YourTango: Back To School With ADHD And COVID Uncertainty (Again) – Reprinted

“Just when we thought we’d turned a corner in the COVID war, the virus is rearing its ugly head for another wave. As kids go back to school, uncertainty looms once again. The Delta variant is making all of us more nervous than we might already be. School districts are debating mask mandates and some have returned to remote learning. It’s worrisome for parents and students, many of whom assumed that in-person learning would finally go forward.”

Click here to read Dr. Saline’s article on YourTango. Click here to read the original blog post by Dr. Saline.

College Opensource – Female Students with ADHD: How IECs Can Help

Article by Eric Endlich, PhD and Sharon Saline, Psy.D. “Nia had been so excited to go to college. She’d been diagnosed with inattentive ADHD in eighth grade and received accommodations such as extra time on tests, preferential classroom seating and getting copies of teachers’ notes. An executive functioning coach assisted her in using a calendar and organizing assignments. Nia worked hard, graduated with a 3.8 GPA and moved into her college dorm with high expectations. Sadly, six months later, she was back home. Depressed, anxious and on academic probation, she’d isolated herself, dropped one class and failed two…”

Click here to read the article.

Healthline – The 10 Best Books for ADHD in 2021

“Whether you’re the parent of a child recently diagnosed with ADHD or an adult seeking new methods for managing ADHD symptoms, there is a wide variety of books for ADHD available to offer you some guidance. Before you can pick up the best book for ADHD that fits your situation, it’s important to understand what you’re looking for. Below, we’ve rounded up the best books for ADHD according to the type of advice and topic you may be looking for, whether that’s a book for managing your own ADHD or solutions for connecting with your ADHD teen.”

Dr. Saline’s “What Your ADHD Child Wishes You Knew” was chosen Best for Parents.

Click here to read the article.

Return to School with ADHD and COVID Uncertainty (again)

4 teens wearing masks and backpacks and holding school supplies and a basketball outside of their schoolJust when we thought we’d turned a corner in the COVID war, the virus is rearing its ugly head again. As kids go back to school, uncertainty looms once again. The Delta variant is making all of us more nervous than we might already be. School districts are debating mask mandates and some have returned to remote learning. It’s worrisome for parents and students–many of whom assumed that in-person learning would finally take place. When you consider the academic and social challenges for many kids with ADHD, it’s tough to know what to do to stay safe and create viable, rewarding learning experiences for your children and teens. 

Transitions back to school are typically challenging for kids with ADHD, LD, ASD and twice-exceptionality. When these changes are marked by continued concerns about the health of being in classrooms and engaging in social interactions, neurodiverse kids, who already struggle with anxiety and emotional regulation, become more stressed, worried and reactive. As parents, when you are confused about what to do or what to believe, it’s harder to put aside your feelings and be patient with your kids’ numerous questions or concerns. In this time of insecurity and frustration, the best thing you can do is name and work through the struggles.

Check-in with your child or teen about their school concerns

Father sitting and having a serious conversation about feelings around back to school with his ADHD son.

Rather than let this anxiety bleed into all aspects of daily living, pick one time per day for up to 20 minutes to discuss what’s happening. Discuss fears, acknowledge the unknowns and reflect on how you’ve all survived the challenges of the past 18 months.

          • What are some resources you relied on?
          • How did you come together as a family to support each other?
          • What types of decisions did you make previously that could be helpful now?

Let your kids ask questions and, if you don’t know the answer to their questions, tell them you will get back to them tomorrow with a response. When you assign a particular time to talk about a distressing subject, you contain it. This containment helps manage persistent anxiety. 

Here are 5 tips for making back to school with ADHD during COVID go as smoothly as possible:

1. Create predictable, doable routines–together.

Planning ahead reduces the frustration and overwhelm of making transitions for kids with ADHD. There’s no way around this. Some type of daily structure helps kids organize themselves and decreases family conflict. Use a whiteboard, chalkboard or large calendar to collaborate on what’s expected of your child in the morning, after school and before bed.

Keep these action items limited to 3 things so they are not overwhelmed. Kids can check the schedule instead of asking you what’s next so they can move themselves through the tasks. This builds confidence and competence, so they experience success as they start their year.

2. Stay compassionate and consistent.

Child laying in bed holding a hammer and holding it to a green alarm clock.Transitions are tough for many kids, especially those with ADHD, LD or other mental health challenges. Give them time to practice going to bed and waking up earlier. Brainstorm new ideas for lunch, and listen to their concerns about going back to the classroom and seeing other kids. Offer them choices about their schedule so they have more buy-in.

Your goal is to notice their efforting and aim for steadiness rather than focus on perfection. If they are trying to regulate themselves or do their chores–more times than not–let them know you see their efforts.

3. Address social anxiety without solving it.

As much as you would like to wave your magic wand and make their worries go away, kids need to learn how to deal with their fears and manage them. This is how they develop resilience, and it’s something we’ve all done to get where we are today.

Talk with them about their concern. Be sure to listen, and reflect back what you hear. Try a role play, or brainstorm possible strategies, phrases or responses. Recall past situations when they were nervous about or confronted a friendship issue and identify what helped them get through that tough moment.

The goal is to apply tools from previous challenges where they ultimately succeeded to what they are currently facing. Normalize–don’t minimize–their anxiety, and explore issues related to rejection sensitivity dysphoria.

Most kids and teens, with or without ADHD, feel uncertain at the beginning of school. Saying, “That’s not such a big deal or you’ll be fine” actually doesn’t give them the tools they need. Instead, try, “Of course you are nervous. That’s natural after not seeing people this summer or when you start a new school or have a new teacher.” This validates their experience and simultaneously reduces any shame about their feelings.

4. Make sure specific supports are in place for your alternative learner.

Notebook with a cover titled "Individualized Education Program" on a desk with other school supplies.

School is often the toughest area of functioning for neurodiverse kids. Make sure all accommodations–any 504’s or IEP plans–are in place.

Plan for an appointment to speak with classroom teachers or guidance counselors before school, and ask if your child can visit their new classroom or school to familiarize themselves with the environment. This will also reduce some anxiety.

Be sure to discuss any social concerns and discuss how you, your student and the school can work together to make this year run smoothly and successfully. Include your student in this part of the meeting so they will have buy-in.

5. Establish a back-up plan.

With so many things in flux, change is inevitable, and pushback and upsets will occur. Rather than being surprised when these occur, take some time to set up some guidelines of how you are going to manage those tense moments in advance of them occurring.

Set aside specific time for a family meeting–when people are calm, fed and awake–for no more than 30 minutes. Brainstorm possible scenarios when things go awry (I suggest using Stop, Think, Act). Agree on responses and talk about consequences for lying, disrespectful language or inappropriate behaviors.

Let your kids take the lead first on what meaningful interventions would look like. It’s useful to hear what they have to say and incorporate it into any plan you create. When you collaborate with them, they’re more likely to participate cooperatively. Write down whatever you decide and, just as you did with the daily plan, post it in a common space. 

Take care of your wellbeing as a parent, too.

Mother going on a morning run on a bike path with headphones in, practicing self-care for parent.

Regardless of the stress you feel, you’ve got this! Breathe, go outside for a walk, run or bike ride and practice self-care. Engage the support of your friends and family. This is a time to up-level your self-care.

Remember, when you travel on an airplane, the flight attendant instructs parents to put on their oxygen masks first before putting masks on their children. If you are feeling out-of-control or emotionally reactive with the stress of this COVID and school uncertainty, speak to your primary care provider or find a counselor.


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Negative Memory Bias and ADHD: Tips to Help Kids and Youth with ADHD Remember the Positives

Neurodivergent teen with ADHD with pink sweatshirt and pink hair and teal headphones on a bed doing homework with on a laptop in her roomHave you ever noticed that your child or teen with ADHD remembers negative comments people say to them more than they do positive ones? While all human brains are wired for the negative memory bias, or negativity bias, the minds of kids and youth with ADHD seem more vulnerable to holding onto what is “bad more than what is “good.” The combination of the negative memory bias and ADHD symptoms such as working memory challenges, emotional dysregulation and low self-esteem can make it even more challenging for people living with ADHD to balance out with positive memories. Let’s dive more into the impacts of the negativity bias on people with ADHD, as well as helpful strategies you can use to help the children and youth in your life focus more on the positives.

The impacts of negative memory bias in children and youth with ADHD

This negative memory bias is strengthened for kids and youth with ADHD during childhood. It’s common for family members, peers, teachers, coaches and other influential people in children’s lives to criticize children and youth with ADHD. Oftentimes, people might intend to offer feedback, but kids still interpret the statements as criticisms. They’re not remembering things, not doing things properly, keeping things messy, not controlling themselves, etc. These encounters are opportunities to focus on, remember and learn from as children with ADHD grow up. But focusing on the negatives can contribute to negative self-talk, as well as feelings associated with shame, anxiety and depression. Young sad girl with ADHD wearing a flower shirt and pink backpack sitting alone in a classroom at a desk with blue chair turned to the side with her hands over her eyes, dwelling on a negative experience and showing the impact of the negative memory bias on kids In addition to the negative memory bias, many people with ADHD experience Rejection Sensitive Dysphoria, which involves having a heightened response – often physical, mental and emotional – to rejection, criticism, mistakes and other negative experiences. Putting more weight on these negative experiences over positive ones can impact behavior and decision making, such as people-pleasing, striving for perfection or avoiding situations that might have negative outcomes (even if those same experiences could also lead to positive outcomes). While our ancestors needed the ability to learn and remember lessons from tough experiences for survival, people today also need to learn how to retain lessons from good experiences. This is especially true for children and young people with ADHD. Beneficial experiences not only serve as the foundation of self-esteem, secure attachment and self-management, but they also nourish inner strengths. How can we help balance the weight of negative experiences with positive ones for children and youth with ADHD?

Working memory, the negative memory bias and ADHD

In order for the good moments to outmaneuver the negativity bias, they have to be installed in the brain’s neural structures. This process requires holding the thought in the working memory long enough to be picked up by short-term memory structures and then transferred to the long-term memory. Of course, people with ADHD, by definition, typically struggle with working memory challenges. Therefore, this transfer doesn’t occur as frequently as we would like, if at all. So the key issue here is “long enough. While there is no research to give us a specific time for this, “long enough” usually means holding a positive emotion, desire, action or outcome to actually feel it–to reflect on it and let it sink in. I would venture to guess this means up to a minute if not longer. How can you assist your ADHD child or teen to do this more successfully?

5 tips to help children and youth with ADHD focus on and remember the positives:

1. Teach and value the importance of celebration.

Young happy child with ADHD running on the beach while playing with wood toy airplane at sunset, overcoming the negative memory bias by spending time enjoying and celebrating her accomplishment of making the toyWhen something good happens, teach them that relishing it is important! In our ultra fast-paced world, everyone moves on to the next thing so quickly. Oftentimes, the important integration needed to consolidate memory can be missed. Therefore, negative experiences, strengthened by negative memory bias and ADHD symptoms, aren’t being balanced with positive ones. SLOW IT DOWN, and celebrate positive moments alongside them. It’s also important to show your child or teen that “celebration” doesn’t have to mean a festive gathering with family and loved ones. Rather, it could mean treating yourself to an ice cream or dancing alone to your favorite song. Celebrations don’t depend on other people showing up – you can celebrate yourself and your personal accomplishments in various ways that might change over time.

2. Ask questions about ‘highs and lows’ at dinnertime

Practice doing highs and lows of the day at dinner with the family. Encourage everyone to say something. Don’t ask questions about the statements during the sharing. Instead, if you want to follow up on an issue, ask first. We are trying to create a safe place to hold both the positive and negative occurrences simultaneously; giving them equal weight. This process will create new, essential neural pathways. If daily highs and lows are too much for your family, then do them once a week at regular meal, like Friday dinners. Try to stay as consistent as possible to create the strongest impact on balancing out the negative memory bias.

3. Give genuine, positive feedback daily that is succinct.

Honestly, nothing is too small to be acknowledged. When you do this, make sure you get down to your child’s physical level. If your ADHD teen is taller than you are, ask them to sit down so you are at the same level. Put a hand on their arm or shoulder, if that’s comfortable. Maintain eye contact with them if you can, and be clear that they get it! A young adolescent boy with ADHD in a low mood while talking to his dad about an experience his dad says is positive to overcome the negative memory bias and ADHD symptoms As corny as it sounds, you could even ask them to repeat what they heard you say:

    • Parent: “Look I really want to make sure that you understood what I said. Can you please repeat it?”
    • Child: “Do I have to?”
    • Parent: “Yes.”
    • Child: “Fine, I heard you tell me that you appreciated that I hung up my coat when I got home.” Or, “I heard you say that you liked when I got off my computer right after the timer went off.”

These exchanges build the neural pathways we are seeking to create and  increase inner strengths, balance out the impacts of negative memory bias and foster interpersonal connection. Kids and youth with ADHD often interpret feedback in any form as negative. Be aware of how you word and how they interpret your statement. Try the ADHD Adapted Sandwich Feedback Method to formulate more neutral and effective statements.

5. Explain the subjectivity of criticisms and negativity.

A mother consoling her teen with ADHD and praising her neurodiverse strengths and differences

Kids with ADHD often endure frequent criticism, or perceived criticism, from influential people growing up. Your child or teen may be motivated to focus on these encounters so they learn not to remake “mistakes,” “improve” their abilities and behavior, rebuild self-esteem, gain acceptance and avoid further criticism.

Children and teens might not yet understand, however, that that criticism can be unwarranted and ableist. In other words, people often make remarks that neglect to accept the differences that come naturally with neurodiversity. Children, instead, deeply value the opinions of – and need support from – their family, friends and community. Instead of questioning the validity of the statement, they tend to trust what they have to say. Review with your child or teen the importance of valuing each others differences. In addition, lead by example by outwardly expressing appreciation for their – and other people’s – different strengths and overall differences. Explain how criticisms can be subjective, and why people might make inaccurate statements or remarks without thinking them through. This can be confusing, so remain approachable and check-in when moments are calm to see if they need support with understanding statements and situations.

5. Keep it up, regardless of any unwelcome response that you may receive.

Remember, the pull towards negativity and retaining bad experiences is longstanding and ingrained. Stopping your efforts to counteract it will likely increase its influence. Educating your teen on the impact of the negative memory bias and ADHD symptoms might help them stay motivated to focus on the positives, too. Though you might not see a difference right away, your values and recognition are making important, life-long impacts on your child or teen’s thought processes, motivation and self-esteem. Start building the GOOD today!


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6 Helpful Tips for Dealing with Rejection Sensitive Dysphoria

Teen boy with ADHD and rejection sensitivity dysphoria, sitting on a chair, looking down to the side with his arms crossed, unhappy, while his teacher speaks to him.

What is Rejection Sensitive Dysphoria?

ADHD has a large group of companions that like to come along for the ride, whether that’s anxiety and depression, learning disabilities, or autism. Rejection sensitive dysphoria (RSD), while not a formal diagnostic category, describes experiences that often occur with ADHD. People struggle with letting go of past hurts and/or rejection and struggle with heightened emotional sensitivity. They may hold onto unkind words or actions directed towards them for months or years. RSD can also reflect a personal belief that you have let someone down. Because many ADHD children and adults may already experience a feeling of otherness, they often already feel like they are at a disadvantage. We live in a society that teaches us to be people-pleasers. This makes it even harder to avoid sensitivities. Here are some great tips to help you work with rejection sensitivity and reduce its tumultuous effects, whether you need a little reassurance or you’re helping a loved one who is struggling.

How to Manage Rejection Sensitive Dysphoria

1. Combat rejection by reinforcing strengths

What everyone needs to remember is that simply having Rejection Sensitive Dysphoria does not make you a human who is weak or incapable. You are just wired to feel things more intensely and replay unpleasant interpersonal interactions over and over. RSD is linked to social insecurity. A helpful tip is to consistently reinforce the strengths of your child or teen with ADHD. What do they love to do? What do they do well? Acknowledging their work, acknowledging their positive efforts and rewarding activities really helps them feel more confident. It can also help them see things from a new perspective and shift from negative self-talk about rejection. This can encourage them to approach future situations bravely as well.

2. QTIP – Quit Taking It Personally!

Many kids and adults with ADHD struggle to separate when a statement is directed specifically at them or when it’s something more general. They take things personally that may not be personal. Assist your child or teen to pause before responding to a question or answer by saying, “That’s a good question/comment. Let me think about it.” Then, they can better assess what’s being said. Remind them that other people can say thoughtless or hurtful things sometimes that are more about them than you. The rejection they perceive may not be purposeful.

3. Develop affirmations

Developing mantras or affirmations assists in reducing the noise of negative thoughts that can come with Rejection Sensitive Dysphoria. Try positive phrases like:

      • “I am stronger than I think.”
      • “My mind is uniquely wired and creative.”
      • “I can make a mistake and be a good person.”
      • “I can take risks and see what happens.”

Sit down with your child or teen and brainstorm some things to say to the negative voice in their heads. Post them somewhere they can see and recall them when they need a boost. Maybe even make time in the morning or before bed when you both say your own affirmations. Starting your day with a positive thought can really help when feelings of doubt creep in. This is also a fun evening activity that can calm them before sleep.

4. Remember that all emotions are valid

As parents, we never want our kids to feel bad. It can be extremely difficult to watch them struggle with sensitivity issues or peer rejection. When someone struggles with Rejection Sensitive Dysphoria, they have often lost hope in their social abilities, been unable to forgive themselves for what happened and feel shame about their experiences and their emotions. It is very important to remind them that every emotional experience is valid. Offer a listening ear to hear about what big feelings they may have. Be supportive without problem-solving.

5. Be prepared to handle outbursts

Anger is a notable side-effect in people diagnosed with Rejection Sensitive Dysphoria. Many people internalize their emotional responses. This can be harmful, especially over extended periods of time. They may lash out as a result, or react in ways that are not as kind as you would like. If you are working with the sensitivities of a child or teenager with ADHD, it could be beneficial to have an action plan when experiencing a notable outburst. Use my Stop, Think, Act tools, pre-arranged ‘time aparts’ to cool down, or other relaxation techniques to cope with outbursts. There may be some benefit to having a room or area designated for your child to slow down and recover.

6. Emphasize family connection

Adolescent girl with ADHD planting in a garden with her family in the sunshine As always, connecting with your family is important. Engaging in fun and memorable activities can really help reduce emotional sensitivities related to acceptance. This will allow your kids to rediscover and nurture the joy of being together, instead of perpetuating a sense of rejection and low self-worth. They can also practice their social skills in a safe place. Once in a while, invite a friend to join you. Surreptitiously check out your child’s interactions and responses to what the other child is saying or doing. Then you can talk about these at a later during quiet time. Or, just use the information in monitoring dinner table conversation and behavior. Kids with ADHD and Rejection Sensitive Dysphoria really need to feel the consistent, loving presence of their parents as an antidote to the painful social experiences they may be having or perceiving. For those older teens and adults who may be experiencing symptoms of Rejection Sensitive Dysphoria and would like to gain more insight into what it could mean for you, check out this free online test offered by our friends at ADDitude. My ADHD Solution Deck is also a helpful to have on hand, helping you employ strategies that can help your ADHD child or teen in the moment as they face a social or emotional challenge related to RSD.


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Fresh Start Family Podcast: Working to Overcome Anxiety & Frustration in Kids Who Have ADHD, Autism, or Learning Disabilities

Families, are you overwhelmed with the challenges of raising a child with ADHD, autism, or learning disabilities? Or are you like so many families who are wondering if your child may be an alternative learner, but just aren’t sure? Even if you are just looking for some ways to connect with your child and restore some peace and balance to your home… This episode is just what you need to hear. Click the image below to listen to the episode.

Additude Webinar Replay – Gender Diversity and Neurodiversity: How to Support a Child, Teen, or Young Adult with ADHD as They Explore Gender

“If every generation of youth finds a way to upend parents’ basic notions of the world, certainly gender is today’s arena for change. With children and teens increasingly declaring a gender different than their sex assigned at birth, and many teens responding to “they/them/their,” nothing short of a gender revolution is taking place. Parents are often left to play catch-up with their children and teens, who increasingly view gender as a spectrum, not a binary. As young people work to understand and define their gender, caring adults may struggle with how to respond appropriately, how to manage their own feelings and reactions, and how to give or find adequate support. For parents of kids living with ADHD, additional concerns about executive functioning challenges — like impulsivity, emotional dysregulation, planning, and focus — may further complicate the picture. It is important for parents, clinicians, and coaches to research how this generation of youth is reframing notions of gender and how neurodiversity intersects with this process. In this webinar, Julie Mencher, MSW, and Sharon Saline, PsyD, will discuss the fundamentals of understanding gender diversity and how ADHD affects the journey. You’ll learn how to:

  • Understand the process of the gender journey, for the young person and their family members
  • Understand and use appropriate, thoughtful language
  • Manage your own reactions to the changes in children, teens, and young adults
  • Prepare for and engage in empathic, informed conversations about gender questioning and transitioning
  • Explore how to read your child’s behavior in relation to gender exploration and ADHD struggles
  • Watch for self-harming behaviors or other mental health concerns

Watch the webinar here!

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