30 Essential Ideas you should know about ADHD, 7B The 30% Rule, 4 Components for Effective Treatment

Summary

This script discusses the challenges of ADHD in children and adults, emphasizing the 'thirty percent rule' which suggests that individuals with ADHD are typically 30% behind their actual age in self-regulation. It advises parents to adjust expectations and accommodations accordingly. The transcript also highlights the importance of proper evaluation, education, medication, and environmental adaptations to support individuals with ADHD effectively.

Takeaways

• 🧠 ADHD is characterized by a self-regulation disorder and a quantitative deficit, often resulting in developmental delays.
• 📏 The '30 percent rule' suggests that on average, a child with ADHD functions at a level 30 percent behind their chronological age, affecting various aspects of life.
• 👨‍👧 Parents are advised to adjust expectations to a child's 'executive age', which is 30 percent younger than their actual age, to avoid unnecessary conflict.
• 🚫 Overestimating a child's capabilities can lead to problems, similar to expecting a dyslexic child to read normally or a child with cognitive impairments to be self-sufficient.
• 🛣️ The environment and expectations should be adapted to match the child's executive functioning level, not their chronological age.
• 🏫 For older children and young adults with ADHD, accommodations may be necessary in educational settings, such as more supervision and support.
• 🚗 An analogy is made regarding the inappropriateness of giving a 16-year-old with ADHD a driver's license, equating it to giving an 11-year-old such responsibility.
• 📋 A comprehensive treatment plan for ADHD must include a proper evaluation, education for the family, medication, and environmental accommodations.
• 💊 Medication is recognized as the most effective intervention for ADHD, and up to 80% of children with ADHD may be on medication at some point.
• 📚 Families need to educate themselves about ADHD to better understand and manage the condition.
• 🛠️ Accommodations and strategies, such as externalizing information and creating 'prosthetic' devices, are crucial to help individuals with ADHD succeed.

Q & A

What is the main issue discussed in the transcript related to ADHD children?

The main issue discussed is the self-regulation disorder and the quantitative deficit in ADHD children, which leads to them being, on average, 30 percent behind their actual age in terms of executive functioning.

What is the 'thirty percent rule' mentioned in the transcript?

The 'thirty percent rule' is a rule of thumb suggesting that the average ADHD child functions at a level 30 percent behind their chronological age in terms of self-regulation and executive functioning.

How should parents adjust their expectations for a child with ADHD?

Parents should adjust their expectations to the child's 'executive age,' which is 30 percent younger than their chronological age, to avoid causing unnecessary conflict and to better support the child's development.

What is the implication of the 'thirty percent rule' for a 16-year-old with ADHD?

For a 16-year-old with ADHD, the implication is that they might function at the executive level of an 11-year-old, which means they should not be given the same level of responsibility or independence as a typical 16-year-old.

How should educational institutions accommodate ADHD students?

Educational institutions should make accommodations such as providing more support, creating a substance-free environment, and ensuring regular check-ins with student services to help ADHD students succeed.

What is the role of medication in treating ADHD according to the transcript?

Medication is considered the most effective intervention for ADHD, and it should not be surprising if up to 80 percent of children with ADHD are on medication at some point in their developmental period.

Why is it important for families to educate themselves about ADHD?

Families need to educate themselves about ADHD to better understand the condition, know how to deal with it, and to ensure they are providing the right support and accommodations for their child.

What are the four components of an effective treatment plan for ADHD as mentioned in the transcript?

The four components are: 1) a good evaluation by a knowledgeable professional, 2) education for the family about ADHD, 3) the use of medication as the most effective intervention, and 4) making accommodations to alter the environment to suit the child's executive functioning level.

Why is it crucial to get a proper evaluation for a child with ADHD?

A proper evaluation is crucial because 80 percent of individuals with ADHD have another disorder that also needs to be treated, and an evaluation helps identify these co-occurring conditions.

How should parents approach giving responsibilities to their ADHD child, such as babysitting?

Parents should consider the child's executive age rather than their chronological age when giving responsibilities. For example, a 14-year-old with ADHD might only have the executive functioning of a 9-year-old, so they should not be given the responsibility of babysitting an infant.

What does the speaker suggest about the use of behavioral interventions compared to medication for ADHD?

The speaker suggests that while behavioral interventions can be good when they are done, they are not as effective as medication. Medication is necessary to fill the gaps that behavioral interventions cannot address.

Outlines

00:00

🔍 Understanding ADHD and the 'Thirty Percent Rule'

This paragraph discusses the concept of self-regulation deficit in ADHD, suggesting that children with ADHD are, on average, 30 percent behind their chronological age in terms of self-control and executive functioning. The speaker emphasizes the importance of parents understanding this 'thirty percent rule' and adjusting their expectations and responsibilities for their children accordingly. It also touches on the implications of this rule in various life situations, such as driving, college life, and babysitting, and stresses the need for environmental accommodations to support individuals with ADHD.

05:01

💡 Key Components of Effective ADHD Treatment

The second paragraph outlines the essential elements for a successful ADHD treatment plan. It begins by stressing the necessity of a comprehensive evaluation by a knowledgeable professional to identify any co-existing disorders. The speaker then highlights the importance of educating oneself about ADHD to better manage the condition. Furthermore, it asserts that medication is the most effective intervention available for ADHD, challenging the notion that behavioral interventions alone are sufficient. The paragraph concludes by advocating for the use of accommodations and strategies to support individuals with ADHD in demonstrating their knowledge and abilities.

Keywords

💡Self-regulation

Self-regulation refers to an individual's ability to manage their own behavior, emotions, and attention. In the context of the video, it is highlighted as a disorder in individuals with ADHD, affecting their executive functioning. The script mentions that a child with ADHD may have a 'quantitative deficit' in self-regulation, meaning they are significantly behind their peers in this area, which is a key factor in understanding the challenges they face.

💡Quantitative deficit

Quantitative deficit in this script refers to the measurable gap in skills or abilities compared to peers. It is used to describe the extent of the self-regulation difficulties in children with ADHD. The video emphasizes that, on average, an ADHD child is about 30 percent behind their age group in terms of self-regulation, which is a significant point in understanding the impact of ADHD on a child's development.

💡Executive age

Executive age is a concept introduced in the script to describe the developmental level of a child's executive functioning skills, rather than their chronological age. For instance, a 10-year-old with ADHD may have the self-control, memory, and organizational skills of a 7-year-old. This concept is crucial for parents and educators to adjust expectations and provide appropriate support.

💡Expectations

Expectations, in the context of the video, refer to the level of performance or behavior anticipated from a child. The speaker advises parents to lower their expectations to match the child's 'executive age' to avoid conflict and to better support the child's needs. This is a central theme in managing the challenges associated with ADHD.

💡Accommodations

Accommodations are adjustments made to the environment or tasks to help individuals with special needs perform better. The script discusses the necessity of creating an environment that suits the executive functioning level of a person with ADHD, such as a college campus designed with accommodations for an 18-year-old with the executive age of a 12-year-old.

💡Medication

Medication is presented in the video as the most effective intervention for ADHD. The speaker argues that up to 80 percent of children with ADHD will be on medication at some point, emphasizing its importance in managing ADHD symptoms. The script also addresses misconceptions about the role of medication in treatment plans.

💡Psychosocial treatment

Psychosocial treatment encompasses a range of interventions that address the social and psychological aspects of a condition. In the script, it is mentioned that while psychosocial treatments are valuable, they are not as effective as medication in managing ADHD and are often used in conjunction with it.

💡Evaluation

Evaluation in this context refers to the process of assessing an individual's condition, often by a professional knowledgeable in ADHD. The script stresses the importance of a good evaluation to identify any co-occurring disorders that may also need treatment.

💡Education

Education, as discussed in the script, is vital for families dealing with ADHD. It involves becoming knowledgeable about the condition to better understand and manage it. The speaker mentions that families need to educate themselves as part of the treatment plan.

💡Independence

Independence in the video refers to the level of self-sufficiency expected from an individual. The script uses the concept of independence to illustrate the differences between a child's chronological age and their executive age, cautioning against granting too much freedom or responsibility to a child with ADHD based on their actual age.

💡Treatment plan

A treatment plan is a comprehensive strategy for managing a condition, which, according to the script, should include evaluation, education, medication, and accommodations. The video emphasizes that all four components are necessary for an effective treatment plan for ADHD.

Highlights

Understanding ADHD requires looking at self-regulation and recognizing it as a quantitative deficit.

The average ADHD child is 30% behind their age in self-regulation, which is a useful rule of thumb for parents.

Parents should adjust expectations to a child's executive age, which is 30% younger than their chronological age.

Homework, chores, and social functioning should be managed as if the child is 30% younger to avoid conflict.

The concept of executive age is crucial for understanding appropriate responsibilities and independence levels.

Driving a car at sixteen may be akin to giving an 11-year-old a license due to the executive age lag.

Accommodations in educational settings are necessary to support the executive age rather than the chronological age.

Parents should be cautious about the responsibilities they assign to children with ADHD, such as babysitting.

Legal cases highlight the dangers of not understanding the executive age, such as in babysitting scenarios.

A comprehensive treatment plan for ADHD must include a good evaluation, education, medication, and accommodations.

Eighty percent of individuals with ADHD have another disorder that also needs treatment.

Families need to educate themselves to become experts in ADHD to effectively manage the condition.

Medication is the most effective intervention for ADHD and should not be underestimated.

Behavioral interventions are not as effective as medication and should complement rather than replace it.

Accommodations are essential to help individuals with ADHD show what they know despite their executive age lag.

Creating prosthetic devices and strategies can help externalize information and support individuals with ADHD.

Transcripts

Now to understand why this disorders why these impairments would

continue into adulthood

we need to go back and understand that its a dish

order a self regulation and it's a quantitative deficit so

that begs the question: how far behind is dis child

and so the rule that I have talked for years in our clinics to families and it

remains a very good

rule of thumb is the average ADHD child is 30 percent behind their age

some are even more but on average across all ADHD children it looks to be about

30 percent so here's what I want parents to do

if your child is 10 yes the self control of a seven-year-old

that is how long he can persist that's how long he can remember that is how

long he can go without supervision

his ability to self organize

is that a seven-year-old now what would you do for a seven-year-old

how would we arrange homework what else would we be doing around chores around

social functioning

around independence from parents you would be doing as much as you would with

a ten-year-old

you would not allow as much responsibility as much freedom

as much independence so I want parents to be

lowering their expectations to the child

executive age what

is his self regulatory age 30 percent younger

art that's what you can expect in if you're expecting more than that

you're my problem because you're causing the conflict

you're like a parent of a dyslexic child demanding normal reading

you're like the parent of a mildly retarded child demanding

normal self sufficiency normal cognitive village or my problem

because you just don't get it so I watch it get it

it a 30 percent lagged that's where they're at

that's what you can expect if you're asking for more you're going to have to

do something

to rearrange that environment to allow them to show what they know

but if you don't do anything they're going to be about 30 percent behind

so what does it mean at sixteen about giving kids a license

are you out of your mind

you just gave an 11-year-old a motor vehicle

and your shot to see the driving consequences are

you may have an 18-year-old who is one of the few that's gonna go on to college

he's 12 that is executive age

how would you have to design a campus if twelve-year-olds were showing up to go

to school

those exactly are the accommodations you have got to make on that campus for this

person

pretender 12 more hand holding

more accountability more reporting to student services

you're gonna get more curriculum materials you gonna study

in groups with older more competent students you gonna be in a

substance-free dorm

and you're going to be accountable to student services four times a day for

the work you doing

in other words when treat you like a 12

and then you might just get through but what do we do not we send you off you

feel the first semester and everybody brings their hands vol what we gonna do

we're gonna have to change the campus will have to change the environment to

suit the executive level

not the chronological level so you need to understand the thirty percent rule

because it applies to everything

I have a 14-year-old daughter with ADHD should should be allowed to babysit are

you crazy

me this is a nine-year-old being given care oven infant

Knoll way I don't care she finished the Red Cross babysitting course

I don't care she's got a certificate we don't let nine-year-old

attend three month old babies on

supervised and that is her executive age

you think this is hypothetical we have legal cases

the people even into their early teens and twenties

who have killed babies out over anger

out of impatience outta immaturity have not knowing

what to do when the baby got upset and then their emotion comes to the

forefront

so we don't want to go there so you should be looking at

all love these avenues have independent and applying the thirty percent rule to

them

and that's what you allow and if you are going to give the more you better be

doing something to see that they can handle it

okay we want you as a parent to understand that every treatment plant

has to have these four components

or it's not going to work component number one you got to get

a good evaluation you have got to see inappropriate knowledgeable

professional it doesn't matter whether it's a developmental pediatrician a

child psychiatrist a child psychologist or a behavioral neurologist as long as

they are well-trained

and knowledgeable about ADHD that's the trick

it's not the degree it's the knowledge it's the training if the experience to

do they see lots and ADHD kids and families for adults

so we need an evaluation because eighty percent of these people have another

disorder

and that's going to need to be treated as well next

families need to educate themselves will talk more about that

but you need to become an expert about ADHD or you're not going to know how to

deal with attending this afternoon has been a big step in that direction

third you need to understand that medication is the most effective thing

we have

and not doesn't matter to me whether you like that or not

that as a statement a fact we have no

more effective interventions that these medications which is why the last decade

we have moved them

up in our priority abusing them it used to be that we would try

everything else under the Sun first and only if they feel go to medication well

guess what eighty percent of them failed

and we went to medication anyway and we should've started with to begin with

because it would have made a more minimal and more susceptible to the

other psychosocial

educational programs we were trying to do so don't be surprised to learn that

up to eighty percent ADHD children will be on medication

at some time in their developmental period whether that is childhood or

adolescence

because there are times in places where you cannot Institute psychosocial

treatment

if your child is driving home from the homecoming

last night which was over the Delta hotel by the way I checked in and

there's a problem going on

you can't be there handing out tokens for following the speed limit you know

this is

idiotic to think the behavioral interventions are as good as medications

they're not

where they're done when they're done they're good but there are places where

they can't be done

and now what do we do the medications feel the homes

gaps so that's why we use them and that's why you're seeing medication

on the increase in both our countries and it is completely irrational to do so

then we make accommodations

that's what I meant by altering the point to performance using goes by

strategies we talked about

externalizing information you need to create prosthetic

devices in these places to help them show what they know