There are a lot of misconceptions about ADHD. If your child is diagnosed with ADHD, know that it isn’t a behavioral problem. You can’t scold or force it out of your child. As a parent, you should understand what they need and what you can do to help. So instead of bringing them to therapy or taking matters into your own hands, seek out ADHD coaching. You will get way better results there.
Join Timothy J. Hayes, Psy.D as he talks to the Founder of the Russell Coaching for Students, Dr. Norrine Russell. Dr. Russell coaches students with ADHD, autism, anxiety, and other learning disabilities. She is also the author of Asking the Right Questions about ADHD Before, During, and After Your Child’s Diagnosis. Learn all you need about ADHD today and transform chaos into calm.
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Debunking The Misconceptions About ADHD With Dr. Norrine Russell
Norrine Russell, PhD is the Founder of the Russell Coaching for Students, where they use an innovative method of coaching for complex students, including those who have ADHD, autism, anxiety, and learning disabilities. This innovative method, connected coaching, has proven successful for hundreds of students across the United States and Canada since 2009. Dr. Russell has been a featured guest speaker on over 25 podcasts, focusing on attention deficit with hyperactivity disorder, including the podcast titled ADDitude.
Dr. Russell, thank you so much for joining us here. It’s nice to see you face to face.
Thank you for having me. I’m delighted to be here.
I was hoping you could tell us a little bit about how you got into the work you do and what drives your passion for it.
My career path first started as a college professor. My graduate degree is in Developmental Psychology. I taught classes in Developmental Psychology and Child and Adolescent Psychology. After several years of doing that, I moved into doing nonprofit work full-time and helping to build healthy communities, healthy adolescents, and healthy families. When I had my son in 2008, I decided to retire from that work.
Completely unexpectedly, I had several clinicians in town here in Tampa, where I live, ask me if I would start to work with some students. They were students who the psychologists felt didn’t need therapy, but they needed some mentoring and coaching. I had not ever thought about that but it was consistent with the work I had been doing in the nonprofit world, and apparently was a need in our community, so I said yes.
That’s how I got started fourteen years ago. It was saying yes to requests from local clinicians for kids who needed coaching and mentoring. Several years later, Russell Coaching is the largest student coaching practice in the country. We specialize in kids who are complex. They have ADHD and anxiety, or they have autism and anxiety, or they have dyslexia and autism. Most of the kids that we work with have two or more diagnoses. We see kids all across the country. It has been a fascinating and rewarding journey given that I started with no vision whatsoever of what I was doing or where I was going to have ended up here several years later.
You say you see kids all across the country. Is a lot of that done remotely or are people traveling to see you or are you traveling to see them?
We have 23 coaches at the practice. They all see students virtually over Zoom. Our model works great. We started our model before the pandemic. We were on Zoom before the pandemic. Our method of coaching is pretty pragmatic, hands-on and practical, and it translates well to Zoom. It’s much different from teaching over Zoom or therapy over Zoom or things like that. We haven’t had a hiccup with moving to virtual sessions. You could have a coach in Virginia seeing a kid in Washington DC. You could have a coach in California seeing a kid in Indiana. It made the practice and what we offer accessible to the kids who need it, and to the parents who didn’t even know that something like this existed.
You’ve also written a book about Asking the Right Questions About ADHD Before, During, and After Your Child’s Diagnosis, which is the title. When was that published?
It was published in the summer of 2022. I never thought about writing a book. I never wrote the book from my dissertation. I didn’t think I had a book in me, but after years and years of working with parents and teaching them how to better advocate for their student with ADHD, and teaching them what questions they needed to ask of various people on their students’ team, the medical professional, people at school, and therapist. I thought that this would be a handy book. We wrote the book to help parents be better advocates for their kids with ADHD. There’s something unique about ADHD that we don’t get a lot of parent education when our child gets a diagnosis of ADHD.
Parents tend to rely on the doctor or the school to lead the way. Sometimes, that needs to be the parent’s role. The book is all about how you ask questions of the doctor, the teachers, and the psychologists so that you can become more fully informed and a better advocate for your student with ADHD. It’s a quick read. It’s very practical. I had someone say, “I can get in all my summer reading and read your book.” I was like, “Great. Good. That’s what we want.”
I greatly appreciate it because when you work in the field, you gain all this expertise and then it’s easy to start thinking, “Everybody understands this.” A lot of people have no clue. You write the book in such a way that you’re letting people know what good questions to ask even before there has been a diagnosis are.
Questions to ask to lead up to, “Should I have an evaluation? If my child gets that diagnosis or I get that diagnosis, does that mean that I have to have a medication?” It’s a very practical piece of work. As somebody who is working in the field, do you feel as though the general population is getting better educated about this? Is the general population getting a lot of misperceptions? What’s the trend that you see?
In my experience, it’s interesting. As a community of people, as parents, and as schools, we are getting better educated about autism, for example. We have a long way to go with autism. We are starting to understand the neuropsychology behind autism better. We’re starting to understand that what can look like behaviors are symptoms of a neurodevelopmental disorder. We’re coming to a more empathic place for kids who have autism.
The same is true for a lot of the mental health diagnoses like anxiety and depression, especially since the pandemic. I do think there is this odd blockage in our American culture about ADHD and the science of what we know about ADHD, and that there is still very much a dominant philosophy that this is a behavioral problem as opposed to a neurodevelopmental problem, and that the cure or the fix is behavioral. It’s to become more strict, more harsh, and to hand down more punishments.ADHD is a neurodevelopmental problem, not a behavioral problem. Click To Tweet
There’s also a real anti-science bias in some sections of our country when it comes to trying to understand what we know about ADHD. That’s hard for kids too. In my experience, there’s something different about getting an ADHD diagnosis versus some of the other psychiatric disorders. As a country, we are less interested in understanding and supporting kids who have ADHD, which is particularly difficult for those kids who have not just ADHD, but have ADHD and a mental health diagnosis, or they have ADHD and autism. ADHD is still seen as a behavioral problem, which is not keeping with what we know about the science of it.
The difference that you’re mentioning would translate into the idea that people get more harsh and try to put more structure on the person, and treat it as though it’s willful misbehavior.
That’s what a lot of people still think. It’s that the symptoms of ADHD are under the child’s control. In some ways, that’s an understandable assumption because we sometimes see the symptoms, and then we sometimes don’t see those symptoms. It can seem as though a child is willfully not listening or willfully not doing their homework or deliberately not cleaning up their room, but if we understood that ADHD symptoms could come and go as with other things like allergy symptoms come and go or asthma symptoms come and go.
Depression symptoms come and go. Anxiety symptoms come and go.
We don’t say the same thing about anxiety or depression like, “You’re choosing to be depressed today. You’re choosing to be obstinate today.” Many people still feel like if a child works hard enough, they can overcome the ADHD symptoms as opposed to realizing that that child is probably already working so hard to regulate their behavior, and in many cases, not having success. They are starting to develop the pattern that we see in older kids with ADHD where they start to check out of school possibly.
They start to have concerns about whether they are smart or are they an okay person. A lot of kids with ADHD end up with poor self-esteem and low self-efficacy because they have been told, “If you just try, you can conquer this.” That’s not the case. There are specific interventions and treatments that are needed in order for a child or a teenager with ADHD to thrive.
One of the questions I had was, can you tell us what you think are some of the most prominent misconceptions about this? You’ve probably handled the primary one. Are there other misconceptions about Attention Deficit Disorder with and without hyperactivity?
There are several. One of the ones that I see commonly in my practice is the idea that medication should be a last resort as opposed to a first resort. Whereas if you take a look at what the American Academy of Pediatrics, the American Psychiatric Association, and those expert bodies say, and what the research says, medication should be a first-line treatment, not a last resort.When it comes to ADHD, medication should be a last resort as opposed to a first resort. Click To Tweet
That comes from parents’ fears. I don’t know where these fears get fed in our culture. The idea is that somehow if we treat this medically, the student won’t learn how to handle it. They won’t learn how to control it. Whereas in actuality, what we know is that the medical treatment side of things and the prescriptions that are written for ADHD help that child or teenager regulate their behavior.
It’s a strange phenomenon that we have where we think giving kids medication for something is going to take away their ability to solve it. If I hand you a pair of glasses, you’ll quit trying so hard to see. I don’t know where that comes from. Another misconception that we have is that ADHD is somehow linked to intelligence, of which there is no correlation. For some reason, I hear this one all the time from parents. You can have kids with ADHD who are bright and gifted. You can have kids with ADHD who are average, like most of us. One of the things that parents commonly say to me is, “He’s smart. He doesn’t try. He’s not motivated.”
There’s an element of parents seeing their son or daughter’s potential, and seeing how much they could do, except that ADHD gets in the way. There’s this strange misconception that either all kids with ADHD are bright, or all kids with ADHD are not smart, but there are some strange thoughts out there about the correlation between intelligence and ADHD.
The other misconception, if I can add one more, is that kids with ADHD are not motivated because they choose to be unmotivated. Whereas if you dig deep into the neurology of ADHD, you see that that’s a symptom of ADHD. People have this misconception that teens with ADHD don’t care about school, or they don’t care about their grades, or they don’t care about their future. Whereas, in actuality, that’s the motivation center of the brain running a little bit low for kids with ADHD.
Those are excellent points. One of the things that I’ve seen over the years, we have people who are moderate to high-level Attention Deficit Disorder with or without hyperactivity. They can at least seemingly have a lower set of social skills. Is the coaching that you do geared towards that?
We do sometimes address that. We have a lot of conversations with parents about the fact that kids with ADHD can be up to 30% delayed socially and emotionally. If you think about that for a minute, it makes perfect sense. If your brain isn’t attending to the cues around you for social and emotional wisdom, and you’re not picking up on those things, and maybe you’re a little bit impulsive because of the ADHD, it’s going to take a little bit longer to learn those social and emotional skills, and then to practice those social and emotional skills.
I was talking with a mom about her fifteen-year-old daughter. I said, “Their behavior is left over from when she wasn’t treated and the symptoms weren’t under control. When she was in middle school, she wasn’t attending to what her peers were doing and saying, and how they were behaving. Because she wasn’t attending to it because she was distracted, which is a symptom of ADHD, she wasn’t able to internalize and start practicing those social and emotional skills.”
She’s fifteen and she still interrupts all the time. She talks quite a lot about herself. She doesn’t express a lot of empathy yet for other people when they’re having a hard time. It’s important for everyone, professionals and parents, to understand that if you have a child with ADHD, all the way through their teen years, they could be up to 30% or three years delayed socially and emotionally. They’re going to need some support for that. They may not have an easy time fitting in with their peers, or they may use their ADHD symptoms to be the life of the party, but not get genuine true connectedness in relationships.
That’s another problem that sometimes we see that concerns me a lot. It’s the kid who is the life of the party because they’re hyperactive and impulsive and always a lot of fun but not necessarily in a healthy, safe way. In our coaching practice, we do integrate learning social and emotional skills. We use the social-emotional learning model where the skills are self-awareness, self-regulation, social awareness, and then relationship regulation and healthy decision-making. We use a pretty common model that’s used in schools called SEL, Social Emotional Learning, and try to help kids to at least have one friend in school to not be socially rejected, to not be that kid who’s inappropriate.
I’ll be honest with you, that takes working in concert with whoever is the medical provider to make sure that symptoms are under good control. If you have a neurodevelopmental disorder where one of the primary symptoms is can’t pay attention and you’re hugely impulsive, we’ve got to make sure that you have good symptom control so that you can learn the skills that go along with that.
It’s fascinating when you say that. I thought about somebody who was bending my ear. If somebody has Tourette’s, they bark out swear words, they can’t control it, and they’ve got a tick that keeps coming, we don’t get angry at them and punish them for it. Right in line with what you’re saying, it seems as though because the symptoms or the patterns of behavior are so much closer to normal.
Most people expect the person to manage it with sure will or because I’m going to stack up the negative consequences so high that you’re going to try to avoid them. On the other side, those are the misconceptions. People think that there’s an intelligence link directly correlated to attention deficit disorder or that that medication should be the last-ditch effort. What are some of the truths that people don’t want to hear about attention deficit disorder and/or hyperactivity?
I’m not sure if this is something that people don’t want to hear, but I will say it’s something that most people don’t know, that ADHD medications are among the safest psychiatric medications and among the most effective. Sometimes people don’t want to hear that because everyone says, “Nobody wants your kid on meds.”ADHD medications are among the safest psychiatric medications and among the most effective. Click To Tweet
If the alternative is that you have a kid with ADHD that’s untreated, you don’t want that either. Something people don’t want to hear is that you’re going to have a decision to make. Are you going to treat ADHD or are you not going to treat ADHD? Either way, there’s going to be ADHD. It’s not like the choice is we’re not going to medicate and the ADHD is going to go away. That’s a difficult truth for a lot of people to hear.
Another difficult truth is that while diagnosing ADHD can sometimes be quite clear cut, getting medication correct and the dose and the duration can be difficult. That’s hard for a lot of parents because they’ve been through this long evaluation process. You might be getting a lot of negative feedback from the school and teachers. You might see that your kid is socially isolated. The last thing you want to hear is that it might take three months or so to get the medication to a place where it’s optimized, in the words of the American Academy of Pediatrics. That is something that people don’t want to hear.
If they decide they’re going to treat with medication, having the patients sit through medication trials and changing doses and changing medications so that the child feels the best they can feel can be difficult. Also, there are a lot of parents who wish that ADHD would go away at some point. “When will they grow out of this? When will they no longer need any of this?”
Research is not clear on that answer. Possibly 50% of people will outgrow their moderate to severe symptoms and be able to manage their symptoms without medication, but we don’t know yet. That’s something that people don’t want to hear, that we don’t have the answer to, “How long is ADHD going to affect my teenager or college student?”
There’s a part of that which you use the phrase outgrow. As far as I’m aware, the jury is still out about whether or not people outgrow it or people grow into a maturity that allows them to apply their own coping mechanisms to deal with what’s never going to go away. This is just their way of interacting with the world, their way of perceiving, their way of ability to focus, or their lack of ability to focus from time to time, just like some people are going to have mood swings and/or anxiety come and go.
I’m glad to hear you say that because of the idea that people outgrow it. Some do, but a lot of us who’ve worked in the field have more of an experience that by the time the parent comes in with the child saying, “Can you help me figure out if this child has attention deficit disorder?” The parents are clearly people who are dealing with this and have never been diagnosed and medicated. They’re functioning quite well. When we take the history, we find out they had a similar history in childhood that wasn’t aided by coaching like yours or a diagnosis in medication or a 504 plan at school or whatever.
A lot of parents have that experience. For some parents, it leads them down the path of, “I want to make sure my child does have all of the components of good multimodal treatment.” For other parents, though, they get stuck in, “I didn’t need a plan at school. I didn’t need coaching. I didn’t need medication. I’m doing fine.” That can take a little while to unpack, whether that’s working with a doctor or working with a coach. How did you get through your childhood and your young adulthood years and adulthood with ADHD versus what’s going to be best for your child or teenager? Sometimes the two are different.
The question for some parents is, “If I’m looking out for the best interest of my child, maybe they’ll be okay. They’ll survive like I did, but do I want them to have as hard a time as I did to get here? How much further could they go if they had the support and the benefits of treatment?” One of the things I wanted to ask you was, do people only come to RussellCoaching.com after they’ve had a diagnosis?
Primarily, we get people who have had a psycho-ed eval or they’ve had an evaluation at school and they have a diagnosis. Maybe 10% to 20% of our practice comes because the pieces haven’t clicked for the parent. “Marianne is having a hard time at school. Teachers are sending me notes all the time. She’s a good girl. She’s trying hard. She just needs some help getting organized.”
We’ll get started with our coaching practice, and then 9 times out of 10, we suggest an evaluation so that we can see what’s going on. Part of why that’s important, and we address this in the book, is that only about 1/3 of kids with ADHD only have ADHD. The other 2/3 have something else that pairs up with ADHD, whether that’s a mood disorder, autism or a learning difference.
Impulse control problems.
That evaluation piece is super important for getting the whole picture. For us in coaching, it becomes important because it helps us to understand, “Does this child have fast or slow processing speed? How is their working memory? How do they do with visual information versus verbal information?” We can teach them how the brain works best, and then how they can adapt to what they’re being asked to do in school.
Most of our kids come to us with a diagnosis. Many of our kids come to us still experiencing problems at school and problems at home. For whatever reason along the path, parents, unfortunately, haven’t been educated about what multimodal treatment for ADHD looks like, and what you can expect for your child or your teen when you have good treatment in place. We do a lot of psychoeducation around ADHD, and then teach them how to ask the right questions of their doctor, schools, therapist, and things like that so that they can become well educated about ADHD and therefore good advocates for their child.
That’s one of the best aspects of this book, Asking the Right Questions About ADHD Before, During, and After Your Child’s Diagnosis. It’s with you, Dr. Norrine Russell and Heidi Condrey. Whether it’s this book or the coaching from people like you could make a difficult process a lot easier. Having somebody who has been through it enough times that they know the kinds of questions to ask doesn’t mean they’re going to have all the answers for you, but it’s useful having a direction to go and these questions to ask to help you tease out, “What would be best for my child?”
As we know, there’s as much variation in people with ADHD as there are people who have it. That’s why you’re talking about multimodal treatment. It’s not just a one size fits all situation. Even after somebody gets the diagnosis, we’re still learning. It’s this educated trial and error process to figure out which medication might help this person and at what dose.
It’s very different to have a child who has ADHD, fast processing speed, and poor working memory. Maybe they have a little anxiety as well. Take that pattern versus maybe the student who has what we think of as inattentive ADHD or ADHD without the hyperactivity. Maybe they have slow processing speed, but they have a great working memory. Maybe they have mild autism in there. Those are two kids with ADHD who are going to present completely differently at home and school.
The ADHD diagnosis alone does not allow you to then predict and put on track what this child needs. It has to be in the context of what we know about their overall functioning if you want it to be the most effective treatment that it can be. It is what we, as parents and professionals, want for all of our kids, clients and patients.
As you’re saying that, I’m thinking about how I’ve seen such a tremendous difference, not just in the way people process it, but if you’ve got an introvert versus an extrovert. Where that person gets the energy that feeds them and fuels them and where they’re having to spend extra energy is a tremendous difference.
If you have somebody who’s an introvert versus somebody who’s an extrovert, on paper, it looks like the working memory is the same and the processing is the same. Whether they take in better with optics or auditory, all those lined up, if you got somebody who gets overloaded in a crowd versus somebody who gets lit up in the crowd and they’ve got more energy to deal with things, you have two different presentations.
My own two children are complete opposites in that way. My son is extroverted. He could spend his whole day talking to people. He thrives on being around people. Interestingly, his medication helps him to control his impulsivity and overtalking so that he can relate well to people. I’m thankful that we have a great doctor and she does a beautiful job of controlling his symptoms so that he has that experience. My daughter, on the other hand, is wired a lot more like I am. She’s very introverted. What we notice is that she’s an introvert. That is her wiring, but the introversion combined with the ADHD, if she’s not taking her medication, she’s even more blank.
I’m an introvert by anybody’s definition of it. It’s interesting to watch your students who are introverted and inattentive with ADHD wake up a little bit when the ADHD is controlled. We definitely see that with our daughter. Is she still someone who prefers to spend a lot of time alone? Does she need to recharge by herself? Yes. Does she spend a lot of time in her head? Yes, but without her ADHD medication, she almost disappears into that.
I realize we’re getting a little short on time here. Take a breath and think about what’s an aspect we’ve already talked about that you would like to highlight or something we haven’t even addressed yet that you would like to make sure we get into in this interview.
One of the things that we haven’t talked about is how beneficial academic or ADHD coaching is for students. When we think about the fact that we can have a kid who is up to 30% delayed, we can have those dynamics starting in middle school, where the parent-child relationship needs to be about something other than school. It can’t be about the parent managing school. That middle school time is when it’s best to start coaching because then we can help the parent move into and stay in a parenting role where they are loving their child. They are supporting them through the social dynamics of middle school, the emotional changes and upheavals.
For the most part, when our kids come to coaching, 95% of them love their coach. They love having to work with someone who is trying to understand their brain and how their brain operates, who is their cheerleader, and who is helping them figure out how they are going to remember that they have a quiz every Friday in Spanish and what’s going to work for them. Someone who has an optimistic view of things.
Kids appreciate being able to work with someone who this is their profession, as opposed to what we often see when they come to coaching, they’re in a lot of conflict with their parents over school because they’re not doing as well as they could be because we know that they’re smart or bright or want to do well. Coaching is an effective intervention for kids. At our practice, we tell parents to expect that the intervention piece will be about a semester to learn new skills and new habits, put those in play, and solidify them.
Some of our kids stay with us for a while after that. Many do for the support, the mentorship, and the parents’ peace of mind. ADHD or academic coaching is not something that most parents are familiar with. Most parents think, “We need to go to therapy because they’re refusing to do school. They have a bad attitude. We’re yelling all the time.”ADHD coaching is more beneficial than therapy when it comes to children with ADHD. Click To Tweet
In terms of something we haven’t talked about, it’s raising people’s awareness that coaching can be very effective for students. We are unusual in that we work with middle school students. Most coaches work with high school or college age, but I love getting them in middle school because you can get all the good habits ingrained in the beginning. I would urge parents to be aware of you don’t have to be the executive functioning assistant for your student. You’re not doing them any favors by doing it that way.Parents don't have to be the executive functioning assistant for their children with ADHD. Click To Tweet
For a lot of people, especially parents, if they’re having any experience with this at all, that will be a tremendous relief because that’s not their expertise, it’s a dual role, and the list goes on. One of the most important things is for them to be able to consistently communicate to their child, “I love you. You’re a good kid. You make good decisions. We can get through this.” If the parent’s feeling overwhelmed and didn’t know how to help them through it, you can see how it would easily transfer over into frustration and negativity.
At a time when that young person is going through a tremendous amount of changes biologically, emotionally and socially, they need to hear from their parents, “I love you. You are enough. You are exactly what this world needs as is.” It’s hard to pair that message with, “Why do you have an F in biology? I love you the way you are.” That doesn’t work.
I greatly appreciate your taking the time to share with us and our audience. It’s RussellCoaching.com. The book again is?
I got the Kindle, which is quite nice. Thank you for sharing with us. It’s a delight to meet you. I’m grateful that there are people out there like you doing this kind of work.
Thank you very much for having me on. I appreciate the opportunity. I wish you the best.
Norrine Russell PhD is the Founder of the Russell Coaching for Students, where they use an innovative method of coaching for complex students, including those who have ADHD, autism, anxiety, and learning disabilities. This innovative method, connected coaching, has proven successful for hundreds of students across the United States in Canada since 2009. Dr. Russell has been a featured guest speaker on over 25 podcasts, focusing on attention deficit with hyperactivity disorder, including the podcast titled, ADDitude. With twenty years of experience creating positive youth development and parenting education programs, Dr. Russell has extensive knowledge of child development, learning styles, special needs, and positive parenting philosophies. She blends this knowledge to provide students and parents with comprehensive support and the tools they need to grow and thrive. Dr. Russell has a PhD from Bowling Green State University with a focus on Psychology and Education. Prior to starting her coaching and consulting practice, Dr. Russell worked at a variety of well-known nonprofit agencies, including the YWCA of New York City, the Tampa Metropolitan Area Y, The Ophelia Project and Boys Initiative of Tampa Bay, and the One Circle Foundation.
- Russell Coaching for Students
- Asking the Right Questions About ADHD Before, During, and After Your Child’s Diagnosis
- Amazon – Asking the Right Questions About ADHD Before, During, and After Your Child’s Diagnosis
- Kindle – Asking the Right Questions About ADHD Before, During, and After Your Child’s Diagnosis
About Norrine Russell, Ph.D
Norrine Russell, Ph.D. is the founder of the Russell Coaching for Students, where they use an innovative method of coaching for complex students, including those who have ADHD, Autism, or Anxiety; and those with learning differences. This innovative method, Connected Coaching, has proven successful for hundreds of students across the United States and Canada since 2009. Dr. Russell has been a featured guest on over 25 podcasts focusing on ADHD, including ADDitude.
With twenty years of experience creating positive youth development and parenting education programs, Dr. Russell has extensive knowledge of child development, learning styles, special needs, and positive parenting philosophies. She blends this knowledge to provide students and parents with comprehensive support and the tools they need to grow and thrive. Dr. Russell has a Ph.D. from Bowling Green State University with a focus on psychology and education. Prior to starting her coaching and consulting practice, Dr. Russell worked at a variety of well-known non-profit agencies, including the YWCA of the City of New York, the Tampa Metropolitan Area Y, The Ophelia Project and Boys Initiative of Tampa Bay, and One Circle Foundation.
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