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Grad School and ADHD

Jax Sanders , Ph.D. Student, Physics

by Jax Sanders | Dec 8, 2011 | Student Voices

According to the National Institute of Mental Health, 4.1% of the U.S. adult population has Attention Deficit Hyperactivity Disorder. I’m one of that 4.1%; in August, I was diagnosed with ADHD, primarily inattentive. Like most adults diagnosed with ADHD, I had ADHD as a child, but my symptoms did not become problematic until I was under so much stress that my coping mechanisms were no longer sufficient. In my case, that stress was graduate school, and I spent much of my first two years severely impaired. The worst part of it was that to an outside observer, my difficulties looked for all the world like laziness, while from the inside, everything felt overwhelming.

The DSM-IV states that for an adult ADHD diagnosis, “There must be clear evidence of significant impairment in social, school, or work functioning.” Before graduate school, I wouldn’t have qualified for a diagnosis, because I didn’t feel impaired. I rejoiced in the strange ways my brain works, the tangential intuitive leaps, the great creativity, and the ability to keep many tasks going at once. Since the symptoms of my iteration of ADHD include issues with self-motivation, lack of focus, and difficulty working in advance, graduate school made it feel less like an adventure and more like a serious disability. I compared experiences with another recently diagnosed graduate student while writing this article, and he agreed with the particular difficulty of ADHD-inattentive with graduate school work.

Both of us were asked to leave our first research groups because of the effects of our ADHD symptoms. I often lost my train of thought with my research entirely, taking a full week to complete tasks that I know should have taken a few hours at most. The feeling of inadequacy when compared to student who could do productive work 12-15 hours a day was punishing, as was my negative self-talk about my lack of productivity. I intellectually knew I was intelligent, but when I couldn’t focus, when I was doing poorly in my classes, when I was falling behind on my grading… I felt like I wasn’t smart enough, and that I never could be smart enough.

I felt inadequate outside of graduate school as well. I’d been living outside of my parents’ house since 2006, but I couldn’t seem to get on top of the basic tasks of self-sufficient adulthood. My house was never clean, and I couldn’t find the motivation to care. Dishes were the worst; I would leave one meal’s dishes to deal with later, then another, then I’d reach a tipping point where I’d feel like I could never finish the dishes and just leave them there. I was also failing at feeding myself. I couldn’t seem to plan ahead well enough to make meals for when I was hungry, and even when I did, I convinced myself that I needed to get things done for school and I didn’t have the time to make food. My friend also experienced this difficulty with planning and acquiring food; he solved it by ordering in too often, while I went the equally unhealthy road of eating far too little. 

In retrospect, it was not only my ADHD that was causing the chaos in my life over the past two years. My version of ADHD has performance-related anxiety along with it, and when my ADHD caused me to perform poorly in school, my anxiety would act up, which would make it even harder for me to focus, which would make the anxiety worse, and eventually I’d lose the ability to do anything but curl up on the couch, not drink the cup of tea next to me, and stare at the internet. Since this was keeping me from pursuing the science career I’d dreamed about since I was 10, I developed depressive symptoms. I didn’t notice until later, but I stopped enjoying things. I’d been an amateur jazz musician in college, and I didn’t listen to music much. I didn’t read books for pleasure. I didn’t feel like dancing, or making new friends, or really much of anything.

Having my official diagnosis helped a lot. The staff at CAPS made it very clear that I wasn’t lazy, I was having legitimate problems, and that they would be there to help me succeed with my ADHD however I wanted. I’ve enjoyed being part of the ADHD group at CAPS, where we talk about our experiences, think about new strategies, and work on improving our focus and relationship to the world using mindfulness meditation. Many of the other members have similar stories; we’re all very smart people doing very difficult things, and we all suddenly couldn’t cope. The support group got me started on a lot of strategies that help me greatly. My two favorites are using timers to break extended tasks into short bites, and “thinking like a waiter”.

By using timers, I can get a rational understanding of how long tasks actually take, which keeps me from falling into the pattern of thinking that I can never finish them. For example, a full kitchen of dirty dishes takes about fifteen minutes to clean. Once I was able to conceptualize that, the cleanliness of my kitchen became far less stressful. “Thinking like a waiter” is the concept of doing small things as you see them, and not giving yourself time to put them on a growing mental task list. E-mail correspondence doesn’t get forgotten, coffee cups don’t get left in my office to mold, and great ideas don’t get lost because I forgot to write them down. Strategies don’t solve everything for me, but they help a lot.

As of this writing, I’ve started the second week of my medication trial. The psychiatrist at CAPS and I decided on starting with Concerta, an extended-release form of Ritalin, and so far, it’s been working extremely well. The first improvement I noticed was that I could filter out background noise. I was able to notice that the HVAC in my office was on, but it wasn’t a distraction, and it didn’t keep me from focusing. The pervasive brain fog that had plagued me for months lifted almost immediately. I could focus on things when I wanted or needed to, and I could just as easily stop focusing on them. Fortunately, I appear to tolerate them extremely well; the only side effects I’ve had were an odd twitch in my right eye the first day and a sharp loss of appetite. I lost five pounds that I wasn’t actually interested in losing in the first four days on the medication. The other grad student who helped me with this article is on Adderall tablets. He’s seen a lot of the same positives as I have, but a few different side effects. At times, he’s felt his heart racing for no reason, and he’s had problems with a dry throat.

Although both of us have experienced a great improvement during treatment, we both have some nervousness related to talking about our ADHD to specific people. The other graduate student is anxious about telling his advisor, since he feels like he’s on thin ice with him already. His greatest fear is that if he tells his advisor, he’ll respond that if he’s having so many problems with ADHD, he should leave with his master’s and try working a normal job instead of continuing in academia. I leave his identity unmentioned for this reason, but thank him for volunteering his experience. I’m worried about telling my mom that I’ve started taking medication. When I was telling her about my experience with counseling and my diagnosis, she was vehemently against the idea of me going on medication, even though I hadn’t mentioned the possibility of talking to a psychiatrist. I hope that if she finds this post, any uncomfortable conversations that follow will at least be based in a knowledge of how severe my symptoms have been, and not an assumption that I’m using the ADHD as an excuse to be lazy.

Now, I’m starting to enjoy things again, listening to more music, learning about new ideas, and socializing with new friends. I’m really looking forward to getting back to fully enjoying my ADHD. At its best, the ADHD brain has some powerful gifts. I’ve missed being able to appreciate the fact that my brain doesn’t have a box to think outside of, and the powerful, chaotic creativity that drives my work. I know that I’ll never be truly detail-oriented, but at the same time, I won’t trip over details when trying to understand the full scope of a problem. I can keep multiple tasks running in my mind, but I can also access hyperfocus, a unique, strange, and intense state of absolute interest and focus. All of the treatment, both pharmaceutical and psychological, won’t make me stop having ADHD, but it will make my ADHD an asset rather than a profound disability.

Do you see aspects of your experience in mine? If you’re distressed by your brain, there are free resources on campus. CAPS, in the Michigan Union, does ADHD screenings and counseling. The evaluation takes two to three sessions. The drop-in ADHD group on Monday at noon has been an extremely valuable resource for me. There are staff psychiatrists at CAPS, and there’s a waiting period of a month after diagnosis for medication evaluation. An ADHD diagnosis can also entitle you to formal accommodations through Services for Students with Disabilities. If you have trouble completing exams in the time allotted due to distractions or mental blanks, more exam time or a quiet room for exams is a typical accommodation. I meet with an academic coach there, and she has been extremely helpful in helping me recognize where my ADHD was causing me difficulties in time management.

ADHD is a real disorder that can cause significant amounts of distress and impairment in everyday life. It is not an excuse for laziness; it’s a difference in the brain. Adult ADHD is often not obvious because the public concept of the disorder is that ADHD is for small, hyper children, not intelligent adult graduate students who suddenly can’t cope with their workload. Furthermore, ADHD isn’t a state of being “abnormal.” I vastly prefer to say that I’m not neurotypical. Being typical is fine for some things, but when you’re working on difficult creative problems, having typical thought processes can be a detriment. The way my brain works might not be common, average, or pedestrian, but when it works with me instead of against me, it’s a powerful advantage.

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Jennifer Kotler is a doctoral candidate in the Graduate School of Arts and Sciences. She developed severe ADHD at age 8, and learned to use her disability as a benefit, eventually focusing on public engagement and education around sexual violence.

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Ph.D. with ADHD brings can-do focus to science, life

Deborah Blackwell

Harvard Correspondent

Jennifer Kotler: ‘It’s really difficult to separate your personality, your identity, from your diagnosis’

This is the first in a series of profiles showcasing some of Harvard’s stellar graduates.

In third grade, Jennifer “Jenna” Kotler was perfectly happy counting the tiles in the classroom ceiling instead of doing her work. What she tried hard to do was sit quietly like her classmates in their French-immersion school in Toronto.

Sitting quietly isn’t a requirement at Harvard, a place no one ever expected Kotler to land. At age 8, she was diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), a learning disability that can challenge even the most determined student.

“I was not disruptive, never got into physical altercations or had vocal modulation,” Kotler said. “But my third-grade teacher knew I had a learning disorder because I could not do the written work. My mom had to stand behind me with her thumbs in my ears and her hands around my eyes so I could finish a page of multiplication tables.”

Twenty years later, Kotler is a Ph.D. candidate in the Department of Organismic & Evolutionary Biology (OEB) at Harvard’s Graduate School of Arts and Sciences. An evolutionary theorist, she uses clinical and genetic studies to reinterpret how humans think about health, disease, and the human evolutionary path, especially as it relates to biological and psychological development.

David Haig , the George Putnam Professor of Biology and Kotler’s doctoral adviser, worked with her to create an interdisciplinary research program that would accommodate her condition. While she doesn’t count the ceiling tiles in her brightly lighted office at the Harvard Museum of Natural History , Kotler still spends nearly every waking moment combating her ADHD, which affects both her memory and her personality.

“My brain works differently … I struggle daily with how to be in the workplace and constantly monitor myself,” Kotler said. “I’m really enthusiastic and eager, so I talk a lot, and really loudly. I interrupt a lot, and can be distracting to others. I’m extremely friendly, and tend to come on very strong. It sets you up for a lot of heartbreak, because that’s not how people typically interact.”

Kotler credits her early ADHD diagnosis with summoning a mission to help others who face arduous paths and learning to convert her own challenging characteristics into strengths.

“It’s really difficult to separate your personality, your identity, from your diagnosis. They are deeply connected,” Kotler said. “Most of the training I got through school was how to be successful there, which was important, but not sufficient when you are trying to survive the rest of the world. I needed support.”

She got that growing up in a family of feminists and activists. Outings with her parents often involved bringing snacks to teachers on a picket line, or sitting with striking daycare workers. Her early engagement in local activism, and her rejection of gender stereotyping, grew into a commitment to social justice.

“I never felt like I wasn’t smart because of ADHD; my parents did not emphasize my diagnosis, and my family talked to me about complicated issues,” she said. “They knew I was capable and also knew I needed to learn the skills to get things done.”

Kotler combined multiple therapies, including neurofeedback, focus training, and muscle-relaxation exercises, to manage her symptoms, but it was years before she could sit still in a classroom. As an undergraduate at McMaster University, studying psychology, neuroscience, and behavior, she often needed to Skype with her mother to do her work.

“It was hard for me to sit and do the work alone. I have some hyperactivity,” she said. “I just needed to know somebody was there helping me.”

One of Kotler’s favorite strategies to combat ADHD is to ask a lot of questions, a habit that makes her a great conversationalist and a welcome participant in GSAS social events such as “Science by the Pint” during Wintersession 2014.

Rose Lincoln/Harvard file photo

After graduating, Kotler worked at Princess Margaret Cancer Centre in Toronto as a research assistant in psychosocial oncology, palliative care, and bereavement, a field in which she retains an interest.

But it was the dynamic between genes and kinship — how genes evolve in interdependent relationships — that drew her to Harvard in 2012 to explore evolutionary medicine.

While her academic focus was on pregnancy, parent-offspring relationships, and sexual development, Kotler also turned her attention to sexual violence treatment advocacy. In 2015 she joined the Boston Area Rape Crisis Center (BARCC) as a volunteer hotline counselor. (She is now a peer supervisor.) Kotler said her struggles with ADHD have produced an ability to connect with women in difficult circumstances; she uses her scientific training to look at the biological drivers of sexual violence — including the role of evolutionary genetics.

“People are afraid of asking the biological questions about sexual violence because it’s so emotionally wrought,” Kotler said. “But putting it in the lens of a public health issue is more scientifically accurate and can form better education programs and better, broader policy.”

“Jenna provides a lot of support around very serious stuff, and she does it with such a positive, caring energy,” said BARCC senior hotline coordinator Jesse Moskowitz. “People feel so confident, calm, and prepared after spending time with her. It’s obvious she operates from the heart in everything.”

At Harvard, Kotler organized “Ladies Who Lab,” an OEB departmental group that addresses women’s issues, helps resolve conflicts, and shares pertinent research about women and their roles in science education and academia. She also works with the Graduate School of Arts and Sciences Action Coalition, helping organize political advocacy and education programs, workshops, and campaigns.

“I’ve always been really interested and engaged in women’s rights and gender politics,” she said. “It can be scary, but I’m always optimistic about positive outcomes, which is why I’m good at talking about death and dying, cancer, and rape. If I can do something to help, I want to” — and that includes drawing on her own experience to encourage others.

“For a long time, I could not be left to my own devices, I needed somebody there helping me. I would be struggling trying to do the same thing for four days and I couldn’t do it. But it’s doable,” she said. “If people don’t talk about their diagnosis or coping skills, others won’t know it’s a realistic option. I’m at Harvard, going to be a Ph.D., it’s positive to talk about.”

Kotler has strategies to maintain what her family used to call the F-word: focus. There are the snuggles she receives from Juno, the support dog always by her side. She has copious notepads for writing down all the things she needs to remember; she schedules almost everything and checks her calendar frequently; and she uses Pomodoro, a timer-based application that breaks down tasks into 25-minute chunks.

One of her favorite strategies is to ask questions. Everybody has something to add, she said, and she can learn things she may not have known otherwise.

Self-acceptance? That she’s got down.

“I always liked who I am, being quirky and unique. I’m not ever going to be perfect,” Kotler said. “But now I’m not afraid to say yeah, I’ve worked really hard, I’m capable, successful, and this is how I got here.”

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Work with us, advertise with us, run a webinar, sponsored posts, write an article, stories, advice and support for your academic journey., how to do a phd when you have adhd part 2: managing the rest of your life.

• March 18, 2023
• York University
• ADHD , Experiences , Mental Health , Motivational , Neurodiversity , Productivity , Wellbeing , Your Academic Journey

If you clicked on this story because you are a PhD student with ADHD, I first want to congratulate you! Doing a PhD is difficult, and it is even more challenging when you have to navigate a neurological makeup that may not inherently be suited to graduate studies. In a study that examined educational outcomes for young adults with ADHD (23 to 32 years old), Kuriyan et al . (2013) found that 15% of participants with ADHD held a four-year degree compared to 48% of the control group, and 5.4% of the control group held a graduate degree, compared to 0.06% of participants with ADHD. I included these statistics to show that we are doing something incredible!

​I hope that by talking openly about the challenges that face PhD students with ADHD we can support our neurodivergent peers and work towards a future in the academy that sees more of us at the table. If you read my first article for The PhD Place, you will have already seen my tips for navigating doctoral studies. In this piece, I’ve outlined some strategies and considerations that I’ve learned for managing life beyond your coursework, fieldwork, or dissertation writing that have been helpful to me.

Figure out how busy you need to be.

Similarly to our neurotypical colleagues, finding a work-life balance can be challenging for folks with ADHD. I’ve found that if I’m too busy and overwhelmed, it’s difficult to get started on anything. Alternatively, if I only have one or two tasks to do and lots of time to complete them, it’s hard to see the urgency in working on them, and I inevitably procrastinate.

​Personally, I need to be consistently busy in order to be productive. If this is relatable, then I would recommend spending some time reflecting on how busy you need to be to stay on top of your work, and plan from there. Something I love about academia is that there are ample opportunities to get involved and expand your skills: you can join committees, you can become a reviewer for academic journals, or you can establish reading groups with like-minded scholars! These opportunities vary in terms of how much time they take, so have a look at what opportunities are available to you, and make decisions about how you’d like to be involved from there.

Talk to your supervisor and committee members about ADHD

If you feel safe doing so, I would have an honest conversation with your supervisor about how you experience ADHD, and what strengths and challenges come with it. I’ve found that disclosing my diagnosis and sharing my specific challenges have saved me a lot of stress and anxiety. The faculty members that I work with are better able to support me when I ask them for what I need. I’ve worked with my committee to ‘chunk’ larger pieces of writing so that I have multiple, shorter deadlines rather than one longer one. They understand when I need an extension if my focus has been poor, and they don’t blink twice if I’m not making eye contact much during meetings while I take notes.

Having honest conversations with faculty members has helped them to help me, and their support has been crucial in my success. I recognize that not all doctoral students have positive relationships with their supervisors, and if this is the case for you, I hope you’re able to access additional support in your institution. Even if you don’t feel comfortable disclosing, I would recommend doing some reflective journaling on your learning style and work habits, and brainstorm what you think you need to be successful. That way, when you run into obstacles, you have a good understanding of yourself, your needs, and ways that others can support you.

Explicitly work on managing rejection sensitivity - ideally before you need to.

One phenomena that folks with ADHD may experience is rejection sensitivity dysphoria (RSD). Essentially, this means that we may experience rejection or feelings about receiving criticism in a heightened way. In academia, we will face myriad forms of rejection: not getting scholarships we’ve applied for, being rejected from academic journals, receiving revisions that we disagree with, or being asked difficult questions from harsh audience members during conference presentations.

​These experiences are all a part of academic life, and not all scholars we interact with will be compassionate in their questions or feedback. It’s therefore important to your own wellbeing to learn to manage rejection sensitivity proactively before these instances happen. If you resonate with RSD, work on building your resilience through lower-stakes contexts: ask a friend to review your course papers, practice presentations in front of peers and ask them for feedback, and reflect on how you’ve coped with moments of rejection throughout your life outside of graduate school. I know it isn’t helpful to simply claim that academic criticism isn’t personal (especially when sometimes, it might be), but if you can work on setting boundaries for yourself in how you conceptualize rejection and criticism, doing so may improve your emotional experience in academia overall.

Make the rest of your life easier.

Sometimes, the daily work of being a PhD student isn’t what stresses you out, but everything else. Feeding yourself, keeping your home clean, running errands, and paying your bills can take up a lot of time and energy, so I find it helpful to streamline or outsource these tasks if possible. Here are some things you can do for free to make your life outside of doctoral studies more manageable:

•  Set up AutoPay on your bills to ensure they’re paid on time. I do this for my cell phone bill and public transportation card and it’s helpful to not have to think about it. You can also set up pre-authorized contributions to a savings account if you’re able to save money every month.

•  Auto renew subscriptions that you know you will use long term, such as a VPN subscription, gym membership, or streaming service.

•  Run errands on your way home from campus or when you’re already out of the house.

•  Don’t leave an appointment without booking the next one so that you don’t have to remember to schedule it later.

•  If you live with a partner or roommate, create a cleaning schedule so that you know when chores are getting done and who is doing them.

•  If you have benefits and your insurance company allows it, have the services you use bill directly to the company rather than paying and filing for reimbursement later.

If you have the financial means to do so, consider these additional tips:

•  Use a meal box subscription to take some of the planning, decision making, and labour out of cooking.

•  Have groceries delivered.

•  Hire someone to clean your home every so often.

•  Have an accounting service file your taxes for you.

Case for your sensory needs and create a baseline of stimulation.

I recently learned that people with ADHD often need a baseline of stimulation to focus. This means creating a sensory environment that engages your mind and drowns out external distractions. For me, this happens most prominently through sound. I used to think I needed silence to focus, but actually I just need to avoid becoming distracted by isolated sounds. Try listening to classical music, music without lyrics, ASMR videos, white noise, or soundscapes created specifically for people with ADHD. While this stimulation is helpful for focus, white noise also helps me sleep.

​In terms of other sensory needs, I only wear comfortable clothes while I work and I minimize visual distractions–for example, I use the “Do not Disturb” function on my phone and put it face-down so that I don’t see texts or notifications. If I’m at home, I’ll change where I’m working so that I’m not sitting in one place for hours: I’ll work at my desk, the couch, my bed, and the kitchen table, and move from one to the other when I need to refocus.

Final thoughts.

Sometimes, you can try every strategy you know to stay on track, and nothing will work. It’s frustrating when this happens, and you feel like you’re fighting your brain to do things that seem easy to everyone else. When this happens, I try to practice self-compassion and acknowledge where I’m at with honesty. Academia can be a competitive environment, but it’s important to remember that sometimes “good enough” is good enough. You’re here for a reason, and you have something to offer the world of scholarship that no one else does!

​I hope you can hold that truth in mind when you’re struggling and remember that you can always try again tomorrow. 

Kristy Smith

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To Be or Not To Be (a Reviewer 2): Should I Review Articles as a PhD Student?

For the wheels to continue turning in research, we need reviewers. Although often a thankless endeavour (littered with Reviewer 2 jokes), acting as a gatekeeper for the integrity of your research field remains vital. As a PhD student, you may find the process of reviewing a manuscript pretty novel, but a reviewer request email may enter your inbox in the near future. This article guides you through the pros and cons of reviewing articles.

‘Stairway to Lecture’: A Roadmap to Progress from PhD to Lecturer

Landing a lecturing role after a PhD can be difficult, and rejection is commonplace. To lower the chances of rejection, it is important to focus on your career planning and gain experience as early into your PhD as possible. Therefore, if you are serious about becoming a lecturer, here are four things you can start doing now.

All views expressed are those of the individual authors and do not reflect the views of The PhD Place Ltd. See our Disclaimer

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Micronutrient Deficiencies in ADHD: A Global Research Consensus

Introduction

Clinical diagnoses of Attention Deficit Hyperactivity Disorder (ADHD) in children, adolescents, and adults have grown remarkably over the last fifty years. Officially recognized in the United States as a medical condition in 1968 by the Diagnostic and Statistical Manual for Mental Disorders (DSM) for the primary symptoms of inattention, hyperactivity, and impulsivity in children, ADHD has gradually spread around the world to reach even underdeveloped nations with equally significant prevalence (Conrad & Singh, 2018; Scheffler et al., 2007). At the same time, diagnostic criteria have been further expanded and specified for adolescents and adults with the acknowledgement that ADHD persists throughout the lifespan (Epstein, 2013). Currently, eighteen core symptoms describe at least forty attention-related behavioral disorders, and dynamic DSM criteria evolve with efforts to categorize the nebulous condition (Epstein, 2013). Globally, ADHD prevalence is estimated at 9.5% for children and adolescents and almost 3% in adults (Doshi et al., 2012; Fayyad et al., 2017).

Until the 1990s, international diagnosis and treatment of ADHD was uncommon. Rapid growth and spread of technology and communication channels, particularly in the healthcare and pharmaceutical industries, introduced Western psychiatry to almost every corner of the globe, contributing to the medicalization of ADHD and other mental health issues (Conrad & Singh, 2018). Estimates for the economic costs of ADHD range from $140 to $260 billion in the US alone, including additional education and medical care for children and loss of productivity and income in adults (Doshi et al., 2012). Adult ADHD is highly comorbid with medical and mental health conditions, generating further individual and public health costs with significant social ramifications (Fayyad et al., 2017). Long-term, individuals with ADHD attain fewer academic achievements, earn lower incomes, and have less-successful relationships (J. R. Galler et al., 2012).

Variations in global ADHD reports are primarily attributed to distinct cultural differences in recognizing, acknowledging, and diagnosing behavioral symptoms (Hinshaw et al., 2011). Yet the pervasiveness of ADHD across age, gender, time, and ethnicity imply common risk factors influencing its pathology. Research consensus points to genetic, environmental, and social contributors to risk. More controversial assessments indicate that vitamin and mineral deficiencies may also play a prominent role (Khan, 2017). Although highly complex and variable, data suggests several diet-related factors that overlap and interact to influence ADHD symptoms, including chronic inflammation, oxidative stress, neuroplasticity, mitochondrial dysfunction, and microbiome profile. A bi-directional relationship between dietary quality and mental health risk is evident, and there is little doubt that nutrition serves a significant role in brain health (Marx, Moseley, Berk, & Jacka, 2017; Rodriguez, 2017).

Malnutrition and Long-Term Outcomes of ADHD

Ongoing scientific research in laboratory and clinical settings demonstrates that ADHD pathology primarily involves dopaminergic and noradrenergic systems, implying a key role for the micronutrient cofactors that help to synthesize and regulate these neurotransmitters. Furthermore, data informing DSM criteria recognize distinct neurobiological and genetic profiles involving specific regions of the brain (Epstein & Loren, 2013). ADHD is marked by behavioral symptoms that reflect neurochemical imbalances. In addition to nutrition, genetics, environmental, and social exposures, developmental conditions before and after birth may predispose an individual to ADHD. Epigenetic pressures during these critical periods of development induce lasting physiological changes (Greenblatt, 2017b). The continuum of ADHD symptoms and impairments suggests that epigenetic influences create unique needs or excesses producing neuropsychological disruption (Epstein & Loren, 2013).

Janine Galler made enormous contributions to the study of malnutrition’s long-term effects on behavior. Beginning in 1967, Galler followed 129 children born healthy and at normal birth weight who then experienced severe protein-energy restriction in their first year of life (Galler, et al., 1983). Follow-ups over the next forty years consistently reflected the adverse effects of malnutrition in early life on intelligence quotients (IQ), with academic, vocational, and social impacts. Ongoing assessment of the participants’ surrounding environments established that maternal, prenatal, and postnatal factors overruled current conditions to predict IQ and behavior. Although physical growth deficiencies corrected over time with proper nourishment, cognitive and emotional consequences persisted. Previously malnourished children showed a reduced ability to respond to stress and adapt to changing environments, symptoms that are commonly associated with ADHD (Galler et al., 2012).

The acute period of malnutrition experienced by Galler’s study participants manifested in smaller brain volumes and fewer neural connections, resulting in language delays and sensory integration (Galler et al., 1983). Behavioral outcomes in 60% of individuals included problems with attention, memory, and restlessness affecting school performance during childhood, and resulting in reduced academic and vocational achievement, lower socioeconomic status, and contributing to greater comorbidity with mood disorders and substance abuse patterns in adulthood. ADHD symptomology in childhood and adolescence persisted into middle-adulthood; 69% of the eighty remaining 40-year-old participants had clinical ADHD symptoms, implying permanent neurological compromise occurred during the critical first year of postnatal brain development (Galler et al., 2012).

Findings from Galler’s study of the long-term impacts of malnutrition and persistent ADHD symptoms have been supported by more recent international research investigations. Walker, et al, followed 129 Jamaican children with stunted growth for over ten years and reported poor psychological function in adolescence, including greater hyperactivity, anxiety, depression, and poorer self-esteem (Walker, et al, 2007). A 2009 World Health Organization mental health survey of over 600 adults from the Americas, Europe, and the Eastern Mediterranean demonstrated that inappropriate and irresponsible behaviors in adulthood were predicted by attention problems in adolescents. More than half of the participants continued to meet DSM diagnostic criteria for ADHD, independent of both age and gender (Galler et al., 2012).

Global malnutrition remains a significant issue, requiring speculation that it is related to the growing prevalence of ADHD. Poor nutritional status in children with ADHD has been shown in studies around the world. A major review of 50 years of United Nations data by Beal, et al, reported that approximately 11% of the global population is undernourished despite increases in per capita energy availability (Beal et al., 2017). A 2017 dietary comparison in Japan between 54 children with ADHD and healthy controls indicated that over 50% had suboptimal nutrition compared to 11% of typically developing children, and that 11% of ADHD children showed muscle wasting, indicating severe malnutrition (Sha’ari et al., 2017). Both diet quality and intake are factors in micronutrient deficiencies. In fact, while developing countries primarily experience deficiencies due to inadequate food intake, some micronutrients are lacking as a result of poor diet quality in high-income nations such as the United States (Beal et al., 2017).

Public health outcomes following the implementation of national food fortification programs and results of micronutrient supplement trials lend further support for the role of nutrition in reducing mental illness. As of 2011, fortification of food supplies, particularly in developing countries, has dramatically lowered malnutrition rates and micronutrient deficiencies from 27% to 14%. Notably, low zinc, magnesium, and iron status, often associated with ADHD, are significantly improved through both increased dietary quantity and quality (Beal et al., 2017). Many studies have demonstrated improved cognition, mood, and behavior in both children and adults treated with micronutrient supplements (Gordon et al., 2015; Rucklidge et al., 2011).

Growing Use and Reliance on Pharmacology

ADHD medications are a global boon, with prescription rates and spending around the world rising three- and nine-fold, respectively, since the 1990s. Indeed, use of these medications is directly correlated with national GDP, reinforcing the profitable medicalization of ADHD (Scheffler et al., 2007). With the US taking the lead in medication use, Europe has quickly followed suit, with prescriptions rising between 10% and 300% (Bachmann et al., 2017; Furu et al., 2017). Standard care involves a cascade of consensus in which a spectrum of symptoms and situations is neatly lumped under a subjective umbrella and treated with a few lucrative drugs (Hoffer, 2008). Despite an all-time high of psychiatric drug treatments, a multitude of research shows that current ADHD medications are ineffective in at least half of patients (Marx et al., 2017; Rodriguez, 2017).

Typical pharmacological treatment of ADHD involves stimulant- and non-stimulant-based drugs, and are often combined or exchanged in attempts to optimize dose while minimizing side effects. In addition to limited efficacy, side effects of ADHD drugs are often serious and disruptive, requiring continuous experimentation and often resulting in discontinuation (Catala-Lopez et al., 2017; Rosen, 2017). A systematic review by Hennissen, et al, reported that both stimulant and non-stimulant drugs significantly increase the risk for cardiovascular events in children adolescents (Hennissen et al., 2017). ADHD patients of all ages are commonly prescribed multiple medications to manage side effects or comorbid conditions, creating a vicious cycle of drug and side effect management (Winterstein, 2017). Overdose and substance abuse are frequent, especially among adolescents and adults, with profound social consequences (McCabe et al., 2017). Developmental effects on children and their long-term outcomes in adults are topics that continue to draw considerable attention from both professionals and patients, underlying the importance of evaluating and balancing the potential benefits and harms of these substances (Catala-Lopez et al., 2017; Karlstad et al., 2016).

Concerns and debates over the ethical and social consequences of pharmacology use in ADHD continue unabated (Singh et al., 2013). Limited efficacy and debilitating side effects of current drug treatments for ADHD call for specific, objective diagnostic markers and more precisely targeted treatment strategies. Large variations in diagnosis and prescription rates, environmental risk factors, healthcare training and clinical practices, and cultural beliefs across the world require ecological sensitivity and new perspectives in identifying and managing behavioral disorders (Singh et al., 2013). The “substitution principle” maintained in the Swedish healthcare system legally requires the priority use of safer substances. With overwhelming support for the role of diet in physical and mental health, it is worthwhile to prioritize nutrition and call upon orthomolecular theories with a deep history of success to address the global impact of ADHD (Hoffer, 2008).

Orthomolecular Approaches and Nutritional Psychiatry

Artificial criteria for diagnosing ADHD that lead to subjective, automated conclusions and ineffective, unsuccessful interventions call for a rejection of universal treatment models. Not only do symptoms vary widely between individuals, they are often fluid over time within the same individual (Epstein & Loren, 2013; Hoffer, 2008). Expanding global prevalence of ADHD and evidence for poor nutrition worldwide strongly reinforce the relationship between diet and brain function that has been a concentrated area of research in the 21 st century (Logan & Jacka, 2014). New discoveries are leading to novel perspectives in psychiatry, shifting conventional paradigms and recommending methods once considered “alternative” (Sarris et al., 2015). Orthomolecular approaches to medicine and psychiatry have produced reliable clinical evidence for decades that has either been ignored or concealed (Hoffer, 2008).

Global research across diverse environments and cultures recognizes that diet is a modifiable risk factor in the prevention of physical and mental illness (Marx et al., 2017). Sarris, et al, boldly suggest that nutrition is “as important to psychiatry as it is to cardiology, endocrinology, and gastroenterology”, endorsing dietary augmentation with selected nutrient-based supplements to address deficiencies implicated in neuropsychopathology (Sarris et al., 2015). William Kaufman, a notable pioneer of vitamin therapy, demonstrated in thousands of clinical trials over 50 years that carefully selected supplements, even at high doses, are safe and effective for improving health and well-being in most individuals. He proposed that even healthy individuals likely do not receive adequate micronutrients from food and water alone (Benton, 1992; Kaufman, 2007; Popper, 2017). Variable growing conditions, locations, storage, and processing of foods can have profound impacts on nutrient content, and personal intake, digestion, metabolism and utilization determine individual needs. Chronic, low-level micronutrient deficiencies are likely at the root of many degenerative diseases (Kaufman, 2007).

Although virtually all vitamins and minerals play essential roles in determining brain health, magnesium, zinc, copper, iron, and Vitamin B6 appear to have substantial effects on ADHD symptoms (Khan, 2017; Zhou et al., 2016). Either deficiencies or excesses of these naturally-occurring substances affect brain areas that influence neurotransmitter control over behavior, mood, and intelligence (Benton, 1992). Oxidative damage by lead and other neurotoxins also deserve attention and recommend specific antioxidant nutrients such as vitamin C that provide protection (OMNS, 2007). The proposed biological mechanisms underlying ADHD and other mental health conditions have directed promising international research with both single-nutrient and broad-spectrum nutrient supplements. Data provides ample support for psychiatrists and other mental health professionals to adopt individualized nutritional strategies to successfully treat ADHD (Gordon et al., 2015; Rucklidge, 2017).

Neurotoxicity, Micronutrient Deficiency, and ADHD

While a host of causes are likely to produce the brain chemical imbalances and abnormalities linked to ADHD symptoms, toxic exposures and inadequate detoxification systems are likely considerable factors (Brown, 2016). An exceptionally high metabolic rate and concentration of lipids in the brain make it particularly vulnerable to oxidative damage and increase its demand for protective nutrients. Acute or cumulative exposures to environmental and dietary-sourced toxins during gestation, early childhood, and throughout life have been shown to substantially impact brain integrity. Toxicity from heavy metals, household and industrial chemicals, tobacco smoke, and pesticides has been strongly linked to behavioral problems and ADHD in children through disruption of hormones and nutrient metabolism (Slotkin, 2004). Brain imaging studies provide incontrovertible evidence, displaying structural damage and cell death of dopaminergic and cholinergic neurons (Yolton et al., 2014). More disturbingly, similar damage and adverse effects have also been linked to ADHD stimulant medications (Advokat, 2007).

A sufficient diet providing appropriate protein, carbohydrates, and fats promotes the brain’s structure and energy production, yet micronutrients, even in minute amounts, are critical for balancing neurochemicals and transmitting signals correctly. Additionally, detoxification pathways throughout the brain require adequate vitamin and mineral cofactors to protect and repair neurons from the oxidative effects of normal metabolism as well as from heavy metals and other neurotoxins (OMNS, 2007). Individual micronutrient status is also highly reactive to bioavailability and the presence of “anti-nutrients” that inhibit absorption. Establishing or restoring chemical homeostasis and facilitating optimal neurotransmission may require concentrated and purposeful nutrient provisions.

Some evidence suggests that broad-spectrum supplements have proven superior over single-nutrients in the treatment of ADHD and other psychiatric conditions. Three randomized-controlled trials in children, adolescents, and adults with ADHD suggested that a comprehensive vitamin and mineral supplement reduces aggression, hyperactivity, impulsivity, inattention, and depression with effects comparable to conventional pharmacology and with fewer side effects (Popper, 2017). Another recent double-blind, placebo-controlled trial in 80 adults by Rucklidge, et al provided further support for the efficacy and safety of broad-based nutrient supplements, reporting significant symptom reductions in 64% of treated participants (Rucklidge et al., 2017). Nevertheless, count orthomolecular treatments with targeted, high-dose micronutrients based on individual biomarkers encourage the use of more precise methods (Kaufman, 2007; Marx et al., 2017).

Zinc and Copper

Zinc deficiency represents one of the most-recognized micronutrient deficiencies linked to ADHD symptoms. With key roles in enzyme activation and neurotransmitter synthesis, zinc is critical for regulation of dopamine, norepinephrine, serotonin, and gamma aminobutyric acid (GABA). Globally, zinc deficiency is a significant concern; at least 17% of the world’s population is at risk, and research suggests that levels of zinc in the food supply may be inadequate to supply needs. Stunted childhood growth in developing countries is considered an epidemiological measure of zinc deficiency, with significant implications for brain development (Wessells & Brown, 2012). Neurotoxins also contribute to zinc deficiency, as byproducts of plastic degradation bind and deplete zinc stores (Greenblatt, 2017a).

Ample evidence confirms a direct correlation between ADHD symptom severity and low blood and hair levels of zinc. In the Slovak Republic, plasma zinc levels in 58 children age six to fourteen were significantly lower than health controls, and were associated with parent and teacher ratings of inattention (Viktorinova et al., 2016). Dietary and nutrient patterns of roughly 300 Chinese children with ADHD demonstrated a highly-significant dose-response relationship between blood zinc and risk of ADHD, suggesting zinc level as a reliable biomarker (Zhou et al., 2016). Supplemental zinc as monotherapy or adjunctive therapy has been shown to normalize brain waves and improve memory and information processing (Yorbik et al., 2008). Children given zinc supplements also show improvements in hyperactivity, impulsivity, and social engagement (Bilici et al., 2004). Furthermore, zinc supplements may increase the effectiveness of ADHD stimulant medications, lowering the necessary dose and reducing side effects (Arnold et al., 2017).

Zinc also plays an essential function in regulating copper levels. While trace amounts of copper are necessary for dopamine and norepinephrine synthesis, excess concentrations can lead to over-excitation by these neurotransmitters and contribute to hyperactive ADHD symptoms. The copper-to-zinc ratio is critical, and like zinc, is inversely correlated with risk of ADHD (Viktorinova et al., 2016). Excess copper and imbalanced copper-to-zinc ratios are linked to elevated levels in drinking water through leaching of copper pipes (Greenblatt, 2017). Neurotoxic levels of copper in plasma and hair samples from children and adults with ADHD reveal adverse effects on mood, attention, and memory (Kicinski et al., 2015; J. Rucklidge, Taylor, & Whitehead, 2011). In addition to inhibiting the beneficial properties of zinc, copper can also reduce antioxidant capabilities and reduce the effectiveness of conventional and supplemental ADHD treatments (Greenblatt, 2017a).

Possibly the most crucial micronutrient for optimal brain performance, magnesium participates in virtually all enzyme reactions, nerve signal conduction, and in the function of dopamine and serotonin receptors. Magnesium also plays a key role in the excitation status of nerves through inhibition of excitatory glutamate receptors and promotion of GABA reception (Greenblatt, 2017). Deficiency of magnesium is identified in almost all cases of ADHD, and is widespread even in healthy populations (Moshfegh, A. et al., 2009). Poor-quality diets and high consumption of processed foods that are stripped of nutrients contribute to inadequate magnesium intakes in many developed countries. Furthermore, the bioavailability of magnesium is limited to approximately 30-40% (Greenblatt, 2017). Globally, at least a third of the population is estimated to be deficient (Hruby & McKeown, 2016). Low magnesium is significantly correlated with IQ and all ADHD symptom domains in addition to comorbid anxiety and depression (Starobrat-Hermelin & Kozielec, 1997).

Abundant clinical evidence promotes magnesium supplements as safe and effective for improving ADHD symptoms. Magnesium depletion of the food supply and its limited bioavailability suggest that supplement doses greater than current FDA daily requirements are necessary to impact brain function and produce clinical results. Significant decreases in hyperactivity were produced in 50 children with ADHD treated with 200 mg of magnesium for six months; symptom improvements were also accompanied by beneficial effects on sleep and anxiety with implications for behavior (Case, 2016). Supplements also containing vitamin B 6 increase the absorption of magnesium and show the greatest promise for reducing ADHD symptoms (Mousain-Bosc et al., 2006). Like zinc, magnesium may also be a successful adjunct therapy to conventional pharmacology. El Baza, et al, demonstrated that magnesium supplements reduced ADHD symptoms greater than medication alone (El Baza et al., 2016). Abundant support for the use of magnesium in ADHD has led some researchers to conclude that it should be a required component of ADHD interventions (Mousain-Bosc, M. et al., 2006).

Vitamin B 6

In addition to supporting magnesium metabolism, pyridoxine (vitamin B 6 ), as pyridoxal phosphate (PLP), has independently essential roles in the nervous system, energy production, neurotransmitter synthesis, heme production, and is critical for strong immune function and the inflammatory response (Ho et al., 2016; Rucklidge et al., 2017; Ueland et al., 2017). Often assessed by measuring tryptophan degradation, reduced activity of PLP-dependent enzymes reflects genetic errors involving vitamin B 6 and subsequent impairments in amino acid metabolism. In children with ADHD, reduced conversion of tryptophan to serotonin results in greater impulsive and hyperactive behaviors. Deficiencies of vitamin B 6 , particularly during pregnancy, can significantly compromise brain development, nerve conductivity, and neurotransmitter regulation. In 2016, a Canadian study showed that at least 12% of healthy multi-ethnic women of child-bearing age had low PLP activity and B 6 status (Ho et al., 2016). The British Journal of Psychiatry recently reported that inadequate levels of B 6 predominate in adults with ADHD and were inversely associated with symptom severity (Landaas et al., 2016). Low vitamin B 6 status also predicts cognitive decline in older adults, emphasizing the vital need for this micronutrient throughout the lifespan (Moore et al., 2017; Porter et al., 2016).

Use of fortified foods and vitamin supplements containing vitamin B 6 is directly related to plasma levels, and food sources alone appear to be inadequate at supplying sufficient amounts of B6 and other B-vitamins (Moore et al., 2017). Supplemental pyridoxine in hyperactive children has demonstrated its ability to normalize serotonin and reduce disruptive behavior (Bhagavan et al., 1975; Coleman, M. et al., 1979). In combination with magnesium, Vitamin B6 supplements help to normalize red blood cell magnesium and therefore facilitate and moderate neurotransmission. The addition of magnesium may also lessen any potential adverse effects from pyridoxine supplements (Mousain-Bosc, M. et al., 2006). Importantly, vitamin B 6 also works synergistically with zinc to produce serotonin, recommending its incorporation in most ADHD treatment regimens in combination with zinc and magnesium (Zhou et al., 2016).

At appropriate concentrations, iron is another essential cofactor in the enzymatic production of serotonin, norepinephrine, and dopamine (Rucklidge et al., 2017). Most reliably assessed by serum ferritin, low iron status is a significant but heterogeneous risk factor for ADHD, independent of anemia diagnosis (Konofal et al., 2008). Iron stores are depleted with insufficient dietary intake as well as heightened inflammation (Wang et al., 2017). In individuals with insufficient serum ferritin, iron supplements show beneficial effects on ADHD symptoms without adverse side effects. Progressive improvements in ADHD symptoms similar to those achieved by stimulants were measured in children with low serum ferritin taking 80 mg of oral iron over 12 weeks (Konofal et al., 2008).

Insufficient iron impacts cognitive, social, and emotional health as well as motor function through its role in neural signaling. Children in Uruguay with low iron status showed problems with cognition, attention, learning, and socialization (Barg et al., 2017). Evaluation of serum ferritin in 200 Turkish children and adolescents with ADHD, demonstrated that iron deficiency is most strongly related to hyperactivity symptoms (Percinel et al., 2016). A recent study by Demirci, et al, showed that approximately 20% of adult women with iron deficiency anemia met criteria for adult ADHD diagnosis (Demırci et al., 2017). A systematic review of 10 studies, including over 1600 individuals from the US, Europe, Egypt, Asia, and Brazil, revealed consistently low iron status in children with ADHD when assessed by serum ferritin. However, results varied significantly across studies, suggesting that individual genetics and environment may have a dominant influence (Wang et al., 2017).

Vitamin C is a critical component of the antioxidant system. Heightened oxidative stress caused by chronic inflammation, heavy metal or other environmental exposures, and hyperexcited neurons place heavy demands on the brain’s antioxidant system. Stimulant medications used for ADHD are also implicated in oxidative damage to the brain (Lopresti, 2015). In the nervous system, vitamin C is also an essential factor in collagen synthesis, promoting the integrity of myelin sheaths and enhancing neural signaling. Much of the world’s population may be at risk for vitamin C deficiency despite its ubiquity in many foods. Easily oxidized and vulnerable to damage by air, heat, and metal, unfortified levels of vitamin C in fresh foods are highly overestimated. Hoffer and Pauling strongly believed that “no one” receives adequate Vitamin C from food alone (Hoffer, 2008). As one of the most familiar micronutrients, vitamin C is underappreciated in its sacrificial and protective roles, but its deficiency has profound implications for mental wellness.

Environmental pollution from industrial and agricultural processes and transportation is a foremost concern world-wide. Contamination of heavy metals in food and water are unavoidable and can confer alarming effects during growth and development. When adequately equipped, the body’s detoxification system provides considerable protection; yet, in the modern toxic environment, promoting antioxidant activity through higher-than-average nutrient doses may be required for certain individuals (OMNS, 2007). Vitamin C participates in metabolic reactions that aid the brain in its ability to remove neurotoxins and reduce oxidative damage by excessive levels of copper, iron, and lead. Additionally, research supports adjunctive vitamin C with both conventional ADHD medications and nutritional supplements, particularly Omega-3 fatty acids, for antioxidant protection and enhanced efficacy (Joshi et al., 2006). The inclusion of Vitamin C in any ADHD treatment intervention is overwhelmingly supported by its safety record, clinical research evidence, and case reports from orthomolecular practitioners (Abbey, 2003; OMNS, 2007).

The 2014 crisis in Flint, Michigan, involving alarming levels of heavy metals in drinking water brought renewed attention to lead as a primary risk factor for ADHD, especially in children. However, water is not the only significant source of lead. Although use of lead paint ceased in the mid to late 20 th century, the persistence of lead in the environment continues to be reflected in elevated blood levels all over the world. Data suggests that any measurable concentration of lead in the blood has cumulative detrimental effects on brain structure and function, affecting intelligence, behavior, and mood (Hong, 2015; Nigg et al., 2016). Multiple studies show direct correlations between high blood lead levels and ADHD, suggesting a four-fold increase in risk (Braun et al., 2006). The ability of lead to easily cross the blood-brain-barrier and other tissues increases its damaging impact during maternal, prenatal, and postnatal neurodevelopment (Nigg et al., 2016). Imaging studies reinforce evidence that reduced cortical grey matter in adulthood results from toxic lead exposure during these critical periods, matching data showing lower executive function and behavioral control (Cecil et al., 2008).

Lead toxicity exhibits heterogeneous effects between individuals, reflecting varying detoxification capabilities. A 5-year birth cohort study investigating lead levels in 578 Mexican children demonstrated a non-linear relationship between blood lead and ADHD symptoms. The study authors concluded that ADHD subtypes may be related to variations in lead detoxification (Huang et al., 2015). Research shows a relationship between genetic determinants of iron status and

lead metabolism, implying that some individuals may be more susceptible to lead’s neurotoxic effects. Carriers of the HFE gene variants show increased iron uptake, exacerbating oxidative stress and increasing vulnerability to developmental damage from lead (Nigg et al., 2016). However, Hong, et al, reported significant inverse relationship between blood lead and all ADHD symptom domains in a thousand Korean children, independent of confounds such as other toxin exposures (Hong, 2015). Still, both studies confirmed pronounced associations between elevated lead and symptoms of hyperactivity and impulsivity, supporting the hypothesis of oxidative damage to dopaminergic systems (Hong, 2015; Huang et al., 2015).

While attempts can and should be made to reduce exposures to lead and other environmental toxins, protecting the brain from their detrimental effects is also achievable from a nutritional perspective. Ensuring adequate macronutrients from food and boosting intakes of brain-enhancing vitamins, minerals, and antioxidants can better equip the body’s natural ability to combat inflammation and oxidative stress. Zinc, magnesium, iron, and Vitamin C augment neural integrity and function and regulate neurotransmitter balance, and have proven benefits for ADHD symptoms in all age groups (Sinn, 2008). These micronutrients also aid in reducing the potential neurotoxic effects of copper, lead and stimulant medications.

Personalized, Integrative Treatments for ADHD

Widespread recognition of diet as a modifiable factor in the midst of numerous, un-modifiable risks, highlight nutritional interventions as first-line strategies for treating ADHD (Marx et al., 2017). In addition to promoting other preventive health behaviors such as physical activity, adequate sleep, and smoking cessation, approaching psychiatry from a nutritional standpoint is no longer optional. Strong associations between dietary quality and mental health risk are consistent across diverse demographics, nationalities, and cultures, encouraging use of a new integrative care model (Jacka, 2017).

While several common nutritional deficiencies have emerged among individuals with ADHD, orthomolecular approaches to treatment remain contingent upon biochemical individuality to tailor interventions on a case-by-case basis. Nutritional psychiatric practice should begin with full genetic and biochemical assessments, including food sensitivity analyses, to identify specific imbalances that require correction (Jackson et al., 1998). Comprehensive panels can also recognize individual variations in metabolism and digestion that inform the correct selection and dose of vitamin and mineral supplements (Kaufman, 2007). Unique ADHD symptom types may require substantially different approaches to restore a homeostatic balance of neurotransmitters in the brain (Benton, 1992).

Although global dietary patterns and practices vary, the basic building blocks of the human diet needed for optimal health and mental wellness are similar across time and culture. As research continues to elucidate the intricate biochemical roles of micronutrients, healthcare practices must take advantage of this knowledge to restore, maintain, and sustain health and wellness throughout the body and mind (Logan & Jacka, 2014). Neglecting evidence for the use of safe, affordable, naturally occurring and readily available micronutrient supplements for children and adults with ADHD is unjustifiable personally, socially, and economically (Marx et al., 2017; Sarris et al., 2015).

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Studying for a PhD with ADHD – tips and advice from one student

Amarpreet abraham was 29 years old when she received an adhd diagnosis. she explains how this diagnosis impacted on her phd work and the measures she uses to manage her workload.

Amarpreet Abraham

For as long as I’ve known about attention deficit hyperactivity disorder (ADHD), I’ve suspected I have it. I would make jokes about it and downplay how much it really affected me.

Previous patterns and past life experiences, both personally and academically, have always led me to wonder about how and why I work the way I do. I’ve found myself unable to focus when multiple tasks are at hand, assignments taking longer than expected, and with a feeling of being misunderstood.

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In 2021, as a 29-year-old, I threw in the towel and said, “What’s the harm in getting tested?” And voila – I was given the shiny new title of someone with ADHD.

It was another diagnosis I could add to the list of conditions I had: chronic depression, chronic anxiety – and now, ADHD. A lot of behaviours I had attributed to laziness, procrastination , boredom or random bursts of excitement and anger started to make sense.

Going to university with dyspraxia Going through university with autism Going to university with cerebral palsy

I would always convince myself that I was using ADHD as an excuse and that I was just a forgetful/lazy/chronic procrastinator. During 2020 and 2021, working collaboratively with others as part of my PhD studies at Monash University , and experiencing a lot of big changes in my personal life led me to realise that the way I functioned on a day-to-day basis was different from others – personally and professionally.

I reached out to a friend who had shared their diagnosis of ADHD on social media and I asked them about the process and how to get started, and they really encouraged me to talk to a specialist and seek a diagnosis.

I often get asked questions surrounding productivity, such as how I cope with periods of procrastination as a PhD student, as well as if I have any helpful tips for people in a similar position. The issue here is that there is no “one size fits all” approach in this scenario.

Everyone experiences neurodivergence in a different way, and it’s always worth experimenting and trying to find your own ways of working. However, although my methods might not work for everyone, they might help kickstart someone else’s journey into discovering their own methods.

In short, a few things that have helped me persevere and overcome my own barriers are:

• It’s OK to disclose and talk about your diagnosis (at your own pace and when you feel comfortable). Once you are done processing the diagnosis and have attributed behaviours and experiences to ADHD, explore discussing your diagnosis, and use it to support yourself and explain to others how it affects you.
• Progress looks different for different people and on different days. It is incredibly difficult to not compare yourself to others, but it is important to exercise self-kindness and remember that every day won’t look the same as the last.
• My PhD is not one big project; instead, it’s multiple little projects that can be further broken into smaller bits. I went from tackling each of my chapters as one big task to breaking them down into manageable smaller chunks so that I wouldn’t overwhelm myself.
• Sensory overload is real. It’s difficult to explain sensory overload, and it works differently for everyone. I now use noise-cancelling earmuffs to avoid noise and disturbances or listen to binaural beats as I work.

Having ADHD doesn’t come without its misconceptions, however. A lack of knowledge or training on the matter can lead to myriad stereotypes surrounding neurodivergence. One example is the misapprehension that people with ADHD are lazy, and it is used as an excuse for their procrastination.

Having ADHD and battling with time-blindness, as well as periods of mental blocks, is a constant struggle, and any effort made towards completing a task, whatever it might be, should be commended.

My diagnosis has been liberating and challenging. Not only because I finally knew what was “wrong” with me, but because I felt validated. I started listening to podcasts about ADHD in adults, reading books and blogs, and joined groups on Facebook and Discord to share my experiences with others who were in a similar boat.

If I was to sum up my experience with ADHD in one sentence, I’d say that it has been a largely positive but also daunting and overwhelming experience.

It’s OK if there are days where I don’t make any progress, or I sit and stare at my screen and seriously consider dropping out of my PhD. But I won’t let my PhD be added to the list of hobbies and tasks that were started but never finished.

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MA, MBA, BS, MS, MSW, PhD, PsyD: What Does it All Mean?

The benefits of college degrees, be it associate, B.A., M.A. or Ph.D level, have been touted and restated many times. Despite rising costs, the investment continues to be valuable one for a wide variety of people. That said, back it up a little bit: just what do all those different degree acronyms mean? Beyond that, what differentiates, say, a B.B.A. from a BSN?

To help answer those questions we put together the following list of definitions for what each degree acronym stands for as well as explanations of the meanings behind all the different terminology.

Associate Degrees

An associate degree is typically completed in two years of full-time study, but may take longer for part-time students. These undergraduate programs can be found at community colleges, vocational schools, technical colleges, and some universities. In general, associate degrees fall into three different categories: Associate of Arts (A.A.), Associate of Science (A.S.), or Associate of Applied Science (A.A.S.).

Associate degrees are a great fit for career-oriented students who want to enter a technical or vocational trade that requires some post secondary education. Along with often being the quickest and cheapest route to a formal degree, an associate program can also be a stepping stone to a four-year degree. Many schools offer students the option to apply credits earned from an associate degree, which is generally 60 semester credits, towards a bachelor’s degree.

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A.A. Associate of Arts

The associate of arts is a basic-level undergraduate degree granted upon completion of a two-year program, usually at community or junior college, technical college or trade school. As such, these are typically a jumping off point towards pursuing a full bachelor’s degree.

A.S. Associate of Science

Similar to the A.A., the associate of science degree is the culmination of a two-year academic program. The A.S. is usually awarded to junior college students enrolled in science or tech-related programs.

Associate Degree Related Content

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Bachelor’s Degrees

A bachelor’s degree is the most popular post-secondary degree option, and typically seen as the standard for employment in most professional fields. In most cases, a bachelor’s program takes four years of full-time study to complete. However, some majors may take longer, or schools may offer accelerated programs allowing students to finish their degree in less time.

The two most common types of bachelor’s degrees are the Bachelor of Arts (B.A.) and the Bachelor of Science (B.S.). There are a number of other options, though, that coincide with more specific major fields, such as the Bachelor of Science in Nursing (B.S.N.). Generally, a bachelor’s degree consists of 120 semester credits, with half being made up of general education or liberal arts courses. The other half is typically filled with courses geared toward a student’s particular major.

B.A. Bachelor of Arts

The usual degree path for majors in liberal arts, humanities or social sciences such as English, creative writing, fine arts or political science. A B.A. is typically awarded upon completion of a four-year undergraduate program at a traditional school or university.

B.S. Bachelor of Science

The bachelor’s typically awarded to undergraduates in science and technical fields.

B.F.A. Bachelor of Fine Arts

Awarded to majors like art history, theater, film studies and photography.

B.B.A. Bachelor of Business Administration

A business-oriented bachelor’s path, typically associated with management, accounting, marketing, etc.

B.Arch Bachelor of Architecture

A bachelor’s degree geared towards the architecture field.

BSN Bachelor of Science in Nursing

A degree path oriented towards the technical and hands-on training necessary to obtain a nursing license.

B.E. Bachelor of Engineering

Concentrates on engineering fields like electrical engineering, mechanical engineering and computer engineering.

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Master’s Degrees

Master’s degrees are graduate-level programs that typically take two years of additional full-time study after completion of a bachelor’s degree. Because most graduate students are already working professionals, many colleges and universities offer part-time or flexible master’s degree programs. These allow students to maintain their career while completing the degree at their own pace, but generally take longer than two years of study.

In order to apply for a master’s program, students usually must already possess a bachelor’s degree. Most students choose to pursue a master’s degree in order to advance in their chosen profession or enter a field that requires a high level of education. Many programs fall into one of two categories: Master of Arts (M.A.) or Master of Science (M.S.). The Master of Business Administration (M.B.A.) is another popular option.

M.A. Master of Arts

The basic graduate-level degree granted to grad students in fields in the humanities, social sciences or fine arts.

M.B.A. Master of Business Administration

The Master of Business Administration is the master-level degree granted upon completion of a business administration or management-oriented program. In contrast to an M.A., M.B.A. programs are typically oriented around subjects more narrowly tailored towards business operations like accounting, marketing and analysis.

M.S. Master of Science

Typically awarded to graduate students in scientific or technical fields.

M.S.W. Master of Social Work

Similar to the M.B.A., the Master of Social Work is narrowly defined master’s degree focused on social work. M.S.W. programs may adhere to either a clinical track or practice track. The clinical track is oriented towards working with patients, while the practice track focuses on politics and policy as well as management.

Master’s Degree Related Content

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Doctoral Degrees

A doctorate is the highest level of academic degree awarded by universities, and can take anywhere from three to eight years (or more) to complete. Some doctoral programs require students to already have a master’s before enrolling, while others can be started directly after completion of undergraduate study.

There are many different types of doctoral degrees, but the most common is the Doctor of Philosophy (Ph.D.). Depending on the specific degree awarded, earning a doctorate can qualify graduates to teach at the university level, or work in a position that requires extensive training and education. Psychologists and medical doctors are two examples of professionals who must hold doctoral degrees in order to become licensed to practice in their field.

Ph.D Doctor of Philosophy

Despite what the name might suggest, this isn’t a degree for philosophers exclusively. A Ph.D is the doctorate-level degree granted in a variety of different disciplines. These are typically research-intensive programs pursued by those who’ve already acquired bachelor’s and master-level credentials in their field of study.

Psy.D. Doctor of Psychology

The Psy.D.is similar to a standard doctorate degree, but granted specifically for students pursuing psychology practice.

Doctoral Degree Related Content

• Doctoral Degree Overview
• Doctoral Degree in Psychology & Social Sciences

What do these letters stand for?

There are two parts; one can classify the educational level of the degree: “B” stands for bachelor’s degree; “M” stands for master’s degree; and “D” stands for doctoral degree. The second part denotes the discipline of the degree, like “S” for science, “A” for arts, or “Ph” for Philosophy.

What are the distinctions between arts and science degrees?

Depending on the school you attend and the kind of courses you take, you could earn an arts degree or a science degree. Typically, an “arts” degree means that you focused on a wide area of learning and discussion, while a “science” degree implies a deep, technical understanding of your subject.

What kinds of designations exist for doctoral students?

The highest degree you can earn in most liberal arts disciplines is a PhD, or Doctor of Philosophy. However, clinical and counseling psychologists earn a PsyD, Doctor of Psychology nomenclature; medical students earn M.D. degrees and law students can earn J.D. (Juris Doctor) degrees.

What about some of the other specialized degrees?

Distinctive nomenclature are named after applied disciplines, include Master of Social Work (MSW), Doctor of Social Work (DSW), Master of Education degree (MaEd), Master of Business Administration (MBA), or Doctor of Business Administration (DBA).

Now that you know some of the benefits of online learning, find a program that’s right for you. Browse our school listings below to get matched to an online school.

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Sharing PhD experiences across the University of Warwick and beyond

Too many tabs open: Doing a PhD with ADHD

Imagine you’re cycling through 50 browser tabs at once, 2 of them are playing different TedTalks from YouTube at full volume and another is stuck in a 5-second loop of that song you heard the other day – oh, and you can’t close any of them. Now imagine, saturated in all that noise, you have to do your research. This is a taste of what it’s like to be a PGR with ADHD. Blogger Riss shares their experience.

By Riss Muller

Whether it’s “that thing where kids can’t sit still”, simple laziness, or something that’s just another excuse, most people have some preconceived idea of what they think ADHD is. But the truth is most people don’t know what ADHD is or how it affects those who have it. ADHD is a complex condition that presents in a variety of ways. Just as each individual is different, it’s unlikely that two ADHDers will report identical experiences with their condition. A common thread though, is that it makes virtually all areas of life significantly harder and, in some cases, completely unmanageable. So, before we get into how my ADHD mixes with my PhD, I want to bust some common myths about what ADHD actually is.

What is ADHD, really?

“ ADHD is a complex condition that presents in a variety of ways. Just as each individual is different, it’s unlikely that two ADHDers will report identical experiences with their condition. “

ADHD stands for Attention Deficit/Hyperactivity Disorder and there are three different subtypes:

• Primarily Inattentive – people mainly struggle with sustaining attention, following instructions, distractibility, attending to details, listening to others, and being forgetful due to poor working memory.
• Primarily Hyperactive/Impulsive – people mainly struggle with feeling constantly on the go, interrupting others, fidgeting, excessive talking, forgetting things, and a lack of impulse control.
• Combined Type – the most common subtype, characterized by a clear mix of all symptoms.

I have ADHD-PI (primarily inattentive) but with high levels of mental hyperactivity. This means I deal with all the inattentiveness, forgetfulness, and distractibility of ADHD-PI but with a side order of constant racing thoughts which rarely turn off. Alongside the symptoms which characterise these subtypes, there are also symptoms common to everyone with ADHD, such as rejection sensitivity, emotional dysregulation, and “time blindness” (the inability to accurately gauge how long tasks take).  

ADHD is a neurodevelopmental disorder; it develops in childhood and, in the vast majority of cases, is present throughout a person’s life, and its cause is thought to be linked to a crucial neurotransmitter: dopamine. Without getting too scientific, dopamine is the “feel-good” hormone. It’s part of our motivation and reward system, responsible for giving us a sense of pleasure and incentivising even the most basic functions like eating and drinking. In the ADHD brain, however, there’s a dopamine deficit, so our brains are always on the hunt for another hit of it. We’re driven by interest , by whatever gives us a dopamine boost, and so people with ADHD constantly oscillate between two poles. On the one hand, we can be highly distractable, forgetful, impulsive, likely to lose track of time, have difficulty relaxing or sitting still…the list goes on and on. But, on the other hand, we can hyperfocus on a task, zeroing in on the thing which is giving us that vital dopamine hit. All other “noise” is blocked out and we lose ourselves in the task, sometimes for hours at a time (though often at the expense of temporarily losing our ability to discern hunger, thirst, and other bodily functions).

In short, ADHD is a disorder concerning the regulation of attention and executive function (the ability to do stuff, even when you don’t want to). It’s not that we can’t concentrate, sit still, or get things done, it’s that we can’t regulate these capacities.

ADHD + PhD = …?

You can probably guess by now that having ADHD and being a PhD student are at odds with one another. The former negatively impacts things like motivation, task prioritization, sustained attention, and time management. The latter demands them consistently and to a high standard. It’s kind of like playing a game on the highest difficulty level…and you don’t know the rules…and whilst everyone else got behind-the-scenes access to the game design, you never got the invite. It’s incredibly hard.

Whilst most PGRs can probably slog through the menial parts of their research, for the ADHDer if our brain says ‘no’ we can’t simply “push through” because we simply don’t have the necessary neurotransmitters available to incentivise the task; our brains are structured, and therefore function, differently. When we look at our to-do lists, figuring out which task is the most urgent can be a labour in itself and folding the laundry can seem equally as important as editing a draft chapter. If we get interrupted, we can’t always jump straight back in; it can take hours, and all of our energy, to resume what we were doing. Not to mention struggling to remember meetings, juggle academic and personal responsibilities, having so much mental noise we lose track of what’s being said to us, or worrying about appearing unprofessional if we lose our train of thought midsentence or blurt something out impulsively.

“It’s kind of like playing a game on the highest difficulty level…and you don’t know the rules…and whilst everyone else got behind-the-scenes access to the game design, you never got the invite. It’s incredibly hard. “

Personally, though, the hardest part is the emotional toll. ADHD has worryingly high rates of comorbidity with anxiety and depression (around 50%) with feelings of shame and low self-esteem being prevalent. Even before starting a PhD, those of us with ADHD are already battling imposter syndrome, low mood, and poor self-image. Why? Well, imagine you grew up always forgetting when your assignments are due, you interrupt people a lot, and you never seem to be able to turn up somewhere on time. People tell you you’re lazy, you’re rude, and you need to try harder…even though you’re already trying your hardest. You compare yourself to everyone around you and wonder why things seem so much easier for them and, in the end, you blame yourself. As an adult, you can’t seem to hold down a stable job, you have piles of laundry and dirty dishes everywhere , and you’re burnt out constantly from the energy you spend achieving the bare minimum. As a PGR, you turn up to the game, so to speak, having already run an emotional marathon.

I got my diagnosis, like most people assigned female at birth (AFAB) , later in life at age 25, a year before I applied for my PhD. Until that point, my academic track record was a mixed bag. I’d failed every A-Level exam (bar one), had extensions on all my undergraduate coursework, and could only manage reading about one article a week. But I also got As in my coursework (even in subjects where I’d failed the exams), managed two jobs alongside my Master’s, and graduated both degrees with Distinctions. I’d never questioned that I was disproportionately struggling, and it was only after the first semester of my Master’s that I spoke to a doctor because my physical health had taken a turn from constant burnout and being spread too thin trying to cope. Overcompensation, abysmal work/life boundaries, and a deep sense of shame were partly the root of my success at university, but I knew it was unsustainable and things needed to change – especially if I wanted a PhD.

“ I get to close those 50 browser tabs for a few hours each day thanks to medication and have learned strategies for managing my symptoms. I can finally exhale. “

Fast-forward a few years and now, at the beginning of my doctoral journey, I have my diagnosis and access to much-needed help. I get to close those 50 browser tabs for a few hours each day thanks to medication and have learned strategies for managing my symptoms. I can finally exhale.

Having ADHD and working towards a PhD is unbelievably challenging. But ADHD is also, in many ways, something to celebrate. Those of us with ADHD are some of the most creative and dynamic people you’ll meet and we care deeply and enthusiastically about the things we’re interested in. We’re excellent problem solvers, insatiably curious, and incredibly resilient people which, all in all, makes us pretty talented researchers – especially when we’re granted the right conditions to flourish.

If you feel there is something affecting your research, you can speak to Warwick’s Disability Services , who will help you get all the support you need. On the PhD Life blog, we have a whole section on student experiences of research, which you can explore here . If you feel like you have an experience you’d like to share, we regularly welcome guest writers to PhD Life, just email [email protected] for more information.

Did you find this blog helpful for your own experiences? If you related to it in some way, let us know in the comments below, by tweeting us @researchex or by messaging us on Instagram @warwicklibrary.

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• Published: 21 March 2022

Pursuing a scientific career with ADHD

• James E. Brown   ORCID: orcid.org/0000-0002-3504-7373 1  

Nature Reviews Endocrinology volume  18 ,  pages 325–326 ( 2022 ) Cite this article

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Attention deficit hyperactivity disorder presents considerable barriers to a successful research career. Universities need to start taking this into account to ensure that talented researchers are retained in the sector and given an equal opportunity to succeed.

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Acknowledgements

I would like to thank Dr A. C. Conner, University of Birmingham, for supporting the preparation of this article and for advocating for more support for ADHD in academia.

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Brown, J.E. Pursuing a scientific career with ADHD. Nat Rev Endocrinol 18 , 325–326 (2022). https://doi.org/10.1038/s41574-022-00664-9

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My PhD and My ADHD

There is a ‘rule of thirds’ when diagnosing Attention Hyperactive Deficit Disorder: One-third of children who are diagnosed with ADHD grow out of it, one-third continue to display symptoms in adulthood, and the remaining third represents those who are undiagnosed, able to mask their symptoms just enough to get by. I was the latter.

The (non)diagnosis

When I was 11, a psychologist pulled me out of class to evaluate me for the school’s gifted program. She brought me to a white-washed room, and sat me on a ‘big person’ chair across from her at a long conference table. For over two hours, I answered countless questions, reordered pictured tiles, and matched abstract shapes. I thought the whole thing was quite fun, but after it was over I didn’t think much more of it.

When my results came in a confidential envelope, my parents raved about my IQ scores, which allowed admission into the gifted program. However, they failed to mention to me, or even acknowledge themselves, that a discrepancy in my scoring patterns had been highlighted. A discrepancy that suggested I had a learning disability.

My test results were eventually tucked away in a folder in my parents’ filing cabinet. It wasn’t until I was in my early twenties that I looked at them again. Searching for answers that might explain my recent difficulties at university, I read the document in a different light. My psychological evaluation from 15 years ago would end up becoming my Rosetta Stone, confirming long-harboured suspicions and frustrations that I might have ADHD. ‘A relative weakness was indicated on tasks measuring her ability to attend to details, visual memory, and the ability to concentrate… she is impatient and anxious to complete the tasks.’

What is it?

ADHD is a neurobiological condition that affects the part of the brain that controls attention, impulses, and concentration. It affects 3-7 percent of children in the UK, and although it was thought that the disorder is outgrown in adolescence, recent research has shown that ADHD often exists into adulthood. Common symptoms are:

• short attention span
• easily distracted
• frequent, careless mistakes
• forgetfulness
• inability to work through time-consuming tasks
• inability to sit still
• little or no sense of danger (my middle name is indeed, ‘danger’)

While everyone experiences these symptoms occasionally in singular form, having ADHD is a constant and unwavering conglomeration of them. Nevertheless, our culture has associated a stigma with the disorder. ADHD frequents casual conversation as an adjective (‘ you’re acting ADHD’ ), is often believed to be a fake mental condition, and is commonly misdiagnosed and over diagnosed in America.

ADHD and the PHD

Growing up, I always knew my brain worked a bit differently than others. I had a difficult time focusing during class, but I taught myself to fill in the missing pieces, and worked hard to make it look like I was paying attention (even though I was not). With my parents’ persistence that ‘nothing was wrong’, I persevered and did well in school. My coping methods continued to work through my undergraduate years, however, they fell short in graduate school.

In class, I struggled to pay attention to lecturers and peers, despite being interested. I had no confidence in seminars because I found it impossible to form my own opinions during a discussion.  If I dared to take part in class conversation, I knew that my scattered attention span limited my ability to bring up a constructive –or even relevant– point.

Just because words were coming out of my mouth, it did not mean that my focus was channelled. My mind would abruptly jump elsewhere before I could finish vocalising a thought. I really struggled using the right words at the right times, and I often lost track of what I was saying mid-sentence. I frequently had to apologise and ask to be reminded of what I was talking about in the first place.

Now, when you apply these unfortunate tendencies to the intensive reading and writing required of postgraduates, it is no surprise that my methods of ‘faking it’ began to fall short. The nature of graduate school made me recognise that I was unable to control, or even follow, my own thought patterns. I shared my concerns to my GP, and she recommended that I track the frequency of my distractions. At the follow-up appointment, I came back frustrated with my efforts, ‘You asked me to pay attention to how often I am getting distracted, my problem is that my distraction is so normal to me, I don’t even realise when my mind diverts to something else.’ She agreed to refer me.

The whole process from referral to diagnosis took five months. During that span, the doctor concluded that I was among the third of children whose ADHD diagnosis slipped through the cracks. To prove her suspicions, she pointed to my bouncing leg, and said that I was intermittently fidgeting the whole time I was sat in my chair. My diagnosis, she explained, would be the start of a 6-month period of ‘self-reflection’. When that was over, I would have the option to try medication. Meanwhile, I began to identify with the fact that ADHD was an explanation of my behaviour, not an excuse.

Photo from the July, 1925 issue of the Science and Invention magazine. It was claimed that the “Isolator Machine” helped focus the mind when reading or writing. Thankfully, in this modern day and age, I have other options.

In my next instalment, I will talk about the positive changes I experienced after my diagnoses and discuss some tips I have learned along the way for helping one focus, especially in the graduate school environment. Meanwhile, if you suspect that you may have ADHD, or any other learning disability, act like a graduate student. Do your research, then talk to your GP. It’s not so scary to start getting the help you need, especially when the first step is already second nature.

Images 1 & 2: Authors own; Image 3:  Science and Invention Magazine , 1925.

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Krystenblackstone.

March 31, 2017

identity , mental health , phd , PhDilemmas , Real Life

August 3, 2020 at 9:45 am

I manged to go and be inrolled in 5 different schools (0th to 10 th class). In the first one my parents took me out because I had reading/writing problems, hence teachers and school administration suspected inferior IQ… I scored an IQ indicating that I should be ~ 13 years old and not 9 years old. In highschool, thou nature and science was my favoured subjects I managed to get the best scores in writing/oral-presentation of my native primary language, which I did not master in writing and reading before the age of ~ 13 years old.

After various travels and jobs the year after high school I started in University. Thou I had plenty of different jobs meanwhile studying… retrospective the job as one of the first bike-taxi-drivers in my capital city was deffently my favourite one… probably because of the non-ties and physical exercise, mostly positive interpersonal human contact and good relative easy money.

It took me in total 8 years to graduate in 2008 with an A-score as Master of Science in Geology.

After university until 2014 I realized that what one is not taught in university is most important thing at a workplace… hence how to interpersonel interact after non-written rules… In 2014 after nummerous jobs that I lost – not do to lack of knowledge in applied science – but do to lack in knowledge in applied “non-logic” workplace rules, hence confrontations.

Since then I have lost an additionaly two jobs. The latter in 2016 with a major stress and depression lockdown. I have not been doing much – workwize since.

Best regards Another skilled human with late- diagnosed ADHD

October 19, 2020 at 12:15 pm

I just read your post. I am pursuing my PhD, for which I should be working right now, but of course I am distracted … searching how people at Graduate School got diagnosed, found out about ADHD or ADD. I hope my psychologist listens to me, whether I have ADD or not , this killing syntoms are here making me to struggle every day on making any progress. I have been reading about the topic and relating it to some life-time patterns. I really hope to get some help after months of depression and anxiety. Do you have some test and/or stategies to find out if I can have it? Maybe I am just a terrible procastinator.

November 28, 2020 at 2:30 am

Hi, Devin, I also read your post when I should be working on my graduate program thesis. Can relate a lot to your story. I was undiagnosed in 2012 at the age of 32. I was given the result of having combined ADHD with Primarily Hyperactive and Impulsive ADHD & Primarily Inattentive ADHD (formerly called ADD). By the way, I am doing a graduate program Chicano (Mexican American)studies. I am focusing on learning disabilities students in higher education. I would like to stay connected, so here is my email hope to hear from [email protected]

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• ADHD Congress

The World Federation of ADHD International Consensus Statement

The world federation of adhd published an international consensus statement in 2021. .

Here, world leading experts in the area of ADHD, such as Stephen Faraone, Tobias Banaschewski, David Coghill, Yi Zheng, Joseph Biederman, Mark Bellgrove, Jeffrey Newcorn, Martin Gignac, Iris Manor, Luis Rohde, Samuele Cortese et al., many of them board members of the World Federation of ADHD, state that misconceptions about ADHD stigmatizes affected people, reduce credibility of providers and prevent or delay treatment. 

By reviewing specific literature, i. e. 208 empirically supported statements about ADHD, they curated findings with strong evidence base. The authors highlight that most cases of ADHD are caused by the combined effects of many genetic and environmental risks and that there a small differences in the brain between people with and without ADHD. Moreover, untreated ADHD can lead to many adverse outcomes and it costs the society hundreds of billions of dollars each year worldwide.

If, after reading...

... the International Consensus Statement, you approve its contents, please join as a signatory by emailing Prof. Faraone to [email protected]

The International Consensus Statement is available in Arabic, Catalan, Chinese, English, French, German, Italian, Romanian, Russian, Spanish, Swedish, and Turkish language.

Welsh translation of the ics abstract, we would like to thank the translators for their efforts., arabic version courtesy of:.

• Saudi ADHD Society

Translation:

• Dr Hussain AlTaweel, Psychiatrist
• Marwah Behisi, Psychologist
• Prof. Mohammed M.J. Alqahtani
• Jeremy Varnham

Translator of the Catalan version:

Juan Pérez Caro President of the Catalan Federation  of Associations of Relatives and Affected by ADHD Sabadell, Spain

Translators of the Chinese version:

Xuping Gao Peking University Sixth Hospital Beijing, People's Republic of China

Ning Wang Peking University Sixth Hospital Beijing, People's Republic of China

Rao Xie Peking University Sixth Hospital Beijing, People's Republic of China

Yilu Zhao Peking University Sixth Hospital Beijing, People's Republic of China

Fuxi Zhangkang Peking University Sixth Hospital Beijing, People's Republic of China

Zhao Fu Peking University Sixth Hospital Beijing, People's Republic of China

Yirong Liu Peking University Sixth Hospital Beijing, People's Republic of China

Edited by:  Li Yang Peking University Sixth Hospital Beijing, People's Republic of China

Li Chen Children's Hospital of Chongqing Medical University  People's Republic of China

Translators of the French version:

Diane Purper-Ouakil MD, PhD University of Montpellier, Centre Hospitalier Universitaire de Montpellier, Hôpital Saint Eloi, Montpellier, France INSERM CESP U 1018 Psychiatry, Development and Trajectories,  University of Saclay, France Hervé CACI, MD, PhD Child and Adolescent Psychiatrist Pediatric Department Hôpitaux Pédiatriques de Nice CHU Lenval 57, avenue de la Californie, Nice, France

Christine Gétin President, French ADHD Patients organization HyperSupers TDAH, France

François Pinabel, MD Psychiatrist Attaché à La Pitié Salpêtrière Paris, France

Jacques Bouchez Neurodevelopmental Disorders – ADHD Centre GHU Psychiatry and Neurosciences - Paris 1rue Cabanis, Paris, France

Prof. Franck J. Baylé Paris University and School of Medicine Past Chair of Psychiatry, HDR, INSERM U1153,  Statistic and epidemiologic research center Sorbonne Paris Cité (CRESS), ECSTRRA team, Sainte-Anne Hospital - GHU Paris Psychiatrie et Neurosciences, France

Translators of the German version:

Michaela Junghänel M.Sc. Neurowissenschaften; M.Sc. Psychologie Ausbildungsinstitut für Kinder- Jugendlichenpsychotherapie  an der Universitätsklinik Köln (AKiP) Cologne, Germany

Univ.-Prof. Dr. Manfred Döpfner, Dipl.-Psych. Ausbildungsinstitut für Kinder- Jugendlichenpsychotherapie  an der Universitätsklinik Köln (AKiP) Cologne, Germany

Translators of the Italian version:

Alberto Anedda, Child and Adolescent Psychiatrist – Psychotherapist  Centro Lucio Bini Cagliari, Italy

Paolo Di Pasqua Charge Nurse band 7 Emergency Department Norfolk and Norwich University Hospital  United Kingdom

Letizia Freschi, Master Degree in International Relations Rome, Italy

Chiara Gori, Neurologist UO Riabilitazione Specialistica  Casa di Cura Ambrosiana Cesano Boscone, Milan, Italy

Anna Maria Sbordone, Paediatric Resident Università Cattolica del Sacro Cuore Rome, Italy

Luca Sbordone PhD in Linguistics at the University of Cambridge, United Kingdom; BA and MA in Philosophy at the Scuola Normale Superiore di Pisa, Italy

Patrizia Stacconi President of Italian Association Families ADHD Onlus, Italy Special thanks for the review of the document: Samuele Cortese, Professor of Child and Adolescent Psychiatry University of Southampton; Honorary Consultant Child and Adolescent Psychiatrist, Solent NHS Trust, United Kingdom

Translator of the Romanian version:

Andrei Hodorog, PhD Research Associate, Cardiff University Founder, About ADHD Romania Cosmin-Adrian Ungureanu, MD Psychiatrist

Translator of the Russian version:

Ivan A. Martynikhin, MD, PhD Department of Psychiatry,  First Pavlov State Medical University of St. Petersburg, Russia

Tatyana A. Mudrakova First Pavlov State Medical University of St. Petersburg, Russia

Translators of the Spanish version:

Xavier A Gastaminza, MD MSc U. Paidopsychiatry Hospital Infantil i de la Dona Vall d´Hebron.  UAB Barcelona Spain

Prof. J. Antoni Ramos-Quiroga, MD, PhD Head of Department of Psychiatry CIBERSAM Hospital Universitari Vall d’Hebron Universitat Autònoma de Barcelona  Barcelona Spain

Translator of the Swedish version and the Swedish version easy read:

Sven Bölte Professor of Child & Adolescent Psychiatric Science, PhD Head of Neuropsychiatry Division, Director of the Center for Neurodevelopmental Disorders at Karolinska Institutet; Center for Psychiatry Research, Dept. of Women's & Children's Health, Child and Adolescent Psychiatry Stockholm, Sweden

Translator of the Swedish version easy read:

Eric Zander, PhD Center of Neurodevelopmental Disorders, Department of Women's and Children's Health, Centre for Psychiatry Research, Karolinska Institutet & Region Stockholm, Stockholm, Sweden Lund University, Medical Faculty, Department of Clinical Sciences, Helsingborg & Region Skåne, Sweden

Translator of the Turkish version:

Hakan Karaş, MD Psychiatrist Department of Psychology, Istanbul Gelişim University, Turkey

Coordination of the Welsh summary:

Anita Thapar, FRCPsych PhD Division of Psychological Medicine and Clinical Neurosciences Cardiff University Wales, United Kingdom

Get the Reddit app

We're an inclusive, disability-oriented peer support group for people with ADHD with an emphasis on science-backed information. Share your stories, struggles, and non-medication strategies. Nearly a million and a half users say they 'feel at home' and 'finally found a place where people understand them'. Note: this is a community for in-depth discussions, not a dumping ground for memes, pictures, videos, or short text posts.

Finding a psychologist - MS vs MA vs PhD

EDIT: I meant Psychiatrist

**Backstory:**I was diagnosed with ADHD as a child, but I'm now 32 and realizing that my understanding of what ADHD is and how it works has been severely limited. I haven't been on medication or seeked any form of treatment since childhood. But as I've been learning more about the ways that ADHD can manifest, I'm also realizing just how much bullshit I go through that I thought was just a "me" thing and not an "ADHD" thing.

There have been times where I started to suspect I had some mild form of Autism. Then I found an article called "Autism or ADHD?" and that's really where my research started. I used to think my ADHD symptoms were limited to inattentiveness and distraction, fidgeting, disorganization...basically the things that affected me in school. I've learned coping mechanisms for those things. I've got those handled, I think. But now I know that things like having trouble processing speech (which I thought was a hearing problem) and getting stuck on words while talking, rejection sensitivity, poor memory, trouble picking up on social cues, and shutting down from overstimulation are all also part of ADHD. These are issues that have gotten progressively worse for me as an adult. The more I learn, the more I realize I need help.

What I'm Looking For:

I currently live in the Burlington area in Vermont. I'm trying to find a Psychiatrist I can talk to, and there's a pretty limited set of them around here that are in my insurance network. So, typical ADHD brain, I'm having a really tough time choosing who to call. Since none of them are medical doctors and thus don't have a "MD" at the end of their name, I'm seeing MA, MS, and PhD. I know what all of these mean (Masters of Arts, Masters of Science, Doctorate) but not really what the difference is...should I stay away from people who have a Masters and not a Doctorate degree? Is Masters of Science ok but not Masters of Arts?

Any help at all (and especially any recommendations from locals) would be appreciated.

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Getting a Degree with ADHD

Find a bachelor's degree.

• The Essential Guide to Online Bachelors Degrees
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Indi­vid­u­als with atten­tion-deficit/hy­per­ac­tiv­i­ty dis­or­der can at times find school­work to be more dif­fi­cult, but with the right approach and assis­tance, the path to a col­lege degree can be made sig­nif­i­cant­ly more man­age­able. As all col­leges and uni­ver­si­ties are required to com­ply with the Reha­bil­i­ta­tion Act of 1973, stu­dents with ADHD are guar­an­teed access to the assis­tance they require to suc­ceed. Whether you are look­ing for a col­lege for your­self or some­one else, it’s impor­tant to under­stand how ADHD is treat­ed at uni­ver­si­ties and col­leges in order to get the best pos­si­ble results for the student.

ADHD Explained: What it Is and How it Affects Students

ADHD is a brain dis­or­der that is most vis­i­ble as dif­fi­cul­ty stay­ing focused and hyper­ac­tive behav­ior, such as fid­get­ing or ver­bal out­bursts. Indi­vid­u­als with ADHD are also more prone to impul­sive behav­ior. It is pos­si­ble to look for signs of ADHD in an indi­vid­u­al’s dai­ly life that can assist in the process of diag­no­sis, includ­ing inat­ten­tion to detail, not appear­ing to lis­ten when spo­ken to, fre­quent fid­get­ing, con­stant talk­ing, and being eas­i­ly dis­tract­ed. Although these indi­ca­tors do not on their own con­sti­tute a diag­no­sis, they should be dis­cussed with a health professional.

Although ADHD and ADD are often treat­ed as syn­onyms, the two dis­or­ders are not exact­ly the same. ADD is a sub­type of ADHD, and indi­vid­u­als with ADD do not dis­play the same hyper­ac­tive ten­den­cies as those with ADHD. Although tasks requir­ing extend­ed focus often still present a chal­lenge to an indi­vid­ual with ADD, they are more like­ly to dis­play their dis­or­der in the form of appar­ent dis­in­ter­est or day­dream­ing than phys­i­cal or ver­bal outbursts.

Building a Platform for Success at College With ADHD

The key to earn­ing a degree at a col­lege or uni­ver­si­ty while deal­ing with ADHD is to treat the dis­or­der seri­ous­ly and attain the assis­tance that will help the stu­dent to suc­ceed in class. Pri­or to the start of class­es, the school’s office for stu­dent dis­abil­i­ties should be con­tact­ed in order to ascer­tain what resources are avail­able to stu­dents with ADHD and to ensure that those resources are in place when the school year begins. Although all schools offer assis­tance for stu­dents with spe­cial needs, the specifics avail­able will vary by school, so be sure to check with the office at each insti­tu­tion being con­sid­ered to help deter­mine the best fit.

It is like­ly that doc­u­men­ta­tion of the stu­den­t’s ADHD diag­no­sis will be request­ed in order to best pre­pare an effec­tive accom­mo­da­tion plan. This may include a note from the stu­den­t’s doc­tor regard­ing the ADHD diag­no­sis as well as infor­ma­tion from pri­or school­ing per­tain­ing to any indi­vid­u­al­ized edu­ca­tion pro­gram or Sec­tion 504 plan. This serves both as ver­i­fi­ca­tion of the stu­den­t’s need and a frame­work from which the school can deter­mine what has and has not worked in the past for the student.

Finding the Right Resources for Success

Just as no two indi­vid­u­als’ ADHD will present exact­ly the same, no two indi­vid­u­als’ assis­tance needs will be iden­ti­cal. A wide range of pos­si­ble accom­mo­da­tions are avail­able to stu­dents with ADHD, and the goal is the build the best pos­si­ble plan to help the stu­dent earn a degree.

Test-tak­ing is often an area of dif­fi­cul­ty for indi­vid­u­als with ADHD, who can strug­gle with time lim­its due to atten­tion prob­lems and be dis­tract­ed in a busy class­room. Pos­si­ble reme­dies include addi­tion­al time for tests as well as chang­ing the time or loca­tion of the test to cre­ate a set­ting more con­ducive to aca­d­e­m­ic suc­cess. If a stu­dent has dif­fi­cul­ty focus­ing dur­ing lec­tures, a note-tak­er may be assigned to take down impor­tant infor­ma­tion dur­ing class so that it is avail­able for the stu­dent to study lat­er, or a tutor could be made avail­able to assist with sup­ple­men­tal study­ing. A stu­dent may even be eli­gi­ble for a struc­tur­al change to the for­mat of the class, includ­ing alter­ations to assigned work or time commitments.

The most impor­tant thing to remem­ber when seek­ing the best fit for a stu­dent with ADHD is that the school and pro­fes­sors also want the stu­dent to suc­ceed. If strug­gles occur, the stu­dent or a rep­re­sen­ta­tive should always attempt to dis­cuss them with the school or pro­fes­sors direct­ly in order to find poten­tial solu­tions. Nobody at a school wants any stu­dent who comes through the door as a fresh­man to leave with­out earn­ing a degree, so when a stu­dent is try­ing their best, they should be able to count on the school to do like­wise in assist­ing them. By work­ing togeth­er to find the right plan, the stu­dent and the col­lege’s staff can all achieve the end goal every­one is look­ing for: the joy of the stu­den­t’s grad­u­a­tion day.

• ADD vs. ADHD
• Atten­tion Deficit Hyper­ac­tiv­i­ty Disorder
• Under­stand­ing Indi­vid­u­al­ized Edu­ca­tion Programs
• Pro­tect­ing Stu­dents With Disabilities
• A Par­en­t’s Guide to Sec­tion 504 in Pub­lic Schools
• Why You Need ADHD Accom­mo­da­tions in College
• Why Col­lege Is Bet­ter for Stu­dents With ADHD
• Rec­om­mend­ed Accom­mo­da­tions for Col­lege Stu­dents With ADHD
• ADHD Schol­ar­ships
• Are There Any Col­leges With Good Ser­vices for Kids With ADHD?
• A Col­lege Stu­den­t’s Guide to ADHD
• What ADHD Looks Like in College
• Effects of ADHD on Exec­u­tive Func­tion­ing in Col­lege Students
• Par­ent­ing Your ADHD Col­lege Stu­dent with Boundaries

The Com­plete Col­lege Study Guide

The Essen­tial Guide to Online Bach­e­lors Degrees

Online Stu­dent Study Skills Guide

From a Dis­tance: Your Com­pre­hen­sive Guide to Online Bachelor’s Degree Programs

Our 62nd annual international Conference | february 27 - march 1, 2025 | orlando, florida

Parenting Children with Learning Disabilities, ADHD, and Related Disorders

Children with learning disabilities, attention deficit/hyperactivity disorder (ADHD), and related disorders puzzle parents because of their many abilities and disabilities. It can also be difficult to understand how much of their behavior is the nature of the condition and how much is oppositional. It is all too easy for parents to sense a child’s feelings of inadequacy and then feel bad as a parent.

Parenting approaches that include clear, concise instructions; structure without rigidity; nurturing a child’s gifts and interests; and constant approval of positive behavior help parents feel better and help children feel safe. It takes time for both children and parents to embrace the concept that being different does not mean being inferior and, in fact, can be a good thing. Parents need to be nurtured and praised to help them nurture and praise their children. Most parents use almost every resource they have to help their children flourish, and still, they worry they are not doing a good enough job. Usually they are!

Introduction

Few people realize how difficult it is to be a parent… until they become a parent. Parents are totally responsible for the safety, welfare, and education of a tiny infant who quickly becomes a growing, ever-changing, maturing child. Parents have to set their own rules, develop their own routines, and form their own expectations. When parents are married, differences of opinions have to be worked out with the greater good of the child held aloft. If it is difficult to be a parent, it is even more difficult to be a parent of a child with special needs.

Discovering the Problem

Discovering a child’s special needs is often a confusing and painful process for parents. First of all, because learning difficulties can be subtle, multiple, and difficult to pinpoint, it can be hard for parents to know whether things are normal or not. Especially with a first child, parents may not know when to expect vocalizing, playing with sounds, and learning to speak. It is also difficult to distinguish between a healthy, very active toddler and a hyperactive toddler with ADHD. What is the difference between the child who is a little clumsy (which will be outgrown) and a child having significant motor skills problems? What are the indications of children being off course in their ability to listen and follow directions? It may take some time for parents to recognize and articulate concerns.

Even after a diagnosis, parents often face a whole gamut of emotions before they can grapple effectively with the stark truth that their child has learning disabilities. Parents may move through emotions like Kubler-Ross’ ( 1980) stages of grief, initially denying there is a problem and rationalizing why it’s not a problem, then having to deal with the fear, the anger, and the guilt of having a child who experiences many difficulties. It is normal for parents to want to blame somebody – anybody – and to bargain in the sense of thinking that changing neighborhoods, schools, or doctors might make the problems go away. Grieving for what might have been follows, and finally parents can come to accept the child’s strengths and weaknesses and try to figure out a helpful plan of action (Kubler-Ross, 1980; Smith, 1995).

Neurologic Basis

Parents often feel guilty because they feel their child’s learning disabilities, ADHD, and related disorders are somehow their fault. But, that is not true. Parents may tend to feel that if they had been stricter, demanded more, forced more practice, it would have changed the situation. That would not have changed the situation.

Children and adults with learning disabilities often have clusters of difficulties that lead to academic failure or low achievement. These disabilities emanate from a neurophysiological base. It is as though the switchboard of the brain short circuits some of the information coming in, scrambles it, and then loose wires interfere with the ability to get that information out. This neurological dysfunction contributes to disorder, disorganization, and problems with communication. Parents can be reassured that these problems are organic and are not caused by external factors (Smith, 1991; 1995).

For years there have been nay-sayers who claim that there is no such thing as learning disabilities – that there are lazy children and motivated students, that there are stupid children and bright students. However, technological advances over the last 5-10 years have laid those issues to rest. Brain researchers using magnetic resonance imaging (MRI) have shown differences between the brains of individuals with learning disabilities and those without (Dr. Martha Denckla, personal communication). Researchers have also found images of ADHD in the central nervous system (Dr. Xavier Castellanos, personal communication). The architecture of the brain of the child with learning disabilities is different.

Brain researchers also point out that neuronal links in the brain typically travel in particular patterns, but in individuals with learning disabilities, they are scattershot all over the brain, resulting in unusual linkages (Dr. Gordon Sherman, quoted in The Doctor is In, 1988). Consequently, exceptional disabilities are often linked with exceptional abilities. As an example, for over 35 years, graduates of the Lab School of Washington have become very successful in the arts as graphic artists, film makers, fashion designers, jewelry makers, actors, architects, photographers, musicians, dancers, and computer graphic specialists. A number of the graduates have also become highly successful entrepreneurs and business executives. Parents can take reassurance in the fact that many abilities usually accompany the constellation of problems or cluster of difficulties that constitute learning disabilities.

Understanding Behaviors

It is often confusing to parent children with learning disabilities, ADHD, and related disorders. One of the biggest confusions and challenges parents face is the large hiatus between what the children can do and what they cannot do. Often they are very smart, know a great deal, and reason well, yet cannot read or write. School teachers and family may be telling them to try harder, and they are usually trying their hearts out. They tend to work 10 times harder than everyone else does, but still they may be called lazy.

Another aspect of the confusion for parents lies in how hard it can be to distinguish between a child who can’t do something and a child who won’t do something. For parents, it can be vexing not to be able to control a 5 or 6-year-old or to know whether to push an adolescent or reduce expectations. In this confusion, parents tend to ask, What is wrong with me? rather than What challenges is my child having to face? Shifting this focus can be therapeutic for parents and children.

Children may seem to be having behavior problems when, in fact, they are confronting difficulties in accomplishing a task. Children tend to withdraw or act out when a task is too demanding. It can help parents to know that when children say they hate something that usually serves as a wonderful diagnostic tool, indicating what is difficult or impossible for them. For example, when a child loves dance, art, and music but hates drama, it could be that the child has a speech/language problem. When a child hates math or reading, these are likely areas of difficulty. Conversely, what children like and want to do usually serve as indicators of their strengths.

While a diagnosis will help to some extent, the job of sorting out these issues on a day-to-day basis is no small task. On a planning level, confusion occurs because teachers, doctors, psychologists, and social workers may disagree not only on diagnosis but on the best treatments or programs for a child. This can be frustrating and anxiety-provoking for parents who have to pull all the information together and decide what to do, right or wrong. Additionally, at home and elsewhere, parents must anticipate problems and sense when their children are tired, or frustrated, or about to explode. Parents must trust their guts as to how long the child can last at a party, or sit in a restaurant, or be pleasant with visitors. While parents have to do this with all children, it is much more challenging with this population.

Parents of children with special needs are constantly trying to puzzle out what’s working, what’s not working, what causes the child’s frustration, and what brings the child pleasure. Parents have to analyze everything, think carefully, reflect on activities of each day, and problem solve to recognize the child’s strengths, interests, and areas of difficulty, and come up with plans for managing the child’s behavior and supporting the child’s development.

The Family with the Child with Special Needs

Learning disabilities can be hard on a family. One parent, often the mother, may recognize and face the problem sooner or more readily than the other. Misunderstanding and conflict can result. Brothers and sisters often resent the amount of attention given to a child with special needs and may proclaim knowingly that the child is a spoiled brat who is perfectly capable. Grandparents tend to blame parents for not doing enough, not being disciplined enough, organized enough, or not giving enough direct help to the child. Neighbors can be intolerant if the child is very hyperactive or has low frustration tolerance and tends to explode or cry at each hurdle.

On a daily basis, children with special needs typically raise the irritant factor in family life. They tend to leave everyone on edge because their behavior is unpredictable, erratic, inconsistent and full of ups-and-downs. Children with learning disabilities and ADHD are usually very disorganized. They have trouble dealing with sequences and order, so they don’t plan well. They are distracted easily and often impulsive. Just getting washed and dressed in the morning can be an arduous task. Sometimes resulting in explosions on the part of the children, their parents, or both. Clashes frequently emanate from a child’s misunderstanding of instructions or going off on a tangent. To complicate the problem, when wrong or criticized, children with learning disabilities tend to fall apart, withdraw into day dreaming, or strike out in one form or another.

Emotionally this population is very immature and fragile. These children tend to personalize things that have nothing to do with them. For example, when family members are laughing at something, children with special needs are often convinced that they are being laughed at, and, as a result, they get very upset. Furthermore, their moods swing widely, and a child may be laughing one moment, crying the next (Smith, 1995). This emotional lability is hard to live with. Children with learning disabilities and ADHD are prone to depression (Smith, 1991). Their sense of defeat and failure is contagious and, sometimes, the whole family feels their helplessness and despair. Often adults, otherwise incredibly competent in their daily lives, feel incredibly incompetent when with these children. This can take a toll on parents, and support and education may be necessary to bolster parents’ sense of confidence and competence in effectively parenting the child with learning disabilities.

Parenting Strategies

Addressing difficulties with time and space. Space and time are organizing systems involved in every task, every performance and every aspect of life. Yet, because of central nervous system dysfunction, neural immaturity that tends to disorder, and poor organization, many children with learning disabilities are very disorganized – unable to keep their rooms anything but a complete mess, unable to accomplish even the simplest task in a timely fashion, unable to follow instructions, likely to lose belongings frequently, and appearing lost in time and space. Problems with sequencing explain why they have trouble remembering the days of the week, seasons, the alphabet, counting, and the order of tasks and instructions. These problems are why they have trouble beginning projects, sustaining them, and finishing them. Poor organization not only affects home life and relationships with friends, who will take only a certain amount of forgetting and lateness, but also academic life. Poor organization means forgetting to bring home the homework or not having the time management skills to meet deadlines. It affects being able to establish priorities -what is most important to study, what is less so. Often this disorganized behavior looks oppositional and hostile, when actually it stems from the very nature of the learning disability.

Parents and teachers of children with learning disabilities can help them by providing clear structuring of time and space. To help children with structuring space, visual aids can be useful. For example, shelves can be used instead of drawers so children can see where things belong and how to put them back. The use of other visual cues, such as lists or labels, can augment efforts to help children organize tasks and belongings.

Developing understandable and reinforced routines can help with structuring time. Breaking routines and other tasks into manageable chunks and communicating what must be done first, next, and last is important. A large number of children with learning disabilities have language learning disabilities, which means they have trouble deciphering language, listening, and following instructions. Because of this, it is also helpful if parents and teachers limit the number of words used in giving directions, using simple phrases such as. Go upstairs. Close the window. Come down.

Parents can also assist their children by engaging them in planning activities. Examples include planning celebrations, planning a garden, organizing what needs to be done to collect food for the homeless, or any other kind of planning that involves developing lists, going shopping, checking off the lists, and then charting the tasks still to be done (which can then in turn be checked off). All of these projects are useful, engaging, and have the hidden agenda of working on organization skills.

Addressing relationship difficulties. While children with learning disabilities face challenges academically, a problem that many parents find more troubling than difficulties with the 3 R’s (reading, writing, arithmetic) is the 4th R: relationships. Many children with learning disabilities cannot play successfully with even one child and certainly not two. They don’t read social signals: facial expressions, gestures, or tones of voice any more than they read letters or words. Additionally, many of these children are literal and concrete; they cannot deal with subtleties, nuances, inferences, or multiple meanings. This affects family life and peer relationships because they often cannot understand jokes, subtle teasing, or sarcasm. One of the consequences of this is that they have to be taught explicitly how to relate to others. Parents have to work with them on reading faces, reading gestures and movements, and learning what is and is not appropriate to say. Parents may have to coach them through common social situations until they develop appropriate interpersonal behaviors.

Parents can provide their children with practice in anticipating what might happen in various social situations. They can role-play with their children about what to do or say when they want to join a game that their cousins or friends are playing, or when grandparents say, “Read this to me.”  Some parents have found it useful to show the wrong way of handling a situation and then to have their children critique them. The process of acting situations out, problem solving, and talking about the situations, helps many children with learning disabilities and ADHD think through various options.

Promoting self-esteem. Early on, children with learning disabilities begin to notice that others can do tasks easily that are intensely difficult for them, and they begin to feel bad about themselves. They may receive frequent criticism or, at best, global praise such as “You are doing better” (better than what?), “You are doing fine” (what is fine?), “You are making progress” (what is progress?). Criticism damages self-esteem, and global praise is often too abstract to be meaningful to concrete thinkers.

By training themselves to comment on the positive as much as possible, by offering concrete comments on what their child is doing well, and by using very specific praise, parents will cultivate desired behaviors and boost their children’s self-esteem (Smith, 2001). Examples of specific praise include phrases such as: You finished the assignment, You are listening carefully, You are sitting properly and looking at me, You remembered to bring home the work you have do, You cleaned the table after dinner, You picked up the bag the lady dropped. Thank you. With specific praise, a child can be very clear on what behaviors are liked and expected.

Visual, concrete proof of progress also helps children notice and feel confident about their progress and accomplishments. Home made certificates, gold stars, stickers, charts, and check lists with lots of checks can be used when children work hard on tasks at home, such as remembering to take out the garbage, shopping without forgetting, setting the table correctly, making their beds, and putting the toilet paper into the holder when the last piece has gone.

Parents and teachers also boost children’s self-esteem by seeking out what they can do well and fostering and supporting these areas to the hilt. Whether it is an art form, science, nature, photography, computer work, selling things, inventing, or telling stories, children with learning disabilities need parental support to become the best in this area at home and to bring their talent into school. It won’t help them feel better about their academic performance, but it will help them feel better about themselves.

Teaching children that many people have overcome difficulties to become successful is another valuable parenting strategy. One way to do this is to read or play tapes of biographies in which children or adults have had to struggle to achieve their goals -adventures where the characters got lost or had to fight sharks or other beasts; stories of achieving despite illness or disability; or stories of fighting prejudice or unfairness. Children enjoy and benefit from discussing these kinds of challenges. Additionally, when parents can introduce their children to highly effective members of society who struggle with disabilities, particularly disabilities similar to those the child faces, children can hold their heads higher. All members of society who are functioning well with learning disabilities and ADHD – firemen, policemen, plumbers, day care center workers, business executives, park rangers, recreation coaches, athletes, and celebrities can serve as role models and inspiration for children with learning disabilities.

When parents learn to cherish diversity, their children learn there are many different ways to celebrate birthdays, get married, raise children, and so forth (Smith, 1994). These children feel better about themselves when they understand that doing things differently, learning differently, being different is OK, and that differences can enrich our lives. Artist Chuck Close said, I think accomplishment is figuring out your own idiosyncratic solutions. Accomplishment is being able to do what you want to do even if you don’t do it the way everybody else does it. (Smith, 1991, p. 703, and personal communication).

Empowerment. Children with learning disabilities and ADHD often feel powerless and inadequate. They tend to be passive learners and need to be totally involved in activities to make them active learners. Parents can encourage hands-on activities, such as cooking, cleaning, shopping, and running errands to show children that they can make things happen. These learning activities have the additional benefit of resulting in tangible, visible products appreciated by the whole family.

Parents must beware of doing too much for children with learning disabilities because that does not empower them. The effects of active engagement are in fact neurological. California neurobiologist Marion Diamond’s research (Diamond & Hopson, 1998) shows that the sights and sounds of enriched environments cause dendrites to form neural pathways that she calls magic trees of the mind. Her data demonstrate that the curious mind, stimulated to further inquiry, makes the central cortex thicker, activating the brain to further enhance learning (Smith, 1995).

Parents can also empower their children to view obstacles as challenges and to know that they have a lot going for them and a team behind them. It helps children with learning disabilities when parents can adopt a problem-solving mode rather than always providing the answers. It helps to say. What can we do about this? What options do we have? Let’s figure out where we can find the information we need instead of doling out the right answer much of the time. Parenting children with learning disabilities and ADHD demands enormous amount of problem solving, and on top of that, parents need to help turn their children into outstanding problem solvers. Grappling with adversity, figuring out strategies that work for them, and learning when to ask for help and who to ask are crucial life skills that these children must learn and will hold them in good stead.

Parents can foster curiosity in their children and lay the framework for thinking and questioning. When children’s minds are questioning everything, their bodies are active, and their hands are into things, children are helped to achieve the highest cognitive development possible. Parents work with their children to develop critical thinking skills when they have them look at photos or drawings and piece together what could be going on; when the family watches a TV show and the children are asked what the big message was; when a mystery story has been read and the children guess who did it; or when a family plays games like chess, checkers, Clue,® and Stratego™. Children often can teach their parents how to work computers, and programs like HyperStudio® allow children to draw, to photograph, to speak, to scan objects from the Internet, and to make rewarding, satisfying multimedia presentations that simultaneously use and develop many skills.

Cultivating Parental Optimism

Because it can be frustrating to parent children with learning disabilities and behavioral challenges, it is encouraging for parents to know that some of the negative behaviors of their children very often become positive attributes in adulthood. For example, the most stubborn children often turn out to have fierce determination. The most manipulative children often turn out to be fabulous entrepreneurs, leaders, or politicians. The children who argue all the time like jail house lawyers actually become lawyers, and those who doodle and draw all through school may well become artists in adulthood. In 35 years of experience at the Lab School in Washington, DC, this pattern has been evidenced again and again. The boy who sold his mother’s jewelry for 25 cents apiece grew up to be a real estate mogul. The boys who were tinkerers, taking everything apart, became mechanical engineers. The girl who tried to help her classmates avoid arguing, who was teased because she was always trying to make peace and never projected any opinion of her own, became a mediator – and a good one at that! Numbers of very hyperactive youngsters have turned out to be very energetic, productive entrepreneurs. The inflexible one way kids have often become scientists who study one problem in depth for many years or airplane controllers who focus intensely on the task at hand. Many bright children with ADHD, who were impulsive, very distractible, and had poor attention spans, have grown up to be outstanding emergency health care specialists, paramedics, and firemen. In an emergency, their adrenaline is apparently stimulated, so they become highly focused, able to put their excellent analytic abilities to use while doing many tasks.

Self-care should be a priority for parents of children with learning disabilities. Parents themselves need nurturing to help nurture their child with special needs. They need to go out and have fun regularly. They need more sleep than other parents, for these children sap their energy, and their condition demands help from parents constantly. Finding supportive friends or relatives, or locating a support group or an online parent support community can provide a place for parents to vent frustrations and obtain valuable suggestions, strategies, and support. Laughter is also important for parents and the whole family. Children with learning disabilities and ADHD need to feel that it is not the end of the world that they have these disabilities – nuisances – and they need to laugh at some of the nonsense they go through. Parents, too, need lightness and humor. When parents can have fun with their children – even being silly and laughing – and can enjoy life as much as possible together, everyone benefits.

It is hard to be a grownup, difficult to be a parent, even more challenging to be a parent of a child with special needs when the parent must become the analyst, the interpreter, the problem solver, the cheerleader, the lawyer, the psychiatrist, the spiritual advisor, the organizer, the notetaker, the friend, companion, advocate, and disciplinarian. Most parents use every resource they have to help their child flourish, and yet, they worry they are not doing enough or a good enough job. Chances are parents are doing an incredibly fine job under difficult circumstances. Professionals need to realize and appreciate the heavy load carried by parents of children with learning disabilities, ADHD, and other related disorders.

References Diamond, M. & Hopson, J. (1998). Magic trees of the mind: How to nurture your child’s intelligence, creativity, and healthy emotions. New York: Penguin Books. Kubler-Ross, E. (1980). Death …the final stage of growth. New York: Simon and Schuster. Smith, S.L. (1991) Succeeding against the odds. New York: Jeremy P. Tarcher/Putnam. Smith, S.L. (1994). Different is not bad, different is the world. Longmont, CO: Sopris West. Smith, S.L. (1995). No easy answers. New York: Bantam. Smith, S.L. (2001). The power of the arts: Creative strategies for exceptional learners. Baltimore: Paul H. Brookes. The Doctor Is In. (1988). (Video). Lebanon, NJ: Dartmouth-Hitchcock Medical Center.

About the author: Sally L. Smith, MA, BA, (deceased) was Founder and Director, The Lab School of Washington: Head, Graduate Program, Special Education: Learning Disabilities. American University, Washington, DC. This article first appeared in Pediatric Nursing, May/June 2002 Volume 28/Number 3 and is reprinted here with permission.

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Visit our website: https://nhlda.org

LDA of America does not currently have an active state affiliate in Nevada.

LDA of Nebraska’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Find us on Facebook: https://www.facebook.com/LearningDisabilityNE/

The Learning Disabilities Association of Montana (LDA-MT) is one of the state affiliates of the Learning Disabilities Association of America, as a nonprofit volunteer organization of parents, professionals, and adults with learning disabilities. Our mission is to create opportunities for success for all individuals affected by learning disabilities through support, education, and advocacy.

Visit our website: https://ldamontana.org

LDA of America does not currently have an active state affiliate in Missouri.

LDA of America does not currently have an active state affiliate in Mississippi.

LDA of Minnesota’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Find us on Facebook: https://www.facebook.com/LDAMinnesota/

Follow us on X (formerly Twitter): https://x.com/ldaminnesota

Visit our Website: https://www.ldaminnesota.org/

Phone: 952.582.6000

LDA of Illinois’ mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Find us on Facebook: https://www.facebook.com/profile.php?id=100063726155725

Visit our website: https://ldaillinois.org

Phone: 708.430.7532

The Learning Disabilities Association of Iowa is dedicated to identifying causes and promoting prevention of learning disabilities and to enhancing the quality of life for all individuals with learning disabilities and their families by:

• Encouraging effective identification and intervention,
• Fostering research, and
• Protecting the rights of individuals with learning disabilities under the law.

Find us on Facebook: https://www.facebook.com/LDA.Iowa

Follow us on X (formerly Twitter): https://x.com/ldaofiowa

Visit our website: https://ldaiowa.org

Phone: 515.209.2290

LDA of Michigan’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Find us on Facebook: https://www.facebook.com/LDAmichigan

Follow us on X (formerly Twitter): https://x.com/LDAmichigan

Visit our Website: https://ldaofmichigan.org

Phone: 616.284.1650

The mission of LDA of Massachusetts is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Affiliate Contact: Kristen Lech Contact Email: [email protected]

LDA of Maryland’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Find us on Facebook: https://www.facebook.com/ldamd/

Visit our website: https://ldamd.org/

LDA of Maine’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Find us on Facebook: https://www.facebook.com/ldame

Visit our website: https://ldame.org

The Learning Disabilities Association of Louisiana (LDA-LA) is one of the state affiliates of the Learning Disabilities Association of America, as a nonprofit volunteer organization of parents, professionals, and adults with learning disabilities. Our mission is to create opportunities for success for all individuals affected by learning disabilities through support, education, and advocacy.

Find us on Facebook: https://www.facebook.com/LDAofLouisiana/

LDA of Kentucky’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Find us on Facebook: https://www.facebook.com/profile.php?id=100067524906403

Visit our Website: https://www.ldaofky.org/

LDA of America does not currently have an active state affiliate in Kansas.

LDA of Indiana’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Find us on Facebook: https://www.facebook.com/LearningDisabilitiesAssociationofIndiana/

LDA of America does not currently have an active state affiliate in Idaho.

LDA of America does not currently have an active state affiliate in Hawaii.

LDA of Georgia’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Find us on Facebook: https://www.facebook.com/LearningDisabilitiesAssociationofGeorgia/

Visit our website: https://ldaga.org

LDA of Florida’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Find us on Facebook: https://www.facebook.com/LDAFlorida/

Visit our website: https://lda-florida.org

LDA of America does not currently have an active state affiliate in the District of Columbia.

LDA of Connecticut’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Find us on Facebook: https://www.facebook.com/LDAofCT

Visit our Website: https://sites.google.com/view/ldaofconnecticut/

LDA of Delaware’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Affiliate Contact: Fern Goldstein

Find us on Facebook: https://www.facebook.com/ldadelaware/

Visit our Website: https://ldadelaware.org/

LDA of America does not currently have an active state affiliate in Colorado.

LDA of California’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Visit our website: https://ldacalifornia.org

Affiliate Contact: EunMi Cho

LDA of Arkansas’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Find us on Facebook: https://www.facebook.com/ldarkansas/

Visit our website: https://lda-arkansas.org

LDA of Arizona’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Visit our website: https://ldaofarizona.org

LDA of Alabama’s mission is to create opportunities for success for all individuals affected by learning disabilities through support, education and advocacy.

Find Us on Facebook: https://www.facebook.com/LDAAlabama/

Visit Our Website: https://ldaalabama.org/

LDA of America does not currently have an active state affiliate in Alaska.