We’re constantly learning more about the world of neurodiversity and how to appreciate that every person’s brain works differently. Yet, given the pressure to conform—to perceive, process, and utilize information in the “right” way—millions of people feel as if they don’t fit in (or can’t cope in)—today’s world. Fortunately, we are making great strides in understanding, embracing, and encouraging respect for neurodivergent individuals by emphasizing that “different” does not equate to “deficient” or “broken.”

Those who are not given the individualized attention and support they deserve often suffer from constant self-doubt, a lack of confidence, and poor self-esteem. When we learn to see beyond a diagnosis and tune into each individual’s unique needs, mental and physical health tend to thrive. Join Dr. Carla Manly and medical expert Dr. Raun Melmed who will be sharing his expertise on ADHD, autism, anxiety, and neurodivergence. This captivating episode may be especially helpful for adults, parents, and children affected by ADHD.

Get the support you need:

https://add.org

https://www.nami.org/support-education/nami-helpline

https://www.corticacare.com

https://autismcenter.org

 

Books by Dr. Carla Manly:

Date Smart: Transform Your Relationships and Love Fearlessly

Joy From Fear: Create the Life of Your Dreams by Making Fear Your Friend 

Aging Joyfully: A Woman’s Guide to Optimal Health, Relationships, and Fulfillment for Her 50s and Beyond

The Joy of Imperfect Love: The Art of Creating Healthy, Securely Attached Relationships

 

Connect with Dr. Carla Manly:

Website: https://www.drcarlamanly.com

Instagram: https://www.instagram.com/drcarlamanly

Twitter: https://www.twitter.com/drcarlamanly

Facebook: https://www.facebook.com/drcarlamanly

LinkedIn: https://www.linkedin.com/in/carla-marie-manly-8682362b

YouTube: https://www.youtube.com/@dr.carlamariemanly8543

TikTok: https://www.tiktok.com/@dr_carla_manly

 

Books by Dr. Raun Melmed:

Marvin’s Monster Diary: ADHD Attacks! (But I Rock It, Big Time)

Timmy’s Monster Diary: Screen Time Stress (But I Tame It, Big Time)

Marvin’s Monster Diary 2 (+ Lyssa): ADHD Emotion Explosion (But I Triumph, Big Time)

Marvin’s Monster Diary 3: Trouble with Friends (But I Get By, Big Time!)

 

Connect with Dr. Raun Melmed:

Cortica Bio Page: https://www.corticacare.com/bios/raun-melmed-md

SARRC Bio Page: https://autismcenter.org/raun-melmed-md

LinkedIn: https://www.linkedin.com/in/raun-melmed-2358082

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Watch the episode here

 

Listen to the podcast here

 

Mindfully Managing ADHD, Autism, and Anxiety with Medical Expert Dr. Raun Melmed

Top Tips for Thriving as a Parent (or Child) with ADHD!

Introduction

We’re constantly learning more about the world of neurodiversity and how to appreciate that every person’s brain works differently. Yet, given the pressure to conform, perceive, process, and utilize information in the right way, millions of people feel as if they don’t fit in or can’t cope in this world. Fortunately, we are making great strides in understanding, embracing, and encouraging respect for neurodivergent individuals by emphasizing that different does not equate to deficient or broken.

I’m joined by a medical expert, Dr. Raun Melmed, who will dive into this real-life question, “I always felt like a failure because I couldn’t focus and was constantly told I was stupid. I was finally diagnosed with ADHD, which explained a lot. My wife and I have a three-year-old. I’m stressed because I think our little boy has ADHD. I recognize the signs. I don’t want him experiencing the pain I did, and I don’t want to mess him up. Any tips?” With that question as the focus of this episode, this is the show.

 

 

I’m joined by a very special guest, Dr. Raun Melmed, who will be sharing his expertise on ADHD, autism, and anxiety. Dr. Melmed is a Developmental Pediatrician, Clinical Director, Author, and so much more. Welcome to the show, Dr. Raun. It’s such a joy to have you with us.

Thank you. It’s a pleasure to be here.

Before we launch into the show, can you tell our audience a little bit about what makes you, you?

First of all, the thing that would possibly be attention-grabbing is my accent. People always ask me, “Where are you from?” I’m from South Africa. I left South Africa at the end of medical school. I went to medical school there. I studied in a number of places around the world and ended up in Boston, New York, and then Arizona. That’s where I am.

I’m a Developmental Pediatrician. I’m a pediatrician with a subspecialty in development and behavior. I see children and adults. Some of them are typical children who seem to have challenges. Others are children who have more difficulty. The morbidity in that situation is higher. I’m involved with autism research, being the proud Founder of the Southwest Autism Research and Resource Center. That’s SARRC, for short, Southwest Autism Research and Resource Center.

It is a wonderful nonprofit organization. Look it up on AutismCenter.org. There’s a lot of good information there. I’m also involved in the actual practice of seeing parents, children, and adults with the day-to-day challenges. I have a little bit of a clinical research background as well as a very practical in-the-trenches experience with this very wide population of neurodivergence.

You also work with adults.

I do. You start as children to your parents and then you become parents to your children, and then you become parents to your parents. Eventually, you become children to your children. That’s the course of it. We found that so many of our children who graduate from the pediatric traditional age group don’t have any place to go because the adult medical world is not necessarily ready for the avalanche of children who are becoming adults with ADHD and certainly with autism.

More adult practitioners are getting used to that and feel more comfortable with that, but we still have difficulty locating specialized treatment for those populations, which is the reason I went into seeing adults. For example, adults being diagnosed for the first time aren’t quite sure where to go. That’s with autism and ADHD. They’re like, “Where am I supposed to go? Psychiatry? My GP? My PCP? A developmental pediatrician. Is there such a thing as an adult developmental internist?” There isn’t, but sometimes, we fill that gap.

Undiagnosed ADHD

Thank you from the bottom of my heart for the work you do because I know there are a lot of adults, and I’ve worked with some and I know some personally, where they do have ADHD and it was never diagnosed. They would resist the diagnosis because ADHD is a familiar friend, so to speak, or a way of being. The idea of facing it later in life can be somewhat threatening. Have you found that?

Absolutely. What caught me about that question you read at the very beginning was how this adult, the concerned father, must feel about himself. In order to have ADHD, we always talk about having two sides of a coin. The one side of it is you have to have challenges. You have to have dysfunction. You have challenges in doing what most people can do. They can focus on their work. They get things done and are not distractible, impulsive, or overly active. Those are often the challenges.

On the flip side of that, we also think those challenges are present in many people, but are they causing harm? Is there dysfunction? Does the person not only have dysfunction or do they have harmful dysfunction? I use the term harmful dysfunction. They’ve got to meet both criteria. In other words, they’ve got to be failing.

 

 

We insist upon that in the diagnostic criteria. They’ve got to be either failing academically if they’re children or failing on the sports field, failing at home, or failing socially. If they’re not failing, regardless of how many symptoms of ADHD they might have, they don’t have it because that’s the DSM-5. It says you must have failure as well.

The interesting part is about what areas you fail in. Maybe you’re a bright individual and academically, you’ve skimmed by regardless. You’ve gotten your family together, but not that much. The biggest and the most under-recognized failure is self-esteem. It’s the impact of having constant people telling you, “We know you can do better. You’re not good enough right now. We know you can try harder. We know that you mean well.” It’s having this constant barrage of challenges being heaped on your head. Parents say, “He doesn’t seem to mind. She doesn’t seem to bother us with it.” It does.

 

 

Often in adulthood, parents are adults beaten down. They’re bright people. They thought they’d be great entrepreneurs. They thought they’d be wonderful mothers. They thought their households would be perfect. It doesn’t turn out like that. They’re like, “I’m a loser. I’m a failure.” That self-esteem has impacted them. Recognizing that as harm that is being done to adults is key. That voice that you used when you described what the question was is the first thing I thought about. I was like, “Here’s another one, an individual whose life has been battered this way and that way with constant negativity.”

I want to jump in for a moment. Many people take the idea of failure in a highly charged way. I like looking at it as negatively impact. You may feel a little wobbly at certain life skills. You may not be as great at English, math, or mechanical things as somebody else. Those beliefs by others become your own beliefs. Thus, that negative cycle and the self-esteem, if it was there, starts to erode. If it was never there, it doesn’t have a chance to build up because you’re surrounded by all of this negative talk from others and self-talk.

ADHD, Autism, and Neurodivergence

I like that idea of looking at it as whether there’s harm. Where is there harm in your life from ADHD, autism, or whatever issue is going on? Could you please give our audience, even though most people are familiar with it, I don’t like to assume, simple definitions of ADHD, autism, and the umbrella term or the non-official term of neurodivergence?

One of the nicest things about ADHD, even though it is a label, is it has become a very useful tool. The word autism spectrum disorder as well has become a useful tool to understand differences. My parents’ generation or the generation before that, and you’re much younger, so you wouldn’t know, didn’t have terms like ADHD. There was that, “This child is lazy. This child is crazy,” or, “He’s dumb.”

Those were the terms that were used to describe individuals, lazy, crazy, and stupid. I’m not that. That has changed. The whole orientation about ADHD is to give us the vocabulary or words to try and understand those individual differences. The beauty of these alphabet soup labels, and there are a lot of things that are not that beautiful about them, is at least they give us some terminology so we can fully understand what’s going on.

ADHD is a complex neurodevelopmental disorder. We usually think about two sets of symptomatology that make up ADHD. The 1st set is the inattentiveness and the 2nd set is the hyperactive and impulsive. Some children are more hyperactive and impulsive, some are more inattentive, and some have both symptoms together.

We talk about ADHD with an inattentive presentation, ADHD with a hyperactive, impulsive presentation, or ADHD combined presentation. The DSM-5 will change the issues all the time and change our little labeling systems as if they’re creating a new situation. For example, we used to say ADHD hyperactive subtype. We are not subtypes anymore. We’re presentation. What a great advance. We’ve been making progress in terms of that.

First of all, they have to be those symptoms. Second of all, those symptoms have to be impacting a child negatively in two or more settings. Those are school, home, sports field, and social activities. I’ve added that self-esteem issue. Also, the symptoms have to be present in more than two situations. Not only do they have to be present in more than two situations, but they have to be causing harm in more situations.

This can impact boys and girls. We like to think about these symptoms starting before the age of 12, and certainly, symptoms evident before the age of 7 impact a child. Depending on the age group or depending if they’re adolescents or adults is a little leeway in having the actual age of onset. That’s ADHD. Those are the most significant points when we think about, “How do we make the diagnosis?”

It’s complicated, though, because hyperactivity, impulsivity, and distractibility are similar to what fever is for maybe an infectious disease specialist. If the child has a fever, we don’t jump and say, “They must have pneumonia,” or, “They must have meningitis,” or, “They must have a URI,” or whatever else. There’s a beautiful thing that medical students learn in the emergency rooms. What they learn is that everything that wheezes isn’t asthma. If you didn’t take a history to find out whether the child was eating peanuts and 3 or 4 minutes later they begin to wheeze, you might treat it for asthma when, in actual fact, there’s a peanut stuck in their throat.

Similarly, hyperactivity, impulsivity, and distractibility can be symptoms of depression, anxiety, learning disabilities, sex abuse, lead poisoning, sleep deprivation, or chronic fatigue. We have to be awfully cautious about not just taking checklists and saying, “You check this. You check that.” If you go online and you can do these checklist assessments and say, “ADHD,” it’s never as simple as that. We have to take it seriously because it is a very serious condition.

ADHD is never as simple as that, and we have to take it very seriously because it is a very serious condition. Share on X

Thank you. I want to pause here to applaud you for saying exactly what you are saying. Often, people self-diagnose, whether it’s ADHD or something else online. They see this checklist that might be offered in good faith, but we have to contextualize it. We have to be able to go to the roots of it. You are a wonderful clinician or a wonderful doctor because you go beneath the checklist to see the whole individual and assess the situation and all of the nuances. That is the danger of getting into a spot diagnosis or a checklist because sometimes, it’s simply confirmation bias at work.

That’s exactly the situation. The symptoms can be caused by many things. One of them is certainly ADHD. The second part of it is that ADHD rarely travels alone. It almost always has other co-occurring conditions. Some people would call them comorbid conditions. Co-occurring conditions are possibly more appropriate.

For example, learning difficulties. Seventy percent of the kids with ADHD have learning difficulties. They’re not necessarily learning disabilities but certainly learning challenges. That could be anxiety. How could you possibly be in trouble all day long and everybody moan and groan at you about how you are this and that and not be anxious?

We talked about self-esteem issues. There could be associated social interaction difficulties. If you’re hyperactive and impulsive, you don’t notice when you might be making somebody else feel embarrassed and making their faces turn red and they’re starting to cry because you’re onto the next thing. You didn’t notice that you hurt that person’s feelings. They’re like, “I don’t like that person. They’re selfish. They’re doing their own thing. They’re into themselves.”

The social challenges of individuals with ADHD are huge. Adults might think that they’re cute because they come up with funny things to say. Younger children, 3 or 4 years younger than themselves, might find them fascinating. Same-age peers don’t necessarily like kids with ADHD. They don’t want to be associated with them. That might be guilt by association. They might not be as fun as playmates.

I love how you were talking about co-occurring disorders. When I was working with juvenile probation, I noticed that there was a high level of individuals who were either suffering from PTSD due to abuse at home or bullying in the schoolyard. We can’t underestimate the truth that if you have a parent who’s calling you stupid, dumb, or, “Shut up and sit down,” or, “You can’t do any better than that,” or whatever. That’s emotional abuse.

Sometimes, there’s physical abuse along with it. The bullying that can occur in the schoolyard is horrific to a child. It’s horrific to anybody, but particularly to the child’s growing brain and development. It can really have a huge negative impact. We’re back to your self-esteem. Negative self-esteem often goes hand in hand with that type of abuse.

Self-doubt kills any kind of confidence. The good news is developing confidence will kill doubt. That’s the reverse of that. There are so many of those interesting things when you use it in reverse. That’s why we have to start early, late, or any time. It’s never too late to build confidence because that will reduce doubt and build ambition because that will reduce laziness.

Thank you for saying that. I have to applaud you again. I love talking to you. It’s never too late. For our audience, the dad who wrote in, and anyone who’s reading who’s thinking, “I’m 40,” or, “I’m 50,” or, “I’m 30,” or, “I’m 60. I can’t change my brain.” Even if you’re 70 or 80, you can change your brain. It might be a little harder when you’re older. It might take more patience. Would you agree we can change our brains at any age?

Absolutely. We know that to be true in a variety of different situations where they’re still layering down with new cells in the cerebral cortex into the 7th, 8th, and 9th decade. I always remember a great story. I had this adult with ADHD. His kids came to see me as well. He’s a household name. You would know his name. He has a wonderful, beautiful wife and a beautiful family. He’s very rich and has been, to an extent, the most successful person that I have probably ever met.

When we started treating his ADHD with a variety of different modalities, he came into the office and, during the course of the conversation, began to cry. He was talking about how the impact of treatment has affected him. I’m like, “Why are you crying?” He says, “If I would’ve known this earlier on in my life and taken charge of my life in this way that I’ve been able to do now, things would’ve been so much easier for me. I would’ve been able to achieve so much more.” I was looking at him and thinking, “Really? You are on top of the world here.” Yet, this person felt after being treated that he couldn’t believe the impact, that recognition of the concern, reading about the concern, and treating it how much that can make a difference.

We know that for adult boys, the average age of diagnosis is 7 or 8. For the adult women we see in our clinic, the average age of diagnosis is 30 years of age. Disproportionate number of children diagnosed as boys versus girls in young kids, but in adults, women especially, definitively because our ratio of men to women in our adult clinic is 1:1 as opposed to 4:1 or 5:1, even in the elementary and high school years.

It’s so beautiful that you are addressing all of these issues. For our audience, regardless of gender, it’s helpful to know that if you’re struggling with ADHD or any disorder, a diagnosis itself is no help. It’s using the diagnosis as a framework to create understanding, get the support that you need and deserve, and persevere until, as you were talking about with the man you worked with or the individual you worked with, finding the right clinician who can make you feel as though you can operate at your fullest capacity. That’s what we want to enable people to do mentally and physically, to operate at our fullest capacity, which is different for all of us. No matter how much money or external success we have, if we’re all operating at our best capacity, we make the world a better place.

 

 

Advice For The Concerned Parent

Thank you for all of the rich information that you are giving to us. When we look at the dad who wrote in, he’s so worried. I don’t want to forget about getting the definition of autism and putting that out there, but returning to the dad’s question, he is very clearly worried about harming his little one. If we read between the lines, maybe he’s also concerned about other people harming his son in ways that he was likely harmed. What would you say? What words of wisdom?

First of all, congratulations to the father for being able to bring to the fore his feelings and concerns, particularly the poignancy of not wanting his own child to suffer the same way that he did when he was a child. He’s already an amazing dad because he’s already looking to see the individual differences that are apparent.

Instead of pigeonholing the child into being a mini adult, he’s recognizing, as we all should be doing, that children are different from adults. That sounds so obvious, but it wasn’t obvious to the previous generation. Children had to be little adults. We know that children have different temperaments from one day of age. Even in a premature child, these children are different from one another. You can determine the differences in temperament in a premature baby. It’s amazing. There are standardized assessments to do that. It goes all the way up to adulthood.

First of all, it is saying we are different. Some of us are easy, and some of us may be difficult. It’s not amazing words and not rocket science, but at least it helps to identify, “My child needs to be addressed differently. My child needs more of this and less of that.” Children are not equal. Children are very different from one another. There is no bigger challenge for children than when we treat children who are unequal equally.

Children are not equal. They are very different from one another. There is no greater challenge for children than being treated equally when they are inherently unequal. Share on X

As parents, we sometimes think, “Everything’s going to be exactly the same.” If we recognize the children’s individual differences, some of the children need more playtime, other children might need more quiet time, and other children might need more alone time. It’s simply like that. It’s being able to feel comfortable with you as a parent and being able to look at that and see it.

Benjamin Spock’s famous quote to parents was, “You know more than you think you do.” He put that in the front end of every one of his books for baby and childcare, which was wonderful. It’s looking at children with differences. You know more than you think you do. You know exactly what your child needs. First of all, that starts with awareness. It’s like, “My child is different, and that’s okay. My child might be more active, and that’s okay.”

We do not necessarily want to be authoritarian parents, but we certainly want to be authoritative parents.  We certainly want to bring knowledge and information to the situation without being taught how to put a child in timeout, punish, and develop behavioral plans. Maybe that gets into the realm of almost authoritative necessarily, but authoritarian. However, this dad’s on a different path. I can tell that already because he’s showing that awareness.

What are we trying to do with our children? First of all, we want them to be happy and part of being happy and part of being joyful, even at this young stage, I believe, is trying to inculcate being mindful and being aware of what is going on around you in different ways. Children do this naturally. They very easily look at different situations, pick up on the big picture, and identify what’s happening without being necessarily sidetracked. How are we going to do that?

There are different activities, for example, that this father should start doing with his child. Let’s start with exercise. We know that exercise is one of the most powerful non-medication treatments that there is for ADHD. That could be repetitive rhythmic activities. Left-right activities help not only to develop the brain because it’s almost like swimming in utero, and you’re trying to replicate that by having these left-right activities, but they also enhance focus and concentration and improve body strength and coordination.

 

 

My favorite activity to start with kids very young, from 3 or 4 years old, is the best movement sport of all time, which is swimming. To start with a child and teach them in a very rhythmical situation. When children are swimming across a pool, you can’t tell which is hyperactive, impulsive, or inattentive because the left-right repetitive behaviors are so incredibly helpful. That’s why children with ADHD also like swinging. They love that rhythmicity. Starting to enhance rhythmicity within the home is a very great thing to do. That’s from an exercise perspective. I can go into more detail about that.

Jumping to the next level of rhythmicity, it’s about music. Music has rhythm inherently to it. It’s about having music, encouraging singing, and encouraging books that have lots of rhythm in them, like Dr. Seuss books and nursery rhymes. I especially love nursery rhymes for that age group. Not only will it be a great precursor to reading, but it will also help keep an inattentive child much more focused on the page when we try to read to them than if we had to, for example, read a story at this age per se.

Rhythmical poetry, rhythmical music, and singing together in a family context are types of rhythmicity. The first step that we’re going to go back to would be exercise and then the music to enhance rhythmicity. There can be other things, too, and we can go on and talk about them, whether it’s nutrition or whether it’s other fun activities to help make children more aware of what’s happening with them.

If I can pause to join you on the idea not only of being rhythmical because no matter our age, but certainly younger ones rocking a child in a rocking chair or on a swing, we love rhythm. Babies love rhythm. Toddlers love rhythm. Adults love rhythm. I appreciate that piece because it’s very doable. We can all find a way to add rhythm.

The other part that I found fabulous and so in line with how I view working with children and adults is the idea of attunement. We say we love our children, and love is so important. One of the most wonderful ways to show our love for our children, partners, or anyone is to be attuned to them. I know in my fourth book, The Joy of Imperfect Love, it’s all about attunement because it’s based on attachment theory.

When we attune, going back to your part that every human being is different and every baby is born different, as much as it might feel easier to put everybody in a mold and say, “These are the guidelines. This is what we need to do, should do, or will do,” it does take a little bit of more work to see the individual and attune to the individual. If you do that upfront, you make the child’s life, the adult’s life, the partner’s life, or the family’s life so much easier in the long run because when we thrive, children thrive as well. We all thrive when someone takes the time to attune to us.

Thank you for pointing that piece out about the differences because that’s what worked for this person’s three-year-old. Let’s say they have another child and maybe the child does or does not show signs of ADHD, but that child may have very different needs. Even ADHD treatment is not one-size-fits-all. There may be certain commonalities, but the beauty of it is you get to be creative with your parenting to notice, “What does this person need? What does this little human being need? What makes them thrive?”

My favorite quote from Marcel Proust is, “The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.” It’s true for discovering nature. When you become more aware of animals and the intricacies of their lives, you understand things that you never would’ve seen prior. When you look at your child and look below the surface, you become attuned to them. That’s exactly what Marcel Proust was trying to say.

When you become attuned to your child and you see them with new eyes, you’ll value them in such a different way as opposed to having preconditions in your brain and saying, “This is how I want my child to be. If they don’t meet those expectations, I’m going to be so upset and depressed and feel like a failure.” You see them as their own individual against the background with new eyes. You’ll have a lot more fun with your child from then on and a lot more appreciation and respect for them. That will be reciprocated when children feel that respect. That gets reciprocated when they’re taken seriously and identified seriously. Without being pedantic and presumptive, it is looking at them and saying, “I get where you are, and that’s beautiful.”

 

 

I love that you said how reciprocal it is because it is. When that child feels seen and loved for who they are rather than the version of what the parent wants them to be or the doctor, the lawyer, the baker, or whoever it is, that child is allowed to grow into being their best self. That child then looks back at that parent with those eyes of love and appreciation for having been seen and met for who they are, their individuality, and the best self that they will grow to be when they feel loved and supported.

When we hear people saying, “Thank you,” whether it’s at the Oscars or whether somebody’s been an amazing success in science or literature, they’re always talking about how much they appreciate that their parents allowed them to be who they are as opposed to standing in the way, blocking, or sabotaging what they thought they should be able to be doing. We can learn something from that. This child’s father is learning that. This child’s going to be all the more lucky for it.

Food Choices

I’d like to invite you to share a few thoughts about diet. You were saying something about food choices that might be most helpful for this dad and his little one.

There’s a lot to be said about nutrition. Dr. Osler, who was a very famous British physician, said, “If the doctor of today does not become the nutritionist of tomorrow, then the nutritionist of today will become the doctor of tomorrow.” Those are interesting words. All of us are becoming much more attuned and aware of diet in a child’s life.

The most important thing in terms of nutrition is to make sure, first of all, that the children are eating. You spoke about a juvenile detention center. Here in Phoenix, we did a study once in a juvenile center where 80% of the kids have ADHD. That’s not to say that 80% of people with ADHD are juvenile delinquents because that’s not true at all. In fact, it’s a teeny percent.

However, when we gave those individuals a good breakfast, it was amazing how different they behaved over the course of the day. You might ask, “What was that good breakfast?” Unfortunately, it was a sugary cereal, but it was much more than the nothing that they were prior eating before having their different school programs.

The first notion that I would suggest is that every single child has protein for breakfast. It’s a very important part of a diet that children have, whether it’s beans, fish, meat, or eggs, that they have protein for breakfast. It’s important as well to recognize that a lot of children with ADHD might have sporadic appetites if they’re on any kind of medication and they might not eat all at one time.

It’s important for kids who come home from school to be given a small amount of complex carbohydrates, whether it’s a quarter sandwich. Rather than putting a whole big thing on the plate, put a little thing that is easy to eat and easily edible. A good mother will tell us, especially in the younger age group when the child misbehaves, “They’re tired. I can tell,” or they might say, “They’re hungry. I can tell.”

Assume they are both. If the child is more difficult in the afternoon at 4:00 or in the bewitching hour of 5:00 when parents are getting home from work, that’s the type of child who needs to have a quarter bread and butter sandwich, a quarter bagel, or a couple of tablespoons of pasta because that will make a very big difference to their diets.

Are there foods that might make a child’s behavior that much worse? Sometimes, I think about excitotoxins that might make the children that much more active. Certainly, we know that excessive amounts of sugar are one of those excitotoxins. We know that MSG, Monosodium Glutamate, is present in those delicious foods that children like, like Top Ramen noodles, and those little crystals that you add to the noodles are 85% MSG. That’s what it is. That’s all it is. It’s not some special flavoring. If you’re going to give the noodles, and I know it’s cheap and convenient, don’t use MSG. Even the rest of the noodles are still high in that.

I would like kids to know that whatever color their tongue turns when eating food, that’s what color their brain is turning. If they’re having a Slurpee or a slushie and green and blue Slurpees and slushies, and they’re in my office and stick out their tongue, that’s the color of their brain. It’s clear that children who have that kind of diet need to be limited. Children have an average of 300 to 400 milligrams of artificial dye in their diets on a day-to-day basis. Some individuals might be that much more sensitive to caffeine, but certainly, colors. One of the big colors that are a culprit is maybe caramel. That’s as far as diet.

Could there be any specific supplements? The supplements that I generally use are not nuts and are present in lots of people’s diets. For example, probiotics. We know that children with a diet rich in probiotics have much fewer mental health challenges in general. Having food with high probiotics, which could be kefir, yogurt, or supplements with probiotics, would not be a bad idea.

Even in the younger age group at 3 years old, 200 or 300 milligrams of Omega-3 fatty acids, a combination of DHA and EPA, don’t worry about that. The dosage is about 300 milligrams. You can get that mercury-free stuff in any supermarket and certainly at a health food supermarket where you can pick that up very readily.

It’s almost an overall orientation. I’m never quite sure whether any of these things I’m talking about have as much impact on the child. If you had to do a little double-blind study, if a parent feels, “I can do this. I can be in charge of this. This is not going to bowl me over. I know how to address my child. I know how to be aware of them, of their moods, and when they’re tired and hungry,” when a parent has that confidence in there, it makes the job of parenting a challenging child a whole lot easier.

When a parent feels confident and aware of their child’s needs, it makes the job of parenting a challenging child a whole lot easier. Share on X

When they incorporate their child into the treatment paradigm and they treat the child as an equal on the team taking care of themselves, then we’re really moving forward. That’s when we can get the child to be given agency to say, “I can be in charge of this. I can be in charge of my body. I can be in charge of my mind.” We want children to be aware of that.

I spoke about mindfulness at the very beginning. We want children to feel, “I can be in control.” There might be some other things like learning from books, bibliotherapy, and different exercises, which they can try. There are a lot of different sweet little things. One of my favorite things, for example, is kids who are very disorganized in the morning and the parents say, “I can’t get them dressed. They’re useless. They’re this. They’re that.”

Take your iPhone. Take a photograph of them when they’re ready to go to school. When, on one particular day, they’ve got their hair brushed, their pigtails are in place, they’ve got their clothes together, they’ve got their little backpacks with a lunch pail inside, and they’re showing the fact that they brushed their teeth, take a photograph of that, blow it up, put it on the front door, and say, “When we leave the house. We got to look like that.” We begin with the end in mind. It’s like, “I want you, little 3-year-old, 4-year-old, 5-year-old, or 8-year-old, to look at that picture and say, “What’s missing from where I am right now?” They can say, “That’s how I want to look. That’s how I want to be.”

There are many different steps along the way, and I don’t want to be too exhaustive about that. We might have to do part two of this. Nonetheless, that child needs to know what it is that they can do and what they should be doing. There are things that parents can do. There are things that teachers could do, even the preschool teacher in the classroom. A whole community can be doing this. The child needs to be included in the treatment process as well.

I love how that example you gave gives a child something to shoot for, that little picture of them being successful and saying, “We can do this. Let’s make this our goal to get here pretty well most of the time.” I also really want to thank you for bringing up the part about ADHD and diet choices, which are so important.

This takes me back to my time working with juveniles on probation. I am so glad that you brought up what you saw because when I was working probation, I was given individuals and was told over and over again, “We need an ADHD diagnosis for this kid. Give us an ADHD diagnosis. This kid has ADHD.” I’d do my evaluation and say, “First, I’m going to start with talking to the child and doing a global screening.”

One of the first things I did was to look at their diet. What are they having for breakfast, lunch, and dinner? What is their day like? I created a little questionnaire so the kiddo could put on smiley faces and how they felt. Overarchingly, not 100%, the diet was either no breakfast at all or a prepackaged pastry for breakfast. Lunch was whatever they could get at school, a slice of pizza or an adrenaline drink. Dinner was a couple of slices of pizza if they had dinner and some sugary snack later on. That could be a bowl of cookies, a bowl of pretzels, or something. That was the diet.

Almost always absent were fruits, vegetables, and protein. There were plenty of cheap carbs and loads of sugar. Once I started working with the families on creating, they didn’t understand simple healthy steps that they could take that were affordable to get more protein in the diet, like peanut butter, yogurt, and some of those basics that can be quite affordable.

The level of the ADHD symptoms went down enormously. Plus, in concert with that, I was working with the parents to help the parents learn that sometimes, the ADHD symptoms were pleasing for attention. The kids come home from a long day of being cooped up in school, and then they bounce around the house. They want to get rid of their energy, going back to your part about where they naturally have a lot of energy that needs to be dissipated in a positive way.

When I taught the parents, “Let’s take that kiddo outside. Play some basketball with them, do some jogs around the block, or whatever it is,” not only were the families coming together more, but the kids were no longer the big problem. There was such a shift. The kids felt seen and loved. It was wonderful. It doesn’t cure all ADHD, but it does bring down the symptoms and the number of people who are diagnosed when you pay attention to the whole person, which is what the dad is doing.

What you’re recommending for the dad is, “Look at the whole person. Look at your kiddo and notice what your kiddo needs in order to thrive.” That includes all of the things you talked about, seeing the child, setting him or her up for success, doing some rhythm-based exercise, some rhythm-based reading and music, and then looking at diet.

Final Tips

With all of those things, and I know there’s a lot more, what are a few more tips you might have as we prepare to wind up? You’re right. We have to do part two because we never got to the autism and the overall other pieces. I’d love to have you back. With that said, what are some final tips for this dad and the mom?

Two or three things. First of all, we have to pay attention to sleep. The number one medical cause of attentional difficulties is how well the child is sleeping. How we pay attention to that is also another subject. If the child is not sleeping well, their attention will be disrupted entirely the next day. Second of all, a quick tip from my series of books, Marvin’s Monster Diary, which would be great for any age group, for a 3-year-old or a 10-year-old for that matter. There’s a little book, A Monster Called Marvin. He has ADHD, but he also is friends with anxiety and agitation. This is one of the books that looks like Marvin’s Monster Diary.

One of the things that Marvin does, because this is a book to empower children and teach mindfulness, one of the lovely tricks he has, and I’ve started this one with my own kids when they were very young, and you can start it with a three-year-old, is use what I call a monster camera. Monster cam for short. You form your fingers like a camera. It’s as easy as that. You go around the room pretending it’s a camera. You can zoom in or zoom out. You can try and be aware of what other people are doing.

You could be like, “Let me look at Carla and see what she’s doing right now on that screen,” or, “Let me look at the other kids in the classroom and see whether they’re paying and focusing attention,” or, “Let me take my camera and put it up on the ceiling, let it focus down on me, and see if they can see Raun and what he’s doing right now.”

This monster cam, that’s simply how you make it. You can make it with your fingers. Kids can go around the room. That is a mindfulness issue to give kids assistance to start focusing on their environment. Can you go close into looking at his eyelashes or can you go very far out and see his whole body? You can do marvelous things with this monster cam. It’s a great mindfulness tool. I hope you enjoy it.

Thank you. I appreciate that you brought the mindfulness piece up as we’re concluding because mindfulness for all of us, particularly those with ADHD, helps them slow down. It creates that slowness and that focus that can be really hard sometimes. I love the idea of the monster cam and also your books. One is Harriet’s Monster Diary: Awfully Anxious. It is such a tremendous series.

I do want to say from my own perspective that the parent who’s reading with the child also benefits. The adult also benefits because it helps them tune in more to the child world. If the dad in the question has ADHD, it creates a sense of healing for the person reading the book who might see themselves as well in some of the characters. You are fabulous. I am so grateful to have you with us. Where can our audience find you?

I’m in Scottsdale, Arizona. I work for a company called Cortica, which has clinics in about 5 or 8 different states across the country. We see these kinds of children. I like the field of developmental pediatrics. I hope there’s a developmental pediatrician in your neighborhood because they have a very good sense of what these types of children need. However, more primary care doctors are engaging, knowledgeable, and helpful to families when these issues arise.

Thank you so much for being with us. Thank you, again, for joining us. It has been such a privilege and a pleasure.

Thank you for having me.

It’s such a pleasure. Thanks to our audience for tuning in. This is the show.

 

Important Links

• Dr. Raun Melmed
• Marvin’s Monster Diary
• Harriet’s Monster Diary: Awfully Anxious
• AutismCenter.org
• A Monster Called Marvin
• The Joy of Imperfect Love
• https://www.CorticaCare.com/Bios/Raun-Melmed-MD
• https://www.Amazon.com/Timmys-Monster-Diary-Screen-Mindfulness
• https://www.Amazon.com/Marvins-Monster-Diary-Lyssa-Mindfulness
• https://www.Amazon.com/Marvins-Monster-Diary-Trouble-Mindfulness
• https://AutismCenter.org/Raun-Melmed-MD
• https://ADD.org
• https://www.NAMI.org/Support-Education/NAMI-Helpline
• https://www.DrCarlaManly.com
• https://www.Instagram.com/DrCarlaManly
• https://www.Twitter.com/DrCarlaManly
• https://www.Facebook.com/DrCarlaManly
• https://www.LinkedIn.com/in/Carla-Marie-Manly-8682362b
• https://www.YouTube.com/@Dr.CarlaMarieManly8543
• https://www.TikTok.com/@Dr_Carla_Manly

 

About Dr. Raun Melmed

Dr. Raun Melmed is the clinical director of Cortica Scottsdale, formerly known as Melmed Center, and a developmental and behavioral pediatrician. He is a co-founder and the medical director of the Southwest Autism Research and Resource Center. A native of South Africa, he completed his postgraduate studies in Israel, New York City, and Boston. He was a fellow at the Children’s Hospital in Boston where he was an Instructor at Harvard Medical School.

Dr. Melmed is an Adjunct Senior Researcher at the Translational Genomics Institute in Phoenix. He is a member of the Society for Behavioral Pediatrics, the Academy of Cerebral Palsy and Developmental Medicine, the Ambulatory Pediatric Association, and a fellow of the American Academy of Pediatrics. He is a board-certified pediatrician and is also certified as a Diplomate in Developmental-Behavioral Pediatrics.

Dr. Melmed has been instrumental in setting up nationally recognized physician training programs for the early identification of infants and toddlers with developmental and behavioral concerns and has authored a program geared toward the early screening of autism spectrum disorders.

Dr. Melmed is the co-author of Succeeding with Difficult Children. He has published numerous articles and chapters and has presented around the world on topics related to development and learning. Dr. Melmed is a member of the board of directors of community agencies including the New Directions Institute, the Council for Jews with Special Needs.

Dr. Melmed is a member of the Society for Developmental and Behavioral Pediatrics and the Academy of Cerebral Palsy and Developmental Medicine and is a fellow of the American Academy of Pediatrics. He is board certified in Pediatrics as well as in Developmental and Behavioral Pediatrics.

The author or coauthor of more than 70 publications, Dr. Melmed is currently a principal investigator of novel psychopharmacological agents in the treatment of autism, Fragile X and ADHD and collaborates on studies of tools used in the diagnosis of autism spectrum disorders.