All the research shows that the best thing you can do to effect a positive outcome is medication therapy, provided it is consistent and effective. The second best thing you can do is engage in behavioral intervention. That would be Behavioral Therapy, Cognitive Behavioral Therapy, or Coaching. The best outcomes come from a combination of the two. I would argue that the third best thing you can do is practice good sleep hygiene. If you are not getting enough sleep, it is impossible to be optimally effective and attentive. I don’t know how much research there is into sleep and ADHD, but I’ve observed that the “brain fog” that accompanies sleep deprivation is not too dissimilar to the default state of our ADHD brains. There is a decent amount of evidence that exercise is an incredibly valuable part of overall ADHD treatment. I’ve never met anyone who could manage their ADHD fully with exercise alone. But, I can attest to the fact that consistent vigorous activity directly affects my attention positively. Incidentally, it also helps me manage my anxiety, depression, sleep, and general health. A well balanced life is key. If we are not getting the social interaction, intellectual stimulation, and whatever else we need like having a creative outlet or a forum for competition, we are not going to thrive. I imagine this is true for most humans, but we seem to be more in need of this balance than many. Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.

Too many doctors as unnecessarily afraid of dealing with stimulant based insomnia. It is actually one of the more manageable side effects. Most people on stimulant therapy have their sleep affected only by meds taken late in the day or by higher doses. Though I take high doses and am medicated late in the day, I know from when I first started medication almost three decades ago that if I take any Ritalin at all at any time during the day, I don’t sleep that night… on my own. I think about how much it would have wrecked my life if I had had a doctor who give up on stimulants at that point. Instead I happen to have one of the best ADHD doctors in the world. He tried many things to counteract the stimulants until we settled on Clonidine. I’ve taken it every night for 28 years and it simply cancels out the Ritalin and I go to sleep normally about an hour later. It’s not a sleeping medicine and may even help with my ADHD symptoms, though my doctor says that the short acting form that I take shouldn’t have any effect in that area. Guanfacine is probably prescribed more now that Clonidine is, but they are related and both offer similar help in sleeping. And, there are several other meds that can help offset the stimulants. So, don’t give up the chance of being effectively medicated in the evening. Whether it’s homework time or your kids bedtime, the evening is part of your life too. Note: As with all my entries pertaining to medication, I will remind everyone that I’m not a physician. I simply post about medication because it is so important, because I so often see people not being educated about all the options…

I know I do. Science tells me that you do to, that is to say, if you have ADHD, you have it all the time. I am consistently amazed at how many medical professionals I am aware of who don’t seem to think ADHD needs to be treated all the time. Essentially, the definition of ADHD includes the concept that the symptoms are present in multiple aspects of your life. It’s not just about school, work, or social situations. Though it may be more or less of an issue in different areas of your life, it will always be there in one way or another. I can’t think of another medical issue that doctors seem content to treat for a select few hours a day. No one would suggest that it’s okay to have high blood pressure as long as it’s only after 5pm. No one would tell me that I only need to wear glasses (for an astigmatism that affects my near and far vision) during my work day. I don’t think it would be prudent for a diabetic to manage their blood sugar Monday through Friday and take weekends off. How about being managing depression and anxiety during the school year but taking the summer off? Of course the one caveat to this is if there are substantial side effects that don’t allow for being medicated full time.* In most cases, with a competent physician, side effects can be mitigated enough to allow ADHDers to be medicated the amount that they need to be. Speaking only from my own experience, I need my medication to be the best version of myself in all aspects of my life. Yes,it allows me to be the coach that I want and need to be, and it allows me to be a…

As several of my clients are applying to and often getting into their first choice college I’m reminded of a “fun” thing that happened to me. I remember the pressure and the stress of getting the applications done. I succumbed less to the stress of getting in than most. For some reason I rolled with that one. Anyway, my first choice was Brown. I knew I didn’t have the “resume” to get in, but I thought that my ADHD gave me an explanation as to why my “measurables” weren’t quite up to snuff but that if you looked at my total package I was a good candidate. Still a reach. Not getting in would have been a minor footnote in my life as it wasn’t that big a deal. For example, I can’t remember if it was Oberlin that wait listed me and Vassar that I didn’t get into… or the other way around. Who cares. But Brown was different. My Dad is an Alumnus. So, when I didn’t get in, they sent him a letter offering him counseling, presumably because he should be so disappointed at his son’s lack of success. I have let this fuel me for the 20 years since. In fact, pretty much every time the world has told me that I can’t do “it,” I’ve made it my mission to do “it” anyway if it was really important. Or I’ve let that fuel me as I’ve gone in a different direction. Standard Disclaimer: In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.

Two of my favorite resources to donate clothes, housewares, etc. are THEY COME TO YOUR HOUSE. IT’S AMAZING! The Vietnam Veterans of America: The Epilepsy Foundation of New England: http://donateclothes.epilepsynewengland.org/massachusetts?utm_source=google&utm_medium=cpc&utm_term=donate%2520clothes%2520ma&utm_campaign=donate%2520clothes%2520ma These are my two favorites because they are very easy to schedule, come to your house, and take more than most services. I’ve used them both and find them to be reliable about coming when they are supposed to. And, the Epilepsy Foundation has recently added drop off locations, if that’s your thing. You can also see a map of those at the above link.

I deal with lots of kids who are super stressed about the SATs and the ramifications. A lot of them take classes, endless practice test, read books, make flash cards, and generally drive themselves crazy. I’m not saying that some kids don’t benefit from a little studying. But, the way most kids get wound up about the test can’t be helpful. I would wager that they lose more points from the test taking anxiety than they gain from much of the studying. My philosophy was to be super chill about it. I had bigger fish to fry focusing on my classes. I figured I either knew it or not. I took the same approach to my SAT II’s and my AP. I never took a class, read a book, did a practice test, or made a single flash card. I just made sure to learn my stuff in school, get a good night’s sleep and eat a solid high protein breakfast. The result was that I went into that room with no pressure, stress, or anxiety. And, that let my brain do its cognitive best without any interference. Results: World History SAT II – conveniently can’t remember because it was bad. Class hadn’t prepared me for it. My parents asked me if I wanted to study and retake it. I laughed. SAT – Eng: 720, Math: 690 US History SAT II – 730 US History AP – 3 or a 4 can’t remember exactly, but a credit-earning grade either way English/Writing SAT II – 780 I don’t mention these scores to toot my own horn. I have always tested well. I honestly believe that if I had studied and got all wound up I may not have done as well. Unscientific, yes. But, sometimes I can color outside the lines.…

I’ve seen it in Lexington, Mass., where parents and educators came together this year to read our book, Beyond Measure, and screen the companion film. Inspired, they’re taking town-wide action. One elementary school ended traditional homework and replaced it with nightly reading for pleasure. Other schools in town are making time during the school day for the academic help and project work that are often pushed into precious after-school hours. Meanwhile, Superintendent Mary Czajkowski is meeting with students, parents, and teachers to shape more change for 2017. The strain students are suffering from overwork and unhealthy attitudes toward learning, she says, “has to bring our way of doing things into question.”

I think this article is a bit all over the place and I’m not totally on board with all the possible solutions or explanations, but it raises some very interesting points. Worth considering

Apparently it is the time of year to start thinking about a gap year for your outgoing seniors.  Info on our local Boston fair:  And more on some of the programs available through at least one local company: 

I have a seven-year-old boy and a two-year-old girl. For me this is a study in developmental comparison. These kids couldn’t be much different. It is hard as a parent to not compare them to each other and to compare them to their peer group. I see this all the time with my clients and with their families. ADHD folks develop at their own rate. It is often said that ADHD kids are two to four years behind in maturity. I agree with this, but with an important caveat. That is that these kids may be super immature in some areas but very mature in other areas. You might be able to have an in depth philosophical conversation with an ADHD 11 year old as if he/she were an adult. Then that same kid might, for example, moon the whole neighborhood from the bus on the way to school the next day. (Side note: I was that kid. Good thing I didn’t take the bus. That one wasn’t autobiographical.) Anyway, I was thinking the other day about some examples that I can point to about folks who developed at their own rate and came out just fine. I thought I would share one such story with you. My Dad did not learn to read until third grade. They were just about to put him the “special” classes when his neighbor, who was a wonderful woman and a retired school teacher, stepped in and give him one on one attention. It worked and subsequently, my dad graduated from Brown with degree in Classics, wrote a play that was produced off Broadway, was a high school English teacher for 30 years, and is one of the most voracious readers I know. I have always loved this story because it reminds me to…

I recently got a brochure in the mail from Camp Ramapo. I’m not really familiar with them, so don’t consider this an endorsement. You’ll have to do your due diligence. But I think I’m comfortable endorsing the concept. It is a “traditional summer camp experience for children with social, emotional, or learning challenges.” So I thought this was an opportunity to address the issue of social/emotional development. This is not my wheelhouse. I am the first one to admit this. Outside of the problems that my impulsivity caused, I never had social problems. more than any average kid. But, I see it more and more with some of my clients, but even more so with the kids of the parents in my support group. I don’t really have expertise in this area. But the pattern that I see is that the traditional remedies like social groups, lunch groups, etc. don’t always seem to be effective for some ADHD kids. My guess is that this is primarily because of two factors. The first is that anger that many ADHD kids experience is not conducive to such a group. Second, these groups usually are composed of kids of different social levels with different social issues. Often the ADHD kids are resentful about being in a group with kids on the spectrum etc. And their attentional issues make it very difficult to be patient about other kids issues if they don’t look like their own. Anyway the reason I decide to post on this is because the camp brochure got me thinking about how much better a social “group” would work better for these types of kids if the group was a whole camp, where some self selection could occur and where the learning could happen in the context of fun. It might…

I was listening to one of my favorite podcasts the other day and got the distinct feeling that the topic was skirting around a topic that I discuss with my clients all the time: stimulation seeking behaviors. The whole podcast is interesting. But, I made a note that about 30 minutes in was a particularly relevant portion. Unfortunately, I can’t remember what it was or why it was so relevant… I was driving at the time. So, I’m grateful that I accessed any of my mental note on the topic.