Parenting Complex Kids: Taking A Comprehensive Approach To ADHD Treatment

The phrase ‘children with ADHD’ labels patients by their diagnosis, but they are so much more than that. They are complex individuals who need care and attention (just like we all do) to help them develop coping skills to manage their medical condition. This is why we prefer the term complex kids – because an ADHD diagnosis is much more complicated than most people understand.

As noted in a recent article from ADDitude, “ADHD rarely exists in isolation.” Most children with ADHD deal with one or more comorbidities, such as anxiety or depression, and ADHD itself is a highly nuanced condition. It is often difficult for kids and their parents/caregivers to manage.

Aside from medication management, parents and caregivers are often skimmed over in the ADHD treatment equation. However, it is important that parents are equipped with tools and coping skills to help complex kids thrive. Parents, physicians and complex kids must all work together for optimal, effective ADHD management.

The Parent’s Perspective: Elaine Taylor-Klaus, MCC

There is a great deal to unpack when a child receives an ADHD diagnosis. Parents often feel uncertainty and shame, especially given the stigma surrounding ADHD and its associated treatments. Medication is one controversial layer to the treatment approach. And then there are other essential measures – like parent training and coaching – to ensure both parents and their kids develop the necessary management skills.

When my children were younger, effectively parenting three complex kids required that I focus on what they needed from me as a parent. It wasn’t enough to get information about their diagnoses. I needed to understand how neurodiversity showed up for each of them and learn tools to support them. At 40, I also received my ADHD diagnosis, which is not at all uncommon, especially for women. As I began treatment for myself, I was in a much better position to create a management environment that worked for the whole family.

As I figured out what could make my children’s lives better, I discovered that shifting my approach to parenting in subtle, yet fundamental ways was the most effective place to start. And when I couldn’t find a community for connection to support me in the process, I joined forces with another coach/mama to create one. It made an enormous difference for all of us.

As parents of complex kids, we need more than information. We need support and guidance to implement the subtle but impactful changes our kids need. For me, I was able to support myself and my family better – and it spurred my passion for supporting other parents of complex kids, as well.

It is key for parents to understand that the goal of treatment for ADHD is not to try to “fix” their child. Instead, they and their medical providers are helping each child learn to manage the various complex ways that ADHD shows up in their life. To do this well, parents need to focus on themselves and find their own support systems.

The Physician’s Perspective: Nerissa S. Bauer, MD, MPH

Helping parents with complex kids must start at diagnosis and go all the way through to a child’s independence. For starters, the diagnostic process can be complicated, expensive, and time-consuming; and despite the effort, it can be met with skepticism from friends and family.

Quantifiable evidence of the presence of core ADHD symptoms – hyperactivity, inattention and impulsivity –improves the diagnostic process and helps fight stigma about ADHD. Technologies like FDA-cleared objective testing help some providers reduce the time to diagnosis by relying on objective data. Data offers a straightforward picture of the diagnosis, which can offer more context and understanding for kids and their families.

In my behavioral health practice, it is important to not only get it right as quickly as possible to inform treatment, but to also help bring parents and children on the same page about what is going on. I find that when I show families the objective test results and we walk through what it means, families understand and feel validated by the data presented. It helps move the communication from confusion to “so, what can we do next?”

The Shared Perspective: Finding the right resources

Once diagnosed, most parents want a comprehensive and effective approach to treatment for their complex kids – but don’t quite understand that this requires them to be part of the process. Outside of just managing any medications and appointments for their child, coaching, training and support for parents is proven effective in improving outcomes for themselves and their children.

Finding the right resources, however, can be a challenge, especially because parents often are not informed that parent training is part of a comprehensive treatment plan for their child. How could they know these resources are needed or available when they are unaware in the first place?

Parents and children need to onboard together after receiving an ADHD diagnosis, as it affects the entire family. ADHD guidelines recommend that we look at ADHD as a chronic condition – and thus requires a chronic care management approach. At the heart of this is psychoeducation for families and skills training for self-management. In pediatrics, we need to do this in a way that involves the parents, who need to encourage child buy-in and participation in developmentally appropriate ways so they can set the stage for future autonomy as the child matures. In addition, when pediatricians suggest school accommodations or make referrals for behavioral therapy, parent training, or coaching, it would support families better if they would address potential conflicts that could arise from scheduling complications or a lack of resources.

Parent training services, along with other parental resources, need to be more widely recommended and available – both through in-person and virtual platforms. As coaches and physicians, we believe effective resources should be provided affordably and accessibly. That is why we both offer resources virtually, so that we can meet parents where they are. In addition, increasingly more community organizations offer holistic local services including evaluations, treatment, and resources for complex kids and their families, including support for parents.

Reshaping the narrative to support complex kids

A few minor tweaks in the treatment process can dramatically improve outcomes for complex kids. First, providers can start the diagnostic process with more objectivity by using FDA-cleared, quantitative-style assessment resources. From there, providers can make direct referrals to widely available parental resources as a core part of treatment plans.

By taking a holistic approach to their child’s care, parents can include their child in their own treatment by understanding how to form better relationships, improve communication, and help their complex kids thrive.