ADD is not a single issue, but a collection of issues with varied symptoms and coping methods, and which he is likely experiencing to different degrees of severity.

Thus, in my 20 years of experience coping with it, I've found the concept of ADHD to an unhelpful abstraction. Push past it and learn about all of the individual underlying issues and related concepts (attention and focus, memory (paying special attention to working memory), capacity for organization and planning, mental flexibility, emotional regulation, impulse control). Figure out how badly these individual issues affect him (they make workbooks for this purpose), then work consistently and patiently to help him understand them and to build up toolkit of coping mechanisms.

If he goes on medication, I would encourage you to investigate appropriate dosing and ensure that he starts out as low as possible so as to minimize the negative impacts. You would expect doctors to do this as a matter of course, but in my experience they do not. Don’t let some jackass turn your nephew into a zombie by proscribing 50mg of Vyvanse when 5mg of Ritalin could be both more beneficial and cause less of a change on his personality.

> you would expect doctors to do this as a matter of course, but in my experience they do not.

My experiences match this as well. After my diagnosis from a dubious battery of psychometrics and interviews from a psychologist, I was expecting the actual psychiatric care to be, I don't know, more scientific?

However, I was met with just simple brute-forcing medications and dosages. No measurements of any kind were ever taken. I'd just get asked questions like, "How do you like <medication>?" or "How is <medication> working for you?" Depending on my answers, dosages were either adjusted or some other medication was thrown at the wall to see what would stick.

Asking questions like, "How do I know if <medication/dosage> is truly working as intended" or "What should I expect to change in my life from taking <medication/dosage>?" were questions that I was never received a satisfactory answer.

I quit going to psychs a fews year back and only go to my GP now. Honestly, the care has been substantially better and somewhat more holistic too. I can actually see what good/bad effects medication(s) have on my body (blood pressure, heart rate, etc.), which various psychs, never measured a single time in almost a decade of care.

A little more on this topic. No teenager with ADHD will be interested in doing the work I've described above. If his parents aren't interested in it either, your ability to help will be severely limited.

One way to help him to do this work will be to get him out of his intellectual comfort zone. Encourage him to take on tough but fun projects (building big models, electronics kits, doing NAND to Tetris, etc) that will require foresight and planning. Make yourself available if he gets stuck, so that you can help explain that hard problems are only hard if you lack the mental framework required to parse and subdivide and organize them into simpler sub-tasks. If you can get him to sit back and think about how to solve hard problems, you'll be giving him a transferable skill which will be integral to working through life with ADHD and minimizing its impact--and you can do it without actually broaching the topic.

Hey there, M33, got diagnosed adult with late 31, so take what I say with a grain of salt.

I have immediately had access to both medication as well as ADHD focussed psychotherapy.

ADHD is the best treatable neurological condition of all with medication and if you can have access to where you live, it's the first route I'd try to access.

Once you have access to meds, nobody can require you to take them as prescribed to keep access, but in my experience, having access is invaluable.

I do not take meds extremely regularly, albeit my daily life as a software developer is much less rigid than it was during my school years.

I won't be needing meds on days where I know for example I have few or no meetings and can uninterruptedly work on a task I enjoy.

And I don't stress on days which I know are fuller or which require more work which I'd typically find rather boring.

That brings me to the second most important point: Finishing school, getting a degree etc. are for me personally very important still.

What I really wish I'd understood earlier is that I'd have rid myself on societal definitions of "success" and just focussed on my strengths.

For me and others I've met with ADHD, reinforcing strengths through receiving motivating rewards is THE system that works.

If it is enjoyable, ADHDers excel at given tasks far beyond what I've seen other people do. We're maximizers for that positive neurotransmitter reward.

Trying to make something unfun fun with (the threat of) discipline just leads to minimizing effort for task achieval.

> ADHD focussed psychotherapy

How does anyone even find this? I find there is a lot of signal vs. noise in this realm of care. What I mean, many professionals list that they treat ADHD, when it's clearly apparent they only list that for marketing purposes. The actual care provided is either antithetical or completely unhelpful -- at least for me.

For example, of the many psychotherapist I have seen, I would often be given advice to make a schedule or a To-Do list, which let's be honest, is common fucking sense, and things I already did/still do.

If I were perhaps struggling to do something, the advice given would be something like, "Well, you just have to get it done." Wow, can't believe one needs a masters degree for that sophisticated level of wisdom. . .

I live in Berlin, and the therapist I found was experienced, i.e. very familiar with common patterns and psychological problems (long term depression caused by adverse life effects, masking, rejection sensitivity, executive dysfunction) in late diagnosed adults.

Working with that person was invaluable for me.

That said, I met them through a personal referral of another ADHD friend and have met several other psychologists before in life with whom I never clicked.

Online services should make finding a good therapist easier accessible than ever before.

All as I can say is if it doesn't feel right, it isn't. No biggie. Keep looking and seek out another person.

You'll know if you found someone with whom it works cause there'll be clear progress early on.

Did you mean to say there is a high noise floor with little signal?

A lot of spectrum disorder diagnoses are misdiagnoses for other (medical) things. The diagnoses are often used as a catchall when no one can figure it out.

For example, chronic heavy metal poisoning mimicks ADHD or ADD diagnoses, blood tests alone are useless because its bound to tissue very quickly after exposure (and bioaccumulates unless a chelator is taken). Toxicity for a number of other substances also presents similarly to these diagnoses (flouride, pfas, microplastics).

I fail to see how your recurrent relativization of the existence of ADHD has anything to do with effective psychotherapist treatment of clear symptoms.

Also, do you have reliable sources for this poisoning hypothesis?

Symptoms don't mean what you seem to think they mean.

Medical issues related to toxic exposure are medical issues, not something that can be resolved by psychotherapy.

See my other post on how to find those reliable sources, or just ask your doctor if this ever happens.

Syptoms in the context of ADHD mean exactly what I think they mean.

ADHD is irreversible, it's not something that can be reversed or goes away on its own.

There is literature on a link between fetal heavy metal exposure and ADHD development.

I can't find anything on neurotoxins "mimicking" ADHD.

Again, by the very biological definition of what happens in a brain on ADHD, this is not reversible. It's chronic.

Sources:

1: https://my.clevelandclinic.org/health/diseases/neurotoxicity

2: https://pubmed.ncbi.nlm.nih.gov/36972880/

You clearly don't know what you are talking about, and you lack the appropriate rigor needed for a proper discussion. Best of luck to you.

> For me and others I've met with ADHD, reinforcing strengths through receiving motivating rewards is THE system that works.

Do you have any specific examples of what that could look like? I have tasks I’m motivated to do, but introducing rewards for ones that I’m not motivated for always feels artificial

Background: I studied psychology and I have very close cases of AD(H)D.

Psychotherapy sometimes feels artificial since if what works would feel natural or obvious, well... we wouldn't need therapy, which is a handcrafted intervention (n=1). This is *really* important to remember while you are trying to improve/do therapy. More on this later [1].

A better mental model for reward-based interventions is to think about your inner "reptile brain" as a weighted graph that connects things (stimuli) with emotions and behaviors. Those connections are mostly learned throughout your life (and therefore "artificial"). And your brain is trying to find the happiest (and laziest) path in this graph.

A very motivated person tends to have a great graph that connects stimuli like "answering emails at 9:00 with music" to "happiness" or "hitting the gym" with "muscle soreness" and with "happiness with realization" and "tasting the morning coffee."

If your lazy, hedonistic, dopamine-maximizing brain does not have a path from the behaviors you want to create (e.g., answering emails) to something pleasant, it will be hard to make that a habit.

In a very explicit way, this sometimes looks like a point system. But don't think about the points. You have two very important tasks:

1. Find your "natural" rewards: coffee, watching TV shows, going for a walk, whatever you want to do, sex. And don't forget about internal rewards: self-respect, pride, nice words for yourself. Add to the mix social rewards: share your achievements... Each person is more sensitive to a different set of rewards. Find yours and pick the ones that make sense for your life context.

2. Make those rewards contingent on your goals. For example, I try to answer important emails first thing in the morning, especially those I want to avoid, and after that I go out for a small walk or have some tea.

Over time, you will internalize that conditioned (artificial) emotion for tasks that before felt horrible. Like many are able to feel nice when they have muscle soreness, because it was conditioned over time to something nice: social reward, internal/verbal rewards, techno music, whatever.

Don't forget to be nice to yourself, start simple with small goals, forgive yourself if you don't hit every goal at the beginning.

[1] Understanding this helps a lot in therapy or "self-intervention" because if you don't understand basic behavioral intervention and why it works, sometimes the intervention itself seems childish or stupid, and that hurts the efficacy. There is a huge body of research that shows that if the patient understands the therapy and has a mental model of it, it works like magic because we change from "I am doing stupid things because my therapist is saying them" to "I am nailing this, what a behavioral change I am making. That's great—in a few weeks I will be able to do X."

I firmly believe the acronym is incorrect. It is not a deficit; it is an advantage in some ways.

I'm a software dev.. Been so for > 30 years, and I can tell you that ADD is a super power. ADD is not so much that you cannot pay attention. It's that you pay deep attention to the "wrong" things.

I bet if you sit your nephew in front of a video game they disappear into it. This getting into the zone like flipping a switch is an amazing skill to have when programming. It's a nirvana like state, programmers dream of.

Your nephew will sit in class and not hear a word his teacher says, because a bird outside has him in the zone.

Get this kid into a coding boot camp.

I am strongly of this view. ADHD seems like a maladaptation in modern times, but in the right context and the right environment it is a superpower. Until this realization a few yrs back (when I was in my early 40s), life was a struggle. Now that I’m aware, it’s less painful.

“Deficit” is context dependent.

> The diagnosis is not a complete surprise but it is hard on him.

My understanding of available evidence is that an ADHD diagnosis isn't helpful for everyone. This is partly due to societal stigma and lack of understanding of what ADHD is.

I can highly recommend Russell Barkley as a source of scientific information on the subject.

> He has always had problems concentrating at school, for instance he is good at math but would often misread the problems and answer the wrong question. Do you have advice for him to be able to go through his teenage years?

Know yourself. Cognitive function and executive function are different. Executive function impairment can be contextual. With time secondary and tertiary symptoms might develop depending on how well he treats his condition.

State of the art ADHD treatment is multimodal, i.e. you treat it many different complementary ways. Depending on severity medication is a very important part of it.

I would echo this and share with the parents: https://www.youtube.com/watch?v=SCAGc-rkIfo

Also Russell Barkley has since fully retired though has been very active in diaseminating what's happening in (good and bad) research, plus other lectures on https://www.youtube.com/channel/UC0tLWu7ljYVFPiZQfHjTMsA

First of all, ADHD is often co-ocurring with other things, like autism.

Second, medicine is helpful, but it's not a panacea. Also, two common ADHD medicines in the US face FDA-imposed shortages, so prepare for many calls to the pharmacy.

Also, ADHD is not just hyperactivity and attention--it impacts emotional regulation, impulse control, task initiation, time management, and other things related to executive functioning.

Finally, ADHD isn't bad. I like to think of it as an insanely strong, overenthusiastic hippopotamus--if you work with it and get to know it better, you will be able to have a hippopotamus friend, which sounds handy, but there's always the risk of it getting a little too excited and breaking stuff.

This is super spot on.

The biggest limitation I have observed with poorly managed ADHD is short-term memory management. Everything else might be a more obvious social indicator, but nothing impairs real world performance like forgetting things in the short term. It means things get lost, tasks remain unfulfilled, instructions get jumbled.

If through regular practice you can teach an ADHD child to improve this everything else gets better as well. You aren't going to fix the brain of a child with ADHD but you can teach solution management and coping strategies through repetition. Its the same with dyslexia in that you aren't curing the dyslexia but instead teaching how to circumvent it.

ADHD can be a super power. Focusing on multiple things simultaneously is really draining, but people with ADHD tend to perform this well so long as they can remain consistently engaged. That is a fantastic capability for operations jobs.

Oh yeah, how did I forget the memory stuff? Working memory is a common issue (as, I think, is conversion from short- to long-term memory).

...This was accidental and not me intentionally forgetting about memory.

I think regardless of the medication decision, a diagnosis like this is a wake up call for self awareness.

Have him start paying attention to himself. Two things that spring to mind are the effects of caffeine and protein. Caffeine causes jitters in normal people and I’ve seen it have overwhelming effects on mentees with concentration difficulties. In one mentee it made concentration impossible. He has now cut it from his diet entirely. When I was mentoring my nephew he was significantly more capable after a protein breakfast compared to a carb breakfast.

Focus on things that work (quiet settings for example) and learn to cope with the things that don’t (my friend has adhd and through coping is immune from distraction, he’s always distracted so he’s always returning from distraction).

Knowing that he’s at a disadvantage he can slow down. Simply consciously going slow and reading things twice can change everything. I knew I was at a disadvantage in my first university course so I read the assigned reading twice. I ended up with the highest grade in the class because I worked to overcome my disadvantage. The coping mechanisms he creates to overcome a disadvantage can become a super power.

There might be simple and easy things that have a huge effect on his ability to concentrate, but he might only notice if he slows down enough to pay attention to them.

Remember your nephew is still a kid with a brain that is developing for some more years.

Taking medication _now_ may be counter intuitive for future development, as the brain never gets a way to fully (under)regulate/calibrate dopamine release on it's own until maturity.

Finding ways to learn that help him. Ex: - Short attention span? short repetitions of digestible chunks that he can relate to. - After school classes where someone is available for questions and some 1-on-1 help gets a long way.

> Taking medication _now_ may be counter intuitive for future development, as the brain never gets a way to fully (under)regulate/calibrate dopamine release on it's own until maturity.

OP, please review this video [0] about the neuroprotective effects of stimulant medication for children and teens with ADHD, or the summary here [1]. If these effects are real and turn out to be limited to or strongest in early life, eschewing medication now could be squandering an opportunity to improve brain development that won't recur (quite aside from the cumulative academic impact of going through secondary education with inadequately treated ADHD). It's important not to default to thinking of avoiding medication as playing it safe. (There's plenty of research you can find on other aspects of ADHD medication, but I wanted to respond specifically to the point about brain development.)

[0] https://www.youtube.com/watch?v=_bQVq1oKpDw

[1] https://reddit.com/r/ADHDers/comments/1d4mxi0/adhd_medicatio...

Seriously, yoga.

Martial arts.

Painting. Crafts. Working on cars, bicycles, motorcycles, skateboarding.

These all have something in common: each has a goal, but these are individual pursuits. They require and reward focus, and succumbing to distractions will be obvious because progress will suffer.

I went down the music track around that age, and it was the gateway into daily routine, meditation, delayed gratification and a community similar to software (at least back in the day) that understands and embraces neurodivergence. It's now this life-long cornerstone that brings me deep joy and stability when things are too hard. It was probably one of the first places where I really felt seen by adults and found peers that got me.

Music! I missed that one, but yes, I think it fits right in.

I'm glad it has served you well.

Beyond meds and various coping skills that may be taught via therapy or advice on the internet, I have a nutritional approach that I found to be helpful as an adjuvant to meds. Meds like adderall or provigil tend to be demanding on the brain neurochemistry, so supporting the biochemistry becomes an important part of the strategy, rather than continually going back to the doctor to bump up the dose.

Mostly focus on Omega 3s (specifically DHA, cuz 80% of the brain lipids are DHA), Choline (via AlphaGPC or Phosphatidylcholine) and Magnesium Threonate (the only bioavailable form that can cross the blood brain barrier).

Other lifestyle aspects that are extremely helpful is exercise and focusing on high quality sleep.

Meds are great, but lifestyle is the other half of the equation that's too easy to overlook. I've gone from needing provigil doses at 200mg to about 1/8th of a pill these days and on most days, I skip it because they tend to be slightly too stimulating.

Hi there itchyouch, I appreciate your reply to my comment and the accompanying document you created: https://news.ycombinator.com/item?id=42379299

Updated my email in my bio, and also you don't have an email address in your bio. I see you also are interested on ADHD. I also was diagnosed with adult ADHD relatively recently. I'm in the process of finding what works for me. I'm interested in your supplement-based approach. I mostly overlooked it till now, basing my treatment approach mostly on the last ADDitude survey (https://www.additudemag.com/adhd-treatments-scorecard-medica...)

> Meds like adderall or provigil tend to be demanding on the brain neurochemistry, so supporting the biochemistry becomes an important part of the strategy, rather than continually going back to the doctor to bump up the dose.

Can you explain what you mean by this? Do the meds lead to overconsumption of scarce chemical resources in the brain?

I'd be glad if we could get in touch via email.

Depending on how severe your nephews ADHD is (and it can go from borderline ADHD to severe mixed type) it might be worth doing sleep training, eating training, stimuli training etc.

In all cases I would recommend multiple psychological education courses.

Sports and diet are very important - protein rich diet has protective effect on neurological system (doesn’t mean only proteins but make sure that healthy amount is included). For the sports: dynamic, unpredictable ones work well - Tennis, fencing, fighting sports etc. (fighting sports also help with confidence and can help mitigate effects of RSD if it coexist).

In general ADHD is very well researched and with guidance of competent doctor he’ll be fine. A lot of information and research is available, but a lot of snake oil too.

Raising diet is very important. Eating fast foods and drinking sodas daily will make a teeanger exhibit ADHD type symptoms. Many people do not think that caffiene is in colas, or energy drinks and etc. Poor diet has become so normalized that a doctor might not even ask about it.

It really depends on the environment I suppose. Caffeine is a stimulant so it’s common for ADHD bearers to self-medicate in it (my former associate, later diagnosed, used to drink full - 300ml - of espresso brewed coffee in the morning).

Sodas in my personal opinion is a different issue. While sugar content is no longer linked to ADHD symptoms it pushes out nutrients - and Omega-3 acids, proteins etc. have positive effect.

I have made a personal “experiment on a child”. Ensuring at least single egg or a single sausage is eaten during the breakfast (i.e. approx. 5-10 grams of proteins) decreased number of fights at school started by friend’s son (previously breakfasts were primarily carbs).

It’s possible to manage ADHD with small changes, that’s why education is the most important.

From my experience as a parent of a 11 year old with ADHD:

- we start the diagnosis process because he was very depressed as being bad at school, everything was hard, while there was no need.

- meds are fantastic, they let all his qualities shine. They do require some experimentation at the beginning. At the beginning I was not at ease with giving him meds, but it turns out there's no lasting effect, and the difference is night and day. Depending on the severity, meds are not mandatory when he will be adult

- ADHD people often have issues with handling emotions, that's why he sees a psychologist (avoid psychoanalysts at all costs, they cause so much damage) twice a month, to help him process, vent and learn how to manage them. That part is slow to improve but that's normal.

- if we hadn't done the process by ourselves, school wouldn't have detected it because it wasn't so explicit,and there's a lot of misconceptions. I strongly suggest reading books/blogs, to have the correct words to describe what kind of ADHD your nephew has. He needs to understand it too, that his brain needs glasses, it's nothing to be ashamed of (even if it's not easy)

- I really like this short book : https://www.goodreads.com/book/show/35888681-my-brain-needs-...

- you will have to monitor teachers and school, because some will be downright abusive, or will ignore your nephew 's disability. Others will be great of course, but school in general has troubles adapting...

- tools and methods will help a lot, actively experiment to find out what works and alleviate your nephew specific issues (attention? Excitation? Time blindness? Social interactions? Etc)

- sleep is key, melatonin is great

To finish, ADHD is not easy everyday (especially in normative contexts like school), but as others hinted it is also a strength, with lots of great qualities and intense emotions.

> others hinted it is also a strength, with lots of great qualities and intense emotions.

The universe can take our "strengths" back. I'd give anything to get rid of this disorder. The reality is that people can have strengths and great qualities despite ADHD and not because of ADHD.

I do appreciate the encouragement and reassurance of your message, but I do believe such talk only downplays the true severity of ADHD.

Which you can read a good synopsis in this journal: https://pmc.ncbi.nlm.nih.gov/articles/PMC8328933/

It's not easy every day that's for sure, and your experience as well as the studies are very clear on that. ADHD severity varies of course; the 5+ people with ADHD in my company do struggle at very varying degrees.

I'd like to be a bit positive anyway, because it gives more agency. My own experience is that by knowing how ADHD works, one can use it to focus on where it shines and avoid where it's definitely not great. People aware of their strengthes and weaknesses, whatever they are, are so much more effective.

The strong emotions, the energy from novelty, even the erratic curiosity are powerful capabilities in the right context : - fuel on anger to speak your mind when an inappropriate situation occurs and no one dares - use your energy to Kickstart new projects, and then give them to someone else to finish - emergencies often require to look everywhere before the root cause is found - etc

It would be easier without the emotional roller-coaster and focusing mayhem, but I'm convinced I couldn't do those things so well without ADHD .

To finish, I wish you all the best!

Just the usual caution that Melatonin can be effective, but it's also really easy to overdose a kid. Consult your doctor first if you decide to go that route.

https://ukhealthcare.uky.edu/wellness-community/blog/melaton...

There’s a lot of good advice here, and everyone I know is different about how to overcome executive functioning issues. But one bit I’ll add:

ADHD can be incredibly lonely. Not even in ways you are aware of until you are older. It’s easy to see the places you aren’t like others or adjusted for in school. There are minor imperceptible ways you might be reminded of this and in all likelihood, those closest to you don’t have it—e.g. teachers, parents. And often it’s framed as something to overcome.

So remind your nephew of what makes him different in amazing ways. And take time to value the things he cares about and excels in. I know that’s good advice for any child, but it’s so important when the world is telling you that you aren’t the same.

Medicate and try not to stop. Don’t avoid it, it’s life changing and the most effective intervention by far. None of the other stuff is nearly as effective. It is very likely turn their life around. As someone who was not medicated in his teenage years (Briefly in childhood and now all through adult hood. But was nissing all through school and it sucked). It’s a real life changer.

Look up Russ Barkley on YouTube. He’s a very well known and respected ADHD researcher and clinician that has some very engaging and informative videos. Here’s a taster: https://youtu.be/_tpB-B8BXk0

human nature is such that one cannot ever stay on low dose of any drug that feels good… this is why drug dealers will always give you “a taste” for free - they know you will be calling for more and more

completely wrong :)

there are always exception to the rule :)

I was diagnosed in my thirties. I knew something was wrong much earlier but I never had any idea it was ADHD, let alone a diagnosis.

Above all: treat him as an individual. There are a lot of stereotypes about ADHD that don’t really match how I experience it. Images of kids running around, can’t sit still, loud and disruptive. None of these were true for me. I was swimming in my own imagination all the time. I’m also extremely sensitive emotionally. I still have to be very careful managing my emotions. One unkind phrase can send can send me spiraling into depression or blind with rage (thankfully I am able to manage it a lot better these days).

Another tip is to work with the ADHD, not against it. If something isn’t working then change it up. Novelty can be a big motivator for people with ADHD. Maybe this means you have a new calendar system every 2 months? Accept it, run with it and enjoy it. Sure, it might be easier to use the same calendar system but that doesn’t work with the condition.

Focus on controlling the micro environment, not the macro environment. Should he go into medicine, law or engineering? Any of those could work well. But the way you succeed in any of them is having the right micro-environment for studying. Short bursts, flashcards, games, active and interesting ways of learning. Again, when something doesn’t work, change it up.

Finally, be and friendly, loving and guilt free as you possibly can. When I was younger I piled the guilt on myself. I was constantly upset that I wasn’t studying enough, wasn’t succeeding, wasn’t following the right path. All this guilt just led to avoidant behavior and worse outcomes. Whenever anything goes wrong try to face is as a curious scientist. What went wrong, how can we do it better next time? The guilt never helps.

ADHD is a very vague diagnosis, worth it mostly to get access to medications and extra support in school, if the parents want to pursue those paths.

I would encourage the parents or some close relative to read the diagnosis in detail and explore what that means for his life. Especially study scoring related to working memory, the ability to focus, ability to communicate, and indicative IQ. He doesn't have to be good at math. Plenty of people aren't. There are lots of hobbies, lifestyles and career paths that suit people with various "disorders" and variations.

My daughter has obvious problems related to ADD, and while we haven't really solved anything yet, the most important step for me so far has been to set expectations for us as parents. I no longer care what grades she gets in classes that bore her too much, or that are based on facts she can't seem to remember. I focus more on her well-being, on improving her learning skills, and on encouraging activities for her to excel in. She has some very strong qualities, and I much prefer if she pursues them rather than setting her up to fail consistently in something she's not naturally suited for.

personally, as a retired psychotherapist

Be very wary of ADHD diagnosis, The consequences are huge and have a massive impact on childrens lives.

I hate all ADHD diagnoses, for me I have always seen just naughty children who need time to develop at their own pace and not develop at someone else's pace or for the benefit of any school cariculum or parental needs.

Do not give any child medication to control ADHD, why would you give an amphetamine to any child

I have had this a few times working with children and I have always suggested looking into Dyslexia.

you say "he is good at math but would often misread the problems and answer the wrong question".

This for me is Dyslexia.

how can a child concentrate when he cannot understand what is in the books he is supposed to be able to read.

The child inevitably becomes disruptive so they are not shamed by adults or their peers for being stupid.

call a psychologist and have a Dyslexia test

> Do not give any child medication to control ADHD, why would you give an amphetamine to any child

This is totally unscientific advice putting your own personal opinion and values above patient outcomes and patient wellbeing.

This is unethical and goes against any professional medical standard.

Medicating a child who has ADHD can have significant long term benefits with regards to harm reduction (substance abuse, depression, risky behavior) and there is a mountain of evidence with long term studies to back this up.

How comments like yours can find their way onto a generally educated forum like HN is really beyond me.

Your lack of knowledge in this shows.

This introduction to the nature of the experience of the different symptoms associated with ADHD will help you understand your nephew. Really opened my eyes.

https://www.youtube.com/watch?v=ouZrZa5pLXk

From the description:

Here’s everything you need to know about Attention Deficit Hyperactivity Disorder (ADHD) in children. Get the transcript at https://www.understood...

Thomas E. Brown, PhD, discusses ADHD diagnosis, ADHD symptoms, available ADHD treatment options, and ADHD medication. As our expert says, ADD/ADHD is not a behavior problem. It has far more to do with the brain’s management system. Remember, ADHD has nothing to do with how smart a person is.

I can't recommend this video enough. I wish this research and understanding was available when I was a kid.

I figured out systems and tools to succeed in school and work (I was largely a C student testing in the top 0.1% of CA school kids on the standardized tests -- found that tidbit cleaning out my mom's things).

It was the rejection I experienced in peer friendships that scarred me deeply, and as someone who has been unmedicated into my 40s, still impacts my adult friendships and professional relationships.

ADHD: Essential Ideas for Parents - Dr. Russell Barkely https://www.youtube.com/watch?v=YSfCdBBqNXY

Some key tidbits to sell you (and your nephew's parents) on spending the full two hours with this:

"... it also helps families to understand some of the other life course risks 50 to 70% of ADHD children are utterly rejected by close friendships by second grade it is in fact one of the more devastating consequences of this disorder is this inability to make and keep close sustained friendships with others their children and it is heartbreaking for parents to see this happening that their child is not as liked as other children that the sleepovers the going to the movies and the other social events in which other children celebrate their peer relationships are shut off for this child why is it there the single best predictor of peer rejection is that symptom the emotional impulsiveness friends forgive you your distractability your forgetfulness your working memory problems and even your restlessness they will not forgive your anger your hostility the quickness with which you emote to other people because it is offensive it is socially costly so now we can begin to understand the numerous social problems that ADHD children are prone to because it arises from this aspect of the inhibitory deficit"

"explains the road rage during driving the job dismissals which are not the result of inattentiveness but of being too quick to anger too quick to express raw emotion in the workplace of which employers are not tolerant especially if it occurs with a customer and it also explains to us the marital difficulties and the parenting difficulties these children may be prone to because the single best predictor of marital problems in the adult with ADHD is not distractability it is emotion so we can begin to paint a better picture of understanding ADHD and its life course risks by understanding the nature of the inhibitory problem..."

> good at math but would often misread the problems and answer the wrong question

Graphics programming with vectors, matrices, shaders, procedural generation, physics simulation. I always hated math before finding that it is able to create worlds.

The child is in more danger from medications during the process of brain development.

Thats why their are different prescribing protocols for adults and children and why pregnant women do not take any drugs because they can damage the developing fetal brain.

Neuroplasticity refers to the ability of the brain to reorganize and modify its neural connections in response to environmental stimuli, experience, learning, injury, and disease processes. NOT taking while DRUGS,

Neuroplasticity refers to changes in brain structure and function throughout the entire lifespan of a human being.

damage the brain when a child is young and it is damaged for life.

Conversely, correcting brain development during active brain development can have very real benefits.

In this talk, Huberman discusses benefits of medicating a child: https://www.youtube.com/watch?v=sxgCC4H1dl8

I believe that school is a huge problem. Don’t give drugs, they can permanently mess up his mind.

ADHD and ADD are defense mechanisms the mind has. His brain is basically saying that what he is learning in school is a complete waste of his time. Even though we all do it, school is a really weird behavior! No animals do it and we aren’t designed for it.

I don’t believe that school is worth it for many people. They become business leaders etc.

Take him out of school and ask yourself what you would want if you were him. Then do it.

That’s my advice for anyone wondering what to do with adhd.

The parent is nuts, please discard anything it says. Science and researches are very effective for ADHD, that's a chance!

Take a 12 year old out of school? That's grade 5. They're learning to write paragraphs and their times tables. Not many business leaders can't write a paragraph or do 7*5 in their head.

Better advice would be to get them into something at school, that allows them to hyper focus. Something that draws them in. Science or programming, or even art.

Also wrong about the learning something that's a waste. ADD can show up as soon as 5 years old. I noticed symptoms in my 5 year old kid. They were slight, but they reminded me of me. She was learning shapes and colors, and how to spell 'cat'.

Should I have taken her out of school so she could avoid learning how to spell?

> I noticed symptoms in my 5 year old kid

If you don't mind, could you share what those symptoms are? I have 5 year old too and have some suspicions of ADHD.

> Don’t give drugs, they can permanently mess up his mind.

Reading your entire comment, but especially this sentence makes my blood boil.

None of this is backed up by science and you provide no sources.

This is the equivalent to flat earthers explaining how the universe works or anti-vaxxers how thoughts cure disease.

The OPPOSITE is true: Medication, especially given during age when neuroplasticity is still high can have the best long term effects on neurological development and avoid many adverse life effects normally associated with untreated ADHD such as substance abuse and risky behavior.

Sources:

https://www.additudemag.com/long-term-effects-of-adhd-medica...

https://childmind.org/article/will-adhd-medication-change-my...

And about a dozen more if you google for 10 minutes.

All typical medication used for treating ADHD has been around for decades with mountains of clinical data.

> Don't give drugs, they can permanently mess up his mind.

This is common and good advice. Ritalin at one point was prescribed for ADD and ADHD, Kurt Cobain ended up dying by suicide as a result of complications from his use of the drug.

Spectrum disorders have been used for the past 20+ years as catchall diagnoses. There have been many stories of people who were diagnosed with these disorders, when in fact they were exposed to toxic products without their knowledge.

Heavy metal poisoning from chronic low-level exposure for example mimics nearly all the symptoms and won't show up in blood tests without a chelator. The doctor generally has to have an idea of the substance they are looking for to justify ordering the specific tests. Low-level chronic exposure rarely presents

Exposure to many toxins can have these symptoms. Some studies suggest high doses of PFAS, microplastics, or even above safe-limits for flouride, and other industrial contaminants can cause these similar-looking issues.

They are actually quite different causes, and brain damage in the more extreme cases can occur if left untreated, especially in youth which are more susceptible to certain toxins.

>Kurt Cobain ended up dying by suicide as a result of complications from his use of the drug.

Oof... you skipped right over the Heroin part of that equation.

Honestly, what if taking drugs as a kid desensitized him and made him feel it was fine? Sure it is legal vs illegal, but once you get used to the idea “drugs are good” it could be bad for the mind

Do you have any sources for what you claim to be fact here?

Cause it sure as hell goes way against common research.

> This is common and good advice.

No it is not.

To be clear: This is equivalent to saying: Don't get vaccinated, vaccines don't work.

Or: The earth is flat.

It is unscientific and plain wrong.

...then post some, instead of obviously biased organisations which make a living of treating it as a problem but can't come up with better reasons than -are less likely to finish high school and college -are more likely to experience unemployment -have more difficulty paying bills -are more likely to experience substance use issues

How likely? I'm not bothering looking it up, it should be mentioned right there! Anyway, it sure sounds like the general crime of being poor + not obeying the system as the ruling classes expect. So instead of perhaps checking on the system, lets fill the child with some completely harmless pharmaceuticals:

"If a child taking a stimulant seems sedated or zombie-like, or tearful and irritable, it usually means that the dose is too high and the clinician needs to adjust the prescription to find the right dose."

No way that could mess up a childs mind, right? Everyone thinking otherwise is clearly a flat earther. Disclaimer: I happen to be a clinician, although not in that field, and drug side effects like those - on a child - usually need very, very good justifications or it's malpractice. And just because it seems to have worked for you the right way doesn't mean that it's right for anyone.

> then post some, instead of obviously biased organisations which make a living of treating it as a problem

https://en.m.wikipedia.org/wiki/Management_of_attention_defi...

Wikipedia is a good start, if you are open to the idea of being proven wrong. There is in fact quite a bit of evidence suggesting that many children with ADHD benefit from getting medicated with e.g. methylphenidate and amphetamine.

Of course ADHD medications come with risks, but the question is if they are on the whole beneficial for the patient or not. Brain surgery has risks, Ibuprofen has risks, exercise has risks.

If you are truly a clinician, I don't understand your comment.

Because it's all about you, your morals and unscientific personal opinion and 0 about interest for patient outcomes.

That is not the medical ethos.

And it seems you actually don't have much touchpoints with modern psychiatric practice.

I'd give a lot for my parents who got indication of my diagnosis at a much earlier age and never told me to act on that instead of me suffering the consequences of their failure to provide medical intervention - both with regards to broken relationships in personal and professional life, years of depression and thousands of Euros out of my own pocket to get to the point of understanding myself where I am today.

As always if you start on a psychoactive medication, adult or not, you'd go trough titration to determine an optimal dose.

This is closely monitored by your psychiatrist where I live.

Nobody in this process has any incentive to produce sedated zombies.

Everyone in this process has incentives to avoid very real human suffering.

If you want to go more in depth, as always, Huberman has an in depth and direct source rich talk here: https://www.youtube.com/watch?v=sxgCC4H1dl8

All right, well I didn’t mean to be offensive in what I wrote. Please forgive me, it was written quickly. I hope we can all learn from each other in this forum, it was very kind of you to post those studies!

Advice: Get a second diagnosis, from a medical doctor that has ruled out chronic exposure to toxins/poisoning.

ADHD and other spectrum disorders have in the past been used as a catchall diagnosis for certain groups of symptoms.

For example, heavy metal poisoning often presents as ADHD or ADD misdiagnoses and was not simple to test in years past.

Mercury may leech from silver fillings (depending on where in the world you live), this naturally happens when kids drink soda (which is acidic/caustic for dental amalgams, or may be contaminated through High Fructose Corn Syrup, where mercury is used in its production).

Lead from inhalation may cause similar issues where lead-based paints may shed chips or dust when its deteriorating even when it looks stable.

Arsenic from water as well.

The problem with heavy metals is they don't stay in the blood so a blood test absent a chelator may not properly indicate the issue. These metals get bound up almost immediately in tissue to prevent damage, and you don't know how much gets stored until you take a chelator which may cause acute poisoning (when its bound up, and suddenly gets released into blood).

Eating cilantro (a good chelator) for example has caused migraines and headaches in people who have chronic exposure to such, like mercury. These toxic conditions may also result in poor learning outcomes, brain fog, and other disadvantages that seem to constantly change where finding the words to describe them are quite difficult for the person afflicted.

There are also studies which suggest some of these related symptoms may be linked with high exposure to unsafe levels of PFAS, microplastics, or high levels of flouride.

Its important you first get a proper diagnosis. If you don't bring up the possibility/concern, few doctors will make a connection. Acute poisoning presents very differently from chronic low-level poisoning.

There are some very good medicines that treat the symptoms for ADD/ADHD, but when the cause is toxic exposure; more damage is done by only treating the symptoms.

There are also some significant side-effects related to ADHD treatments, that may be permanent, which may result from those treatments for children who are still developing.

Advice for you: accept him as he is, and provide support.

I had three sons so diagnosed. One was a soldier and now a Process Engineer. One does software in Silicon Valley. One is a musician and works as a programmer at a major retailer data center. All three quite successful.

Understand that help from doctors and schools are all about pushing him back into a box for their benefit. When they have challenges dealing with school processes, they double down on those processes (instead of adapting them so he can succeed). They drug him to remove objectionable parts of his personality. They'd rather blunt his intellect with drugs to make him fit, than direct his energy usefully.

Advocate for him! He's being told on all sides that he is defective or abnormal, instead of just a different kind of person.

Medication and skills training. ADHD is both a boon and a curse. Knowing how to live with it can make a huge difference.

Keep him away from cigarettes, vapes.

I recommend to read Scattered Minds by Gabor Mate. You will find the answers in the book.

Research the ketogenic diet. Recommended for neurological disorder.

Good god there are a shit tonne of morons in this thread. Please do not listen to these morons pushing an agenda about "medication bad".

ADHD is a difficult diagnosis. I have it. I have struggled with my mind since I was young, now early 30s with a diagnosis a few months prior.

Medication has been the most effective route, and has amplified all my good qualities and allows me to relax and focus, rather than being extremely overwhelmed and unable to focus.

The difference in my happiness is night and day on medication.

ADHD is one of the "best" "issues" to have, in that the medication for it is super effective and has minimal side-effects. Also, you only get an ADHD diagnosis if it is causing issues. ADHD is a spectrum etc.

You can do all the self-help in the world, without medication it is hard to overcome the major issues (relationships/mood).

With the medication, you can build healthier habits, which in turn allow you to use the medication less :)

Good luck

Just save yourself a ton of time and watch these two videos from top to bottom. Good luck. It looks like there's a growing body of knowledge and help out there nowadays, unlike the past.

https://youtu.be/xkXpcs_an80?si=BvDuIHScLWNNA43r

https://youtu.be/sxgCC4H1dl8

Also - https://www.drugs.com/medical-answers/ritalin-adderall-diffe...

honestly just treat him like any other kid. be supportive on his interests, understanding on his fits, and try to get him into positive habits like eating healthy and being physically active.

i wont talk about meds as thats really up to you to research and decide as a parent.