Raising a child with ADHD

Webinar Transcript

Introductions and International Collaboration

Phil: Welcome everyone. Lisa and I were fortunate to take a team to an international ADHD conference in Dallas, Texas. We met many colleagues, including Paulina, during a session with international visitors. We felt an immediate connection and shared vision. Paulina is a Speech-Language Pathologist (SLT), bringing a specialized discipline that complements our clinical work. We put together the idea of hosting a joint webinar across the pond, and Paulina enthusiastically agreed.

Paulina, please introduce yourself and your discipline, and then Lisa will introduce herself before we begin our discussion.

Paulina: I am a Speech-Language Pathologist by training, specializing in language development with expertise in children with ADHD and autism. I run a neurodiversity-affirming private practice in New York. Many of my clients struggle with executive function skills, emotional regulation, behavioral challenges, and mealtime difficulties.

Phil: In the UK, we typically refer to your role as a speech and language therapist. Lisa, would you introduce yourself?

Lisa Mangle: I am the Clinical Director at ADHD 360. I manage a team of over 45 clinicians assessing well over a thousand children, young people, and adults each month. I have worked in the ADHD field in various roles for over 20 years, and like Phil, I am passionate about reaching as many people as possible in a safe, effective way.

Integrating Speech and Language Therapy into ADHD Care

Phil: In the UK, speech and language therapy is traditionally directed toward autism. However, incorporating it into ADHD therapeutic care is very compelling. Paulina, what does speech and language therapy bring into an ADHD treatment pathway?

Paulina: I bring a play-based framework to understand how play dynamics interlock with executive functioning capacities. Executive function skills grow through play, which directly impacts language usage. The words we use with children and parents profoundly influence their emotional states—a small shift in phrasing makes a massive difference.

Phil: Language has an enormous impact on people struggling with emotional regulation and rejection sensitivity. For instance, I teach people to use open-ended questions starting with “who,” “what,” “when,” or “how,” rather than “why.” Asking “Why did you do that?” sounds accusatory and pejorative, whereas asking “What were we hoping for?” opens productive communication.

Paulina: I completely agree. “Why” sounds very accusatory. I prefer asking, “How did that work for you?” or “I wonder what else we were looking at.” For parents or adults listening, if we wrote conversational prompt words on a board, “why” should be written in red to signal caution.

Emotional Dysregulation and the “Lose It Line”

Phil: Managing rejection sensitivity dysphoria (RSD) and emotional dysregulation is critical. Lisa, how do you approach language and emotional threshold with patients clinically?

Lisa Mangle: I often explain this using the concept of the “lose it line.” Individuals with untreated ADHD carry significant accumulated frustration and negative feedback received throughout the day. Because of this, their baseline stress level rests extremely close to their emotional tipping point, even if they appear calm externally.

When a minor issue occurs, it triggers an instant jump from zero to one hundred. In reality, they were already sitting near one hundred. Treating ADHD medically and therapeutically lowers that baseline stress level, placing them far below the “lose it line.”

Additionally, children with ADHD require a high ratio of positive reinforcement—around ten positive comments for every negative one—to maintain healthy self-esteem.

Therapeutic Play, Conflict Resolution, and Reframing Behavior

Phil: Paulina, moving to play therapy and communication: how does observing a child during play help them lower their boundaries and regulate?

Paulina: Play is exploratory and individualized, without rigid boundaries or labels like “aggressive.” I look at the ideas a child brings to play. Often, parents struggle to step out of “fix-it” mode because they view play as having a right or wrong outcome.

In play therapy, children learn to navigate conflict in a safe environment. If a conflict arises, instead of scolding, I say, “I didn’t realize that was your idea; I was thinking of something different.” The child automatically de-escalates, recognizing that differing ideas are acceptable rather than reacting with distress or aggression.

When parents contact us in crisis because a child is labeled “oppositional,” I reframe that term. “Oppositional” usually means the child has strong intentions, internal ideas, and leadership desires. Changing the language and mindset around a child alters expectations and transforms the family dynamic over time.

De-escalating After-School Overwhelm

Phil: When a child returns home overwhelmed and emotionally exhausted from school, what communication techniques should parents use to de-escalate the situation?

Paulina: Describe the situation objectively rather than projecting emotions onto the child. Instead of saying “You look frustrated,” say, “It looks like you’ve had a rough day; something at school must have been tough.” This opens conversation without imposing labels.

Everyone starts the day with a set amount of cognitive and emotional energy. For neurodivergent children, masking and exerting self-control throughout the school day consumes those resources rapidly. Home is their safe space where they drop their defenses.

Instead of rushing to fix things or saying “It’s okay,” validate their discomfort: “It looks like this does not feel good.” Sitting with that discomfort while remaining calm helps the child co-regulate.

Play Tools and Identifying Signs of Dysregulation

Phil: We previously discussed building tools like Lego or Plus-Plus blocks and why they are so effective for neurodivergent individuals. What makes these activities work, and how do you spot dysregulation during tasks?

Paulina: Open-ended building tools allow individuals to process problem-solving visually and tactilely, which can be deeply regulating. However, if a task lacks clear structure or feels overwhelming, a child with ADHD may reach cognitive fatigue quickly.

I monitor physical indicators of dysregulation, such as pacing, opening containers rapidly, dumping toys out, or physical restlessness. When executive function under stress drops, impulse control declines first.

When I notice these signs, I alter the language: instead of “Let’s see how fast you can complete this,” I say, “Let’s see how much of this challenge we can handle together.” If they approach their limit, we pause the activity immediately to transition into a movement-based or relaxing break, avoiding any perception of failure.

Parent Regulation and “The Oxygen Mask Principle”

Phil: Many parents struggle to regulate their own emotions when managing an dysregulated child, often realizing that ADHD runs in their family. Lisa, how do you address parent assessment and self-care?

Lisa Mangle: ADHD is highly hereditary. When assessing a child, we look for ADHD traits in parents and siblings as well. Helping the entire family yields optimal outcomes for the patient.

I use the airplane oxygen mask analogy: parents must secure their own mask first before helping their child. If a parent receives diagnosis and treatment for their own ADHD, they are in a far better position to manage their child’s needs calmly and effectively.

Rethinking Homework Battles and School Accommodations

Phil: Homework is a massive source of household stress. How do we balance school demands against emotional well-being?

Lisa Mangle: In the UK, homework is not compulsory, and if it harms family cohesion, it needs to be addressed. Preserving the parent-child relationship is far more important than completing a worksheet.

Parents can communicate with schools to establish realistic homework boundaries—for example, limiting homework to specific 40-minute blocks a few days a week. Accommodations such as replacing non-essential assignments with library study sessions can prevent evening burnout.

Paulina: Homework can easily cause frustration because repetitive worksheets feel boring, and boredom is kryptonite for an ADHD brain. Parents can make photocopies of worksheets so children can complete them flexibly without fear of making mistakes, or reframe corrections invitationaly: “I read this question in a different way, let’s take a look together.”

Technology, Screen Time, and Interactive Play

Phil: How should parents approach screen time, video games, and hyperfocus on gaming consoles?

Paulina: While I do not use technology directly in my clinical play sessions, video games offer rich problem-solving opportunities. Rather than isolating the child, parents can join in and play together. Turning gaming into a shared activity creates bonding and shared engagement rather than conflict.

Supporting Non-Verbal Communication and Overload Response

Phil: What key advice do you have regarding communication barriers and sensory overload?

Paulina: Speech refers to articulation, whereas language encompasses engagement and back-and-forth interaction. Communication occurs through gestures, body language, and movement long before formal words are used. Honor the child’s non-verbal communication without forcing unnecessary verbal prompts.

During acute sensory or emotional overload, minimize verbal language. Complex explanations add sensory input to an already overwhelmed system. Simple, grounding statements like “I see you, I’m right here” provide safety. If a child requests space, respect that boundary while letting them know where you will be when they are ready to reconnect.

Closing Thoughts

Lisa Mangle: Discuss coping strategies with your child when they are calm, rather than during a moment of crisis. Ask them when things are peaceful, “When you feel overwhelmed, what can I do to help?” Allow them a peaceful transition time when returning home from school without immediate demands.

Paulina: Strive to view the world from your child’s perspective rather than expecting them to adapt to yours. When a child feels truly seen, heard, and understood, it builds deep emotional security and resilience.