Amanda Sovik-Jonston
Wed, Feb 01, 2023 2:10PM 55:26 SUMMARY KEYWORDS adhd, parent, girls, inattentive type, folks, students, difficulty, question, child, people, homework, support, kids, hard, terms, absolutely, pediatrician, educators, struggling, signs
00:00 Come on. Okay, so just so you know, I will like you, I'll do my intro and outro later, but I'll just say hi. Welcome to the show. Thanks for having us. Amanda, can you introduce yourself and,you know, give us a little bit of personal journey into the strategizing world. So we're talking about preteens and teenage girls with ADHD. 00:23 Sure are, let me pull up, I have some stats I'm going to pull up. I have like literally one stat, but I want to make sure I have it available. 00:33 I should have said my stat one and 40 students are identified as having a learning disability in aclassroom and how many more are struggling? Oh, that's an interesting step, actually. Okay, I got it. Okay. Here we go. Hi, Amanda, thank you for joining us today. 00:54 Oh, I'm so happy to be here. Wendy, 00:57 can you kick off our conversation by introducing yourself and giving us any kind of personaljourney into this world of talking about preteens teenage girls, specifically with ADHD? 01:10 Absolutely. So my name is Amanda Johnston. I am a clinical psychologist, and I am the founder and CEO of Virginia family therapy. And before I was working at a group mental health practice,what I was doing was specializing in teenage and pre teenage girls and working with their
gpg gpgg gfamilies. So girls that have ADHD, anxiety, depression, mood disorders, kind of anything,because I love working with teenage girls. By the way, I also have three sons, as I'm an expert and teenage girls, which is, 01:46 which is funny you say that because I'm always say, you know, I'm a mom of three boys. And then people say, ask me about a girl. And I'm like, I don't know anything about girls. Oh, I know, my professional world. I know a lot about girls. But that's kind of how I say it in my family. I know way too much about working with girls. And also, I was a school psychologist and a teacher for over six years. So I have really been trying, I believe in being where the kids are, which is in schools. And so I know a lot about schools and school systems and how to help girlswithin those settings. This is incredibly important. So many parents call they're overwhelmed. They're not sure what to do. And they're questioning is there an attentional issue. And I think it presents differently for different students. And so I'm excited for us to kind of dive into that. How do you define ADHD. 02:40 So ADHD overall is difficulty with executive function. So essentially, you're if you've ever seenthe movie Inside Out with the cartoon, and there were in the, in the top of the brain where allthe emotions were and all the things that were happening. That's kind of the command center. And so your executive function is the command center of where you put your attention, howyou transition, how you plan for the future, how you remember how quickly you can rememberthings that already happened, and how you kind of make meaning of all of it at once. And so difficulties with executive functioning are linked to ADHD. There's a lot of crossover talk right now, I'm not an expert in the crossover talk. But I am an expert in figuring out who has ADHD and who doesn't. So typically, when you're thinking about ADHD, we think about folks that arekind of off the wall, right? Like we have a typical image in our head of impulsivity, difficultygetting things done forgetting things, hitting, saying things we don't want to say. And a lot of kids do that. Right. A lot of kids demonstrate ADHD in that way. And that's what we call the hyperactive type. There is another type of ADHD which is inattentive type, and difficulty withinattentive type is where you kind of lose focus. Someone might give you a direction and you forget to do it. You, I don't know, gaze off into counting the swans that you see outside, youforget what you're saying mid sentence, or you really have a hard time getting things done.You don't look like you're having a hard time but on the inside, you really are. 04:38 So how does that how do we then know in terms of, you know, does it look the same for bothstudents who identify as male or female? 04:50 That's a great question. And I think the answer is, overall, boys can have inattentive type ofADHD For the hyperactive type of ADHD, they can have both. And girls can have both as well. There's also combined type which is a little bit of all of it
There s also combined type, which is a little bit of all of it. 05:09 Got it. So and when I say that I mean in terms of like, the assigned at birth, not identifying our pronouns. Now I just wanted to clarify in terms of like, genetically speaking, what we're talking about. So can you bring us into the world then of girls with ADHD? What are those signs? Wetalked about a little bit about the signs and symptoms, but can you just kind of help us seewhen those would pop up? And what would a parent needs a look for? Those kinds of things? 05:41 Absolutely. So while girls can have ADHD hyperactive, or they can have inattentive type, right,more than likely, girls demonstrate more symptoms of inattention than the hyperactivity, right.So they don't necessarily always look to the outside observer, like they're struggling withADHD. So when we think about when kids go to school, the kids that are getting into troublethe kids that the teachers notice are the kids that are allowed. They're the kids that are callingout, they're the kids that are saying something kind of nasty to the kid next door to them,they're the kids that are forgetting their homework. And so those types of signs are more aremore are seeing in the hyperactive population, right? Girls, or folks that are struggling with theinattentive type absolutely fly under the radar way more obviously, because no one is payingattention to them, their behaviors are not kind of screaming, I'm having difficulty. So someone was inattentive type might take forever to get their homework done, they might get to a testand absolutely freeze and not be able to remember anything and stop halfway through, theymight have a hard time figuring out how to write their assignment from the board onto theirpaper, they might, I mean, they might just stare out at the window the entire time, or they canchat with their friends all day long. That's how I was in school. And a lot of times, girls, whenthey're in school, they have a hard time focusing on what's at hand. So they might be chattingwith the person next to them, they might be singing out loud, and maybe getting into sometrouble that way. They might be writing notes to all of their friends. So it can look very differently than the quote unquote typical boy presentation. But the impact on how kids are doing academically can still be the same. 08:02 What does data tell us in terms of statistically? The inattentive type diagnostic 08:10 part, you know, I actually don't know the statistics on inattentive type, in particular, but I doknow this, that the CDC just released an aggregate of data from 2016 to 2019. So you know,they have to, they look at time chunks, and it takes a while to get the data up and out into thepublic. So this is the most recent aggregate study I found. And what they found is that folksfrom ages six to 11 10% of the population is diagnosed with ADHD, whether that's inattentive,or with hyperactivity. 13% of the population is diagnosed between 12 and 17, ages 12 and 17.But boys are two times more likely than girls to be diagnosed with ADHD. It's 13% for boys and girls are at 6% of the population. And what studies are suggesting is that there's actually moreof a one to one ratio of boys and girls who are struggling with ADHD, but the diagnoses are notbearing that out. So what can parents do to kind of start thinking about this and looking at it, sothat they can start taking action if they have a daughter and they're concerned? That's a greatquestion. So number one, I would really start looking at some of the signs and symptoms, y'all Iwould Google, ADHD and girls, let's be honest, they have some great lists that are prettyreliable and they will be very, very specific. So if we think about academically, what are theystruggling with? Are they having a hard time getting their homework in is their backpack adisaster? Is? Are they forgetting their lunch? Are they getting into trouble for talking? Are theynot following directions? Is their handwriting atrocious? Those Those are some pretty goodacademic indicators. And they're also some more some social emotional indicators. Are theygetting into trouble with their friends? Because they say something kind of mean, and theydon't mean to? Are they emotionally labile, which just means they're, they're having outbursts,because they're having a hard time holding it together? Do they have a hard time initiatingtasks starting something? Do they have a hard time with long term planning, those can all besome of the social indicators. And another thing I always want to tell parents, I always seeparents in my office, and they say there is no way that my child has ADHD, because when theystart doing something, they are so focused that I can't get them to do anything else. So in myfamily, I have kids with ADHD, and my kids will work on Legos for four hours straight, they willsit with Legos, they will sit with a book, they will sit on YouTube in their dream world for fourhours, and you can't get their attention. But there is a piece of ADHD that's called hyper focus.So if you have one of those kids that gets into those four hour stints of only focusing on onething, that's actually a deficit in executive function and is related to ADHD. So if they can hyper focus, that's also a sign that they might be struggling. To educators need
11:46 more training on recognizing the signs and symptoms? And I guess this Yes, 11:53 I think absolutely, educators need more training on recognizing signs and symptoms,specifically of inattentive type, and how ADHD impacts girls. I also think it's gonna be hard,right? Educators are people they are doing so much right now. And they are going to beresponding to the kids that are having a hard time in the classroom, the loud ones, the onesthat are disrupting other people's learning. And in many ways, we want them to be doing that,because that is getting in the way of everyone's learning. And we want them to take some time and slow down and think, who seems to be staring off, who seems to be pretty bright, verballywhen I interact with them, but never seems to get their homework in, who is doing a lot ofchatting. And is only turning things in at the very last minute, very messy. There are all these more subtle signs that if you pay attention to them, you will notice that the girls or folks ofinattentive type are struggling. 12:59 So let me ask you this, then Amanda. So if I am an educator and a classroom and I'm noticingthese symptoms, i My guess would be I would just share that with a parent if the parent asked me.
13:15 Absolutely. That's a great point. So I think number one, if you're a parent, you should ask yourteacher, have you noticed any of these difficulties? You can also say I've been doing all of thisat home to help and start thinking about what are you doing at home to support yourdaughter? At in their ability to access the curriculum? Are you setting them up? Are you do youhave your pencil in place? Are you going through their plan are with them. If you're a parent,and you're spending a ton of time with your kids planner, you're likely providing support that'sallowing them to be success, and may even be masking where they're struggling or maskingthe ADHD. I also think it's really important to recognize that teachers, many therapists and andeven medical professionals, doctors are drastically under diagnosing ADHD and girls. So you might suspect it. You go to the pediatrician and you ask and they might say no, no, like they'redoing fine, no big deal and they're doing the best they can. But I will frequently see that daughter three years later and say this is ADHD. Let's get them let's get them some support.And let's move them forward and that can be really beneficial. 14:39 So how does a student get diagnosed with ADHD in terms of girl so we're focusing on girls andthen I as a parent, you're right. There's a lot of times and speaking with parents, that they aredoing a lot at home and even when I've had consults with neuro psych neuro psychologist, interms of you know, what is work? gain what is not working? And a lot of times parents aredoing this at home to support this. So how does one then say if you if I go to the pediatricianwith my daughter, and I'm like, you know, this is what's happening, I'm doing this at home tohelp. 15:16 What's Is there something specific I need to ask for, to seek a diagnosis? And then to how dowe diagnose? That's a great question. So I think the pediatrician is the easiest first step, youalready have a relationship with them, you know, they know you more than likely. And so you'll go and you say, I suspect they might be struggling with ADHD. And let me say this before Iforget, because sometimes I get a little inattentive is if you're, if your child is always late, andyou're always fighting about getting places on time, that's another really good indicator thatthey might be struggling with this. But if you go to the pediatrician, they will give you typicallywhat's called a Vanderbilt and a Vanderbilt is 25 to 250 questions that they will ask you aboutyour your child, and they will score the Vanderbilt and they will say, Oh, your child is above thenorm, or below the norm on various indicators. Typically, those indicators are more about thehyperactive, the hyperactive tendencies with ADHD, they will be more about the externalizingfactor. So are they hitting? Are they getting in trouble? Are they chatting too much? Are theyimpulsive? There's less information on the Vanderbilt that can be indicative of the inattentive type. So it puts parents in a little bit of a bind, because the initial screening tool at the pediatricpractices, it doesn't always recognize the symptoms that girls have. 17:02
17:02 So let me ask you, I have a couple thoughts there. Then. Again, I'm a parent. And I am suspecting something I go to my pediatrician. I think I'm asking the right questions. They giveme the Vanderbilt for and but what if that? So then what would? How would I know as a parent,I need to do additional investigation? Because a lot of times it's like, well, I went to thepediatrician, the pediatrician said she's fine. Absolutely. 17:33 I think that's a great question. I think your next step is you can call the school and talk to thefolks at the school, talk to the guidance counselor, talk to their teacher, you can talk to theschool psychologist and go through the steps that you do such a nice job one day of talkingabout and get the school involved and collect data from the school. And then I think you take ifyou're getting stuck, you take that data to a therapist, you take them to a psychologist that canhelp you because more than likely, if they have untreated, an undiagnosed ADHD, they'rehaving a hard time somewhere, right? And so a therapist can really help you look and figure outis this ADHD? And, honestly, whether it's ADHD or not, they can put some interventions in placethat can help your child be more successful. Right? Like, I'm just thinking, my six year old has a terrible bedtime routine miserable. We're arguing or fighting. It's absolutely no fun. Now I'm a psychologist. So I know the answer is just to create a bedtime checklist, right? And that's easy.I'm gonna create, maybe I'll create a bedtime checklist tonight, I'm gonna at least try to followthrough on that. But that's an intervention that I will put in place that will make bedtimes easier for our family. So a therapist can help you come up with strategies to help your kid managetheir symptoms of ADHD. Beyond that, you can also take your child to a psychiatrist, apsychiatrist is is more trained, they can usually do like a two hour intake that's beyond what apediatrician can do. And they can tell you at the end of it, hey, you know ADHD, no ADHD, youcan talk about medication and the benefits or the not benefits. You might not choosemedication, but you're still gonna get the diagnosis and have understanding and that can bevery useful as well. 19:36 If I can talk about assessments again, so if I'm if the Vanderbilt if our ADHD screeners andassessments or are they are you saying that they're normed towards 19:52 boys, and then that then under diagnosis, the girls are there any assess Since that can then doa better job on identifying the inattentive component that would impact a girl more sostatistically. So I'm not quite sure if the Vanderbilts are normed towards, towards males, butwhat I do know is that the indicators that they're asking about are more related to ADHD withhyperactivity, right, they are less the questions are less related to inattentive type and morerelated to the hyperactivity. So what you can do is if you continue to suspect it, you can askyour school to evaluate your child for special education and see if because you suspect thatthey have another health impairment or ADHD. And if you go through that process, the schoolpsychologist, hopefully will be able to use more specialized tools in order to diagnose or notdiagnose, or in order to identify or not identify your daughter with ADHD.
21:09 As a former school psychologist, can you kind of walk parents and professionals that may havenot sat at an IEP table? What does that look like from a school psychologist lens? If you have aparent saying I have these concerns, I already went to the pediatrician and this my information.What does that look like for a parent or professional in terms of a role as a school psychologist? 21:39 That's a good question. I think to be honest, as a school psychologist, when faced with this, oneof the issues that is going to be challenging is the fact that girls in general, tend to have morecompensatory behaviors than their male counterparts. So what I mean by that is they may have ADHD, but they are also really, really anxious. And really, really people pleasing y'all. I'm doing drastic, broad sweeps. So this isn't completely true for everyone. But anxiety and ADHD are very, very linked. Because if you know you're forgetting something, you're going to beworried that you're going to forget something which then makes you forget more things. So there's this cycle between anxiety and ADHD that is very, very present in girls. So when girls orwhen folks in general, get anxious, they can overcompensate, they become they can, they canbecome very, very rigid, very, very strict in what they're doing very, very attentive to whatother people want and what other people need. And because they're putting so much energyinto doing things, right, that they are compensating for their difficulty with attention. And so that's where it's going to be difficult. As a school psychologist, seeing, wow, this kid is doing pretty well academically overall. And I don't know how much time or how much energy this girlis putting in to be able to achieve the level that she's achieving at. And I think that is where parents and psychologists and educators need to have a conversation. What is it taking to getthis girl to where she is despite the difficulty that she's having with attention? Yeah, and Ialways say that what is the time energy? And 23:39 that goes into that processing memory and attention as it relates to your school day. Not all academics, but your school day. And that is a huge part. And you brought up the anxiety and the ADHD. How does? How do we as either professionals or parents or both? Understand thatcomorbidity that CO occurring? Like what comes first is always a magic question, right? Is it theanxiety that's making it look like contention, or even ADHD and autism? How to how to aparent? How does a parent or professional determine the best course of action? If we sense thiscomorbidity? 24:24 So, honestly, a parent doesn't do it on their own? Right? You need a team of folks that can helpyou figure this out. So my husband's a child psychiatrist, and we talk about this all day, everyday because I sent him a ton of folks and he sends me some of his folks and one of the thingswe talk about is this anxiety ADHD cycle. So again, you have difficulty remembering something,you get anxious because you know that you forget things which then makes you forget morethings. So in that situation, the ADHD comes first right? You're forgetting things and then you get anxious. However, there's also a group of folks that are just really, really anxious. And because they're so anxious, they're always worrying in their head, or they're getting distractedby their worries. And once they get distracted by their worries, they start forgetting thingsbecause they're spending all of their time worrying. And so then that leads to difficulty withanxiety again, so either way, there's an anxiety ADHD feedback loop. And sometimes it's just acrapshoot, which one you treat first, just to be honest with you, it therapists and psychiatrists,and people at school can help, but sometimes you try one that doesn't work, you try the otherone next, and you see where you get.
25:46 So how do we weave this into the school day for a kid in terms of getting support, whether it'sthrough a 504, or an individualized education plan? No, go ahead. 26:00 I think it can look a lot of different ways. So I think a lot of folks could benefit from extended time, a lot of folks can benefit from preferential seating, a lot of folks can benefit from help withgetting, honestly just getting the information from the board to your planner about what thehomework is, there are a lot of supports and accommodations that the schools know and utilizewell, that they can help a girl with ADHD be better able to succeed in the classroom. 26:36 And to kind of piggyback on that I always encourage parents to prioritize what they see as animpact, like you just said, if it is writing down the homework, if that's your major impact, as anexample, what can we do? You know, there's, I have some students that they write theirplanner down, then they leave their planner, right? Or they're unable, or they're unable to justbecause of the writing component, whether it's the parameters of the box that they have towrite into, or that near or far copying and the processing within that. And then somebody sayssomething, and I've written HW for homework, but I didn't write the page number or the bookor any of those things, thinking about taking each of those priorities, and then thinking aboutwhat can we do to support that individual child as a parent, again, looking back at what you'redoing. So I know, on smartphones, there's, it's called Google Keep. And I know some kids that have really benefited from that, because a lot of times they're not losing their phone. So then they have that home with them, they can speak into it instead of having the physical, right. So kind of just prioritizing, and if it is preferential seating, preferential seating isn't always let mesit in the front of the room for some students, and maybe let me sit near the door because Ineed to fidget or sit in the back or wherever that may look like. So having really goodconversations as a team, and I think you as you said, that is amazing in terms of what can wedo as educators, professionals, parents come together to collaborate and to support thatstudent with their support at school. 28:24 And I will add to, we talked a lot about kids almost over focusing or overcompensating for theirdifficulty in this area, we're also going to have a crew of folks who are getting stuff done at the difficulty in this area, we re also going to have a crew of folks who are getting stuff done at the very last minute, right, and they need that procrastination and that pressure to actually followthrough. So I use myself as an example all the time, I used to write my papers in class on myleg, right, and I would tell my teacher every day, sorry, our printer broke, but I would just writethem and turn it in. And I was very fortunate that I could compensate with my other verbalskills, because you can tell I like to chat. So I was compensating with my verbal skills are able to get it done when I needed to. But if you have a child who's always kind of sliding in at thelast minute with disorganized messy work, that's absolutely another sign or symptom of ADHD.
29:26 So how do we know what's working and serving the student? And then what's not like yourexample is perfect, right? So was that an impact for you to write the paper on your leg? Or wasit not? 29:38 I mean, honestly, I know it works for me, right? On the spot. Yeah. No, it was working for me.You know, I ended up going to UVA and I have my PhD and writing my dissertation was very,very hard. And we have a whole different generation of young women that are in college now.Oh, and 40 year olds that are getting identified with ADHD, now that were never identifiedwhen we were younger. And so we have all of these compensatory behaviors that have workedand have served us well. But getting a diagnosis has been, for some folks, absolutely lifechanging, because they feel like they finally understand what's been so hard for them. And I think that that has been really interesting. You know, I did a podcast on girls ADHD in me probably a year ago. And I get more responses from women saying, I finally got diagnosed afterlistening to that, than any other podcast I have released, because girls have been missed for solong. We've been really, really missed. And I think it's exciting that people are finding out and really starting to talk about it. To your point 30:54 there, right, so you have been successful and these women have been successful in theirholding their lives in their career and their families and such, but let's not dismiss or dismiss itdiminish this running internal record that you're having with inside, right, because again, backto that energy effort that you have to put in to get things done to keep things together to maskwhat's happening. But internally, you're fully aware. 31:25 Absolutely. And I think, I think that's one of the things that can be difficult about ADHD. I believe this is true for boys, I know this is true for girls, you can be a high achiever, and stillhave ADHD. And I think that is where people have gotten confused for a very long time. There are plenty of folks out there that are doing very, very well, but are working so hard to be ableto get there. I even say for me, I didn't realize I had ADHD until honestly through the pandemic,because I exercise for an hour to an hour and a half every day for most of my life. And once youtook that exercise away, because exercise is a great way to manage ADHD, once you took that exercise away, I couldn't focus. And I took it away, because I was with my three kids all day, every day all locked inside. Absolutely. But that's what a lot of folks do. So you might have agirl who is an athlete who's doing really well running around, and really putting in a lot of theseinterventions that we would put in place for folks with ADHD. And when you take some of themaway, whether it's, you know, whether it's a really good plan or or whether it's an hour withyour mom, every night going through each piece of homework, or whether it's exercise, youtake all those interventions out, and you see how hard the kids are really, really working.
32:53 So when could a parent start to notice signs, right? So is it the frog in the hot water analogywhere you put a frog in the water and the water slowly starts to boil? And then they don'trealize it until you know, we've hit a wall? So to say, because I think then if you're, you're tiny,you're like, Okay, well, they're really engaged. They like you know, whatever it may be, andyou kind of start to put these into place, and maybe not even recognizing that you're puttingsome accommodations into place for your child. 33:29 That's a great question. It absolutely makes sense. And I think you just said this on my podcastis that there are some key ages and stages for kids. And you said third, sixth, ninth. And then I think entering college and that first year of college, that's where we're getting these new,larger developmental tasks. We're asking more of kids. And so those if they have a hard timegetting to that phase and succeeding in that phase, that's where we're going to see kind of ajump in difficulty, a jump, because the demands are higher in each of those grades. But I also think, you know, like last night, as a parent, I realized I'm spending an hour trying to get my sixyear old ready for bed an hour, y'all. It is ridiculous. And that is a frog in boiling water, right?That's like, oh, it was 20 minutes, then it was 25 then it was 30. And all of a sudden you're likein a deep power struggle, but also a deep routine that when you take a step back, you're likethis does not make sense. This doesn't make sense as a parent. So if you find yourself in thatsituation, where you're doing your homework with your child, you're doing a half an hour ofprep on their planner, you are reviewing their their essays for grammatical errors every singlenight in order to keep them afloat. And you look back and you just say This doesn't make sensefor how for for what I think they're capable of. And for their age, if you really feel like there's amismatch, that's a great sign as a parent that it might be worth looking into, and just Googlingsigns and symptoms of ADHD for girls. Dr. Google solves a lot on like deep thoughts, y'all. I'm really, really glad they're listening to me. 35:25 How can parents advocate best if they are seeking to assess their student for ADHD? Or like,what type of language should they use? I know, we've talked about this in the beginning, butlike, what would be your best, you're like, Okay, every here's my low hanging fruit for people, 35:43 I think parents are going to have to not only advocate for their daughters, but also educate for
I think parents are going to have to not only advocate for their daughters, but also educate for your daughters. So when I say look at a Google, look at a Google, whatever, the first thing thatcomes up is, print that out, take it out and write specific examples of where your child isstruggling in each of these places, and what you've seen, and then take that to the school.Because in many instances, you're also going to be educating whoever's on the other endabout the signs and symptoms for girls. Now, when you look at that checklist, your daughtermight have ADHD, and is not going to ring the bell on every single sign and symptom, they willlikely not have an issue in some of those places, and really have an issue in other in otherplaces. So be honest, we do something called confirmation bias, which is where we want ourkids or we think our kids have something so then we only look for data that supports that,right? So you got to be really honest, when you're looking at that checklist and know you'regoing to have some stuff that hits and some stuff that doesn't. But take that to the school with you. 36:54 And every kid is different, right? Every kid presents different. I mean, I know just even in mypersonal family, people have said, Oh, your kids must all be the same. I'm like, they are noteven the same different chapters within a book or they're on different library, there's a million,also different. And I think what you just said is incredibly important, I tell parents that the samein terms of collecting data with specific examples to whether you're bringing it to yourpediatrician, to a psychologist for assessment for the school, make sure that you have cleardata that shows that impact so that you can I love that educate the people that the folks thatare maybe not seeing it, and just to be able to kind of correlate, I'm seeing this at home, I amnow seeing this at school. And here's my specific data to support that, because I think thatempowers parents to be a part of that team. 37:52 And there's nothing you know, there are great people on the other side of that table in schoolsthat maybe graduated, you know, even five or 10 years ago, folks weren't talking about ADHDand girls, so they could be on the top of their game in so many ways and still not know this.And that's okay. So coming to them with love and support and understanding is probably goingto get you farther than coming in like, Look at this. I got it off Google and here are myexamples you want to work together with with the folks at school? 38:26 On that same conversation on data? Are there certain types of data that parents should belooking for, if they're bringing this to the school, or they're bringing it to the IEP team? 38:39 I think anything that is measurable is going to be useful. So if you're looking to say, you know,it took my child a really long time to do their homework, well, let's get a little more specific,right, it took my child 32 minutes to get these five questions done. It took my child 20 minutesto go from walking to their backpack to get there to get their homework to sitting down at the kitchen table to start doing it. It took my my child said this not so nice thing to another girl. And they spent two hours crying and in drama and texting with all of their friends because of thisimpulsive thing that they said. So really looking for measurable data around time and quantitybecause that's what the school is going to be looking for. They want to know how long and how frequently and also how intense.
39:37 Yes, exactly that. intensity and frequency and duration is key is key. So let's talk we kind of mentioned a little bit about medication. But can we talk a little bit about kind of medication and or therapy options for parents? Absolutely. 39:57 So many Qishan in general, there's an entire group of different medications that treat ADHD.I'm not a psychiatrist, my husband would be very angry if you heard me talking about it thisway, because truly psychiatrists are the experts and and pediatricians are the experts on this.And medication can be a useful tool. The thing with ADHD medication is it can be prescribed by a psychiatrist or a pediatrician. And if you don't have to take it every day. So there are some medications like SSRIs that help with anxiety and depression that you take those every daybecause your body needs them. And they're in your system every day. ADHD medications youcan take when you need them, and you can not take them on the weekends. You can not take them over summer break. It doesn't matter whether you take them one day or not the other day. Another question? Yeah, go ahead. I had something else I was gonna say about ADHD medication. Sorry, I'm totally off track. Now. We can cut that out. We got it. Okay. Okay, go with your next question. Sorry. 41:08 Let's talk about therapy. Oh, 41:10 absolutely. So, a lot of times with kids, we see kids come in, and they struggle with a certainset of difficulties. So let's say the difficulty is bedtime routine is terrible and miserable. And there's a lot of fighting around it. So as a therapist, we whether the child has ADHD, or not, wecan put certain interventions in place to support that bedtime routine. So I can say that kid has ADHD. And let's create a checklist. Because they can look at the checklist, step one, step two,step three, it's done, I can create that intervention and bedtime will be easier. The same situation, if the child doesn't have a diagnosis of ADHD, right, bedtime is still hard. So I can create a checklist step one, step two, step three, it's done. So therapy can help with diagnoses.And whether there's a diagnosis or not, you can still get interventions that will help specificdifficulties that a kid is having at home or in school. 42:25
42:25 What kind of accommodations? Have you seen work really well, like school basedaccommodations? 42:31 That's a great question. I think, extended time can be useful. I think for girls, maybe this is myown qualitative data, but I think many of them would benefit from having testing away fromother folks, or even in the front of the room. Because I think for girls, they're, they're a little more social in nature. So if they're in the back, they're going to be looking at all the things that are happening. So if we can get girls in the front of the room where they're not able to see allthe things that are happening, that can be particularly beneficial. I think some girls reallybenefit from social skill groups, because again, girls tend to be a little more relationship based.And so if they're having a hard time with their impulsivity, and what they're saying, a counselormight actually be really beneficial and helping them work those things through and even justintegrate them into a social circle at school. I'm sure you have some other ideas, too. What do you what do you see? 43:30 I mean, I think if you look at if you look at again, what are the priorities, what is the greatestimpact, and that individual student, right. So I've seen some students work really well in front of a class, I've seen some not. I've seen devices in terms of just my tip before in terms of getting homework done. I have seen that's worked really help helpful. It's worked really well isa landing launching pad in terms of when you come in the door, you can put all your stuff andI've seen parents do it in big buckets, I've seen them doing trashcan clean ones fresh,whatever. But you know what I'm saying just even a carpet square. So you have one place to stick your your items. So really thinking about what is the impact in terms of reading, helpingpause after whether it's one sentence or a paragraph and do a little margin, note or picture tohelp. Sometimes some students really benefit from visual taking visual notes versus actuallylong form notes in terms of drawing a picture and creating a web from that. So really be an individualized and systematic and how we support our students. I've even had I did a walk with Wendy on it recently. It was getting me thinking in terms of you know, a student goes in to takea shower and you're thinking oh my gosh, I don't even know if they stood near the soap. Do they know the steps in the shower and then taking a clear shower curtain and with picturestaped to the outside of Oh, cool, that's one, step two, step three, and then have a even take it astep further and get a shower mirror so they can actually see themselves. I know people can'tsee me as I don't know why I'm keen washing my hair, as I'm saying this, but they can seethemselves actually washing their hair. So really under making sure that, you know, andshowing them what does that look like, right? So we tell our students go clean the room. And it's not up to what that looks like. So what does done look like in a classroom? You know, I know that you're done when these steps have taken place, you know, you're done when these stepshave taken place. So ensuring that they even know what done looks like they know what the shower looks like. And so kind of making sure that we're chunking out the areas of impact andbeing thoughtful to what best supports that child and I love our our kiddos that can actually tellus like that strategy really works? Well. For me, I'm that strategy does not work well. Fantastic. That's information we can build upon that. Alright, that really works well for you. Okay, how dowe then put this into action and other areas? How do we transcend that beyond this one classroom or our house? How do we make this work? We're out. And these are life skills, right?Like, if we're talking about what does completion look like? How do we ask questions? How dowe advocate? How do we break down long term assignments, these
46:32 are all life skills, that our students need to be successful not only in the classroom, but on thejob and beyond. And I think for us, there's a lot of school districts that have gone to no examswithin a high school. And I'm now myself other professionals are really seeing this huge impact.I don't know if you are as well, Amanda, but with our college a students that are getting intocollege and falling up Absolutely. They those, whether if it's attentional learning, however it is,they don't know how to take an exam. So they never really learned how to chunk out theirmaterial, do a five day study, plan, whatever that may be. And so I think, again, all of theseitems really do impact our students, but they also impact them in the work world. Absolutely.And to be honest with you, I think part of it is continuing to think outside of the box for the forour daughters and for other kids. So as you were talking about that, I realized I always tellpeople to use their planner, and you're talking about Google because they don't lose yourphone. I think you're right about their phones, I always tell people to use their planner becausethey can doodle. Teachers don't really get mad at kids for writing down in their planner, they'llget mad if they're on their phone during class, or they'll get mad if they're doing somethingelse. But if it looks like they're writing in their planner, they don't get in trouble. And a lot of times, kids need to be doing something else in order to listen, and that's a good thing. And so talking to our kids, what helps you learn? Yeah, sounds do you stay engaged? What wouldmake it easier for you when you're in that lecture? Or? Or how can you remember to write thisstuff down, but really starting the conversation? Because I think that's the conversation that isgoing to help our kids when they're adults? Yeah, that's right. And having them in tune of what works for them? Absolutely. And then being able to advocate for it. Absolutely. And say, I can do this, like I can doodle and pay attention to you. I'll you know, try calling on me tomorrow.And we'll see if I'm listening and say in a kind way, in a kind way you say that but saying I cando this. Let's let's give it a shot. 48:59 As we wrap up, can you give me three tips for parents that they can use to successfullysuccessfully navigate their student, their daughter's educational experience? 49:16 That's a great question. I think number one, start warm. I think teachers are going through somuch right now and they have so many demands on them. And you, you will advocate better for your daughter. If you start warm. I know you're probably scared and starting warm andcreating ally ships to get you through whatever is coming up is is going to be the easiest placeto start because I think teachers want to be your allies. It just can get tricky and it's hard right now, but that's where they want to come from. So let's introduce them from that place. I think number two is to use your resources. Find your team, find folks that can support you, whether that's Google, great. Also have a discerning eye. But find a team of folks that are going to be onyour team and make sure to talk to those people. Like like a pediatrician, like the school counselor, like the teacher. And then I also think, honestly, educating yourself and educatingthose around you, because folks really don't know a ton about ADHD and girls. And I hope that this podcast is providing education to some folks. And I know there's a lot more out there, that a lot of other people that need to learn more and so advocating for yourself and your daughter,
50:40 what would be tips for professionals, specifically, educators that have girls that either arediagnosed or not diagnosed? How can we better support our girls within a classroom? 50:56 I think, honestly, one time a week, I think educators should sit back for three minutes and say,What am I missing? Right? Who are the people that I don't think about all of the time, because Ithink it's really easy, whoever, you know, the squeaky wheel gets the grease, or whatever thatis, the folks that are having a hard time are getting more attention. And I think really puttingtime in proactively to look at the whole class or who isn't getting the most attention and tryingto make sure you're trying to understand them as well, because I think that's going to give youopportunities to learn about those folks and maybe find some of this stuff out. Can you repeattelling me the question again, I'll give you the other two? Oh, what should I be looking for? Ithink, looking at homework, looking at who's turning it in regularly, who is missing it? Who hasa ton of like scratch out marks and eraser marks, who is whose parent is doing a lot of the workfor them. So really thinking about the homework, and seeing what you can learn from how thehomework is or isn't coming in to you. And then finally, I would also just look at what are thesocial signs for girls, I think girls tend to have a few more subtle social signs that can be veryinformative. So getting in trouble for saying things that aren't always as nice and causing a lotof relationship drama with that, because I know you see it on the playground, kind of sidetalking and side chatting, and also some emotional outbursts difficulty regulating theiremotions, because that those can all be signs and symptoms of ADHD. 52:42 tremendous value, tremendous love. As we wrap up today, is there something that I didn'tknow enough to ask that I should have asked you? 52:56 I don't think so. I think honestly, if I were a parent listening to this, I would be like, Oh, yes, mydaughter has ADHD. And then I can imagine taking it somewhere and then saying no, yourdaughter doesn't have ADHD and feeling really stuck, not knowing which way to go. And as we're talking about educating other folks, I don't want that to mean that you as a parent can bea sole diagnostician of ADHD and your girl. So I think it's really remembering that you're going in with your thoughts. You're listening to professionals, and it's gonna be a back and forth working together. Because it is hard. And I think just understanding that it's gonna be hard. Is okay, because that's what parenting is, right? It's just, it's fun. And it's lovely, and it's hard. It is,
53:50 if you had one tip for parents to place on a billboard, what would it be? And why? Finalquestion. 53:58 Be patient with yourself. I think we are really in this world where we expect perfectionism and we want to be perfect. And there's so much information that we're getting from all these othersources, and we're never going to be able to achieve what everyone else wants us to do. And so I think just being patient with ourselves and knowing that there's gonna be ups and there'sgonna be downs, and it's okay if we make mistakes, because everyone makes mistakes. How can people find you? So I work at Virginia family therapy, which is just www dot Virginia familytherapy.com. We provide therapy for folks actually across the United States and across the world. But I also host a podcast called active and connected families and it's really for folks whoare working pretty hard and we know that in order for our whole families to be healthier, we'vegot to stay active and we've got to stay connected. And it's the fun hopefully and smart, hopefully, but I love doing it. 55:03 Thank you very very much for sharing your information and your talents and tips for some littleknown information. So hopefully folks that are listening can have the best course of action tosupport their kiddo at home or in our class. 55:18 Amazing. Thank you so much, Wendy. I hope you have a great day. You too. Thank 55:23 you. Bye
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