In part two of this two-part series, Mike and Ryan discuss why families often abandon medication too quickly after a single difficult trial, the importance of trial-and-error in finding the right medication regimen, and why genetic testing isn't the shortcut many parents hope it will be.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

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Timestamps

[00:00:00] Start

[00:00:46] Why Families Give Up on Medication Too Easily

[00:01:30] Two Main Stimulant Categories Explained

[00:03:42] Non-Stimulant Medication Options

[00:04:22] Why Medication Alone Is Not Enough

[00:07:15] Genetic Testing Is Not Recommended

[00:09:43] Key Takeaways on ADHD Medication

[00:12:13] Final Thoughts on Kids and Medical Decisions

Citations

American Academy of Child and Adolescent Psychiatry. (2020). Clinical use of pharmacogenetic tests in prescribing psychotropic medications for children and adolescents. ⁠https://www.aacap.org/aacap/Policy_Statements/2020/Clinical-Use-Pharmacogenetic-Tests-Prescribing-Psychotropic-Medications-for-Children-Adolescents.aspx⁠

American Academy of Child and Adolescent Psychiatry. (2022). Attention-deficit/hyperactivity disorder: Parents’ medication guide. ⁠https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/med_guides/ADHD_Medication_Guide-web.pdf⁠

American Psychiatric Association. (n.d.). What is ADHD? ⁠https://www.psychiatry.org/patients-families/adhd/what-is-adhd⁠

Centers for Disease Control and Prevention. (2024). Clinical care of ADHD. ⁠https://www.cdc.gov/adhd/hcp/treatment-recommendations/index.html⁠

Dalsgaard, S., Leckman, J. F., Mortensen, P. B., Nielsen, H. S., & Simonsen, M. (2015). Effect of drugs on the risk of injuries in children with attention deficit hyperactivity disorder: A prospective cohort study. The Lancet Psychiatry, 2(8), 702–709. https://doi.org/10.1016/S2215-0366(15)00271-0

Dalsgaard, S., Østergaard, S. D., Leckman, J. F., Mortensen, P. B., & Pedersen, M. G. (2015). Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: A nationwide cohort study. The Lancet, 385(9983), 2190–2196. https://doi.org/10.1016/S0140-6736(14)61684-6

de Vries, W., Boer, M., Stevens, G. W. J. M., & van Dorsselaer, S. (2025). Exploring concept creep: Youth’s portrayal of ADHD on TikTok. SSM Mental Health, 7, 100374.

Harpin, V., Mazzone, L., Raynaud, J. P., Kahle, J., & Hodgkins, P. (2016). Long-term outcomes of ADHD: A systematic review of self-esteem and social function. Journal of Attention Disorders, 20(4), 295–305. https://doi.org/10.1177/1087054713486516

Myer, N. M., Boland, J. R., & Faraone, S. V. (2018). Pharmacogenetics predictors of methylphenidate efficacy in childhood ADHD. Molecular Psychiatry, 23, 1929–1936.

Shaw, M., Hodgkins, P., Caci, H., Young, S., Kahle, J., Woods, A. G., & Arnold, L. E. (2012). A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: Effects of treatment and non-treatment. BMC Medicine, 10, 99. ⁠https://doi.org/10.1186/1741-7015-10-99⁠

Wetterer, L. (2020). Attention-deficit/hyperactivity disorder: AAP updates guideline for diagnosis and management. American Family Physician, 102(1), 58–60.

Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., Evans, S. W., Flinn, S. K., Froehlich, T., Frost, J., Holbrook, J. R., Lehmann, C. U., Lessin, H. R., Okechukwu, K., Pierce, K. L., Winner, J. D., & Zurhellen, W. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528. ⁠https://doi.org/10.1542/peds.2019-2528⁠

Yeung, A., Ng, E., & Abi-Jaoude, E. (2022). TikTok and attention-deficit/hyperactivity disorder: A cross-sectional study of social media content quality. The Canadian Journal of Psychiatry, 67(12), 899–906. ⁠https://doi.org/10.1177/07067437221082854⁠

Ryan and Mike take on four of the loudest myths in Facebook ADHD parenting groups: pharmacogenetic ("cheek swab") testing for medication selection, the idea that every ADHD child needs one-to-one talk therapy, the "everything is sensory" framing, and rejection sensitive dysphoria as a discrete diagnosis. For each one, they walk through what the actual research and clinical practice guidelines support — and what they don't.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠IG⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube⁠⁠⁠

{{chapters}}

[00:00:00] Start

[00:02:13] Myth 1: Genetic Panel Testing for ADHD Meds

[00:04:25] Myth 2: Every ADHD Kid Needs Therapy

[00:10:36] Myth 3: Everything Is Sensory

[00:13:00] Myth 4: Rejection Sensitive Dysphoria

[00:16:25] Closing: Research Over Popularity

CITATIONS:

American Academy of Pediatrics. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528.

Antshel, K. M., & Barkley, R. A. (2020). Psychosocial interventions in attention deficit hyperactivity disorder. Child and Adolescent Psychiatric Clinics of North America, 29(3), 499–519.

Barkley, R. A. (2013). Distinguishing sluggish cognitive tempo from attention-deficit/hyperactivity disorder in adults. Journal of Abnormal Psychology, 122(4), 978–990.

Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (4th ed.). Guilford Press.

Barkley, R. A. (2020). Taking charge of ADHD (4th ed.). Guilford Press.

Doffer, M., et al. (2023). Behavioral parent training for children with ADHD: Long-term outcomes and effectiveness. Journal of Attention Disorders, 27(5), 1–14. (Note: verify exact pages for final)

Evans, S. W., Owens, J. S., & Bunford, N. (2014). Evidence-based psychosocial treatments for children and adolescents with ADHD. Journal of Clinical Child & Adolescent Psychology, 43(4), 527–551.

Luman, M., Tripp, G., & Scheres, A. (2010). Identifying the neurobiology of altered reinforcement sensitivity in ADHD. Neuroscience & Biobehavioral Reviews, 34(5), 744–754.

Pinquart, M. (2017). Associations of parenting dimensions and styles with externalizing problems of children and adolescents: An updated meta-analysis. Developmental Psychology, 53(5), 873–932.

Sibley, M. H. (2021). Annual research review: Defining and treating ADHD in adolescents. Journal of Child Psychology and Psychiatry, 62(6), 706–724.

Tripp, G., & Wickens, J. R. (2020). Neurobiology of ADHD. Neuropharmacology, 173, 108–127.

In this episode of the ADHD Parenting Podcast, hosts Mike and Ryan tackle a provocative but critical topic: why high expectations are the most loving thing you can do for a child with ADHD. They respond to a listener’s experience in which an effective classroom point system—backed by decades of research—was canceled after other parents of children with ADHD complained. Mike and Ryan break down the difference between evidence-based structure and popular social media narratives, explaining why removing consequences and lowering the bar can lead to learned helplessness, prompt dependence, and failure to launch. They cite leading ADHD researchers like Dr. Russell Barkley, clarify what the science actually says about connection vs. consequence, and offer practical advice for IEP meetings, home life, and navigating parent group chats. Above all, Mike and Ryan argue that high expectations combined with high empathy aren’t the opposite of love—they are love.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠IG⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube⁠⁠⁠

{{chapters}}

[00:00:00] Start

[00:05:29] Debunking the "connection, not consequence" myth

[00:08:14] Dr. Russell Barkley: ADHD as a self-regulation problem

[00:10:39] The cost of removing structure: Learned helplessness

[00:14:05] "It's not fair": Neurology explains but does not exempt

[00:15:30] Setting kids up for failure to launch

[00:16:53] Research-backed classroom policies that work

[00:21:26] What parents can do at home and in IEP meetings

[00:25:05] Confidence is earned by meeting standards

[00:25:44] Closing: High expectations + high empathy = love

Citations:

• Gaastra, G. F., Groen, Y., Tucha, L., & Tucha, O. (2016). The effects of classroom interventions on off-task and disruptive classroom behavior in children with symptoms of ADHD. Consequence-based approaches showed the largest positive effect.

• Barkley, R. A. (2015 / 2022). ADHD: A Handbook for Diagnosis and Treatment. Self-regulation model and "point of performance" principle.

• Power, T. J., Mautone, J. A., & Soffer, S. L. Family-School Success for Children with ADHD: A Guide for Intervention. Guilford Press. From the Center for Management of ADHD at Children's Hospital of Philadelphia — research-based home-school partnership intervention.

• Pelham, W. E., Fabiano, G. A., and colleagues. Daily Behavior Report Card evidence base.

• Rosenthal & Jacobson lineage. Pygmalion Effect / adult-expectation research in education.

• Milich and colleagues; 2024 review on learned helplessness in ADHD populations.

In this episode, Ryan and Mike explore the real reason children with ADHD struggle with reading comprehension and written expression—working memory issues, not laziness or oppositional behavior. They explain the role of nonverbal working memory (mental movies) and verbal working memory (inner voice) , share key research findings, and offer practical strategies to support children at home and school.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠IG⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube⁠⁠⁠

{{chapters}}

[00:00:00] Start

[01:38] The real problem is working memory, not laziness

[06:14] The mental movie that never gets made (nonverbal working memory)

[13:36] The inner voice goes quiet during writing (verbal working memory)

[17:29] The blank page: oppositional behavior or working memory failure?

[20:06] What actually helps: make external what other kids do internally

[23:00] Closing takeaways

Episode 56 Citations:

1. Gray, C., Rogers, M., London, K., et al. (2016). Children with attention-deficit/hyperactivity disorder and reading disability: A review of the efficacy of medication treatments. Frontiers in Psychology, 7, 988.
2. Miller, A. C., Keenan, J. M., Betjemann, R. S., et al. (2013). Reading comprehension in children with ADHD: Cognitive underpinnings of the centrality deficit. Journal of Abnormal Child Psychology, 41, 473–483.
3. Soto, E. F., Kofler, M. J., Irwin, L. N., et al. (2021). Executive functions and writing skills in children with ADHD. Journal of Abnormal Child Psychology.
4. Molitor, S. J., Langberg, J. M., Evans, S. W., et al. (2016). The written expression abilities of adolescents with attention-deficit/hyperactivity disorder. Research in Developmental Disabilities, 51–52, 49–59.
5. Re, A. M., Pedron, M., & Cornoldi, C. (2007). Expressive writing difficulties in children described as exhibiting ADHD symptoms. Journal of Learning Disabilities, 40(3), 244–255.

In this episode, Ryan and Mike take on one of the most hotly debated topics in the ADHD parenting space: do kids with ADHD actually need consequences? Social media influencers say no — just connection, co-regulation, and emotional validation. Ryan and Mike push back hard with decades of research showing the opposite: ADHD is a disorder of performance, not knowledge, meaning behavior is governed by immediate consequences far more than by understanding or insight, and kids with ADHD need more consequences, not fewer — clearer, more consistent, and delivered in the moment. They also dismantle popular labels being used to justify removing consequences altogether — masking, rejection sensitive dysphoria (RSD), pathological demand avoidance (PDA), and vague "nervous system disorder" language — and explain why these frameworks, however emotionally compelling, leave parents stuck without real strategies. The takeaway: authoritative parenting, warmth plus structure, is what the evidence supports, and parents can step into that authority with confidence.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠IG⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠
Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube⁠⁠⁠

{{chapters}}

[00:00:00] Start

[00:00:39] Research vs. Social Media Parenting Myths

[00:02:41] ADHD as a Disorder of Performance, Not Knowledge

[00:04:21] Connection Is Not the Problem

[00:07:39] Why Parents Are Over-Connecting and Over-Functioning

[00:08:48] Authoritative Parenting: Warmth Plus Structure

[00:11:08] Feelings Talk vs. Behavior Change

[00:13:53] Why Therapy Alone Doesn't Work for ADHD

[00:15:10] Masking, RSD, PDA, and Nervous System Labels Debunked

[00:19:03] Real Reasons Kids Act Out at Home

[00:20:31] Help vs. a Hug: What Parents Actually Need

[00:21:09] Act Don't Yak: What Keeps Parents Stuck

[00:23:41] The Bottom Line on Consequences and Praise

[00:25:05] School Accountability and the Principal Strategy

Research Citations:

Wolraich, M. L., Hagan, J. F., Allan, C., et al. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528.

Doffer, D. P. A., et al. (2023). Sustained improvements by behavioural parent training for children with attention-deficit/hyperactivity disorder: A meta-analytic review of longer-term child and parental outcomes. JCPP Advances, 3(4).

Dekkers, T. J., Hornstra, R., van der Oord, S., et al. (2022). Meta-analysis: Which components of parent training work for children with attention-deficit/hyperactivity disorder? Journal of the American Academy of Child & Adolescent Psychiatry.

Luman, M., van Meel, C. S., Oosterlaan, J., & Geurts, H. M. (2009). Are ADHD symptoms associated with delay aversion after controlling for neuropsychological functioning? Journal of Abnormal Child Psychology, 37, 587–598.

Hulsbosch, A. K., et al. (2024). Behavioral and emotional responding to punishment in ADHD.

Today's episode is a re-release of Episode 43, because the message is just that important.

In this episode of The ADHD Parenting Podcast, hosts Ryan Wexelblatt and Mike McLeod explore what it means to “step into your parental authority.” Drawing from research and clinical experience, they discuss how authoritative parenting—balancing warmth with structure—helps children with ADHD develop self-regulation, emotional safety, and independence. The hosts challenge social media’s rebranding of permissive parenting as “gentle” or “compassionate” and explain why consistency, clear expectations, and calm modeling are key. They also tackle the fears many parents have about being “too firm,” offering practical examples of how to set limits with empathy and predictability while nurturing connection and confidence in their children.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠IG⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ & on ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Youtube⁠⁠⁠⁠

In this episode of the ADHD Parenting Podcast, Mike and Ryan answer several listener questions about common challenges parents face when raising children with ADHD. They discuss why some children struggle to initiate friendships despite wanting them, the role of social anxiety and executive functioning in social behavior, and why screen time can reinforce avoidance of real-world interaction. The hosts also address sibling conflict when children are at different developmental stages, explain why brain scans and “types of ADHD” promoted by certain authors lack scientific support, and offer strategies for parents dealing with teens who claim to feel sick to avoid responsibilities.

Find Mike @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.grownowadhd.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

Find Ryan @ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.adhddude.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠

{{chapters}}

[00:00:00] Start

[00:01:01] Podcast Intro And Updates

[00:04:10] Question: Child Struggles Making Friends

[00:09:00] Social Anxiety And ADHD

[00:13:00] Path Of Least Resistance Brain

[00:15:55] Sibling Conflict And Age Gaps

[00:23:20] Brain Scans And ADHD Myths

[00:28:55] Teen Avoidance And “Feeling Sick”