Attention Deficit Disorder with Dr. Susan Landers

Hi, welcome to Real Life Momz. I'm your host Lisa Foster and Real Life Momz is a podcast that is all about connecting moms through real conversations. I believe that moms have so much insight and knowledge, and together we are powerful. And in this week's episode, I invited Dr. Susan Landers. She is a neonatologist who worked full-time in the NICU for over 30 years and has raised three grown children. She is the author of her new book, So Many Babies, My Life, Balancing a Busy Medical Career and Motherhood.

Susan is here today to help discuss our topic, Attention Deficit Disorder. She shares her medical perspective as well as her parent's perspective on raising a child who is diagnosed with ADHD.

Hi Susan. Welcome to Real Life Momz. It is an honor to have you here today. I have had some listeners that recently reached out to me and they requested a discussion on Attention Deficit Disorder. So I know you're a neonatologist, but you're also a mom and so you have personal experience having a child with ADHD. Right. So it's kinda, Yeah. So I kind of felt that it's kind of that just right balance, right, of getting that medical advice a little bit, but also really the important advice that parent perspective of this subject.

So thank you so much for being here today.

Oh, my pleasure. I appreciate the invitation. It is a very important topic.

Yeah. And a lot of people have questions. I feel like there are so many questions about it that parents have. Yeah. Uhhuh. And I feel, well, we'll get into it, but I feel like a lot of these kids are a little misunderstood, a little bit. Oh,.

They're for sure.

So let's start with a little bit about you. Let's hear your background a little bit and just tell us about yourself.

I practiced, uh, neonatology for 34 years. I loved working in the NICU. I loved being part of a very well-oiled team. You know, we attended high-risk deliveries. We took care of small PREMIES and sick newborns, and I really enjoyed getting to know parents and, um, working with nurses and physicians that I respected a great deal. I miss that. Since I'm retired now, I retired about five years ago. Um, while I was practicing full-time.

I'm also married to a physician, um, a pediatric nephrologist. And he and I, yeah, he and I raised three children together. They're all young adults. My daughter is a pediatric ICU nurse, so I'm really enjoying watching her balance, working full time, having two kids, being a mom, be a wife. Oh, everything that I went through. Mm-hmm. <affirmative>. Um, and it's really been fun being her grandmother. So, um, that makes my retirement very wonderful and, but it's not as fulfilling as I had hoped it would be.

Medicine gave me a great, uh, sense of pleasure and fulfillment because, I felt like I was always making a difference.

Yes.

And I felt like I could really give myself to the care of my patients and their parents. And now that I'm retired, I've written a book about my life as a working mom and as a NICU doc. And I wanted that book to be helpful and reassuring to other moms because I feel like I've been through so many mothering challenges and I hear other mothers say, Oh, your children must be perfect.

And I'm always going, Are you kidding? My kids have problems like everybody else's. And so I wanted my book to reflect that what we're doing is working moms is really tough. Mm-hmm. <affirmative> and balancing work and personal life and being a mom and being a partner or a wife is difficult. And I wanted other mothers to get a sense that if they feel tired, it's because they deserve to feel tired. <laugh>.

Right.

Yeah. Yeah. It's really hard. I mean, it's hard to balance everything. It's not a balance. It's more like a juggling act.

Exactly.

Because none of us can be in two places at once. Mm-hmm. <affirmative>. So I wrote all the stories about my challenges as a mother and, mostly some of my challenges professionally too. So I hope your readers will check out my book So Many Babies it's on Amazon and it's on my website too. And I understand that you wanted to talk specifically about ADHD.

I did, yes. I've had a lot of people reach out just about this topic, so Yes, I.

Understand.

Yeah. What, well, what are you saying? Cause you're, you're saying it's so important. So what is it that?

You're saying it's important because the incidents have gone up a little bit. It, ADHD occurs in about nine and a half percent of children. Huh. So that's, that's roughly one in 10 kids.

Yeah. That's a.

Lot. And yeah, it's a lot. And two and a half percent of adults have adult ADHD. When, uh, my son was in the first grade, his teacher here, Um, his teacher said, We're losing him. He has an executive function disorder. I went, What, what is that? And um, she said, I just can't, I just can't reach him in class.

He's always looking somewhere else. He's always doing something else. He's always blurting out answers. And I said, Well, I don't, I don't know what executive function disorder is <laugh>, but I had heard about ADHD and so at her urging I had him evaluated for ADHD mm-hmm. <affirmative> and I read a lot about it. It turns out that a lot of the patients that I take care of are in the NICU mm-hmm.

<Affirmative> and sent home tiny preemies especially grow up to have ADHD. Hmm. We do not exactly know why premature babies have three times the risk of ADHD as full-term, but it probably has something to do with their exposure to various things in the NICU during a very important, um, phase of brain growth and brain development.

But plenty of full-term babies grow up to get ADHD. You know, most kids will develop symptoms about the time my son did six or seven mm-hmm. <affirmative>, Um, some kids have symptoms as early as four. So we had David, uh, evaluated by a developmental psychologist and had some IQ testing. He's very bright. I didn't know exactly how bright. And I talked with a friend of mine who was a gifted and talented teacher and she said, Oh, come on.

A lot of GT kids act this way.

He's not hyperactive. He can sit alone and play and he can make things and he's very creative. So the psychologist said, Your son is rather impulsive, but he did not have ADHD. And I learned that the main features for ADHD besides impulsivity are distractibility and hyperactivity, which is more common in boys than girls. Uh, but he did not think that my son qualified based on the criteria that he used at the time.

It turns out that he was very distractable and he did have some features of ADHD, but he managed quite well I think because he was so bright. Mm-hmm. <affirmative>. And so I didn't think much more about it except this kid's backpack was always like a trash can. You know, it was always homework just stuffed down in it and uh, assignments not completed and things turned in late and Oh mom, I don't really care about that.

Oh, sounds familiar to me. Sounds like my, Sounds like my son. Yeah. But he was always fiddling with computers and making things with Legos and very creative and mm-hmm. <affirmative> and even was filming um, movies. He would film little movies of the neighborhood kids playing and dressing up. And so I thought, well he is just smart and creative and I didn't think any more of it. Mm-hmm. <affirmative>. Um, so, but I did read a lot about ADHD and he did have some symptoms of it.

Then uh, my second child came along, and she was very different. She was a good student, you know, always did her work, probably bordered on a little perfectionistic, always organized, and never made a mess of anything. And I thought, well, he is different from his sister, who was more traditional, more typical. Then when my third one came along, this was a child who at four years of age would look at books and hold them upside down and she was perfectly happy.

I went, What in the world? And we decided after much evaluation that she had dyslexia, which was diagnosed when she was about five. Her dyslexia was the first sign of a language or learning problem. And then she turned out to have ADHD in first grade when she was six as well. Okay. So the teacher noticed each time with my son and with my daughter, and a lot of your mom's listening will identify with this.

The teachers see things in our children that we don't see because they're sitting at a table, they're sitting at a desk, they're doing schoolwork, they're having to conform mm-hmm. <affirmative>. And we don't see them in that kind of environment at home. So often the teachers are the first to suspect something's going on.

And they do spend like six hours a day with.

Them. Yeah. Right, right. Exactly. And so when my daughter's teacher said, she's really distractable, and she daydreams, I said, Really? Cuz when I work with her, she's on focus cuz we're, you know, trying hard to learn to read and learn to spell. But she was seeing something different in the classroom. And so we had Laura evaluated again, you know, hearing auditory integration, sensory interpretation, developmental tests, IQ tests, the whole shebang.

Mm-Hmm. <affirmative> and the developmental psych pediatrician and psychologist said she has ADHD, not the hyperactive type, the distractible type. And I said, Okay, that makes perfect sense. Now, what do we do? And that's when the big question arose to treat or not to treat. Um, probably when you hear from parents mm-hmm. <affirmative> listeners of your podcast, they are having questions about how do I get my kid diagnosed?

Who do I go to for help? Yeah. And do they need treatment or not? Yeah. I think those are the big three.

Yeah. And sometimes it's, it's undiagnosed kind of like what you said, you didn't notice it so much at home. Mm-hmm. <affirmative> or you just put it as their personality. But then I think another piece of it is sometimes like the teacher maybe isn't as savvy as yours and they, they might just be getting in trouble a lot at school.

Yes. Um, my son was like that. He was one of these kids that couldn't wait his turn, blurted out answers, got in trouble in school, and was kind of socially inept. Mm-hmm. <affirmative> and I talked to other mothers of gifted kids and they said, Oh yeah, he just acts kinda not with it socially. And he had a friend that was kind of another computer geek kind of kid. So I didn't think much about it, but several teachers mentioned to me that that was a problem.

Mm-Hmm. <affirmative> and, and I noticed it was a problem on the soccer field and on the basketball court. And he wasn't really a team player kind of kid. He certainly wasn't coordinated. He was rather uncoordinated. But no one else raised the issue of ADHD for my son until middle school. He was like in the eighth grade and one teacher said, Do you think he has ADHD? And I said, Well, he had him worked up for it when he was seven, and they said no.

She said, Well, maybe I just need to give him harder things to do. And this particular teacher did that. She gave him several grade levels above where he was working to do, and he was happy and did fine throughout middle school, and high school and did fine throughout college and grad school. And guess, what? My son at age 31 called me up, he said, Mom, I have ADHD. I went, You are kidding.

Who.

Said no I do. And I went to see a psychologist, and I went to have some cutting, and I wondered why I couldn't stay on task, and I couldn't complete projects and I was always putting things off and I was always, you know, wanting to do something else that was more fun. And so I got to talk to my adult son about this. Mm-hmm. <affirmative>. And he told me something really interesting. He said, When you have ADHD it's like you're so interested and everything in front of you and everything in front of you is enticing and distracts you.

And so if you're supposed to be reading something, but you get something else out of the side of your eye, or something else interesting pops up, you go after that. And so it's an overstimulated brain thing, and you can see why if that's the case that children in school would have a difficult time conforming and doing their school work.

Oh yeah.

They're looking at the wall, or they're looking at their friend, or they're looking at a different place in the book, and they get sidetracked.

Right. Cause there's so much going on at school, there are so many different kids and things.

Right. And so, and I was reading recently about the neurotransmitter issue in ADHD and it, it turns out that there are various parts of the brain that process information, some visual, some auditory, some sensory. And some of the brain areas, and I don't understand all this, I'm no neurologist, but kids with ADHD have neurotransmitter differences, meaning the chemicals that signal per certain parts of their brain mm-hmm.

<Affirmative> and they actually cannot do and process certain things that other kids can. There is a neurotransmitter, a chemical signal problem in certain parts of their brain. Isn't that interesting? That is so.

Interesting. So interesting. And the question to me then is like, how do you support them?

Yeah. So it's not that they can't do it mm-hmm. <affirmative>, it's that they have trouble focusing on one thing at a time. Yeah. Well, you know, it's like I learned to treat my daughter with dyslexia. She had to have certain reading, she had to have certain color markers, and she had to have a certain quiet place without distraction. She had to have a certain tutor go over things with her. And she learned fine. But it took huge effort. And some kids with ADHD have to be in a place where they're not easily distracted.

And the other thing about this condition that's so important for people to understand is that medication is very effective.

Can you Yeah, let's talk about that. Cuz that is a big question. It is from parents. Yes.

Parents don't wanna medicate their children, but I just explained how ADHD involves certain areas of the brain and it's about a lack of neurotransmitters. No epinephrine specifically, mm-hmm. <affirmative>. And it goes back to either dopamine or dopa, chemical constituents of no epinephrine. And we've learned from huge trials of thousands of children back in the nineties, in the late nineties, that stimulant medication amphetamines basically actually coax their brain to function more normally.

So it has the opposite effect of if you or I took stimulant medication, we'd be buzzed. Mm-hmm. <affirmative>, we'd be high, we would be, um, like hyper-caffeinated mm-hmm. <affirmative>. But a child with ADHD who doesn't have the right neurotransmitter pathways with medication will function better. They'll do better in school. They'll do better with their friends, and they'll do better as adults in relationships, and in job performance.

Uh, I was rereading some studies about medication in children, and there are lots of different meds.

The American Academy of Pediatrics has published, um, resources and medication guidelines for parents. Oh, wonder I want your listener to know about a website called healthy children.org. Healthy children.org. It is a website for parents created and updated by the American Academy of Pediatrics. You can go there and search for any condition. There's a lot of information on ADHD, how to get it diagnosed, what the symptoms are at home, and what the symptoms are at school.

Teacher checklist, parent checklist. There's a great guide on different medications to treat ADHD. Uh, it answers questions about dosing and different drugs. Some drugs are short-acting, some drugs are long-acting. So the question that that parents are asking is a legitimate, solid question, Should I medicate my child? Mm-hmm. <affirmative> the data shows that the answer is yes.

Medication helps the child learn better, function better, and interact with others better.

Is there a specific age that would be ideal to start?

I, I reread recently the recommendations and the AAP, American Academy and Pediatrics, and I'm sure there was input from the American Psychiatric Association too, says no sooner than six or seven.

Okay.

I get a lot of questions from parents of my preemies, and they say, Oh, I can see it by age four, I can see it at age five. What do I do? I said, Well, it's just working on behavior modification. We really don't medicate kids that are four and five.

Is that because of the brain? Is that because of brain development? Or.

Is, you know, I'm not sure. I know the reason that we hesitate at ages four and five, I would speculate that it's because we can't be sure of the diagnosis. Oh. You have to see symptoms at home and at school. Mm-hmm. <affirmative>. And is a preschool, like a kindergarten or first grade, enough to know whether a child is distractible or hyperactive or inattentive. Mm-hmm.

<Affirmative>. So I think it has to do with the ability to be sure of the diagnosis. Cause no one would wanna treat a child where the diagnosis was not certain.

Right. And there are different types of ADHD, right. You said there's, you know, the distractability or the hyperactive; I'm assuming it's a different medicine for different types and does one need it, you know, more.

<Laugh>? Well, yeah, that's a good question. The boys that are hyperactive, it's more typical in boys running around the room, going crazy, driven as if by a motor. Mm-hmm. <affirmative>, those kids respond to medication, and it's, it doesn't slow 'em down, but it controls their behavior. Mm-hmm. <affirmative>. And I've heard teachers say, Boy, it was like flipping a switch. Mm-hmm. <affirmative>, I said, No, it can't be that black and white. She said I'll tell you, I can tell when they haven't had their meds the second they walk in my classroom.

The hyperactive type, which is more common in boys, responds beautifully to medication. Mm-hmm. <affirmative>, I'm not sure that there's a preferred med that's way outside of my league. And I would recommend that any of, uh, your parents listening, talk to their pediatrician, talk to their developmental specialist, if their child has been evaluated, they will know which medication is best for their child.

Mm-Hmm. <affirmative>, It's interesting that I didn't notice it in my daughter because she was not hyperactive. Well, neither of my kids was; they were distractable and inattentive mm-hmm. <affirmative>. And so girls are not diagnosed as early as boys are because people think they're Oh, just a cute little daydreaming girl. Mm-hmm. <affirmative>, I mean, that sounds horrible, but you could imagine a little girl sitting in a kindergarten or first-grade class and she's kind of looking at the wall and looking out the window and not paying attention and maybe daydreaming and, and the teacher, you know, calls her back to focus and she does okay.

But she's having trouble staying on task. Mm-hmm. <affirmative> and, and it's, it's not as noticeable as a boy who's buzzing around the room and blurting out answers and interrupting other people.

Mm-Hmm. <affirmative>. Yes.

And so perhaps it's harder to make the diagnosis in girls mm-hmm. <affirmative>, but the testing always shows. And when parents and teachers fill out checklists, I remember going through these checklists, you know, you'll, you'll be given 25 traits, and you assess whether or not your child has this sometimes all the time or never. Mm-hmm. <affirmative> and I, I was going, Wow. Has this, has this has this has this. It's easy to see the symptoms when they're listed in front of you on a checklist.

And the American Academy of Pediatrics has developed some guidelines for the diagnosis and for checklists for parents and school systems always know how to evaluate kids.

So what are some of the symptoms that maybe parents at home could be looking for?

Parents at home would notice poor responses to boundaries. Not finishing chores. Distractible in the kitchen, starting on one thing and ending up on another. Um, not putting away toys, starting with one project, and moving immediately to another project. Not getting along with siblings. But that is so complicated. It's hard to say.

<Laugh>. I know. I'm not kidding. I'm checking my kids off as you speak about kids. Well, they don't really finish their chores or <laugh>.

I know, I know. So it's, it's hard to see it at home because they're in a wholly different environment than at school. Mm-hmm. <affirmative>. Um, and if you've got the daydreaming type and she's watching a video or a movie, you might never notice it. Mm-hmm. <affirmative>. So, um, that's why it's so crucial that they have symptoms evaluated at home and at school. Mm-hmm. <affirmative>, people who are not the parents tend to notice symptoms sooner than the parents do.

And I remember comparing my son to other little boys his age and his classroom over the years and thinking, you know, does he have it or is he just clumsy or is he just rude? And so sometimes it's a behavioral question, sometimes it's a lack of focus issue. Sometimes the teacher will raise the question. Sometimes a sibling will bring up something like, why can't he just stay outta my stuff?

Mm-Hmm. <affirmative>, um, I think parents hear it from multiple sources when their kid has ADHD. Mm-hmm. <affirmative> in my experience. Or they notice it because they're looking for it. Like the parents of my preemies, my tiniest preemies, they go home noticing whether or not their kids are growing up. Okay. Behaviorally, they know to look for certain things.

What do you think, I mean, medication is one, but what else has been the best support for your kids?

Mm, good question. When Laura was evaluated, I remember the principal of her school. We were in a public school system in, in Austin, a really good school system that had lots of master's level teachers, Slingerland teachers. That's one of the multisensory curriculums for kids with dyslexia and ADHD. Mm-hmm. <affirmative>, the principal said Some parents do not want their kids labeled ADHD. I went, What? Why not? Well, they just don't want people to know.

They think that diagnosis is bad. I said, it's a brain condition, it's not bad. It's just something, it's a condition. Mm-hmm. <affirmative>, if the kid had diabetes, they wouldn't wanna hide that, would they? And she said I have the hardest time getting parents to accept the diagnosis. Hmm. Now, I don't know if that is still the case, but when you do have a child with ADHD in public school, your child qualifies for an individual educational plan, i e p.

And, they get something called 5 0 4, which is based on a law for children with disabilities. And the 5 0 4 and I E P allow the child to get pull-out classes and instruction for reading and math and the pullout classes. I thought that would be hard on my daughter. I thought she would hate it. She said, Oh, I love it, mom because it's me and like four other kids, and she was in a class of 16 or 18.

And I said, You really like it? And she said, Oh yeah, because we get so much attention. We have one teacher, and there's only three or four of us; and she remembers to this day pulling out of her regular kindergarten, first, second-grade class to go to special reading classes. So if your child has ADHD in public school, they benefit from all of these special services called 5 0 4 or ind, individual educational plan.

Mm-Hmm. <affirmative>. And you'll be able to meet with a vice principal or a social worker or counselor, I guess school counselor who will tell you the kinds of services that your child will qualify for. And I thought those services were wonderful. Mm-hmm. <affirmative>, Laura got to know a lot of extra teachers. Some of those teachers became her tutors when she was in middle school. Some of those that I would, you know, hire and pay them for after-school help mm-hmm.

<Affirmative> because kids with ADHD have trouble learning all the time. Mm-hmm. <affirmative>, it's not like it's just for second, or third grade. It is all the time. The other thing kids with ADHD get is untimed tests if they qualify for it. So that means in middle school and high school, if it takes 'em an hour and a half to complete a test and their peers are done in 45 minutes, they get a place to go do their extra work and get the timing.

So the services that children get when they have that diagnosis are well worth it.

And it sounds like your daughter at least expressed that they were helpful.

Yeah, she did. Yeah. I mean she, now, there were some days in the early days of her diagnosis she would come home and say, I'm stupid. Yeah.

And,

And I went, No, you're not. You just have trouble learning. And she said, No, I'm stupid. And some of the other kids said I was stupid. And so my mantra with her over the years was this, your brain is just wired differently. Mm-hmm. <affirmative>. And there are lots and lots of articles that help parents understand that this wiring of the brain, this the nervous system, the parts of the brain, the neurotransmitters, uh, the chemicals that tell certain brain parts to talk to each other, That's what I mean by wiring.

Mm-Hmm. <affirmative>, their brains are wired differently, and medication helps. Mm-hmm. <affirmative>, you know, the other thing your parents need to understand is that a lot of people with ADHD and learning disabilities are brilliant. They're creatives. They are, you know, famous photographers and the same famous engineers and famous physicists and wonderfully creative film, uh, filmmakers and movie producers.

So we don't understand why almost 10% of children have brains that are wired differently from the other 90%. Mm-hmm.

<Affirmative>,.

We don't understand that yet. We just know that they are different and that medication helps.

I have to ask this too, as just myself as a parent, I guess. Um, so I'm a physical therapist, and I work with, and I work with pediatrics, and I get a lot of kiddos who have diagnoses of some sort of, uh, ADHD or hyperactivity, impulsivity. And what I find is like, since they're moving around so much, like kind of always getting in trouble, you know mm-hmm. <affirmative> mm-hmm. <affirmative>. And, and I have to wonder, like, for instance, you know, I was treating this kid just the other day, he has a diagnosis of ADHD and doing more physical therapy, so coordination activities and like by accident, you know, he had, you know, grabbed something of course and it, it fell and it was no big deal for me.

But the immediate response was like, Oh my god, I'm so sorry like apologizing, feeling terrible. Like they innately, I feel like he must apologize all the time.

Yeah. And it must feel really horrible. And I guess my question is how do we, I don't know, build these kids up a little bit more to not feel that they're, you know, being bad when they are being impulsive or, you know, cuz they are, I feel like they're all really good natured. They mean well. Yeah. It's just like, it's an accidental thing or their brain is maybe overfiring or whatever. Right. But how is like a person, as a parent, as a teacher, really making these kids feel more empowered than always having to apologize?

Well, I think we need to tell them that their brain is wired differently. Mm-hmm. <affirmative> and that they don't think the same way that other kids do. And that sometimes they're, they make, uh, poor choices about behaviors, and we understand that, and we are trying to help them learn to control their choices and their behaviors because really their behavior is a manifestation of choice in the moment.

Mm-Hmm. <affirmative>, if a kid reached for something and it fell, see that, that that kid noticed that thing mm-hmm. <affirmative> instead of interacting with you or what was going on on the table, the kid reached for something that might have been in the corner of his eye, but he saw it as a stimulus mm-hmm. <affirmative>. And so I, we should say, I think this is the way your brain is and that's okay, but we wanna help you learn to make good choices mm-hmm.

<Affirmative> to be able to, to live with other people, to follow the rules of the classroom, to follow the rules of our home. Mm-hmm. <affirmative>, the only thing I said that was helpful for my children was you're okay. You're just trying to learn how to live with people who are not like you, and who don't think like you. Um, but you're right, Lisa. It's so important that they don't feel like there's something wrong with them.

Them. Yeah. Mm-hmm. <affirmative>, I love that that that that was a perfect answer.

Hard <laugh> because you get embarrassed if your kid's hyper. You get embarrassed if your kid's impulsive or distractible. You just want to go, Oh my God, is this my fault? Yeah. And you know, the other big part of this that I didn't mention is that ADHD is very genetic. It's, um, runs in families. I'm convinced that my husband had it <laugh>, and because I keep noticing more and more symptoms and since we have two kids that have it, it makes sense, but it does run in families.

Mm-Hmm. <affirmative>, we don't understand the genetic aspects of it. But again, genes have something to do with how our brains work. You know, some people are right-handed or left-handed. If you're right-handed, you're more logical and more mathematical, and more, uh, you think about things differently. If you're lefthanded like my son, you're more creative, and you're more, uh, imaginative. And so we understand that left and right-handed people and left and right-brain people are different.

And we accept that we need to accept that ADHD kids are different, but they're still okay. They just think differently. Mm-hmm. <affirmative>, they see things differently, they interact with their world differently, and they're having to learn to interact in a way that the other 90% are expected to do.

I know one of your other kind of passions is, you know, working with careers and people with burnout, but I can't think of better, like a bigger population that's burnt out than parents and then parents who have maybe a child that has ADHD.

<Laugh>. Right. Right.

So, so what, what would advice would you give them?

Oh, that is a great question. Um, having been there. Mm-hmm. <affirmative>, if your child is difficult, if your child is different, if your child is neurodiverse, if you have a difficult or demanding child and or a difficult and demanding job, you could be at the end of your rope on any day of the week. That needs to be recognized as a situation in which you are taxed beyond your limits. You try your hardest, and still things don't work.

And you need to be somewhat kind to yourself and say, Gosh, this is hard. I need some help. I need some understanding. Mm-hmm. <affirmative>, when we have burnt out as parents, we have got to get away from the situation. Even if it's 30 minutes, we've got to talk to somebody else who understands. Even if it's a phone call or a quick lunch together, we've got to have 30 minutes for ourselves, even if it's a walk.

Cause parent burnout, especially with a difficult or challenging child, can just seep in so easily. We've got to have adequate sleep, and we've got to have adequate help. Our husband or partner has to understand what we're struggling with. Especially if they walked in and we've got everything under control, and they don't understand why we're at the end of our rope. I'm a big proponent of talking about the issues and setting aside some time for ourselves.

That sounds so selfish when you work full-time. Mm-hmm. <affirmative>, if you have a stressful, even if you don't have a stressful job, you have to take care of yourself in order to be a good mother to take care of them. So I'm just really harping on working parents, taking care of themselves, carving out a little bit of time to replenish, to re uh, to fill up your cup if you will.

It's just so crucial because what you're doing is difficult. The first part of the answer is to admit to yourself that what you're doing is difficult. That having a challenging child is gonna wear you out, and get some help as often as you can. Talk to a friend as often as you can. Get outside in nature and walk, preferably by yourself for 20 or 30 minutes, and you'll be able to deal with things better.

Yeah. Because then you're not at the end of your rope when you know something happens.

Right. It's not easy, It's just not easy. That's one of the reasons I wrote my book. I wanted people to understand that we all feel guilty. Mm-hmm. <affirmative>, we all feel like we should do be doing a better job. We should be perfect moms, perfect partners, perfect friends. And we just keep dropping the ball because we're so busy. Mm-hmm. <affirmative>. But being easy on ourselves, giving ourselves a little bit of grace, a little bit of extra time, a little bit of, you know, Pat on the back.

Wow, this has been a really hard day.

I love the, you know, finding a friend to talk to. I mean I, I know for, I think myself, I think a lot of women, we need other women, you know, sometimes to really just, even just the energy of being around other women or just talking, there's something about that that is very healing too. And even if it's a phone conversation or a walk together, Yes. That can really make a huge difference. Yeah.

It makes a huge difference. Even if you just see somebody at lunch, even if you just run into somebody coming in or out of the building or in the after-school line. Even if you just touch base with how's it going? And oh, we're drowning and oh we are too. And gimme a call. It just makes a world of difference. You are so right about that.

Mm-Hmm. <affirmative>. And sometimes for myself at lunch, cuz I, I do work as well. Yeah. Um, you know, I'll grab a friend, and we'll go for a walk a colleague and we'll take, you know, instead of just sitting down and eating the whole time, we just take a 15-minute walk, you know, and that for you. And that changes things too. And so I'm with somebody else, and we can talk, we get our walk, I'm at work, so it's within the hours I'm already away from my family. Mm-hmm. <affirmative>. So sometimes that's really nice too.

Yeah. Good example. That's a great example.

I'm asking this because it's the holiday time coming up already, and people are thinking about what gifts to get their kids. So for the holidays, what has been like your best gift that your kids just loved?

Books. Always books.

Books.

That we can read together.

Oh, is there a specific one you really, really remember?

Uh, where the sidewalk-ends? You know, shell, Silverstein, poetry.

Books.

Oh yes. They're hilarious. And my husband would sort of act them out sometimes.

<Laugh>.

Yeah. So I, I'm a real fan of books and books that have meaning and significance and, and, you will find that over the years, the books themselves become a tradition. It's amazing.

And your kids, are they reading 'em now to their kids?

Oh yes.

Oh.

Yes.

<Laugh>. Well thank you so much for coming on and sharing your story, but also just all that insight on the topic of ADHD. I mean, it's really helpful. It's good to hear just those personal stories but also have that medical knowledge behind it. So I think it was really helpful.

Oh good. But I do encourage your listeners to talk to their pediatrician to go to healthy children.org to ask a lot of questions cuz they need to understand what's going on. It's a very perplexing condition.

Great advice.

Thank you for listening to this episode. I truly appreciate Susan's medical background on Attention Deficit Disorder, but really I enjoyed hearing her personal stories of raising her own children on this topic. If you have any questions regarding your own children, follow up with your pediatrician, but also check out healthychildren.org for more resources.