Speaker 1: This is Ellen Stewart, the pushy broad from the Bronx, saying,
Speaker 1: remember everybody needs a little push.
Speaker 2: From the pushshit broad from the Bronx, New York at Home.
Speaker 1: Welcome Transformation Talk Network listeners. My name is Ellen Stewart
Speaker 1: and I am the pushy broad from the Bronx. Welcome
Speaker 1: to my show Recovery Recharged, where we share advice and
Speaker 1: support from experts in addiction and recovery and today's special
Speaker 1: behavioral health. I know this is something that many of
Speaker 1: you mothers out there are going to be very concerned about.
Speaker 1: We are talking today about ADHD attention deficit hyperactivity disorder,
Speaker 1: and I have my expert today and we're going to
Speaker 1: ask her a lot lot of questions so that we
Speaker 1: can unlock some real hope for parents and talk about
Speaker 1: the latest treatment in ADHD treatment for young children and adolescents.
Speaker 1: So the push she brought from the Bronx is introducing
Speaker 1: to you today a woman by the name of Carrie Russige.
Speaker 1: Let me tell you about her. After years of working
Speaker 1: in intensive settings, Carrie formed a virtual mental health practice
Speaker 1: to support children, teens, young adults and parents especially. So
Speaker 1: I want you listening in and taking notes, and as
Speaker 1: a licensed clinical social worker, she specializes in ADHD, trauma, anxiety,
Speaker 1: and depression. So I am very very pleased to introduce
Speaker 1: to you Carrie Russige. Hi there, Carrie. How are you today?
Speaker 3: Ellen? I'm doing great. How are you?
Speaker 1: I'm good? Thank you. I really appreciate this. You know,
Speaker 1: I do a recovery podcast, and that means that we
Speaker 1: talk about addiction, and we talk about substances, and we
Speaker 1: talk about how that sometimes overlaps with a behavioral health
Speaker 1: or a mental health diagnosis. And one of the most
Speaker 1: prevalent diagnosis that we hear and the term gets bandied
Speaker 1: about continuously is ADHD, and we don't know exactly a
Speaker 1: lot about it, and that's why we want to hear
Speaker 1: from an expert, and certainly we want to be able
Speaker 1: to catch the signs and signals early. So let's start there.
Speaker 1: What are some of the early signs that small children
Speaker 1: might exude that would constitute the possibility of ADHD and
Speaker 1: parents should look out for.
Speaker 3: Great question.
Speaker 4: So, ADHD is a neurodevelopmental disorder which primarily affects our
Speaker 4: prefrontal court. So for those that are watching on video,
Speaker 4: that's kind of this front center part of our brain here.
Speaker 4: This is our thinking center, This is where we process information.
Speaker 3: This is our executive function.
Speaker 4: So we know that ADHD is a disorder of executive function.
Speaker 4: Typical developmental toddler behavior. We're seeing kids running, jumping, having
Speaker 4: a hard time sitting still, maybe feeling like they're constantly
Speaker 4: in motion. So when we're looking out for early signs
Speaker 4: of ADHD, these symptoms are going to be the ones
Speaker 4: that are disruptive to their daily functioning and likely having
Speaker 4: a negative impact in different areas social, emotional, academic, etc.
Speaker 1: Okay, so when you're talking about running all over the place,
Speaker 1: certainly children do naturally run around all over the place. Right.
Speaker 1: I substitute taught for kindergarten. Okay, that was probably the
Speaker 1: hardest thing I've ever done in my life and probably
Speaker 1: will never do it again. So what's the difference between
Speaker 1: normal running around and the H in ADHD, which means hyperactivity?
Speaker 1: So lay it out for us.
Speaker 3: Okay, sure, sure, it's a really good question.
Speaker 4: Typically, what we tend to notice, especially as adults and
Speaker 4: sometimes kids and peers too, are the behavioral manifestations of ADHD.
Speaker 4: So those are the kids that can sit in their
Speaker 4: seat at school, are constantly getting up and down, are
Speaker 4: running and jumping to the point where they can't stay
Speaker 4: maybe with their caregiver, right, and so maybe there are
Speaker 4: some safety issues. Really typical are intense emotional outburst, difficulty
Speaker 4: regulating and self soothing themselves, and often difficulty with transitions.
Speaker 4: So maybe coming in from school or getting out in
Speaker 4: the morning to go to school, and especially following multi
Speaker 4: step instructions can be particularly difficult.
Speaker 1: Okay, so now we're talking kids that are a school
Speaker 1: age is there something that we should look at beforehand?
Speaker 1: We have lots of young mothers that are listening in,
Speaker 1: so what about toddler behavior?
Speaker 4: Yeah, So the reality is whether we're talking about an
Speaker 4: ADHD disruptive behavior or we're talking about disruptive behavior in general,
Speaker 4: the treatment is not necessarily different. And what I mean
Speaker 4: by that are the strategies that we use.
Speaker 3: To manage them. So if we're concerned.
Speaker 4: About our toddler behavior, I think a great place to
Speaker 4: start is just talking to your pediatrician, starting with like, hey,
Speaker 4: this is what I'm noticing.
Speaker 3: Is this typical?
Speaker 4: And if we bring it back again to those younger years,
Speaker 4: it's going to be those disruptive behaviors that are getting
Speaker 4: in the way of maybe safety or being able to
Speaker 4: function fully in their everyday lives.
Speaker 1: I see, okay, so I know that you're doing us
Speaker 1: a long time when you can see the signs, and
Speaker 1: certainly the professionals can see the signs. So what should
Speaker 1: you touched on it for a moment? But what should
Speaker 1: parents do? How is the child actually diagnosed ADHD, properly diagnosed?
Speaker 1: Where do they go? What do they do?
Speaker 3: I like that you use the term properly.
Speaker 4: I think because of all the information on social media,
Speaker 4: a lot of us have become our share therapists are
Speaker 4: diagnoses and we really want to make sure that we're
Speaker 4: our child is getting a proper assessment. What that means
Speaker 4: is taking them to a qualified professional. So again, we
Speaker 4: can still with the pediatrician, we really don't we don't
Speaker 4: want to be diagnosed there. We want to be referred
Speaker 4: to a psychiatrist, clinical therapist, psychologists, someone that can do
Speaker 4: the proper testing.
Speaker 3: What do I mean by that?
Speaker 4: That involves an assessment with the child, that involves an
Speaker 4: assessment with the caregiver, and that involves an assessment with
Speaker 4: the school.
Speaker 3: Feedback from the.
Speaker 4: School, parents, caregivers and teachers they're with the kids the
Speaker 4: most time, they have the most valuable information, and so
Speaker 4: it's taking all of that information and the child's report
Speaker 4: of what they're experiencing that's ultimately going to give you
Speaker 4: a diagnosis.
Speaker 1: Okay. So it also helps that when we're going to
Speaker 1: a clinician for an assessment that we bring up some
Speaker 1: of the things we're seeing and try to look for
Speaker 1: a clinician that has a specialty in ADHD. Would you
Speaker 1: say that would be appropriate?
Speaker 3: Absolutely? Absolutely?
Speaker 1: All right. So while we're at it, why don't you
Speaker 1: tell us where your license is and how people can
Speaker 1: find you.
Speaker 4: Yeah, so my clinical license, I'm a license clinical social
Speaker 4: worker is in New York, Connecticut, Massachusetts, North Carolina, and Florida.
Speaker 4: That's where I specifically can do my clinical work. Something
Speaker 4: we can talk more about is coaching and the benefits
Speaker 4: of parent coaching as sort of a primary modality for ADHD,
Speaker 4: which is a tried and true method and for parents
Speaker 4: that are looking for coaching that is actually something I
Speaker 4: can do multi state outside of those states.
Speaker 1: Terrific And on the bontom of your screen you will
Speaker 1: see where to get in touch with Kerrie, And would
Speaker 1: you say our website forest with the people that are
Speaker 1: just listening to us.
Speaker 4: Yes, So you can find me at Kerrie ruschlcsw dot com.
Speaker 4: I'm also on psychology today, but my website is definitely
Speaker 4: the best place to learn more about me, what I provide,
Speaker 4: and how you can get in touch with me.
Speaker 1: Terrific. All right, so let's go back to the actual
Speaker 1: ADHD and your specialty. The first thing I'm thinking is
Speaker 1: is it different in girls than in boys?
Speaker 3: It's a really good question.
Speaker 4: The way that ADHD is experienced in the brain is
Speaker 4: not different between girls and boys.
Speaker 3: However, it's often expressed differently.
Speaker 1: Give me an example. I mean when you say it's
Speaker 1: not different, but it's expressed differently, two distinct examples said
Speaker 1: parents can relate to.
Speaker 4: So, boys tend to be more externally expressive because of
Speaker 4: the way we socialize them. Girls tend to be more
Speaker 4: internally expressive. What does that look like? We tend to
Speaker 4: see more of the behavioral symptoms, the sort of disruptive
Speaker 4: symptoms from.
Speaker 3: Boys and girls.
Speaker 4: Actually, we tend to see more of the attentive symptoms.
Speaker 4: That means difficulty sustaining attention, internal disorganization, perhaps appearing unmotivated.
Speaker 3: They can often be called.
Speaker 4: Lazy or seen as lazy, having poor follow through, making
Speaker 4: careless mistakes, and so there girls are actually also there's
Speaker 4: a higher level of misdiagnosis, or actually they're undiagnosed because
Speaker 4: we can't see these symptoms.
Speaker 1: You know, that is true no matter where we go.
Speaker 1: There's a distinct difference in addiction as well between male
Speaker 1: and females because men and men and young adult males
Speaker 1: seem to be more overt in the behavior, which is
Speaker 1: exactly what you're talking about with ADHD symptoms. Right. I
Speaker 1: will have clients that will have committed some kind of
Speaker 1: minor crime or major crime. I have clients that will
Speaker 1: openly go out and do something, get into a car accident,
Speaker 1: flunk out of school, have you know, not be able
Speaker 1: to hold down a job. But a woman is much
Speaker 1: more introverted and isolated in their problems. And it seems
Speaker 1: from what you're telling me, to start at a very
Speaker 1: young age in terms of the way boys and girls operate.
Speaker 1: Would that be true?
Speaker 4: Yes, And of course depending on our environments upbringing, this
Speaker 4: might look different.
Speaker 3: But this is the trend that we tend to see.
Speaker 1: Okay, So I mean, if a child is suffering from ADHD,
Speaker 1: whether they are a boy or a girl, it must
Speaker 1: really affect their socialization and their life and their friendships.
Speaker 1: Give us an idea of how long that may go
Speaker 1: on and what that looks like.
Speaker 4: Yeah, so, regardless of gender, kids with ADHD, And when
Speaker 4: I say kids, I'm talking about children and teens. So
Speaker 4: when I say kids, I'm sort of using it as
Speaker 4: this blanket term. They can struggle interpersonally, specifically because they
Speaker 4: experience higher levels of social rejection because of their internal dysregulation,
Speaker 4: They might have higher rates of impulsivity. They might have
Speaker 4: difficulty reading social cues. So this might be your kiddo
Speaker 4: that is constantly talking and talking over people, which we
Speaker 4: that might disrupt some of our friendships, right or some
Speaker 4: of our relationships. Something that also can happen is there's
Speaker 4: a high correlation between whether no matter your gender, of
Speaker 4: kids with ADHD feeling like they're dumber or not as
Speaker 4: smart or not as capable of there as their peers,
Speaker 4: when in fact ADHD is not a disorder of intelligence.
Speaker 4: But because they're working so hard and because they're seeing
Speaker 4: people doing things that are more challenging for them to
Speaker 4: do that it can also cause low self worth, which
Speaker 4: can then, in turn also show up interpersonally.
Speaker 1: I understand not to mention the inner turmoil that the
Speaker 1: child is going through and every day over physical aspects
Speaker 1: like sleep problems and screen addictions, right, and even maldowns
Speaker 1: in young children or you know, or in teenagers. Do
Speaker 1: you find that's prevalent as well.
Speaker 3: I'm so glad you brought up screens.
Speaker 4: The reality is screens are a huge part of our life.
Speaker 4: You and I are on a screen talking to each
Speaker 4: other right now. It is how we function in this world,
Speaker 4: and there is no denying there. It doesn't matter how
Speaker 4: we try to reason. Screens are bad.
Speaker 3: For the ADHD brain.
Speaker 4: When we when we have ADHD, we are already starting
Speaker 4: naturally with the.
Speaker 3: Depletion of dopamine.
Speaker 4: So when we talk about addiction dependence, things.
Speaker 3: Like screens short form media, things that we can get
Speaker 3: easy hits of enjoyment with.
Speaker 4: No matter how you try to reason it, screens are
Speaker 4: bad for ADHD.
Speaker 3: They disrupt our thinking center.
Speaker 4: We don't have to put any thought into decision making,
Speaker 4: into self soothing when we have a screen in front
Speaker 4: of us. When we think about dependence, it's a similar
Speaker 4: feeling of when we are addicted to alcohol or other substances.
Speaker 4: I have something in front of me, I get that
Speaker 4: dopamine hit. I want to do it again. And when
Speaker 4: we have ADHD, we are more naturally depleted with dopamine.
Speaker 4: So if we look for things that will do that easily,
Speaker 4: screens is particularly one of them.
Speaker 3: So is negative attention, which is why there can be
Speaker 3: so much conflict of all I understand.
Speaker 1: Okay, all right, so let's go towards some of the
Speaker 1: home strategies here. Okay, what can parents institute daily routines
Speaker 1: or some kind of parental hack that can help a
Speaker 1: child and a teenager build focus, which is part of
Speaker 1: what ADG. That's the attention deficit portion of this journey, right,
Speaker 1: the inattention, trouble staying focused those things. What can pairs
Speaker 1: do in a daily routine to help strength and self
Speaker 1: control and focus at home with their child?
Speaker 3: The keyword there is routine.
Speaker 4: Kids and especially ADHD kids need predictability, consistency, boundaries.
Speaker 3: This has to be built into a structure. When we talk.
Speaker 4: About ADHD treatment, One of the actually most research tried
Speaker 4: and to treatment is parent training and what that means
Speaker 4: is how are we responding to reactivity? What are we
Speaker 4: putting in place so that our kids can be independent
Speaker 4: and learn to do things on their own. So we
Speaker 4: want to cultivate a space that promotes independence, confidence, and competence.
Speaker 1: You know, when you say parent training, I always think
Speaker 1: that parents need to be aware of the fact that
Speaker 1: it's not their child with the problem, and you don't
Speaker 1: hand them to as therapist and say please fix my
Speaker 1: child or take them to a a pediatrician and say
Speaker 1: is their medication right?
Speaker 3: Yes?
Speaker 1: Yes, okay, So now give us an idea about what
Speaker 1: you talk about and what you do when you say
Speaker 1: parent coaching in this arena.
Speaker 4: Yes, yes, so parent coaching, parent training, parent management training,
Speaker 4: behavioral training.
Speaker 3: These are all sort of interchangeable terms.
Speaker 4: What it means is we're working with the parents on
Speaker 4: talking about what are they experiencing at home, and we
Speaker 4: are focusing on improving the child's executive function. That doesn't
Speaker 4: mean connection. There are kiddos and parents that struggle with connection.
Speaker 4: When we're talking about ADHD, we're talking we're not talking
Speaker 4: about connection, and so we're talking about routine. We're talking
Speaker 4: about rewards and consequence system. What happens when X happens,
Speaker 4: How are we responding and while parents are generally loving,
Speaker 4: well meaning, we tend to we can do things that
Speaker 4: enable these behaviors that are disruptive.
Speaker 1: So it sounds like you spend a lot of time
Speaker 1: teaching parents how to handle ADHD situations with really practical solutions. Correct.
Speaker 4: Yes, evidence based, research based solutions.
Speaker 1: There we go. And that also includes some time management technique,
Speaker 1: some organizational skills, and probably how they can regulate their
Speaker 1: temperament so that they're not yelling and screaming or nagging. Yeah,
Speaker 1: let's address that for a little bit.
Speaker 4: Yes, So the research shows that the most effective parenting
Speaker 4: style is authoritative. This is different than authoritarian, which I
Speaker 4: think they're sometimes confused, which is also different than permissive.
Speaker 4: And so it's this idea of firm but loving. When
Speaker 4: we try to get down to our child's level too
Speaker 4: much and during times of conflict, we end up giving
Speaker 4: attention to the dysregulation versus if we take this authoritarian
Speaker 4: approach and use punitive measures, they're not actually learning independent.
Speaker 4: So it's about when you work with a coach, they
Speaker 4: can help you to find that line of authoritative. What
Speaker 4: is it that I'm trying to accomplish here? How can
Speaker 4: I do that effectively? And ultimately your relationship with your
Speaker 4: child will improve because of that.
Speaker 1: Okay, so can you give us some concrete examples of
Speaker 1: what that would look like? If my twelve year old
Speaker 1: is completely disruptive? The room is an absolute mess on
Speaker 1: a constant basis, can seem to be getting any task done,
Speaker 1: doesn't know how to move from A to B, and
Speaker 1: I'm ready to tear my hair out of my head.
Speaker 1: What are you suggesting?
Speaker 3: Yes?
Speaker 4: So, first off, your overwhelmed, as normal, the very overwhelming
Speaker 4: situation to be in, right, we have to address each
Speaker 4: of the behaviors separately. If we're talking about clothes all
Speaker 4: over the room, what are we doing about it?
Speaker 2: Right?
Speaker 4: Is it mom or dad or caregiver comes in and
Speaker 4: nags about it?
Speaker 3: The child is not feeling that consequence.
Speaker 4: So when we talk about rewards and consequence, it has
Speaker 4: to be things that the child can feel and can visualize.
Speaker 1: Like what say? What should I be saying to my kid?
Speaker 3: Yes, So it's.
Speaker 4: Less about the saying more about the doing. It's talking
Speaker 4: to your kids in advance and saying, Hey, here's the
Speaker 4: structure we're going to put in place. When you don't
Speaker 4: clean up your room, you don't earn TV time, or
Speaker 4: you have to do X, Y and Z things. You
Speaker 4: have to clean up your room, you have to do
Speaker 4: your morning routine, then you can earn a TV time.
Speaker 4: We want screen if if that's the motivator, right, if
Speaker 4: that's what's motivating your child, if they're motivated by other things,
Speaker 4: that's the reward and the consequences not earning that reward,
Speaker 4: they will feel that.
Speaker 3: And these things also have to be done in the moment.
Speaker 4: If we say, if you don't clean your room now,
Speaker 4: you're not going to get to see this movie a
Speaker 4: month from now, that is not going to resonate.
Speaker 3: They don't care.
Speaker 4: It has to be these in the moment, proportionate rewards
Speaker 4: and consequence to the behavior that they're going to feel.
Speaker 1: Do you find that a child that is more athletic
Speaker 1: and has more movement and maybe has good nutrition diet
Speaker 1: and exercise really makes a difference in ADHD symptoms?
Speaker 3: Yes.
Speaker 4: What you're talking about is how do we specifically improve
Speaker 4: executive function?
Speaker 3: So what we're talking.
Speaker 4: About with the parents are what do I have to
Speaker 4: do in place to help my child be independent?
Speaker 3: Successful?
Speaker 4: Right? Understand how to do things? We want to really
Speaker 4: improve executive function. We have to about down to the basics,
Speaker 4: what am I eating, how am I moving?
Speaker 3: What am I doing? Movement is vital for ADHD kiddos.
Speaker 4: Whether that is sports, whether that's just getting outside. There's
Speaker 4: actually a lot of studies that show being in nature
Speaker 4: physically looking touching, Looking at and touching nature improves our
Speaker 4: executive function. You can see it in in the neuroplasticity.
Speaker 4: Certain foods are linked to help with ADHD. Foods high
Speaker 4: end protein and that again comes back to foods that
Speaker 4: tend to improve improve cognition and neuroplasticity are ultimately going
Speaker 4: to help with ADHD. Getting things that help them with
Speaker 4: body awareness. A lot of kids why they this also
Speaker 4: can impact them socially, like they don't know how close
Speaker 4: they are to someone, or like when they're bothering someone.
Speaker 3: Get it in something like dance, something.
Speaker 4: Even sports where they team sports, they have to engage
Speaker 4: with other people in a certain way to get to.
Speaker 3: A common goal.
Speaker 4: You're helping them access creativity, body awareness, and ultimately improving
Speaker 4: these areas that are going to help with emotional control
Speaker 4: and behavior regulation.
Speaker 1: Well, that's certainly something that parents can do that seems
Speaker 1: very routine and appropriate and specific in terms of their tasks.
Speaker 1: So go rite out their parents and talk about diet
Speaker 1: and exercise and get your kids involved and moving because
Speaker 1: that really does help them. Okay, So now I want
Speaker 1: to ask your professional opinion. I want to know how
Speaker 1: you feel about whether or not and when it is
Speaker 1: medication appropriate to treat children for ADHD, and what you
Speaker 1: have seen in terms of the combination of medication and
Speaker 1: behavioral therapy or coaching therapy for the child, and what
Speaker 1: the evidence may research is showing these days. Because parents
Speaker 1: just want to say, give them a pill and let's
Speaker 1: fix it. So what's your photos? What do you yu?
Speaker 4: So the research shows medication is the ultimate, tried and
Speaker 4: true when it comes to improving executive function.
Speaker 3: That is also just one piece of the puzzle.
Speaker 4: Not every parent wants to put their child on medication,
Speaker 4: and I understand that there is a lot of misinformation
Speaker 4: out there. So I think you can just starting with
Speaker 4: talk to your doctor, talking to psychiatrists and understanding what
Speaker 4: is involved. Here are we what type of medication, What
Speaker 4: does that mean for my child?
Speaker 3: What are the side effects?
Speaker 2: All of that?
Speaker 3: Right then, right next to.
Speaker 4: That is the parent coaching that is shown to have
Speaker 4: the most benefits for kids and improving their executive function
Speaker 4: and overall independence. Where therapy comes in tends to be
Speaker 4: more helpful for teens and adults because there's treatments like
Speaker 4: cognitive behavioral therapy CDT, which helps teens and adults get
Speaker 4: that are connected with their thoughts, feelings, and behaviors. It's
Speaker 4: actually not shown to have a helpful improvement for young
Speaker 4: kids with executive functioning difficulties because they have a harder
Speaker 4: time accessing their thoughts, feelings and connecting it to their behavior.
Speaker 1: I see, okay, So it's up to the individual child
Speaker 1: in terms of their symptoms, and it's also up to
Speaker 1: the individual parent and the people that they're working with,
Speaker 1: and I completely understand that. So we only have a
Speaker 1: short amount of time left. So give us a hopeful
Speaker 1: message for parents who are feeling overwhelmed, one or two
Speaker 1: easy things to give them early help and helping them
Speaker 1: to change their child's future. What can they do right away?
Speaker 1: Thirty seconds go?
Speaker 3: Yes, so overwhelmed as normal.
Speaker 4: Again, we're not giving parenting manual. We're sort of just
Speaker 4: thrust into these things. So ADHD is not a curse,
Speaker 4: and in fact, if we use it in the right way,
Speaker 4: and I often when I work with kids with ADHD
Speaker 4: or even parents, I talk about it as a superpower.
Speaker 4: We do beautiful things with ADHD. We are often more creative.
Speaker 4: We can think outside the box. We can see solutions
Speaker 4: to problems that are not directly in front of us.
Speaker 4: We can be really outgoing. We can put our energy
Speaker 4: into these beautiful places. So we want to hone in
Speaker 4: on our kiddo's strengths we don't, and we want to
Speaker 4: put those establish routines that are going to ultimately help
Speaker 4: that they do that both at school and at home.
Speaker 1: Fantastic. Thank you so much, Carrie, and I want you
Speaker 1: to take a good look at this. Save this clearies,
Speaker 1: listen to it again. ADHD Kids Unlocked, There is hope.
Speaker 1: This is Ellen Stewart, the Pushy Broad and the Bronx
Speaker 1: saying thanks for listening and we'll see you next time.
Speaker 2: She's a pushy broad from the Bronx, New York. Follow
Speaker 2: her voice, a stray dog, a nice She's a pushy
Speaker 2: broad from the Bronx. Oh yeah, don't be surprised if
Speaker 2: you wanta this or twice. Make decisions, find the right choice,
Speaker 2: no yourself, better find your own voice. It's okay. We
Speaker 2: need today because everybody needs a little push from the
Speaker 2: pushhit broad from the Bronx New York, that let out,
Speaker 2: let that at home,