Podcast: What is ADHD?


Lindsey and Wellspring therapist Nicole discuss the symptoms and statistics for ADHD, focusing on kids and teens.


Host: Lindsey Steffen, LMHC
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Nicole Velez, LMHC


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Speaker 1:           Welcome to wellspring on the air where professional Christian counselors share practical life and Bible insights. Why? Because hearts and minds matter. We're glad you joined our show today to hear from our host Tova Kreps, president of wellspring counseling in Miami. Tova is a licensed therapist with many years of experience as a Christian counselor. Tova teaches, writes and consults and life FM is pleased to have wellspring counseling, restoring hearts and minds in our community. Hi there. I'm Lindsay Stephan, a licensed mental health counselor at wellspring and cohost for wellspring on the air. Today is part one of a two part series. I'm excited to talk with Nicole Velez Alfonzo, one of our therapists here at wellspring and we have here, with her a very

Speaker 2:           Special guest. Her son Christian is going to be with us. So part one we're going to be talking about ADHD, what it is, what are the signs and symptoms. And in part two we're actually going to interview her son Christian, who does have ADHD and hear a little bit about his story and how their family has dealt with this. Really it's a challenge, but also how, how he's dealt with this challenge and how the family is managing it and he is successful in school and socially. So it'll be really inspiring to hear some of their story. So we'll welcome Nicole. Thanks for being with me today. Thank you Lindsey. So we're going to go ahead and start just talking a little bit about ADHD. I think it's a term we hear a lot, especially as kids are in school and maybe having difficulty concentrating.

Speaker 2:           You know, the teacher might say, Oh, I'm not sure if your child, your son or daughter have ADHD, but let's actually learn what is ADHD. So let's hear from Nicole. So attention deficit hyperactivity disorder, that's what it stands for. And it's a neurological brain disorder. It's marked by ongoing patterns of inattention and or hyperactivity and impulsivity. And this usually interferes with functioning and development. So when we talk about ADHD, we're talking about a neurological brain disorder. It's something that is different in the brain. The brain, the part of the brain affected by ADHD is the frontal lobe. And that's where a lot of the executive functioning happens. And so organization and focus and things like consistency and being able to concentrate, those things happen in that area. And so if that area hasn't fully developed or is delayed, then those things won't be working as well.

Speaker 2:           Yeah. Yeah. And we can see how that would definitely cause some difficulties probably first at school. I'm imagining just keeping up with work, being organized to remember what work to do. So. Absolutely. And one of the, the things that is important to remember when we're thinking about diagnosing ADHD or, you know, does my child have ADHD, is it must be dysfunctional in two settings. So we're talking about there is a dysfunction in the home. Okay. And also school or there's a dysfunction in the home and at work when we talk about ADHD in older people, so what we look at is it's affecting them in both settings at a high level. Okay. So today we're gonna focus on children primarily. So, but also we do want to definitely put out there that, you know, many adults suffer with ADHD as well. And there's medication or therapy, different things they can do to get help.

Speaker 2:           So if you think you are someone we're going to talk later about resources, but today let's focus on children. Yes. So first let's dive into what are the three types of ADHD? There's three different types of ADHD and when we say types, we're talking about the way they present themselves. And so the first one is in attentive type. And so this is where the person is just not able to focus fully. They make careless mistakes in school. They overlook or miss certain details. They turn in their work incomplete or inaccurate. They have difficulty sustaining full attention during the time they're at at school. Listen to the teacher. They tend to daydream. So these are some basic inattentive symptoms. There's also things like difficulty following instructions. They can start something and then not be able to finish it. They get sidetracked easily. They have difficulty organizing a task and organizing themselves for homework or school or, or projects.

Speaker 2:           Things like that. Time management is, is not what good either. Things like they can lose things easily. They can forget books. They can forget that, you know, their eyeglasses, their retainer, they can lose things like that. I see Christian smiling. Was that a personal example? We actually just found it today. It's awesome. That's awesome. I love that you're talking through these, cause I just imagine a lot of teachers and parents who aren't educated on this, they're thinking that their child is being lazy or, Oh, why didn't you finish this? You only did half. But I hear what you're saying is that it's really an inability at this point to complete or stay focused or have maybe even just the stamina to get through something. That's right. And I think it's really important when we talk about a brain disorder, we're talking about something that they're not willfully trying to do this difficult thing.

Speaker 2:           Like, you know, they're not willfully trying to not pay attention. They're not willfully. It's really their brain just unable to do it. Yeah. You know, so I hear it. Probably it could be mislabeled as, oh, you're being rebellious. You're, you know, kind of you're acting out when really it's like, no, my brain is just not doing what it's supposed to today. [inaudible] Exactly. Yeah, exactly. That's right. That's a really good way to describe it. Oh, right. So that is the primarily inattentive type. So let's go on and talk about primarily hyperactive type. Okay. So this one, it presents as that really fidgety kid in class. Just, you know, tapping and the pen is clicking and, and the feet are like moving and he's moving, you know, they're just, you know, maybe they get up in the middle of class and they're, they're like, no, I just need to go do something real quick.

Speaker 2:           It's okay. You know, and they have a hard time realizing that needing to stay still, that's just really, really, really difficult for them. Yeah. And they actually can't really think unless they're moving. It's like really interesting. So you might see the kid doing their work, standing at their desk. It's like, sit down, sit down. But that's actually working for, right, exactly. Yeah. So, and I'll just mention my son, you know, when we're working through the, let's say the Bible verse and he's trying to memorize a bible verse and he's just throwing the ball against the wall, memorizing the Bible verse. And at the beginning I was like, okay, this is not, this is not okay. Like this is not normal, right? This is not like how kids should do it. And then with time I realized, you know what, it works for him. This is what works for him.

Speaker 2:           I have to allow this to happen because this is what helps him do it. Right. You know, for him. And so it took me a little bit to like, be okay with that, but he, you know, he does what he needs to do to engage his brain. You know? So you hear that as a parent, you have to be flexible. It's not gonna just be cookie cutter, which is true of all parenting anyway. But yeah, but if you have a child with ADHD, things might not always look typical, but that's what's working. That's right. Very true. And it took me some time, but you know, we're there. What do you need to do to, to get this done? Yeah. So yeah, so that's a hyperactivity and so some other things are like always on the go, driven by a motor or just like really like having to always be doing something.

Speaker 2:           Sometimes they talk a lot, you know, excessively, maybe they're like that social butterfly at school, you know, chatter box. The chatter box I always had on my report card. Is very social teachers trying to say talks too much. Yeah. Also difficulty maybe waiting his turn, you know, or you know, answering a question without raising your hand or things like that. It's just really hard to kind of control that. So energy, I hear the body, lots of men to come out. Yes. Yeah. So that's the hyperactive type. And so then the last one is a combined type. So it's a combination of both. And in order for there to be a diagnosis, there needs to be six of each of these symptoms. So six of the nine for, you know, an attentive would say, you know, this child does happen attentive ADHD, but for combined type, they have six of each, six of each.

Speaker 2:           So you can see, you know, six inattentive symptoms and six hyperactive symptoms and then you're like, okay, my child has both, you know. Okay. so yeah, they might be forgetful but also very fidgety. Yeah, we're seeing that, that Combo. Okay. And like you said, the symptoms must impair them in more than one setting. Exactly. I guess that's letting us know, hey, if this is only happening at home or at school, then there's something going on in the environment. But if you're seeing across the board, they act this way in two or more settings than it probably is something neurological going on. That's right. Yes. Well, let's start for our listeners who maybe have children of all different ages, let's focus a little bit on ADHD symptoms. We're going to start in the younger years. We'll do preschool degree too. And then we'll talk a little bit about grades three to seven and then ADHD symptoms in teenagers because definitely I think some stuff is probably across the board, but in different age groups, the symptoms will present differently.

Speaker 2:           That's true. Absolutely. As they grow older it changes. So let's get started with the preschoolers. Okay. Preschool to grade two. So some of the things that you may notice, our trouble getting started on tasks and routines. So getting dressed might be a hard putting away some toys. Sometimes they ignore directions and it takes them longer. You, you, you know that needing to ask many times has a harder time sitting still during meals gets up or talks when they're expected to be quiet. Okay. So I hear a lot of disruptive behavior, so I'm imagining these kids are probably getting in trouble a lot, either at home or school. Yes. That is very possible. That they're being looked at as behaviorally challenged kids. You know, when it's something way deeper than that, I know something out of their control. Exactly. That discipline is going to change.

Speaker 2:           It's just going, I'm hearing that it would just frustrate them. They're not doing anything intentionally wrong and they're being punished. Yes. It'll frustrate them even more knowing that this is not something I'm meaning to do and you're getting really upset at me, you know? So sometimes also you'll see things like being unable to wait for directions before starting like an activity and so they'll just start doing it without the direction has trouble maybe remembering the directions. Oftentimes they say tell them to do just two things. Right? Because that's as much as they can actually remember to do. Right. The first two steps and so sometimes has trouble recalling information that they learned. So there's a memory kind of like a slow memory issue. That would be frustrating. Just test-taking. That's a huge part of your life as a child in school. So I imagine maybe some low self esteem, not feeling like I'm not smart.

Speaker 2:           I studied all night and then I still got a d on this test. That's right. Sometimes even with Greektown we would study the spelling words. He knew them all the day before. Then he would get like three or four wrong and it's like, yeah, you know, like I knew them, you know? So that's so frustrating. Absolutely. Those are some things you'll notice between the ages of preschool. So somewhere between maybe four to second grade. Yeah. That stands out to me to what you noted that they might get very upset or angry over what would be a minor frustration. Yes. And so that's another piece of ADHD that we can talk about, but that emotionality, the responses, the emotional responses tend to be much higher. And there's difficulty in managing emotions. Okay. So yeah, and maybe too, I'm imagining that upset that angry is probably a lot of the frustration. We've talked about being maybe feeling misunderstood, feeling like I'm doing my best and it just doesn't seem good enough. So it's kind of that volcano eventually we might just explode. That's right. Yeah. Well, you know what, we're actually going to take a short break and then we're going to come back and keep talking through these symptoms. So that was preschool degrade two. We're going to come back and talk through grades three to seven and then teenagers and their symptoms. So I'm Lindsay Stephan with wellspring on the air and we'll be right back.

Speaker 1:           Wellspring now offers professional Christian counseling at six locations in Dade County. Therapists are now taking clients at new locations, one at Crossbridge, Miami Springs and key Biscayne for more information, (786) 573-7010 or wellspring miami.org for more information.

Speaker 2:           Welcome back. I'm Lindsay Stephan with wellspring on the air and I'm here with Nicole Velez. Alfonzo, we've been talking through ADHD in children. What are the symptoms, what are some of the statistics, what is ADHD look like and present as, so we just talked through some symptoms in the younger ages, more preschool to third grade age or second grade, but we're going to go ahead and talk about a few statistics of children are kind of in the same age group. So what are some stats children with ADHD? So the first thing I want to say is that the CDC, the latest research says that 13% of children have ADHD. And this range is all the way from young kids to 18 that's like the entire population. So we're at 13% right now. Also 40% of youth with diagnosable ADHD symptoms don't get treatment. And this is a huge thing because the sooner we can help children to manage their symptoms, the more confident they will be, the more socially appropriate they'll behave.

Speaker 2:           So just a lot of different things school wise they won't fall behind. Right? And so it's important for us to know that, you know, there's kids out there that have ADHD and are not getting the treatment they need. That's significant. 40% are not treated who are diagnosed. So if you think about it, almost half of the children in school with ADHD are probably repeating grades, maybe even eventually dropping out because they're so frustrated and feel like they learn. So that has really big implications. And I think it really impacts self confidence and self esteem because schooling is one of the main ways kids, you know, feel like, oh, I'm doing well, I'm proud of myself because I'm getting good grades and when that's not happening and yet their primary responsibility is to go to school. Right. And when that's not working out, you know, what else do they have?

Speaker 2:           And so their self esteem really declines. Yeah. They don't get that sense of accomplishing. Exactly. Yeah. Yes. Okay. Another very interesting and important statistic and I think for our family it is true. 40% of children who have ADHD have at least one parent who has ADHD. In our family we recognize that dad has ADHD and so Christian has ADHD. You know, our son has ADHD and so it is a highly hereditary condition. So it's helpful. Actually the way it worked with us is that Christian, when we were in the process of identifying what was going on in his diagnosis during that process is when dad said, wait a minute, wait a minute. This is what I have. Like, are you kidding? Like, oh my God, it's identifying with, he like totally like was able to like pinpoint. And so he was able to find his treatment.

Speaker 2:           But it was really a revealing to us and, and it's been very helpful to our entire family. I can imagine. I imagine just the anxiety and frustration levels going way down and knowing, okay, this is what we're dealing with and poppy and Christian and this is what we can do about. Yes, absolutely. And I think when you're, when you have ADHD and you're trying to help a child with ADHD, it can get really complicated. I mean, talk about people that you know, can't follow through, can't, you know, be consistent. I mean, that's just, you know, it's hard. So yeah, you have to put on your air mask before you put on us. Exactly. So it's been really good. But we do want, you know, parents out there listening, you know, could you have ADHD? Could you, you know, need to find a way to manage it to better help your child.

Speaker 2:           Right. That's something to think about and consider. So, yeah. So those are some statistics just about ADHD in general with children. I think it's important as you're reading through these, just obviously the child, they can have higher self esteem, actually enjoy school, enjoy even tasks at home, accomplishing things. It's so important for their overall wellbeing. But I notice also this stat that parents of a child with ADHD are three times more likely to separate or divorce than parents of children without ADHD. So it does show that you need to know what you're dealing with because obviously this is as many issues are but so challenging that it can really even drive families apart if you don't diagnose it accurately and then treat it. Yes, that's right. Thank you for mentioning that Lindsay. It's sad but it's true. You know it's, it can be very frustrating at times and very hard on the couple, you know, maybe one thinks they should handle it a certain way, the other a different way and that can cause some division.

Speaker 2:           So. Sure. Even talking about medication, I think culturally there's different views on that. Mostly being here in Miami. I think we have all different cultures and people groups and some people are okay with medication. Some are. And it sounds like from what you've described, sometimes that is a piece of treatment absence important. Yes. And I think that being open to all possible treatments is important also because you don't know what's going to help your child, you know? Right. And I think, you know, next show, I'll talk about that and how that process was for our family and how the medication topic is a hard topic is a scary topic at times, but how we worked through that and the benefits that we're seeing from it. Yeah. Yeah. So this show, this first part is a lot of this stats and symptoms, but tune in next week to hear Nicole and Christian talk about their own family's experience dealing with this.

Speaker 2:           So that should be really interesting and we're really grateful to them for being vulnerable and just sharing some of their own story. So tune in next week for that. All right, well let's go ahead and jump maybe back. We talked some about some stats of children with ADHD, but let's go back to some symptoms. Let's talk through grades three to seven. So if you have a third to seventh grade age child, here's some symptoms to look for. Yeah. So often fidgety moves around a lot, makes maybe sort of too much noise when he's expected to be quiet. Maybe being in the classroom also doesn't really, is not very interested in reading or doing much schoolwork unless it's actually really interesting to him or her often rushes through assignments or it produces messy work with lots of careless mistakes often stops, you know, doing their chores or homework gets distracted and doesn't finish. It tends to forget things like bringing home, you know, notes or books or things like that and worries that he'll forget what he wants to say unless he says it right away. That's like, it's not going to stay in my head.

Speaker 2:           Sometimes works too slowly. So it takes a really long time to get through something that could take a very short time. And you know, homework time can be a four hour process rather than an hour. And a half, you know, so things can take way longer and so has just trouble finishing tasks and writing book reports in a reasonable time can be really hard. Organizing a book reports, you know, it's like, no, I'm just gonna sit right the whole thing today and be done. You know, I imagine as you get into the older grades that this is really difficult when you have big assignments, research papers, things that you know are going to take a lot of time and effort. I just imagine if you haven't been treated, these things would seem too daunting. And then once you actually realize, oh my goodness, I really actually have to do it and it's due tomorrow, then there's that emotional piece of like, oh my gosh, how am I going to do this?

Speaker 2:           You know, and, and panic that panic mode. And so now you have to do the entire project. Yes. And manage your emotions that go with it, you know? Yeah. So it, it's, it can get hard for sure. So those are some symptoms between the grades of third grade and seventh grade. Yeah. So maybe notice if you have a kid who is in your eyes disobeying a lot, not completing task, really evaluate is this perhaps what's going on? Are they really willfully not doing something or are they forgetting? Yeah, I hear often parents say, I know he can do it. You know, I know he, he's very smart. I know he can do it. And let me tell you, ADHD kids are very smart kits, right? But if their brain is enabled to function, that area of the brain isn't able to fully function. It's somewhat delayed.

Speaker 2:           Then as smart as they are, they just can't put it to work. Right? Yep. Kids are really smart, but they need help to organize themselves. They need help to execute. And oftentimes that comes from us as parents. You know, a lot of the, the ways that we help our kids is by us being the ones to guide that process. Right. So it's important to coach them through it. Yes. Coach them. Do. Yeah, exactly. A lot of times now the treatments are mostly geared towards the parents because the parents are the ones that can help. The kids have a harder time being able to do that. Their brain just doesn't allow it. So the parents are more of the ones that are supposed to kind of, you know, be the consistent ones, be the ones to structure the environment. Right. They're responsible for that. Exactly. Kids aren't able to do that.

Speaker 2:           And sometimes, and this is me as well, like when he hit third grade I was like, nope, you got to do everything on your own. Like you're independent now. Like you got to do it. And the truth is that he just wasn't able to do that. I really did have to sit next to him or you know, redirect him structured, you know, help with let's do this today. Let's do this tomorrow, you know, so that he could organize himself better because he just is not right. And with that in mind, I do want to say this one statistic, and this is, this is for me, it just really like, wow, this is truth right here. The rate of emotional development for children with ADHD is as much as 30% slower than it is for their children. Without the condition. So for example, a child that's 10 years old with ADHD operates at the maturity level of about a seven year old.

Speaker 2:           Wow. So there's about a two to three year delay. Okay. When we talk about emotional maturity, so I mean this is so important to understand that if you're telling your 10 year old to do this on your own, they're really at a seven year old level, which at a seven year old level, they really couldn't do it on their own. You know, this other amazing statistic, which you know, sorry buddy, you're not going to be able to drive till later. A 16 year old beginning driver is using the decision making skills of an 11 or 12 year old. Now that's just scary. That's really scary. Yeah. A family that's not aware of this and you wouldn't let your 11 or 12 year old take the car drive to school. Right. So they definitely need more practice. You know, you need to know that you can trust your child to make decisions while driving.

Speaker 2:           Right. Not Be impulsive. But anyway, it's important. This really, really got me because I was, I was functioning as a parent at the level of you're a 10 year old, you can do this. And when I realized that his brain wasn't at that level, it really helped me manage myself and manage him to have reasonable expectations actually. Exactly. That's the word limit. That's reasonable expectations for for your children's behavior and abilities. Yeah. I imagine too, from that stat, I'm thinking you have a 10 year old around other 10 year olds. So it really, they're functioning like a seven year old that's going to have social implications. Absolutely. Just noticing how they need support. Maybe even in social skills areas and you know, they might be kind of younger acting or silly or something. And all right, well we're getting close to the end of our show and we do want to quickly touch on teens.

Speaker 2:           So they have symptoms that can be similar kind of spacing out when trying to do an assignment. I'm having trouble getting organized, setting priorities. They can try struggle with the impulsivity, being restless or fidgety. So there's many other symptoms. Definitely if you think you have a teen who, even out of those few symptoms, you're noticing that they are having trouble remembering things or keeping track of their stuff, definitely look more into this. And let's hear a couple more stats from Nicole. So some of the stats for teens, 21% of teens with ADHD, they tend to skip school repeatedly. 35% of teens with ADHD eventually drop out of school. That's a really scary number. 35%, 45% of teens with ADHD have been suspended. That's almost half of kids of teens with ADHD. And 30% of teens with ADT have failed or had to repeat a year of school.

Speaker 2:           And I, and I mentioned these stats and they seem a little scary and everything, but the reason I want to say these things is because if this is happening to your child, if you're seeing these symptoms, you know, let's get, let's get them some help, let's find out what is really happening. Maybe it's not ADHD, maybe it's something else. But if it is ADHD, there are many ways you can help. So, you know, I don't want to scare parents, but I do want them to see that there are consequences when there's no treatment for this. Exactly. And really with any undiagnosed mental health or you know, neurological thing going on, anxiety, depression, these eventually have bigger issues coming out if we don't get our children and teens help. So we definitely want to encourage you, not scare you but encourage you that this is an important thing to explore and really figure out what's going on with your children and your teens. So. Well Nicole, thank you so much for being with me today and yeah, we're going to wrap up for today. So I'm Lindsay Steffen with wellspring on the air because hearts and minds matter.

PodcastAlexandra Delgado