Raising a Child with ADHD: Symptoms, Treatment, and Hope for the Future

If you are a parent or caregiver, then you don’t need us to tell you that raising a child is hard work. This already daunting task can become even more challenging if your child suffers from a disorder like attention deficit hyperactivity disorder, or ADHD.

Speaking broadly, ADHD is a disorder characterized by inattentiveness, hyperactivity, and impulsivity. Individuals who have ADHD might struggle to concentrate on tasks for extended periods of time or inhibit their own thoughts and actions. They might have trouble adhering to strict rules and schedules, and they could have a tendency to say or do things at socially inappropriate times.

Because ADHD usually develops during childhood, parents and caregivers often find themselves in charge of managing their child’s disorder. They might have special difficulty helping their child navigate the highly structured environment of the school classroom. On their worst days, they might find themselves frustrated, exhausted, and struggling to know how best to help their child with this challenging disorder.

Raising a child with ADHD isn’t easy, but fortunately, help is out there. Thanks to modern psychiatry, ADHD is very treatable, and many individuals with ADHD go on to live full, normal lives. They just might need a little help learning to manage and cope with their disorder.

To learn more about ADHD, we spoke with Dr. Tammie Dones, who is one of our three staff psychologists at Cummins. In today’s blog post, Dr. Dones explains the basics of ADHD and how individuals can overcome its challenges to lead happy lives.

Dr. Tammie Dones
Tammie Dones, PhD, HSPP, Psychologist at Cummins Behavioral Health

What Is ADHD and Who Does It Affect?

ADHD is what’s known as a neurodevelopmental disorder. In less scientific terms, this means that ADHD is the result of abnormal development of the nervous system.

“When ADHD is studied in a lab setting, there are brain differences in the frontal lobe, which relates to what we call ‘executive function,’ “ Dr. Dones explains. “Executive function is kind of like our mental secretary or our mental organizer. Executive functions in the frontal lobe also help us inhibit responses. For example, if I thought right now, ‘I’m thirsty, I’d like to get a soda,’ my brain can tell me, ‘Don’t do that, you’re in the middle of an interview.’  But some people with ADHD don’t inhibit that well.”

ADHD can be broken into three distinct types with slightly different symptoms:

  1. Hyperactive Type: individuals have difficulty paying attention and controlling their behavior, and they tend to be highly active
  2. Inattentive Type: individuals have difficulty paying attention and frequently experience procrastination, hesitation, and forgetfulness
  3. Combined Type: individuals experience hyperactivity/impulsivity as well as inattentiveness

Dr. Dones provides some examples of what these symptoms might look like in action:

“The combined and hyperactive types are characterized by over-activity. This could be restlessness or fidgeting. One of the criteria is being ‘on the go’, or feeling as if driven by a motor. With the inattentive type, there’s difficulty sustaining attention and focus, difficulty harnessing attention and focus, and difficulty often with emotional regulation. And then the other cluster is impulsivity, which of course affects your attention span as well, because if you’re trying to do, say, a math worksheet, but another thought crosses your mind, your mind drifts away from the math worksheet.

Impulsivity has other social and life management aspects, too. There tends to be about a 25% to 30% delay in general maturity in somebody accurately diagnosed with combined type ADHD. This means reaching life milestones later. For example, an 18- or 19-year-old with ADHD is going to have a harder time managing their debit card, driving without impulsivity, and things like that.”

Approximately 5% of children are diagnosed with ADHD, making it a fairly common mental disorder. Males are about twice as likely to be diagnosed with ADHD as females. The typical age of onset is 4 years old, although the inattentive type is often harder to detect and might not be diagnosed until closer to age 9 or 10.

How Can ADHD be Treated or Managed?

If your child has been diagnosed with ADHD by a psychiatric professional, there are several different treatments they can receive to help manage their symptoms.

To begin, prescription medications tend to be highly effective at reducing symptoms of ADHD. The specific medications used to treat ADHD, known as stimulants, help to regulate impulsive behavior and improve attention span by increasing the levels of certain naturally-occurring chemicals in the brain. According to the Cleveland Clinic, these medications improve ADHD symptoms in 70% of adults and 70–80% of children.

Dr. Dones adds, “At Cummins, we have a strong psychiatry staff. They’re very experienced, and they stay on top of the research in terms of side effects and things like that. So medication treatment is fairly common.”

Whether or not medication is used in treatment, it’s also important for individuals to learn strategies for managing their ADHD symptoms. For example, Dr. Dones emphasizes the importance of using visual cues and “thinking out loud.” She says, “You want to do things that draw that mental organizer or mental secretary out into the open. This could involve visual prompts and cues or the adult thinking out loud to help the child.”

Dr. Dones gives an example of what this might look like from her own life experience: “When I was teaching my daughter to look both ways before she crossed the street, I’d say, ‘Now, we’re going to look both ways before we cross the street.’ I wonder how many times I said that? Probably 9,000 or 10,000 times. Because we want that deeply trained in their brain, right? So for someone with ADHD, that type of thinking aloud, with their parents verbally mediating things using prompts and cues, is really important.”

At Cummins, most people who enter treatment for ADHD can also benefit from our life skills services. These services are specially designed to help individuals learn and implement skills for managing their disorder in the real world—not just in therapy settings. “ADHD is kind of a point-in-time disorder,” Dr. Dones explains. “Oftentimes, the problem isn’t a lack of knowledge; it’s that we don’t perform the right behavior at the right point in time. It’s like, ‘Oh, I knew that, but I didn’t do it right now.’ The skills training matches well to what people need when their symptoms happen in the real moment. So that’s one thing that I’m proud that Cummins has.”

Many individuals who have ADHD continue using the self-mediating skills they learn in treatment throughout the rest of their lives. Adults diagnosed with ADHD continue to use a lot of prompts, cues, and calendar reminders,” Dr. Dones says. “Post-it notes are a typical thing I’ve heard about from clients. They would say, ‘I knew I didn’t want to forget this appointment; look, here’s my post-it!’ People with ADHD, whether it’s inattentive or hyperactive, also tend to have a rough time with sense of time. So time either feels like it takes forever, or it passes without them noticing. So they might use timers like how some people do with social media now. They have those timers on their phones that say, ‘After 45 minutes, I have to get off this social media device.’ Those are the kinds of things that a person with ADHD might have to do just for normal tasks.”

The Role of Family Support in Recovery

As we mentioned in the previous section, parents, caregivers, and other family members play an important role for children diagnosed with ADHD. The younger the child, the more likely it is that they’ll need help learning how to manage the symptoms of their disorder. Family members can be instrumental in modeling and guiding new coping behaviors.

However, the experience can be challenging for everyone involved. “I think it’s important to meet the situation with as much grace, compassion and nurturance as you can, because ADHD is a chronic problem,” Dr. Dones says. “It can wear parents down. It can frustrate parents. Some of the things that are inherent to the disorder make it hard for children or teenagers to profit from experience. So you’re like, ‘I told you that yesterday.’ But it’s kind of lost on them. So you need to be patient, consider each day its own day, and reteach the best you can.”

Children who have ADHD may face frequent punishments and sanctions for their behavior outside of the home environment. It’s important that caregivers deliver praise for good qualities and productive behaviors whenever possible. “These kids are going to hear, ‘You messed up. Did you forget? What are you doing? Stop it!’ They’re going to get yelled at. So somebody has to counteract that self-esteem damage,” Dr. Dones says.

Having a young child with ADHD can be emotionally challenging for parents and caregivers. On top of the difficulties in managing their behavior, parents might also worry about their child’s future. They might wonder if their symptoms will ever improve or if they will ever be able to fit harmoniously into society. The good news is that many people live full and successful lives despite an ADHD diagnosis. For example, actress Emma Watson, gymnast Simone Biles, and musician Justin Timberlake are just a few people who have had great success in their lives despite living with ADHD.

Dr. Dones says, “When we say ADHD is chronic or lifelong, that can be discouraging. But people do improve. There are developmental lags, but a developmental lag eventually catches up. It’s an additional challenge for that person to meet each day, and a responsibility to manage things that come naturally to the next person, but many people do manage successfully.”

Although ADHD, like any mental health problem, can be a challenge for the individual diagnosed and those who are close to them, it is a disorder that many people can nevertheless rise above. With proper treatment and support from caring individuals, many children can grow up to be healthy, happy adults despite their ADHD.

If you’re concerned about your child’s behavior and wonder if they might have ADHD, we encourage you to speak with their primary care provider to voice your concerns. Your child’s doctor can look into the situation and determine next steps with you as appropriate.

Alternatively, you can call Cummins Behavioral Health at (888) 714-1927 to discuss the possibility of receiving a mental health assessment for your child. Our staff will treat you and your child with the respect you deserve and help you see the hope of recovery from ADHD.

Introducing Cummins’ Transportation Services for Justice-Involved Individuals

If you stop a moment to think about it, you’ll probably agree that life can be difficult.

Most of us want to live our lives the best we know how. The problem is that our best efforts don’t always turn out how we’d hope. As a result, we all make mistakes in life. We might disappoint someone we care about, fail to meet one of our obligations, or take an unwise action with possible legal consequences. Some mistakes are small and easily fixed; others can get us into serious trouble.

Everyone deserves a second chance, but not all second chances are created equal. When a mistake ends with involvement in the criminal justice system, for example, there are debts that must be paid and obligations that must be met before the mistake can be forgiven. A person who violates the law, even unintentionally, is responsible for dealing with the consequences. However, this doesn’t mean they don’t deserve a little help.

With this in mind, Cummins Behavioral Health will soon begin offering free transportation services for our clients who are involved in, or have been involved in, the criminal justice system. These individuals may have a variety of appointments they must attend as they work to rebuild their lives, and lack of reliable transportation can be a significant obstacle. By providing free transportation to important medical and legal appointments, we hope to remove some of the barriers these individuals face on their journeys toward recovery.

In this blog post, we’ll explain how these transportation services will work and why we believe they’ll make a difference for our clients and our community. We’ll also include explanations and insights from Tracy Waible and Jessica Hynson, who have been instrumental in bringing these services to Cummins.

Tracy Waible, LCSW, LCAC, Cummins' Director of Recovery (left) and Jessica Hynson, LMHC, CSAYC, Cummins' Director of County Operations for Marion County (right)

How the Services Originated

Our transportation services for justice-involved individuals are a collaboration between Cummins Behavioral Health and Indiana’s Family and Social Services Administration. More specifically, they are funded by a year-long grant from the Division of Mental Health and Addiction (DMHA).

The process started when the DMHA indicated its desire to fund programs of this type. Tracy explains, “We receive emails periodically for various grant opportunities, and when this one came through, we knew that we had to apply. We have an obligation to look at whether our consumers have the ability and resources to do what we are asking. If not, we need to help them problem solve those barriers—one of them being transportation.”

As part of the grant application process, Tracy and Jessica coordinated outreach to community partners who would also benefit from having these services in place. “The Director of County Operations in each county reached out to partners, like local court systems and the Department of Child Services, and asked for letters of support,” Jessica says. “I know Putnam County even got one from the 911 dispatch center because they have a good partnership.”

“We received letters from almost every county, and multiple letters from some of our counties. So I think those stakeholders were all really excited about this opportunity, and definitely willing to send us referrals and to help this to be successful,” Tracy adds.

Ultimately, Cummins was awarded a grant to pay for five vehicles—one for each of our counties of operation—and reimbursement for time spent transporting consumers. Since public transportation options are sparse in Indiana, and services like Lyft and Uber are not consistently available in rural areas or have extremely long wait times, we anticipate our transportation services to be a significant benefit for our consumers.

How the Services Will Work for Consumers

Once our transportation services are up and running, any Cummins consumer who is involved in the justice system will be eligible to use them. “They’re for anybody justice-involved,” Tracy says. “That could be DCS, probation, drug court, veterans court—any kind of legal involvement.”

Individuals will be able to submit an online form to request a ride to an appointment. This could be an appointment for Cummins services, a physical health appointment, a court-related meeting, or other legal appointments, to name a few possibilities. Once a request is submitted, the appropriate staff in that county will review their availability and make arrangements to provide transportation if at all possible.

Due to the specific details of the grant, the services will only be available to existing Cummins consumers or those who are beginning services with Cummins. Tracy explains by way of an example: “There’s a large correlation between justice-involved and substance use disorder. We worry about that gap between leaving incarceration and entering treatment, because maybe a person has 30 days of sobriety now, and they’re at risk of overdose if they leave and start using again. If we could transport them straight from jail to an intake or to some kind of support, we’re hoping to reduce drug overdose and recidivism.”

Piggybacking off of Tracy’s example, Jessica gets to the core of why we’re so excited to provide these transportation services. “This justice-involved population is one of the populations that struggle to get back on their feet, because there are just so many barriers constantly in their way,” she says. “I think some people sit in jail and think, ‘OK, I’m going to turn my life around.’ They’re motivated, but then they come out to the same environment, the same challenges, maybe more challenges, because now they have a record. So I’m very excited to have the opportunity to break through some of those barriers, just by saying, ‘Well, we can do that. We can take them there.’ “

“If I think about our mission, vision and values,” Tracy adds, “and if we know that there’s always hope, and recovery as possible, I don’t want transportation to be the barrier to making that a reality for the people we serve. Because if I don’t have a way to access the care, then I’m more than likely going to become more hopeless, and not be able to do the things that I’m hoping to do with my recovery journey. So I think that’s why I’m excited about this. It’s going to give people an opportunity to tap into that hope and to see what recovery is about.”

At Cummins, our mission is to inspire the hope of recovery, to achieve excellence in all aspects of care, and to make the goals and aspirations of those we serve our highest priority. We are thrilled to improve our services for justice-involved individuals by adding these transportation services!

We will update this page with information about requesting transportation once the service is live.

If you enjoyed this article and would like to help spread our message of hope and recovery, we encourage you to share it with others!

What You Should Know and What You Can Do About Indiana’s Youth Mental Health Crisis

If you are a parent or legal guardian to a child or teenager, then you might be aware that youth have been facing increasing mental health challenges in recent years.

Several statistics from the office of the U.S. Surgeon General showcase the severity of the situation. Even prior to the COVID-19 pandemic, mental health challenges were the leading cause of disability and poor life outcomes among American youth, with as many as 1 in 5 children ages 3 to 17 suffering from a mental, emotional, developmental, or behavioral disorder. In addition, more than 1 in 3 high school students reported persistent feelings of sadness or hopelessness in 2019—a 40% increase over the previous decade. And most sadly, suicide rates among youth ages 10–24 increased by 57% from 2007 to 2018.

Fortunately, there is much work being done to address this growing crisis. Among other initiatives, the Indiana Family and Social Services Administration (FSSA) announced earlier this month that it’s entering an $8 million partnership with Riley Children’s Health to provide mental health services at pediatric primary care offices across the state. This partnership will integrate mental health services into Riley Children’s Health’s primary pediatric care settings throughout Indiana, which will make it faster and easier for Hoosier parents and physicians to help youth with their mental health needs.

In light of these recent developments, we wanted to do our part to inform our community about the state of the current youth mental health crisis. We know that frightening situations like these can be improved if we understand why they are happening and what we can do about them.

In this week’s blog post, we’ll provide a brief overview of youth mental illness in our country, including why it’s on the rise and what you can do to help a child or teen who is struggling with mental health challenges.

What Is Causing the Youth Mental Health Crisis?

When discussing the mental health of young people, it’s important to explain that many mental illnesses first manifest during childhood or adolescence. The age at which a person first displays symptoms of a mental illness is referred to as the disorder’s “age of onset“.

Across the world, about 1 in 4 people will experience a mental illness sometime in their life. This means that as many as 25% of youth may experience the onset of a mental illness that negatively impacts their overall mental health. According to surveys by the World Health Organization, the average age of onset for various types of mental illness are as follows:

  • ADHD: ages 7–9
  • Phobia-related anxiety disorders: ages 7–14
  • Schizophrenia: ages 15–35
  • Substance use disorders: ages 18–29
  • Generalized anxiety disorder and PTSD: ages 25–53
  • Mood disorders: ages 25–45

As you can see, the development of a mental illness is one factor that may affect a child’s well-being. However, a number of environmental factors are also contributing to the youth mental health crisis our country is currently experiencing.

According to the U.S. Surgeon General’s Advisory on Youth Mental Health, research suggests that factors like the growing use of digital media, increasing academic pressure, limited access to mental health care, financial insecurity, highly-publicized societal violence, and anxieties about climate change may be worsening young people’s mental health and wellness. More research is required to determine precisely these subjects are affecting youth.

The COVID-19 pandemic has further added to the mental health challenges of many individuals; children and teens whose daily routines have been disrupted by the pandemic, who have experienced greater financial instability as a result of the pandemic, or who have lost a family member to COVID-19 are most likely to have suffered mental health challenges as a direct result of the pandemic.

What Can You Do About the Crisis?

Clearly, the challenges facing youth today are not ones that are easily solved. But there is plenty that we can do to help.

We have already seen signs that our government and health care professionals are attempting to respond to the crisis. In October of 2021, the American Academy of Pediatrics declared a national emergency in child and adolescent mental health, urging the country to take steps to address the problem. The following December, the U.S. Surgeon General’s office issued its advisory, signifying the federal government’s commitment to addressing the crisis. And in Indiana, the state government is allocating tens of millions of dollars to make mental health care more accessible and more effective for all Hoosiers. These are all encouraging signs.

There are also several things you can personally do to look after your child’s mental health. First and foremost is to have your child screened for mental illness and mental health challenges. Screenings are an important part of prevention and early intervention for mental illness, and they can often be obtained through your child’s pediatric primary care physician. In addition, Mental Health America offers free online screening assessments for a variety of mental illnesses, including an assessment that parents and guardians can take for their children.

In addition to screenings, the importance of talking to your child about their fears, worries and challenges cannot be overstated. Young people need trusted adults whom they can confide in without fear of judgment or punishment. As a parent or legal guardian, one of the best things you can do is normalize mental health challenges and encourage your child to share their struggles with you. The more they believe that you understand and support them, the better off they will be.

Dr. Ashleigh Woods, Cummins’ Senior Psychologist, adds,

“One of the biggest challenges I see facing children, teens, and families is lack of connection. Human beings are social creatures, and connection to others is what helps us regulate our thoughts, feelings, and bodies. When a parent or caregiver engages face-to-face with their child, that child’s mirror neurons and vagus nerve react to the caregiver’s facial expressions, tone of voice, etc. Not only is the child taking in what their parent is saying, but those nonverbal cues are also having a neurological impact on the child’s developing brain.

If we can help families improve both the quantity and quality of their face-to-face interactions, we can improve their connections and create more emotional safety and stability, which goes a long way toward building resiliency.”

Ashleigh Woods, Psy.D., HSPP, PMH-C

There is no question that many young people in our country are struggling with their mental health and well-being. Of the challenges they face, some have been around for generations, while others are more unique to today’s world. None are easily solved, but they can all be helped by unconditional love and support from caring adults.

If you are the parent or guardian of a child or teen, we strongly encourage you to speak to them about their mental health. Listen to their concerns, and show them that you’ll always be there to help. Share your own concerns about their mental health with their pediatric physicians.

You have the opportunity to be a powerful advocate for your child’s mental health. We encourage you to make the most of it!