Women, like myself, my clients, and more famously Em Rusciano and Hannah Gadsby, are reaching middle age, and finally discovering nothing is ‘wrong’; they are not a failure. There is a reason for the overwhelm they feel, that their friends do not. A reason that life can seem so hard. That reason is ADHD. Unfortunately, the path to diagnosis is rarely easy due to stereotypes of who has ADHD and how it presents itself.
Mention ADHD in most circles, and you will hear about young boys who can’t sit still, don’t focus, and struggle at school. We would now describe this as ‘hyperactive’ or ‘combination’ ADHD. However, women often present with slightly different ‘inattentive’ ADHD symptoms which can be much harder to see from the outside. As to how we define ADHD, I like the definition Solden and Frank use, describing ADHD as a genetic, chronic, brain-based condition that impacts the management functions of the brain, including:
- Ability to activate yourself enough to begin a task,
- Sustaining focus once you start a task, and
- Sticking with it when your energy or interest wanes.
Many of my clients can relate to this. However, many have learnt to show the outside world a different face in order to fit in. This ‘masking’ contributes to the difficulty in obtaining a diagnosis. Luckily, even while you await a diagnosis, or are unable to attain one, there are a few steps you can take to support yourself in managing your symptoms.
Why is it so hard for women with ADHD to get a diagnosis?
Women’s ADHD symptoms are different
Teachers and parents of a hyperactive young boy may remember a child who was constantly bouncing around, couldn’t sit still or would have been a high achiever if they only focussed. They may recall a loud child who was impulsive. Such traits often refuse to be ignored. This helps young boys get the correct diagnosis at an early age.
On the other hand, women and girls are often less hyperactive in their ADHD. Instead, they may experience challenges sustaining attention, following through on larger tasks, and organising themselves on tasks and activities. They might be easily distracted and avoid or dislike tasks that require sustained mental effort. Unless clearly ‘off with the fairies’, these traits can be much more complex for the outside world to see, especially if a girl or woman has learnt to mask them.
Masking is a coping skill that many of my clients have learned, either consciously or inadvertently, through life experiences, to ensure they appear normal. They may only be able to keep it on for limited periods, like work or school, or they may have adopted it so strongly that not even their immediate family know the difference anymore. Some of these learned behaviours can be helpful, but they can also come with an energy cost that takes a toll at the end of the day. Masking can include:
- Mimicking or copying others
- Consciously suppressing more obvious movements, but the desire will remain
- Learning to react the way society expects rather than as you feel
- Withdrawing inward and being overly careful about everything you say
- Perfectionism or obsessively checking and organisation
- Overcompensating to appear in control, even if struggling
These strategies may have kept us from being socially cast out, but they can often leave women with depression or anxiety because it is so difficult to hide or because it delays a diagnosis that may provide healthy support for moving forward.
The impacts of a delayed diagnosis
“We diagnose ADHD based on the DSM-5 diagnostic criteria, which requires evidence of ADHD prior to the age of 12 as it is a neurodevelopmental disorder. Without this evidence we are unable to provide a diagnosis of ADHD.”
– an all too common response from medical professionals and diagnostic clinics.
The DSM-5 (the rule book for mental health diagnosis) classifies ADHD as a ‘Child Mental Disorder’ and requires evidence of the ‘disorder’ prior to 12 years of age.
Often it is not until women have children of their own that the scaffolds that supported them, school routines, work routines, masking and checklists, cease to be enough. These women can end up diagnosed with depression or anxiety, when really, they are overwhelmed with executive functioning challenges. Sometimes, the diagnosis of a child prompts a woman to investigate her own symptoms. (Not that having children is the only reason midlife can prompt diagnosis.)
By this time parents and those who ‘knew us when we were younger’ may have passed on, left our lives, or simply not be able to recall the details necessary to see through younger masks and assist with diagnosis. For some of us, we won’t even remember ourselves.
What can you do if you think you have symptoms of ADHD?
Know your support network
Being diagnosed with ADHD as a woman can be challenging, long and expensive. I wish it were otherwise. It really helps if you have one or two people in your corner that you can talk to about what is happening so that you know you are not alone. Try and find that person in your network who has been there themselves, or the close friend or family member who always has your back no matter what, and don’t be afraid to be honest with them about your journey. Having support will make it so much easier for you.
Talk to your GP
In Australia, your GP will usually run through a few questions to determine whether you have enough symptoms to warrant a referral to a psychologist or a psychiatrist for a potential diagnosis.
Whilst GPs are getting better at understanding the nuances of women with ADHD and how we may present, some are still hesitant to make the referral. If you feel strongly that you may have ADHD seek a second opinion. Remember, at this point, all you are doing is asking for a referral to a specialist who can assist with your symptoms whether it’s ADHD or something else. Once you have a referral, your specialist will advise their diagnosis process as these may differ.
While you wait to see the specialist or find the GP who understands you, while you save the money or even if you receive a negative result after testing, you can take some matters into your own hands.
Many ADHD resources are available to support women with symptoms, including podcasts, books, YouTube videos and websites. You may also find a counsellor or coach (like myself), who cannot medically diagnose you, but has more immediate availability to work with you to put in place systems and plans to help manage your symptoms (regardless of their cause).
After all, the diagnosis is only part of the process. What we are all really after is an easier life, and a little understanding. Understanding yourself and supporting yourself just as you are can be done without diagnosis so don’t be afraid to start now.
 Solden, Sari & Frank, Michelle, A radical guide for women with ADHD, 2019, New Harbinger Publications.
For neurodiverse children dependant on routine for security, returning to Face to Face learning may feel like a new routine, which may undermine their sense of security and comfort. Even those excited to return to school may find themselves quickly overwhelmed, just as some adults will be in returning to work.
Now is the time for practicing compassion. Compassion for your child and compassion for yourself. Just like oxygen masks on aeroplanes, it is just as important to look after yourself first, so you can be there for your child when they need you. Take it gently, accept your child (and yourself) where you are, and consider using an energy accounting practice to keep all your cups full.
Take it gently – triggers may be there even if they don’t articulate it
Children through to early high school often lack the emotional intelligence, regulation or even the language to fully identify how they are feeling and why. It is up to us as parents to step back and observe or ask the questions. Without your child realising it, their anxiety triggers and stressors may be present in their lives again.
For many students it has been 11 weeks since they last saw their friends or had to engage socially in a classroom. Maybe their day is more tiring now, maybe the class bully is back in their life, maybe it just takes too much effort to follow instructions all day in a noisy classroom. Every day may be different, and the best support you can provide is to accept your child where they are now.
Accept your child where they are now
When children feel truly accepted, they are freed to move forward and think about how they might want to change.
In the days and weeks to come there will be (as there always are) good days and bad days for your child at school. Actively listening, through empathic reflection of their words and feelings, will allow your child a safe space to express themselves. It is important during this period of change that your child is heard and accepted in any of their feelings.
By accepting your child exactly as they are each day, you will be able to provide them compassionate support, that meets them where they are in any given moment. Don’t plan too much in the diary, don’t race back into everything all at once, take it day by day. One way to gently identify where your child is at on a given day is to use a system of energy accounting.
Energy Accounting – building back up after a day of deficit
A system of reflecting on and keeping track of the things that have drained or increased personal energy during the day.
Energy accounting is a simple way of reflecting over a day (or planning a day), where energy is treated like a bank balance. Withdrawals are activities that reduce personal energy levels. This might include making a mistake, being teased or an unpredicted change. Deposits are positive activities that increase personal energy levels. For children this often includes time on iPad, ice cream after dinner or an enjoyable play with friends. Not all energy impacts equally so each deposit or withdrawal is given a value between 1-100 that is relevant to your child. This method assists communication between you and your child and allows for adjustments to be made when you can see or know in advance that deficit is likely.
Energy accounting is a great way to support yourself too. By making sure that you are putting into your energy supplies too you can better be there for your child. Review the activities in your own day that fill or deplete your energy books. Take some time out to enjoy a coffee with friends, prioritise going to the gym or let everyone know Sunday morning is me time for running a long hot bath. Parents needs are important too and by looking after yourself you not only provide a good example for your child, but you are also better placed to support them in the here and now.
Small steps are ok
Both parents and children should remember that it is ok if you need to take a day off school for mental health improvement. It is ok if your child doesn’t want to play with friends on weekends yet. It is ok if you are also tired as a parent and need to relax more, take a day off work, or remain quiet on weekends. Small steps back towards a new normal for 2022 are all that is needed of any of us right now as we wind down the school year.
Take care of yourselves and your families at this time.
Send me an email if I can be of any assistance to you.
NOTE: All transitions can be a challenge for students, particularly neurodiverse students. If your child is starting High School next year, you may also like to read my article on Transitioning to High School
At Social Living Solutions, we are all about helping your child meet his or her potential. Coming up over the next few months is a series of helpful blogs centred around life skills that will help your child to flourish. Today I am going to talk about the essential life skill of cooking.
Love it or loathe it, cooking is a necessary life skill to survive. Apart from it’s obvious necessity, let’s look at the benefits of cooking for our special needs children; and the skills and benefits it can provide them with.
Using the example of a simple task such as baking a batch of biscuits, I will demonstrate how we can teach and provide children with many life skills.
When you have jointly decided which recipe to make, assist the child to check through the pantry and the fridge to determine which ingredients they already have in the home, and which ingredients need to be purchased from the supermarket. The next step would be to construct a shopping list together.
This simple straight forward task assists with executive functioning as it requires planning and forward thinking. It also assists with working memory, as the child is using their immediate conscious and perceptual memory and linguistic processing.
Then plan two things in collaboration with the child: plan when would be a good day and time to bake or cook the recipe, depending, if it is a family meal or a baked item. Also plan what would be a good day and time to go to the supermarket to purchase the missing items.
The next step is the trip to the supermarket. I ask the parent/carer to be available at the supermarket but not to find the required items for the child. Instead, I ask them to assist the child in negotiating to find their way around the supermarket and locating the required items.
This again assists with executive functioning, and working memory but also helps with slow processing, growing self-esteem, confidence and independence. After several visits like this to the supermarket, the child will eventually be able to negotiate the supermarket independently and confidently.
Another step in this process is to teach the child to examine the price of the items and ascertain which item by weight, volume and price is the best value for money. Here we are teaching them the value of money and to consider the parameters of working within a budget. We are also incorporating math principles in this exercise. Again, we are using executive functioning, working memory and processing speed as they are having to plan the best value for money, and think about working within a budget.
I ensure that the parent/carer provides the child with cash to purchase the items as I want them to understand the value of money as well as the concept of change. I encourage the parent/carer to assist the child in working out what the amount of change will be, prior to receiving it.
This transaction also is an excellent opportunity to teach the child the social skills involved in having to interact with a complete stranger whilst purchasing the items.
Following on from this experience the child then cooks or bakes the recipe. Whilst cooking or baking, a variety of life and math skills are addressed. The child may have to weigh out or measure ingredients. They may have to use their fine and gross motor skills to cut items up and mix them together. They will also have to utilise their fine motor skills when stirring ingredients in a pot or cake mixer. This is also fantastic opportunity to teach them the considerations around using a hot stove or a hot oven.
Naturally, they are also learning the valuable life skill of cooking. When they have completed cooking, or baking the item they will feel a real sense of accomplishment. They have been able to successfully produce the dish and/or baked goods. This will enhance their self-confidence and belief in their own abilities and belief that they can accomplish new and complex tasks.
In conclusion, the life skill of cooking has wonderful benefits, and helps develop important skills for your special needs child that most of us take for granted – planning and preparing a meal. If you would like more information about how I can assist and support your family, with this life skill or any other issues then please email me at email@example.com.
Many of you will be becoming increasingly aware of how to best assist your child to transition from Year 6 into Year 7 and the different challenges associated with this major transition time.
Parents often get in contact with me at this stage of their child’s lives to assist and put different strategies in place as to how to best support and guide their child in this daunting transition phase of their lives.
So, I thought I would share with you “My top five tips” for children of varying special need transitioning for primary school to first year high school:
- Familiarity – It is important that your child is able to gain as much familiarity of his/her new school as possible. Arrange as many transition visits to the new school as possible. If you attend a transition visit with your child, video the school and the new surroundings. Make sure you video classrooms, toilets, lockers, canteen, playground areas, any oval or PE areas and the library. This way your child can then watch the video as much as he or she needs.
- Ask the school to provide you with a sample Year 7 timetable. This way you can familiarise your child with the concept of timetables, having subjects at different times, having multiple teachers and changing rooms.
- Find out if the school has a map with all the different classroom numbers, and if not consider making one. This is to assist when going through the transition visits and timetable your child can then work out the best way to navigate around the school and to get to classes.
- Ask the school to provide your child’s new timetable at least two weeks prior to the new school year commencing. Upon receiving the new timetable colour code each subject on the timetable with a highlighter colour. You can then purchase specific colour coded folders whereby the colour of the folder corresponds with the colour of the subject. Your child can then keep text books and materials for the specific subject in the folder, so then they can obtain the specific folder out of their locker for the next subjects without having to find text books etc.
- Ask the school whether they can implement a specific peer support person for your child. Another boy or girl in an older year who can take on the role of being both a mentor and contact point for your child. This is to assist against any bullying that may start, and provides a familiar person as a reference point and stability for your child.
In addition, it is also good to implement checklists and timetables for the mornings and afternoons to ensure homework is well understood and completed. If a child has impaired executive functioning and poor working memory this will really come into play in the high school years. These checklists really do become imperative.
These are just some of the tools and skills that I can assist your special needs child with at this very important stage of their life. If you would like more information about how I can assist and support your child as they transition into high school and navigate their way through the crucial first few months then please email me at firstname.lastname@example.org or you can find out more at https://sociallivingsolutions.com.au/ where you can get in contact with me and book an appointment.
Assisting special needs children to become less anxious and more focused through Mindfulness meditation practice.
Mindfulness meditation calms and trains the mind to stay in the moment.
This is of great benefit to our ASD, ADHD, ADD children and others who suffer from anxiety. This is because regular practice of mindfulness meditation trains your brain to recognise random thoughts as they come into the mind. Mindfulness meditation trains the brain to view these random thoughts as if they are “clouds passing through the sky.” This allows the mind not to become overburdened with a whole mass of thoughts at any one time but to able to filter out and only have an awareness of the thoughts that are relevant to the current moment.
This aids to prevent the individual from ruminating or getting caught up in a cycle of anxiety and anxiety provoking thoughts.
We have all heard of mindfulness, however few of us would have a true understanding of what it means and the benefits the practice can allow the individual.
Mindfulness means paying attention in a particular way – paying attention on purpose, in the present moment and non-judgmentally of one’s own thoughts. Mindfulness is a meditation practice that begins with paying attention to the breath in order to focus on the here and now. This is so that the mind is not ruminating on what might have been or what an individual is worried about what could be. The goal is to give an individual the tools to recognise disturbing thoughts and emotions and to be able to observe them without immediately reacting to them.
Mindfulness allows the mind to create conditions for contentment. The mind learns to focus on the present moment and observe the world and it’s thoughts in a non-judgmental way.
For our peers with special needs this is of great benefit as it provides a way of training the mind to focus and stay in the moment. Staying in the moment prevents one’s mind from ruminating going over past and possible future events. Therefore, providing a calmness and serenity within an individual.
Some individuals need specific help to regulate their emotions. Teaching them mindfulness meditation helps them to regulate and understand their emotions.
The great benefit of mindfulness meditation and working with children individually is I that I can tailor what I am offering them and what will work best for them.
The first thing I teach them is an awareness of the breath. I explain to them how there is a quiet stillness within the breath and that, that stillness is always with you; even when we are sad, angry, excited, happy or frustrated. I teach them how to feel this stillness within the breath within their bodies. For the children, it becomes an experience where they are aware of what they are feeling. They can then learn to observe their thoughts and feelings.
This then provides them to be able to move forward from this teaching and choose their behaviours.
Mindfulness meditation decreases anxiety and helps to improve attention. It teaches children to be less emotionally reactive and more able to handle the daily challenges of life.
If you would like to learn more about mindfulness meditation and other tools can benefit your child please do not hesitate to contact me for an obligation free discussion on 0420973042 or contact me on email@example.com