1. ADHD Awareness Expo
www.adhdexpo.com
ADD / ADHD Parenting Q & A
Dr. Rory Stern
enter.
Sep 17 2010, 4:54 PM
Rory F. Stern: Hi everyone
Sep 17 2010, 4:54 PM
slipreefish724: Do you recommend it as a good resource and tool when attempting to help a child with
challenging behaviors??
Sep 17 2010, 4:56 PM
Rory F. Stern: Hi everyone...so I am still learning the technology here and I might have lost your
questions if you asked them already... So if you have questions for me, please go ahead and ask away

2. Sep 17 2010, 4:57 PM
Rory F. Stern: @slipreelfish724 - Do you mean "what" tools do I recommend?
Sep 17 2010, 4:58 PM
Rory F. Stern: test test test
Sep 17 2010, 4:59 PM
Guest726 (guest): Hi, Rory!
Sep 17 2010, 4:59 PM
Rory F. Stern: Hi @726
Sep 17 2010, 4:59 PM
Rory F. Stern: I'll begin answering questions soon if anyone has questions on Parenting Children with
ADHD
Sep 17 2010, 5:01 PM
Rory F. Stern: @Nicole I don't necessarily have specific tools as much as I recommend setting clear
rules, boundaries, and expectations as a family
Sep 17 2010, 5:02 PM
Rory F. Stern: With that comes the need for follow-through on the rules and both parents or caretakers
to be on the same page....consistency is everything
Sep 17 2010, 5:02 PM
Rory F. Stern: That said, I do believe that some children can benefit from behavior charts...but that all
depends on the individual child. It may work for some and not for others
Sep 17 2010, 5:04 PM
Rory F. Stern: @slipreelfish - did that answer your question too?
Sep 17 2010, 5:05 PM
Guest679 (guest): What evaluation do you recommend to diagnose 9 year old girls with ADHD that
also have a diagnose with Neurcognitive Disorder, alcohol unknown but suspected and a
Sensory/Regulatory Disorder?

3. Sep 17 2010, 5:07 PM
Rory F. Stern: @679 - I would recommend speaking with a neuropsychologist about having a full
evaluation if you are looking at multiple conditions to rule in or out
Sep 17 2010, 5:07 PM
Rory F. Stern: You also might need to see a sensory specialist to have that evaulated
Sep 17 2010, 5:08 PM
Rory F. Stern: ADHD is a difficult condition to diagnose, and the gold standard is a clinical interview
Sep 17 2010, 5:09 PM
Rory F. Stern: When you include other conditions, especially behavioral, psychological testing can help
clarify the diagnostic picture
Sep 17 2010, 5:10 PM
Guest859 (guest): suggestions on positive behavior plans in school to encourage tolerance
Sep 17 2010, 5:12 PM
Rory F. Stern: @859 can you tell me a little more about what you mean? Do you mean behavior plans
with the schools help? Or do you mean help with awareness and tolerance at the school?
Sep 17 2010, 5:12 PM
Bonnie (guest): What do you suggest for my 16 year old son who can't sleep well and is afraid of being
alone in the dark. My husband tries to understand, but thinks we need to be tough on getting him to
grow up. I understand what he is saying, but at the same time I know that these things are symptoms of
ADD.
Sep 17 2010, 5:13 PM
Rory F. Stern: Hi Bonnie - I'd first want to know why he has a difficult time sleeping? Have you had
him speak with a psychiatrist? Is it related to ADD? Is there something going on in the home or at
school that is upsetting him?
Sep 17 2010, 5:14 PM
Rory F. Stern: If it's related to ADHD, I'd want to know if it is a side-effect of the medication? There
are also sleep clinics that can check his sleep cycle to see if that is affected or how it is affect.

4. Sep 17 2010, 5:15 PM
Rory F. Stern: It could be as simple as switching his diet or using "melatonin" to help with sleep...and if
you consider that route, I would absolutely speak with a psychiatrist or your son's prescribing physician
first. I am NOT a medical doctor, so always check first
Sep 17 2010, 5:15 PM
Rory F. Stern: The reason I asked about things at home or at school...could be related to anxiety, stress,
or any number of factors. I am NOT suggesting something is going on, but I always want to look at the
big picture... How is the child interacting with and responding to his environment?
Sep 17 2010, 5:16 PM
Rory F. Stern: In terms of being "more tough," that can work, but I always take the approach of
understanding and comfort first.
Sep 17 2010, 5:17 PM
Rory F. Stern: At 16, I am going to think that there is some pattern or recent change affecting this
behavior, so I want to understand the behavior and what caused the change... It's like they say, you get
more bees with honey
Sep 17 2010, 5:17 PM
Rory F. Stern: I'm sure you know this Bonnie, but sleep is incredibly important for everyone,
particularly for people with ADHD, so it's important we balance sleep, with exercise, and diet.
Sep 17 2010, 5:18 PM
Rory F. Stern: I want to make sleep a positive experience...so getting "more tough" could take away the
positive benefits of going to sleep and recharging our batteries.
Sep 17 2010, 5:18 PM
Rory F. Stern: I hope that helps, and if you have more questions, please let me know or follow-up with
information and I'll be happy to answer
Sep 17 2010, 5:18 PM
Rory F. Stern: Before I answer the next question, I just want to welcome you all here!
Sep 17 2010, 5:19 PM
Rory F. Stern: I see a lot of great questions and I will do my best to answer as many as I can.

5. Sep 17 2010, 5:19 PM
Rory F. Stern: If you were here before we started at 5:00 PM, I need to ask you to ask your question
again. I made a "goof" and lost some of the questions.
Sep 17 2010, 5:19 PM
Guest30 (guest): Hi Dr Rory nice to meet you. I am going to be working with a child who is 4 years old
with ADHD and he is also deaf. Also i will have two boys with Autism any advice
Sep 17 2010, 5:19 PM
Rory F. Stern: Hi Guest30 - Nice to meet you too.
Sep 17 2010, 5:21 PM
Rory F. Stern: At 4 years old, it can often be difficult to tell the difference between "normal"
development and ADHD...they can look a lot alike
Sep 17 2010, 5:21 PM
Rory F. Stern: Best advice I can offer in this situation is a lot of love, encouragement, and praise for the
child.
Sep 17 2010, 5:21 PM
Rory F. Stern: Does he know how to sign?
Sep 17 2010, 5:22 PM
Rory F. Stern: How will you communicate with him?
Sep 17 2010, 5:22 PM
Rory F. Stern: At 4, this boy is pre-verbal, so your communication will be largely non-verbal...physical
communication...so you will want to be a positive role model.
Sep 17 2010, 5:23 PM
Rory F. Stern: Keep in mind that children at this age are still developing and looking to take in the
world in a very curious way... Be positive, supportive, and patient...
Sep 17 2010, 5:24 PM
Guest150 (guest): Hello Dr. stern and thank you for the time you are giving to help . I have a 10 year

6. old son hw was diagnosed by three different resources. He is not hiperactive but does lose his focus,
memory and reading comprehension. As hard as i have tried to look for resources and the best
enviroment he has fallen bak in school after taking mediaction off. It seems i have to star medication . I
know ADHD is forever but then my concern is if he doesnt learn to thrive without medication , he
would then take it for life?
Sep 17 2010, 5:25 PM
Rory F. Stern: Hi Guest150 - You are welcome, but thank you for being here and for asking such a
great question
Sep 17 2010, 5:26 PM
Rory F. Stern: Medication can be very tricky. It has been "proven" to be effective, but we must
remember that there are always underlying "issues" that still need to be addressed. While medication
might improve focus, we still need to provide an opportunity to learn strategies that will help a child be
more productive in particular settings.
Sep 17 2010, 5:26 PM
Rory F. Stern: So if we are talking about school, yes medication might help with focus, but there is still
a need to work on social skills, study skills, good note taking, etc... (just as an example)
Sep 17 2010, 5:26 PM
Rory F. Stern: The reason I am saying this is to address your question about "medications for life"
Sep 17 2010, 5:27 PM
Rory F. Stern: While I can't speak to how long your child might need or benefit from medication, we
know a number of things about ADHD over the lifespan
Sep 17 2010, 5:27 PM
Rory F. Stern: ADHD typically persists into adulthood for about 60% of those diagnosed as children.
Many symptoms can "disappear" or lessen with age...for instance the hyperactive ones
Sep 17 2010, 5:28 PM
Rory F. Stern: The other piece of these symptoms lessening is typically the application of strategies
learned as child that help someone "naturally" cope, react, and manage particular situations
Sep 17 2010, 5:28 PM
Rory F. Stern: So....your child might NOT need to be on medication forever. It all depends on their
symptoms, how their individual ADHD affects them, and the goals you and your doctor (with your

7. child) have for being on the medication.
Sep 17 2010, 5:29 PM
Lori-SouthAfrica (guest): What suggestions do you have about a 14 y.o. ODD girl that does not/will
not pick up her clothes, towel,etc., off the floor. She leaves the bathwater in, does not flush the loo,
leaves thelight on, even though she is not there.is disrespectful of her mom (who is borderline
dysfunctional ADD, but is trying really hard). She is also rude and tries to hurt her mom without
explanation (e.g. I hate you phase at the moment.)
Sep 17 2010, 5:30 PM
Rory F. Stern: Hi Lori! First off, my heart goes out to you. This sounds like a difficult situation, and I
am glad you are actively looking for help. I know this can't be easy
Sep 17 2010, 5:31 PM
Rory F. Stern: Now I should telly ou...I do not specialize in ODD...so I will offer what advice I can, and
hopefully we can find you a resource through a colleague who does understand ODD better than me
Sep 17 2010, 5:32 PM
Rory F. Stern: In any situation when I work with families, I always let everyone know that safety is
first....everyone has the right to safety
Sep 17 2010, 5:33 PM
Rory F. Stern: That's what I would address first in this situation....Being rude, disrespectful, or harmful
are things I will not tolerate
Sep 17 2010, 5:34 PM
Rory F. Stern: I would make that very clear... Assuming you agree with that
Sep 17 2010, 5:34 PM
Rory F. Stern: The other problems you describe are things that will take time, effort, and patience....and
could possibly need to be addressed one at a time
Sep 17 2010, 5:36 PM
Rory F. Stern: In terms of the behavior issues Lori, I would ask you how does your daughter respond to
consequences
Sep 17 2010, 5:36 PM

8. Rory F. Stern: You'll have to focus on one of these issues at a time as I mentioned, and I would let her
know what the minimum expectation is... What is acceptable and what is not.
Sep 17 2010, 5:37 PM
Rory F. Stern: Now that alone won't necessarily make a difference, but you've got to start with the
basics...with a foundation before we do anything else
Sep 17 2010, 5:37 PM
Rory F. Stern: I am firm believer in having a strong, positive foundation before we move anywhere else
Sep 17 2010, 5:38 PM
Guest679 (guest): I've done both. I am an occupational therapist too. They are currently doing The
Listening Program. A neuropsychologist did diagnose ADHD but said it was unclear.
Sep 17 2010, 5:38 PM
Rory F. Stern: @679 This is where the diagnosis gets so frustrating, it can be so unclear for so many
different reasons. Sometimes it just takes time to figure out what is going on...and time is the only
obstacle we can't force
Sep 17 2010, 5:39 PM
Guest805 (guest): One on one teaching within a country setting - Does it have more positive benefits
Sep 17 2010, 5:39 PM
Rory F. Stern: @805 I think one on one teaching or at least some additional one on one support can
absolutely be beneficial.
Sep 17 2010, 5:39 PM
Rory F. Stern: I would be interested in focusing on a learning environment or support structures that are
positive and account for the child's individual learning style
Sep 17 2010, 5:40 PM
Rory F. Stern: So many schools are set up to teach to the masses, and I'm sure I don't have to tell you, a
lot of children learn differently
Sep 17 2010, 5:40 PM
Rory F. Stern: Encouragement is everything and can make a HUGE difference when working with a
student

9. Sep 17 2010, 5:40 PM
Rory F. Stern: Anytime a teacher, tutor, or other educator can really reach out and give positive support
to a child, that is a great benefit
Sep 17 2010, 5:42 PM
Guest726 (guest): My 14 yo boy is diagnosed inattentive ADD with dysthymia - he has low energy and
poor appetite and is irritable. He thinks ADD is "bulls**t" and doesn't want to talk about it. He thinks
everyone forgets to turn in their finished homework and forgets to follow directions. He never knows
when meetings are for things he is involved in. Now in high school the demands on him will even be
greater. How do I get him to accept ADD and prepare for what he will need?
Sep 17 2010, 5:43 PM
Rory F. Stern: @726 - I would want to focus for a moment on the clarity of the diagnosis.
September 2010
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Sep 17 2010, 5:43 PM
Rory F. Stern: Is it ADHD that is contributing to the dysthimia, or is the dysthimia contributing or
exacerbating the ADHD symptoms?
Sep 17 2010, 5:43 PM
Rory F. Stern: In this case I would focus in on diagnosis being of utter importance....this will then lead
to the right treatment approach and help us understand what we are treating
Sep 17 2010, 5:44 PM
Rory F. Stern: With dysthimia, I'd want to address treatment there and find out if your son is taking
medication...or otherwise find out how that is being addressed?
Sep 17 2010, 5:45 PM
Rory F. Stern: Getting your son to "accept
Sep 17 2010, 5:45 PM
Rory F. Stern: his diagnose could be very tricky. How does he respond or would he respond to specific
descriptors of his behavior....
Sep 17 2010, 5:45 PM

10. Rory F. Stern: For example, my son has a difficult time keeping track of assignments... He has a
difficult time with focus and attention when he is bored. Is he "accepting" of that?
Sep 17 2010, 5:46 PM
Rory F. Stern: The most important part of "treatment" or support is when a child / teen "buys-in" to
what is causing them difficulties.
Sep 17 2010, 5:46 PM
Rory F. Stern: If they are unwilling, then you have to start there and consider how you will help him
gain more understanding of who he is...
Sep 17 2010, 5:47 PM
Rory F. Stern: I am curious...does he think that having ADD is a bad thing...so he wants to "deny" it?
Sep 17 2010, 5:47 PM
Rory F. Stern: Does he get picked on in school for being different?
Sep 17 2010, 5:47 PM
Rory F. Stern: Can we help develop his strengths to build his self-esteem so he knows what he is good
at or passionate about?
Sep 17 2010, 5:48 PM
Rory F. Stern: Also keep in mind that teens are going through a lot hormonally and develomentally, so
that can change the picture as well
Sep 17 2010, 5:48 PM
Rory F. Stern: Teens are notorious for "rebelling" - and maybe that's where the fight in him comes from
Sep 17 2010, 5:49 PM
Rory F. Stern: There is a lot here, and I feel for you. I really would suggest again that we start with a
strong foundation...understanding, education, and advocacy.
Sep 17 2010, 5:49 PM
Rory F. Stern: I wouldn't necessarily push the diagnosis on him right now, as much as I would focus on
helping him understand who he is...if that is possible...if he open to that.

11. Sep 17 2010, 5:50 PM
Rory F. Stern: And of course, I would suggest figuring out which of his diagnoses is "causing" the most
trouble for him...that may call for a specialist to determine whether the ADHD or dysthimia is more
present
Sep 17 2010, 5:50 PM
Bonnie (guest): He has always had a hard time sleeping, his doctor did say that it is probably related.
He is on strattera, but this hasn't gone away. I feel really bad that I can't help.
Sep 17 2010, 5:51 PM
Rory F. Stern: Bonnie...it is hard and I definitely feel bad as well. I would consider speaking with a
sleep or doctor, or looking into the "melatonin" option - again speaking with a doctor about this... There
are a number of natural aides that can help with sleep.
Sep 17 2010, 5:51 PM
Rory F. Stern: Then of course there is the issue of the side-effects of the medications... Is it the right
dose? Is it the right med?
Sep 17 2010, 5:51 PM
chrzzz (guest): What your opinion of manditory testing for adhd? Can a child once he/she becomes an
adult sue for damages if parents neglects their child and never has them tested for adhd?
Sep 17 2010, 5:52 PM
Rory F. Stern: Hi Chrzzz... This is interesting when you mention the word "neglect"
Sep 17 2010, 5:53 PM
Rory F. Stern: It is an interesting idea, but I don't believe a parent could be sued...unless the neglect was
harmful enough... I have never been asked this before
Sep 17 2010, 5:53 PM
Rory F. Stern: Mandatory testing is also interesting, but very difficult considering how many people
have ADHD-like characteristics in the population, but won't fully meet the criteria for diagnosis.
Sep 17 2010, 5:54 PM
Rory F. Stern: In this situation I would encourage the child in question to speak with someone at school
about this and see what resources are available for testing, evalution, or support in the schools when
parents are not willing to request

12. Sep 17 2010, 5:54 PM
Guest859 (guest): Well...my 13 year old is struggling academically...and feels when hes corrected that
he is not accepted. he is very impulsive..and no, the teachers in genenral dont understand. I thought if i
could have 2 or 3 target behaviors in place with rewards, i could make it a more positive
environment..and this would also guide the teachers into better reponses to him when he is disruptive...
Sep 17 2010, 5:54 PM
Rory F. Stern: @859...thank you for the extra info. This is very helpful
Sep 17 2010, 5:55 PM
Rory F. Stern: In this case, related to teachers, I might speak with them about using "non-verbal" cues
when he is being discupritve in class
Sep 17 2010, 5:56 PM
Rory F. Stern: Not many students like being singled out in front of their peers, so you can ask the
teacher to tap him on his shoulder, or walk by him and tap a pencil on the desk...something that your
child will recognize as a sign to focus or to remind him that he is being disruptive
Sep 17 2010, 5:57 PM
Rory F. Stern: As for "target behaviors" and rewards, you might consider a behavior chart... I can
recommend two resources.
Sep 17 2010, 5:57 PM
Rory F. Stern: 1) www.freebehaviorcharts.com
FreeBehaviorCharts.com — Parents & Teachers: These free behavior charts work with kids at home
and at school…
}
Sep 17 2010, 5:57 PM
Rory F. Stern: 2) www.smartdiscipline.com
Smart Discipline helping parents with child behavior.

13. Sep 17 2010, 5:57 PM
Rory F. Stern: Both of those resources are from colleagues I work closely with and trust when it comes
to behavior
Sep 17 2010, 5:58 PM
Lori-SouthAfrica (guest): she is ADD, ODD co-morbid
Sep 17 2010, 5:58 PM
Rory F. Stern: Thank you Lori for the additional info. I hope this advice was helpful. It's hard
sometimes to get everything right on chat like this I am much more of a "people" person and like
talking
Sep 17 2010, 5:58 PM
Guest150 (guest): Thank you
Sep 17 2010, 5:59 PM
Rory F. Stern: @150 You are welcome. I really hope this was helpful
Sep 17 2010, 5:59 PM
Guest805 (guest): Thank you i live in cyprus and there is no support out here i am trained to work with
Autism and learning problems. Helping familys who need it
Sep 17 2010, 5:59 PM
Rory F. Stern: @805 My pleasure. It's difficult when there are no supports near you. Please let Tara or
myself know if we can help you further.
Sep 17 2010, 5:59 PM
Guest726 (guest): I think it is both
Sep 17 2010, 6:00 PM
Rory F. Stern: Thank you...and yes, it can be both. The trick is in figuring out which one is more
prominent. Which one do we need to address first...that's all I meant.
Sep 17 2010, 6:00 PM
Guest679 (guest): One of my 9 year girls responds to her mom and dad with I wish I could kill you or I
am going to kill you. Stupid used to be her response. This is when she needs to stop doing something or
to do something. She also says often in respone to others too when corrected or given a request, She
hurt my feelings. How do I help her work through her emotions. Does this sound like symptoms of

14. ADHD?
Sep 17 2010, 6:00 PM
Rory F. Stern: @679 - I'm not certain I would group this as "ADHD" like
Sep 17 2010, 6:01 PM
Rory F. Stern: But it is definitely troubling
Sep 17 2010, 6:01 PM
Rory F. Stern: I mentioned earlier setting up clear rules about what is acceptable and what is not.
Sep 17 2010, 6:01 PM
Rory F. Stern: Safety comes first in the work I do with children...that's for both children and adults.
Sep 17 2010, 6:01 PM
Rory F. Stern: Words like those count to me as "not safe"
Sep 17 2010, 6:03 PM
Rory F. Stern: In terms of helping her work through these issues, I would suggest a positive
environment where she can express herself without being judged...or being offensive to you or the
parents...
Sep 17 2010, 6:03 PM
Rory F. Stern: And that to me is therapy... Would she be willing to speak with someone?
Sep 17 2010, 6:04 PM
Marr (guest): I have a friend whose husband had an anyisum, he was dxed ADHD with some Autism.
Would ADHD be addressed first or the Autism?
Sep 17 2010, 6:04 PM
Rory F. Stern: @Marr - that is a great question and I'm afraid I don't know in this particular case.
Sep 17 2010, 6:04 PM
Rory F. Stern: My suggestion again would be to speak with a specialist...possibly a psychiatrist to find
out which condition is causing the most difficulty

15. Sep 17 2010, 6:05 PM
Marr (guest): He is very difficult and refuses medication, which is was better behaviorily.
Sep 17 2010, 6:05 PM
Rory F. Stern: That's frustrating I'm sure. I wish I had a better answer
Sep 17 2010, 6:06 PM
Rory F. Stern: Thank you everyone for your questions. I hope there was some helpful information.
Sep 17 2010, 6:06 PM
Marr (guest): I'm assuming what you said about teens might be be good for his wife to try.
Sep 17 2010, 6:07 PM
Rory F. Stern: It could help
Sep 17 2010, 6:07 PM
Guest150 (guest): Dr. Stern before this chat ends, in what state do you practice?
Sep 17 2010, 6:08 PM
Rory F. Stern: @150 I am located in Massachusetts, but work primarily as a coach now....so I work
internationally
Sep 17 2010, 6:08 PM
Marr (guest): Thanks you for trying to help!
Sep 17 2010, 6:09 PM
Rory F. Stern: I'm sorry Marr...I wish I could help more. It hurts when I can't offer you something
Sep 17 2010, 6:09 PM
Guest805 (guest): Marr i may be able to help you as i am Trained for Autism i will email you anna
Sep 17 2010, 6:09 PM
Rory F. Stern: @Marr - this is from one of our attendees. I hope you two can connect

16. Sep 17 2010, 6:09 PM
Marr (guest): Thank you anna!!!
Sep 17 2010, 6:10 PM
Rory F. Stern: Thank you everyone. If you have any questions, please feel free to let us know in the
forums, or through expo@adhdexpo.com
Sep 17 2010, 6:10 PM
Rory F. Stern: Goodnight everyone!
Learn more about Dr. Rory Stern at:
www.adhdfamilyonline.com
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