It’s heartbreaking when your son or daughter shares that they don’t like their bodies. They may dislike their shape, their height, their hair color, their fingernails, their nose or their feet. All too often, kids (and adults) compare themselves to an unattainable ideal of beauty put forth by mainstream media and culture. We see actors, models and social media icons who look polished and seemingly perfect. It seems impossible for us to measure up because their images are carefully crafted and maintained with lots of money and support staff. Kids also perceive other kids as prettier, stronger and more popular. Sometimes family members may criticize us in particularly cruel and painful ways which makes it even more difficult to love who we are. For kids with ADHD who often get on a hamster wheel of negative thinking and may already feel diminished academically or socially, it’s especially tough to stop the repetitive, critical thoughts in their heads. Shifting your views about your body means accepting who you are, what you look like and appreciating our differences. We need to remind kids that yes, they’re not perfect but no one is. Of course, the work is really about what’s inside as much as what’s on the outside. We all have to learn to fill up our own approval cups instead of holding them out for others to fill with compliments and reassurance. This is really tough for kids with ADHD who want to fit in and be accepted by their peers. They want something about themselves to be “normal” since their learning styles are different. Outer appearance, however, may give them some relief but it won’t mend the insecurities inside of them. You really can’t compare your insides to someone else’s outsides. We have to teach our kids and teens that people may look one way but have something entirely unexpected going on inside of them.
To challenge distorted or negative perceptions about body image, start by helping your son or daughter create a supportive team of caring friends, teachers, mentors and family who love all parts of them.
If people around your youngster are critical of their appearance, brainstorm ways they can deal with these comments appropriately. In a calm moment, create one or two comebacks that are witty and easy to remember and then practice using them. If you need to intervene with teachers or school administrators to set limits because of suspected bullying, talk this over with your son or daughter and protect their safety. It’s not okay for someone to criticize your body and kids need tools to convey that it has to stop. Saying it was a joke or they were just being sarcastic is also unacceptable. These are simply passive aggressive ways to put someone down. If necessary, encourage your son or daughter to take a break from interacting with this person for a while. Sadly, it’s typical for many kids, especially tweens and teens, to dislike some parts of their body. Sometimes dissatisfaction with one’s appearance can have serious and disturbing consequences. Body dysmorphic disorder, bulimia and anorexia are serious mental health conditions that require immediate attention. There’s a difference between casually disliking how your bottom looks in a certain outfit or wanting a smaller nose or wishing your torso was more muscular and actively trying to change your appearance or manage uncomfortable feelings with obsessive thinking and self-harming behaviors. If you notice that your child is seeing bodily defects or malformations that do not exist, if your child is showing changes in how, when and what they eat or if they tell you that they are throwing up on purpose, consult their pediatrician or primary care provider immediately. 
In the meantime, focus on healthy living. Offer positive body-affirming comments and monitor how you talk about your physique. Our kids notice everything and take in what we say and do. Accepting ourselves, warts and all, is a process that benefits everybody. Empathize with their feelings and also remember to, as the song says, “Accentuate the positive!” without being a pollyanna.
Feeling nervous is different that feeling anxious in terms of intensity, frequency and focus. Nervousness, like anxiety, is experienced cognitively and physically but it doesn’t stop you from doing something. Nervousness is a temporary feeling of insecurity related to specific concerns about a new or stressful situation. Usually these concerns go away once you’ve mastered the tasks associated with that situation or lived through and managed it successfully. You’ll feel nervous with a flutter in your stomach or some perspiration about doing something like getting a flu shot or going to see a friend for the first time in months, but you’ll do these things anyway. Anxiety disorders are more debilitating and persistent, reflecting repeated all or nothing thinking, negative expectations of events and an inability to tolerate uncertainty. They can be related to general or specific fears that don’t go away despite positive experiences of successfully overcoming them. Although anxiety 
can be adaptive by helping us prepare for real danger, anxiety disorders involve the experience of a natural emotion at an inappropriate time and to an excessive degree. Sometimes there can be episodes of fear or worry in the absence of a genuine threat. Whether it’s a true emergency or a false alarm, anxiety disorders distort your perceptions and create uncomfortable bodily states including racing heart rate and shortness of breath. Most people try to avoid whatever triggers the anxiety which, outside of crisis management, actually makes it worse. Instead, it’s most helpful to identify what triggers your anxiety, your typical, distressful reactions and brainstorm alternative responses. The goal for reducing anxiety is learning how to tolerate the discomfort that comes from uncertainty and realistically assess the safety of a given situation. For example, your child may be very anxious about being stung by a bee, refusing to spend any time outside. You will have to work with her to go outdoors slowly, by increasing the minutes she successfully tolerates the fresh air each day. We want her to learn that she can worry about bee stings and live through her fear. She’ll likely need to create and use self-calming phrases such as “I don’t see any bees around me,” “Bees want pollen” or “A sting will hurt less than getting my ears pierced.” She’s learning to how to manage her anxiety and you are supporting her budding confidence. 
Whether your child or teen is dealing with nervousness or anxiety, they need to figure out a strategy for self-soothing. You won’t always be there to reassure them that things will be okay. Practice some phrases and calming behaviors outside of challenging situations so they’re familiar enough for kids to summon up when needed.
After a spring semester with remote learning and its many complications for students, parents and educators, schools are reopening in the fall. While each state is dictating its own guidelines for this reopening, it looks like many independent schools and public school districts will opt for some type of hybrid learning–a mix of in-person and online instruction. These hybrid models differ according to age groups but the details have yet to be ironed out. The general consensus is that primary school students need more face-to-face instruction that allows for safe distancing and mask-free breaks. Secondary school students, those in middle and high school who tended to adapt better to online learning, will likely face some classroom time alternating with virtual instruction. It’s quite possible that these students won’t attend school daily to accommodate recommendations about social distancing and class size. But, with so much still unknown about the fall semester and information about COVID changing daily, parents, kids and educators are understandably anxious and uncertain about what to expect. How can you prepare yourself and your child or teen for the start of school in this constantly shifting situation?
School closures in the spring and the quick shift to virtual learning combined with job, housing and food insecurity for many people led to high levels of stress and frustration for families. Kids faced losses of daily routines that kept them on track and organized, extracurricular activities that brought them self-confidence, fitness and fun, and regular social interactions with peers and caring adults. They felt angry, discouraged and lonely. As parents, you did the best you could in a tough situation: you managed work, health and safety concerns while making sure your kids with learning differences kept up with their schoolwork. You became their teachers, tutors and advocates–roles, frankly, you were simply not trained for. It’s hard to imagine repeating this scenario again this fall, especially for those of you who have returned to work outside of the home. 
Although many things about school remain in flux, now is a good time to begin preparing your kids and yourself emotionally and mentally for the re-entry. Start with these steps:
I’ll be addressing specific tools for the transition back to school in future blogs. In the meantime, focus on the present. Things are unfolding so quickly that it’s important not to get ahead of yourself. Try not to worry. You’ll have the information you need soon enough and then we can figure out what to do next.
Now, more than ever, there seems to be very little we can predict and hold onto. Every day we hear new reports about climbing COVID cases as we struggle to practice safety measures, keep up with work, manage bored kids and keep our sanity intact. It can all feel like too much.
Of course, in the midst of trying to keep your head above your water, there’s nothing like a defiant tween or teen with ADHD to put you over the edge. Angry and frustrated with the many changes to their lives wrought by COVID and feeling helpless to do anything, many kids are acting out in ways that are often inappropriate. It seems that they’ve taken a giant step backwards in managing their distress. With their executive functioning challenges related to emotional and impulse control, scattered kids are prone to intense pushback and aggressive anger. What can you do to help them manage their big feelings and reduce family conflict?
Teens and tweens with ADHD whose brains mature more slowly than their neurotypical peers are particularly torn between what they would like to be capable of doing and what they can actually accomplish. They’re often very frustrated with themselves and, unable to tolerate their shame, act out their personal dissatisfaction towards others–often their parents. They unconsciously want you to make it better for them, just like a young child would. Teens are still struggling with how to tolerate disappointment appropriately and how to pivot when faced with limits they don’t like.
With all of the changes surrounding COVID and losses of familiar and beloved activities, the natural challenges with shifting, flexibility and planning for transitions for many kids with ADHD are intensified. Of course, when they are triggered, emotional and verbal impulse control fly out of the window.
Underneath all of their bluster, many defiant tweens and teens suffer from low self-esteem and shame. They need tools for expressing themselves appropriately and signs of parental support for their attempts to use these techniques, even if they’re not completely successful. You’ve got to remember that, while they may seem to enjoy the sense of power in the moment, they really don’t like the conflict any more than you do. It’s just that they lack skills.
Instead of convincing your tween or teen why things aren’t the way they perceive them, validate their feelings. Mirror what you hear them say with language like “I hear that you are upset about X” or “What you’re telling me is Y.” When kids feel seen and heard, they’ll begin to slow down.
Discuss with them what ways of expressing anger or displeasure is appropriate and what are not. Be specific about language and physical actions. Set up incentives for cooperating and logical consequences for obstruction. For instance, “If you curse at me, you will not earn the privilege of your phone for the rest of the day.” Or, “If you can go through a day and not scream or break something, you’ll earn extra screen time.” Work with incentives that matter to them.
Let’s face it, you will get into fights. Instead of being surprised each time this happens, identify signs that you are heading into the red zone and how to take a planned, timed break. Make a list of acceptable choices for this “Calm-me-down” time and post it in the kitchen and bedrooms. Separate for an agreed-upon time until you can re-convene without hot tempers. For some kids, this break may need to be a few hours. That’s okay.
Instead of trying to teach a lesson, talk about what’s needed to move on. Ask questions, listen and reflect back what you hear. Wonder about alternative choices you both could have made in that instant or could make in the future. Collaborate on an action for moving on. Refer back to your agreement about ground rules while staying compassionate but firm. You can talk about any lessons at another time, perhaps the next day in the car or perhaps at a scheduled hour.
It’s really important to notice and validate the activities and emotions that your defiant teen is becoming triggered. This type of validation will lower their rage and shame. Your goal is to cool the flames in the moment and follow your collaborative agreement. Teaching lessons will come later.
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