And I’m gonna challenge you on that.

Elaine Taylor-Klaus

OK, because I don’t disagree. I don’t think it’s a misnomer. I think the question is: what do you do with the information? I think it’s helpful to know if you’re impacted in some areas or if you’re likely to be impacted in all areas.

As a parent, it’s really helpful to know if your kid’s got a really whopping dose of ADHD. Yes, it’s really calling your attention. And I am not by any means saying that if it’s mild to moderate, it doesn’t need your attention. In fact, it absolutely does, and it will likely be easier to get your head around it and learn to manage it and help them be successful with it.

I think what’s important for parents is to understand, to shift expectations, to be able to set reasonable expectations. If I’ve got a whopping dose of ADHD, medication may help reduce the symptoms. It’s not gonna organize the backpack in any circumstance, but it’s gonna make things easier. Chances are it’s gonna take a little less intervention, or a little less time, or a little less intensity over time, depending on how it shows up.

And so it’s not about mild to moderate or moderate to severe. It’s about understanding how ADHD shows up in this kid or in this adult: where does it manifest, and how does it manifest, because you gotta learn to manage it no matter how intense it is. Is that fair?

Diane Dempster

Well, and I guess I feel like we’re kind of saying the same thing because ultimately you can’t use the language of mild to moderate or moderate to severe as an indicator of what interventions or supports are actually needed for the kids.

What I don’t want parents to hear is, “Oh, my kid’s only got a little bit of ADHD, so maybe I can just let ’em tough it out and they should be able to do better in school.” Or, “My kid has significant ADHD, oh my gosh, they’re never gonna make it.”

I want us to not use that language because it’s a spectrum challenge. It’s a subjective diagnosis. And what you’re ultimately saying, Elaine, is that every kid is different, and you wanna make sure you’re really clear on what your kid’s challenges are, and that you’re accommodating or advocating for that kid based on where they are. And we can put a link in the show notes to the episode we did a couple ago about accommodations versus remediation.

Elaine Taylor-Klaus

Yes. Yes. You couldn’t remember the word, accommodations versus remediation. Yeah. Yeah. So I agree with you. I think what I’m reacting to a little bit is that I’m stepping in as an adult with neurodiversity.

Diane Dempster

Yeah.

Elaine Taylor-Klaus

And the more I understand, the better. Here’s an implication of how the mild to moderate impacted me, OK?

I spent a lot of years doubting myself, doubting the diagnosis and wondering, “Did I really have it or not? Did I really need this support or not? Did I really need this help or not? Was I just making excuses? Was I just lazy?”

So where the problem comes in, when we don’t treat the diagnosis, no matter how moderate or severe it is, is that if we don’t give kids an explanation, or adults an explanation, for what we’re dealing with, what we make up is a whole lot worse.

And what we make up is that we’re lazy, crazy, or stupid. And I went through 40 years of life thinking I was actually stupid and just fooling everybody. And then after I was diagnosed, I spent another 10 years thinking, “Well, maybe I’m just lazy. If I just tried harder, I wouldn’t need this support.”

Elaine Taylor-Klaus

I wouldn’t need this medication. And that was with a lot of knowledge, I still had that feeling. Yeah. So I think when I join you on your soapbox, the message that’s so important is this: there’s already so much stigma out there around this diagnosis. Mm-hmm. We need to understand it well enough to learn to manage it, no matter how mild, moderate, or severe it is. It’s still gotta be managed.

And if we somehow justify that we don’t really need to do anything about it cuz it’s mild, we’re actually setting people up for a disadvantage, and we’re not setting them up for success. Is that fair?

Diane Dempster

We’ve been talking about the spectrum of ADHD, from mild to severe, and the importance of the labels that go along with it. I wanna take us back to the fact that saying you have mild ADHD is like saying you’re a little bit pregnant.

Even if there’s just a little smidge, I think about myself as a non-neurospicy human who has executive function challenges in moments. In those moments when I have executive function challenges, like when I go into the living room and have no idea why I’m there, it’s usually because I’m having a stressed-out day. I’m like, “What did I do? What did I forget?”

If I say, “Oh wow, I’m such a loser, how did I forget?” instead of, “I’m having an executive function moment because I’m stressed and overwhelmed,” it completely changes the story.

So the point is that the challenges are real in the moment, and we don’t wanna use it as an excuse not to support it. As you were saying, Elaine, the important piece is that these kids, and us as adults, will create stories about why things are hard if we don’t actually help them understand that it is hard, period.

Elaine Taylor-Klaus

And I think, just to end that thought, as I was listening to you, it can get better over time as we learn to manage it, or it can actually get worse, right?

Undiagnosed and/or untreated ADHD becomes all kinds of other complicating factors as we move into adulthood. It can become what’s underlying addiction; it can become what’s underlying underperformance or challenges with job performance. It can lead to anxiety, depression, relationship challenges, eating disorders, and other physical health issues.

There’s so much research now on what happens when ADHD is not identified and treated, it has this negative, cascading impact on all kinds of life circumstances.

So part of what I think we’re calling for is this: if it’s mild, let’s keep it that way. If it’s moderate, let’s keep it that way. Let’s manage it so it doesn’t become, what’s that expression?, the horse outta the barn. Let’s make sure it doesn’t get ahead of us or take off, cuz it will snowball on us as adults if we don’t understand it well enough to manage it.

Diane Dempster

And not just snowball as adults, but what I notice, and I’m guessing you see the same thing, Elaine, is that these kids hit the wall at some point, right? Yes. I had a parent of a third grader who said, “Oh my gosh, my kid is hitting the wall.” I had a parent of a sixth grader last week saying the same thing. “They did fine in elementary school, and now all of a sudden they’re struggling.” The kid going into high school, the kid going into college, or even postgraduate work, it’s not always linear, but at some point the challenges become difficult.

If they don’t understand why they’re having a hard time, “I haven’t ever had a hard time before,” that’s where the stories tend to creep in and the misinformation tends to grow. A parent said, “My kid did fine in elementary school; now fifth grade is hard.” This parent had a kid who literally was having meltdowns, cried for three days because they’d done so well, and suddenly middle school was really hard.

It was great that the parent and the kid were able to articulate the 20 things that were different and hard for them in middle school. And it’s like, OK, great, we understand it’s completely different. It makes sense that it’s gonna be harder. Let’s help you figure out how to accommodate yourself in a more challenging environment instead of assuming, “You were really smart last year, now you’re stupid.”

Elaine Taylor-Klaus

Right, which is what it feels like from this lens. Yeah, absolutely. It really does.

And so I think the message here is: it doesn’t matter what the diagnosis is, it needs to be treated. Untreated, it can have all kinds of negative consequences.

And treatment is not just medication, right? A lot of people say, “Well, I don’t have emotional issues with it, it’s only attention, so I’ll take medication, that’s all I need.” Or, “I don’t ever wanna do medication, so I’m only gonna try these other things.”

The thing about managing ADHD is that the brain is involved. You have to find a way to activate the brain.

What Diane and I have been saying for 15 years is: I don’t care if you do it with medication, meditation, nutrition, or exercise, doesn’t matter what you do, you have to engage the brain in order to manage the ADHD.

And then you’ve gotta manage the ADHD: understand what the obstacles are, how it’s showing up, and find the path to manage it.

Diane Dempster

And as you say that, I’m like, so what does it mean to understand the patterns that are showing up? It’s about understanding executive function. It’s about understanding what’s going on.

My kid is having a hard time turning in their homework. My kid is having a hard time following through when they say they’ll get off their computer, and then they never get off. It’s about taking that minute, and this is part of what we talk a lot about in our programming, to say, “OK, it’s not just that my kid is having a hard time getting off the computer. What’s really going on from an executive function perspective underneath that? And how do I support them, knowing that they have strengths and challenges in executive function, so that they can be successful in getting off the computer long term?”

Again, this isn’t just about taking care of the situation today. Ultimately, what we wanna do is raise kids with a lot of awareness of what’s going on in their brain and their body, so that they know how to support themselves long term, once they’re out of our purview.

Elaine Taylor-Klaus

Well, and that’s where it becomes so important to help them understand themselves well enough. Yeah, right. And to approach that, helping them understand themselves, without shame, without feeling blame, without judgment. We have to pull our own judgment and stigmas out of it so that we can meet them where they are.

That’s why we do so much work with parents, not the kids themselves, because we show up to parenting with all these scripts and all these stories and all these expectations from our own life up until now. And we really gotta figure out and do the work to get ourselves outta the way so that we can be present to them and what they need.

Diane Dempster

Well, even as I’m listening to you talk about “we have to help them understand,” I mean, that’s another sticky spot because it’s like, well, fixing them, right? Because how many times do parents say, “I’m trying to explain to my kid what executive function problems they have, and they won’t listen to me”?

Right? So we’ve gotta go backward and go, “OK, what’s really going on?”

Yes, your kid has executive function challenges, but are they ready to hear about it? Are they in a space where they can hear about it? How do I make it safe for them to hear about it?

Elaine Taylor-Klaus

All the things. Or what’s a coach-approach to help them discover it without you being the one directing it? A lot of it is about how to create conversations around these things so they’re not getting defensive, and we’re not, you know, wagging our fingers.

Diane Dempster

Well, because understanding your ADHD becomes one more thing on our checklist for our kids: “Get your homework done, clean your room, and understand your ADHD.” It’s this sort of, again, it may be hard, it may take a bit to get their attention and their buy-in to do that. I have to tell you—

Elaine Taylor-Klaus

With a lot of parents, I encourage them, for a while at least, to stop using the word ADHD. Stop using the term, because it becomes weaponized.

And it doesn’t help them, and it doesn’t help you. So if you shift from, “Well, because of your ADHD, da-da-da-da-da,” to “It looks like you’re having a hard time with…” or “It looks like you’re struggling with…” or “Would you like some help with…” you’re focusing on what’s in it for them instead of telling them what’s wrong with them.

Diane Dempster

Yeah. Yeah. And some kids need to understand that it is a diagnosis, that it’s legit, something different, and not just, “You’re struggling with…” so that they don’t think they should just try harder. And part of this is navigating when to call it what. That may not be the call right away, that may not be what’s needed first.

Elaine Taylor-Klaus

May not be the first step. Like, there was a point in time I remember with one of my kids where I stopped using the term for a while because we were in this battle about, “Well, it’s different for me.” It’s like, “OK.” And so it wasn’t helping the dynamic for me to keep saying, “But you’ve gotta understand.” I had to pause and manage myself and get out of the way so that he could figure out what was important to him. And that’s the piece, we were able to come back later and talk about it in the context of ADHD.

Diane Dempster

And I think that’s the piece, meeting your kid where they are. Going back to the very beginning, it’s about: what are the challenges they have? What’s their perspective of the challenge? And what’s gonna make it easier for them to understand and accept help, and see themselves not as broken, but as needing support in a way that other people might not.

There’s nuance and flavor to every kid that might be different, which is why it’s so important for us to go, “OK, what’s going on, and how do I wanna help my kid?,” and not expect that there’s gonna be a playbook that says, “When this happens, do this. When that happens, do that.” Wouldn’t that be nice? Which is why I love the coach-approach. I wish there was a playbook sometimes.

Elaine Taylor-Klaus

Sometimes, well, I think this is a playbook. It’s just a different kind of playbook. It’s like, here are a bunch of different scenarios you can use for different circumstances. Try this, spare that. OK, I’m curious, before you and I close, what are you taking away from this conversation?

Diane Dempster

No, I think, I mean, whenever I’m on this soapbox, I always wanna go back and go, “OK, wait, what is it about this that’s got me charged so much?” I think that’s the reflection, this is a hard conversation, and parents often are looking for the easy way out because it feels so hard. And I wanna say: it doesn’t always have to feel hard. We’ve gotta meet our kids where they are.

Elaine Taylor-Klaus

Where they are.

Diane Dempster

Yeah.

Elaine Taylor-Klaus

What about you?

Elaine Taylor-Klaus

I think it’s important to remember the snowball effect of untreated ADHD, always.

I’m constantly reminded of how many years I questioned my own ADHD because I wasn’t “so severe.” I questioned whether I needed support, assistance, help, accommodations, whatever. And how unfair that was to myself, right? That I was judging myself as not ADHD enough to need help. And so to anybody out there who’s got anyone in your world with a diagnosis of ADHD, my invitation, my plea, is to take it seriously and hold it lightly. Right? It’s not… I mean, there’s a lot of joy that comes with it.

Diane Dempster

Take it seriously and hold it lightly. Lightly. I love that.

Elaine Taylor-Klaus

Because they’re both true, right? Yeah, it’s the and of it. I wouldn’t trade being ADHD and having an ADHD brain. It’s complicated sometimes, especially when I have a family of us, right? So take it seriously, get support, and hold it lightly, and try not to freak out, cuz once you understand it…

Diane Dempster

You can begin to learn to manage it, and it’s kind of fun. And we haven’t said this, but the reminder is that even if your kid has just a little bit of ADHD, the recommended treatment is still: get training for you as the parent. Yeah. So we’re glad that you’re here.

Elaine Taylor-Klaus

Yeah. Awesome. Thanks, everybody, for being here. Oh, wait, wait, wait, wait, so what are you taking away? Those of you listening, thank you for being here, thanks for tuning in, and thanks for doing the work for yourself and for your families.

What’s your insight from this? What’s your awareness?

Diane Dempster

What do you wanna take away?

Elaine Taylor-Klaus

And how do you wanna bring it into your life? How might you apply that insight in the coming weeks?

Diane Dempster

As always, thanks for what you’re doing for yourself and for your kids. At the end of the day, you really do make a difference.

Elaine Taylor-Klaus

Take care, everybody. Have a great week.