Associate Professor Erin Schoenfelder Gonzalez   Hi, I’m Erin Gonzalez. I’m a Clinical Psychologist  and I’m going to talk about common myths about   ADHD and what the research tells us about  which ones are true and which ones are busted. Our first myth is, “My child will outgrow ADHD.”   For the most part, this one is false. We used to  think of ADHD as a childhood disorder and that   by the time you turn 18, you’re an adult, it’s  no longer going to be an issue. Our research   shows that that’s true for about half of kids.  By the time they’re 18, they won’t technically   meet criteria for a diagnosis of ADHD anymore, and  that’s often due to brain development catching up,   learning good skills for how to handle  distractibility and disorganisation,   and the very real phenomenon that hyperactivity  gets to be less and less over time. But that means about half of kids diagnosed with  ADHD will still meet full criteria to be diagnosed   with ADHD as adults. And what more recent research  shows is that even if you’re not diagnosed with   ADHD as an adult, you’re probably going to have  some lingering symptoms. Almost everybody with   childhood ADHD has some symptoms that last  into adulthood, usually things related to   organisation and keeping track of your schedule  and things that you need to bring with you. So, that means it’s not a great  idea to just wait and see with   ADHD and hope that it gets better over  time. It is really important to figure   out if that diagnosis fits your child and  start setting them up for success early,   getting them resources they need and possibly  treatment that they need so they can have the   skills into their teen and adult years to prevent  ADHD from being a major problem in their lives. Our next myth is, “ADHD is over-diagnosed.”  This one is actually mostly true. The rates   of diagnosis of ADHD have been skyrocketing,  especially in the last one to two decades.   ADHD is talked about in pop culture, in the  movies, in the media, a lot. There’s a lot   more awareness of it, so people are going out and  actually asking to be evaluated and diagnosed with   ADHD, which has not been the case in the past.  That also means that a lot of people are getting,   kind of, quick, hasty evaluations or being  told, after just a few minutes of conversation   with a professional or Doctor, that yes,  they do have ADHD and they need treatment. Doctors are great at diagnosing ADHD, but there  should be a process of looking at rating scales,   of how the symptoms show up in different  situations, and ruling out any other possible   explanations for that distractibility. And  unfortunately, there’s often not a lot of time   to do that in typical Doctor visits. So, it’s  true that although we believe that the rate of   ADHD in the world is about 10%, which is really  high to begin with, some places have rates of   diagnosis as high as 15% or even higher. So, yes,  ADHD is over-diagnosed, especially in populations   of people who have a lot of resource and  a lot of trust in the medical system. However, the reason it’s only mostly true is  that there are many people with ADHD who don’t   have access to evaluations to get that diagnosis  in the first place. Especially groups of people   who don’t have as many resources, don’t have  access to good medical care or have had bad   experiences with medical professionals in the  past. So, some people who would really benefit   from getting that diagnosis and getting access  to resources and treatment are going undiagnosed.   So, that’s why it’s a little bit complicated,  but for the most part, yes, I think we can all   agree that ADHD is being over-diagnosed  right now and you need a really good,   thorough, careful evaluation to make  sure that that diagnosis is accurate. Our next myth is that “You have  to be hyperactive to have ADHD.”   This one is definitely false. Back in the 80s and  90s, we really mostly believed that hyperactivity   was a core feature of ADHD. I mean, you think  of kids who really can’t stay in their seat,   or climbing on things, running around,  way more energy than other kids.   But we know now that’s only about 50% of  people with ADHD or children with ADHD   have that hyperactive piece, and about 40% have  just the inattentive piece. That final 10% are   people who have only hyperactive symptoms and  no distractibility. That’s, kind of, unusual. But yes, it is possible to have ADHD predominantly  inattentive subtype. This used to be what we   called ADD, and that means you’ve got the  symptoms of distractibility, inattention,   losing track of things, having  trouble with organisation,   but you don’t have a high energy level.  You might have an average energy level,   or even sometimes a slightly below average  energy level, compared to other people. Our next myth is, “If my child can focus on  videogames, then they don’t have ADHD.” I hear   this one from parents a lot. They may see that  their child can, kind of, hyperfocus, sometimes   for many hours, on things that are exciting, new  or interesting to them. Often, that’s videogames   or something else creative, playing with Legos,  building things, doing a creative art project,   and this is very much a common part of ADHD.  ADHD is not actually a lack of attention and   focus. It’s what we call a dysregulation  of attention and focus, which means that   you just can’t control well what things can  hold your attention and which things can’t. So, when a person with ADHD finds something that  they love that’s really exciting, that gives their   brain a lot of that dopamine reward chemical, they  can zoom into that and focus, sometimes, for many   hours. This can lead to a lot of creativity,  new ideas, outside of the box thinking.   But even if your child can hyperfocus for hours on  one thing, they may struggle to focus even for a   minute or two on other daily tasks that aren’t  giving them that dopamine and sense of reward.   So, this one is busted. It’s very much the case  that even if your child hyperfocuses, they could   still have ADHD and inattention that’s causing  a big impact on other areas of their lives. Our next myth is, “Therapy can cure my child’s  ADHD.” I think we often believe that if there’s   a mental health issue going on, therapy should be  the go-to, “Get my child a great person to talk   to, who can motivate them and help get them  to focus.” But this myth is really busted,   especially for younger children. Talk therapy,  one-on-one therapy in a professional’s office,   just doesn’t lead to learning and practising  skills that can be used in everyday life.   So, kids with ADHD really need support at  what we call the “point of performance,” or,   basically, in the real-world setting. Kids  are going to learn skills by having adults   give them feedback and structure in the  classroom, during their daily routines,   during sports activities, at social  events. And therapy, one-on-one therapy,   actually doesn’t have any evidence to help control  ADHD symptoms and definitely not to ‘cure’ ADHD. So, for younger kids, especially, the first  type of behavioural treatment or therapy that   will help is actually working with the parents,  because you’re there many, many hours of the   week. If you’re equipped in a coach role, your  child’s getting lots of intervention in their   real lives, rather than one hour a week in  an artificial setting, like a quiet office.   So, for – if ADHD is the main  concern you have for your child,   look into parent behaviour management  training rather than individual child therapy. Our last myth is, “ADHD medications  will change my child’s personality.”   This one is mostly false, but there are some  situations where it can be true. If your child’s   medications are being very carefully managed and  the dose is the right fit for them and the type of   medication is the right one for them, you should  see their wonderful personality shining through.   It is true that ADHD medications can make kids  a bit more serious. They’re not going to be as   silly and distractible, so sometimes, that seems  a little bit different from their usual sunny,   cheerful, hyperactive personality, even,  but it shouldn’t change who they are. Sometimes I hear this concern  from adults who knew people,   or who themselves took ADHD medications back in  the 90s, when we knew a lot less about how to   dose them correctly and they weren’t formulated  in quite as helpful of a way as they are now.   There have been tonnes of advances in medications  for ADHD in the last ten to 20 years, so that they   now release very gradually, and we avoid that  situation where they have a very strong effect   and then, they wear off very sharply. So, if your  child’s personality is really drastically changed   by medication, or if you see your child  seeming really flat or like a ‘zombie’,   it’s a good idea to talk to your Doctor. That’s  not a side effect you should have to tolerate and   there are many, many options of medications that  would be likely to be a better fit for your child.