Fresh Take: Michael McLeod on ADHD and Executive Function

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0:32Hey, everybody. Welcome to What Fresh Hell. This is Amy. Today, I am talking to Michael McLeod. He is the co-host of the ADHD Parenting Podcast and the founder of Grow Now ADHD, which seeks to improve quality of life for youth and families facing ADHD and executive function challenges. Michael has more than 20 years of experience, and he blends deep expertise with a practical, strength-based model that gets results. Today, we'll be talking about his book, The Executive Function Playbook, Building Independence in Kids with ADHD. Welcome, Michael. Thank you so much for having me. This is quite a privilege to be here.

1:11I love your podcast. I love your work, and I'm really excited to chat. Oh, that's great. Thank you. The feeling is truly mutual because parenting a kid with ADHD is a lifelong process, I feel like. Can we start with your own experience? Because you talk in the beginning of the book about growing up with ADHD yourself. What was your experience like? I grew up in the 90s when these things really weren't very understood or talked about. It was very strange or different or taboo to someone to get therapy or counseling or services at school or anything like that. Now it seems like the majority of kids are doing some sort of therapeutic work after school or have an IEP or have a 504.

1:52Back then, it was none of those things. These things weren't talked about. They weren't openly discussed. And it was something that I really struggled with, especially socially in so many ways, lacking self-awareness and lacking just really just being behind my peers, being overall delayed. But overall, I knew I wanted to work with kids, work with students. My mom was a very decorated teacher in New York for decades and decades. And I knew I wanted to be a teacher or work with youth. And I eventually ended up finding myself working at this residential treatment facility in New York where kids lived full time on campus because they had such significant needs.

2:27I went to school on campus. They were not home with their parents. And I was able to observe one on one that these kids were getting speech and language therapy, directly improving their quality of life. So it wasn't like I was teaching them math and science and social studies, all these things that really aren't going to improve the quality of their life. They're working on skills that will actually help them communicate and make friends and those kinds of things. So I immediately went back and got my second bachelor's and then my master's degree in speech and language pathology. I learned rather quickly that there's very little out there for kids and teens with ADHD.

2:59They were being sent to all these therapies and counseling and OT and play therapy and all these different things that just weren't moving the needle. It wasn't improving life. It wasn't improving dysregulation in the home. wasn't improving grades, wasn't improving their social lives, and wasn't making them more employable or more ready for college. So I took a very deep dive into the work of Dr. Russell Barkley, Dr. George McCloskey, Sarah Ward, all the great pioneers in this field. And I developed the grow now model of internal skills. And everything's really expanded from there. And you also say in the beginning of the book that even today, I think things are better.

3:33There's so much more awareness. Kids are being diagnosed at a much earlier age, and there's a lot more awareness around what to do next. However, you call it a bifurcated misunderstanding of how ADHD is presented, I think by some experts and also in social media. So tell us about that misunderstanding and how it splits into two things that are equally not useful. Yeah, so ADHD could not be more misunderstood. You know, ADHD is a horrible name for ADHD. It's not an attention disorder. It's not enough attention. Exactly. It's not all this nonsense about attention and focus where, oh, everyone has a little ADHD, all this nonsense.

4:11ADHD is a true developmental disorder of executive functioning, of the executive functioning system. So it's not like attention and focus and hyperactivity and inattentiveness. It's a disorder of executive functions, the prefrontal cortex, the last part of the brain to develop that develops all throughout childhood and adolescence over the first 30 years of life. So the brain is not fully developed until you're 30 years old with peak executive functioning, full cognition. And executive functions also are not time management organization. They're not messy backpacks, messy folders, messy bedrooms and using a calendar, using alarms.

4:47Executive functions are the greatest predictor of success for human beings. Yeah. A greater predictor than grades and everything else that we focus on incorrectly. You need executive functions to move out of your parents' house, get a job, keep a job, make friends, keep friends, and live independently. That's how important executive functioning skills are. So obviously it's a lot more than just time management organization. It's an individual's ability to self-regulate and self-motivate towards things that are non-preferred, non-instantly stimulating, and in today's world, non-screen based. Can they do things in life that don't offer instant gratification, that don't have instant dopamine in them?

5:25And that's really 99 % of life. That's pretty much all of school. That's a lot of social relationships. That's a lot of, you know, it's all the things that are actually worth doing are outside of the comfort zone. And it is often presented or that we are supposed to present it to our kid with ADHD. It's your superpower. It's your gift. Certainly there are gifts that come with it, but it's presented as you're extra awesome in a really special way. Turns out that isn't everything they need to function successfully as they go out into the world. And I think also we can get sometimes really scared when you present it as the way you just said it.

6:00Like you need executive functioning to exist as an adult. And if you have ADHD, you have a developmental disorder that affects your executive functioning. It doesn't have to be doom and gloom, but it is a lot more serious than the fidget spinners or fun kind of stuff that we're sometimes given is the right way to approach it. Correct. Yes, they made a lot of money off those fidget spinners. And ADHD still exists. You know, yes, we can phrase it to some of the younger kids as a superpower, all these kinds of things. You know, it all depends on the kid and the family of how you want to present it to them.

6:32But it's all about building self-awareness. That's the whole thing about being a kid with ADHD is you lack self-awareness. You don't realize the choices you make affect you and the choices you make affect other people. And understanding full cause and effect thinking, it's really, really hard. being fully self-aware. And it's something that ADHD individuals and kids and teens can struggle with. And the number one most clinical recommendation for ADHD and executive functioning is parent training. So it's really about empowering the parents to ensure this child is being put in all these different situations, is not being given screens, not being bought a phone, is not able to stay in their comfort zone all day, does have multiple adults in their lives to hold them accountable.

7:14And it's not about over-accommodating, like many are doing now with 504s and IEPs, it's actually about increasing consequences. The best 504s and IEPs I've seen for ADHD kids increase consequences, more deadlines, you know, a consequence of being late to school, a consequence for calling out in class, whatever it may be. And it's not about shaming the child or disciplining them. It's just about having a natural consequence so they can better understand cause and effect. So if you have less self-awareness because your executive functioning is not matching your peers. Does more scaffolding and more consequences, more touch points of self-awareness, is that why that's the right approach?

7:52Yeah, that's exactly it. You know, Dr. Russell Barkley has the quote, if you want to see an ADHD child fail, put them in an environment with no consequences. And that's really what we've done with today's education system. We're over-accommodating because that's what parents are being taught on social media. And parents need to be very, very careful with any parenting advice you get on social media because that's for likes and shares and follows. But the best advice in life is not advice you want to hear. It's kind of hard to hear. It's like, yeah, I'm going to have to make some changes or yeah, maybe not doing that so right.

8:24That's the best kind of advice. And that's not going to get likes and shares and follows. When I make posts about screens are horrible for ADHD kids, get them out of your house. I get more hate messages than likes and follows. Because that's not right. Yeah, but that's exactly it. So yeah, it's all about scaffolding. It's about increasing consequences. is this is the hardest time in history to be a parent. And you talked earlier about how ADHD parenting is just so damn hard. And that's because parenting, number one, is hard. But I define ADHD parenting and ADHD as the 100 times rule. So Dr. Russell Barkley describes ADHD as it's not a quantitative problem.

9:00It's a qualitative problem. So ADHD kids and teens don't have different behaviors from their neurotypical peers. They do the exact same things, just 100 times more. How interesting. Yeah. Neurotypical kids will emotionally manipulate their parents. ADHD kids will do it 100 times more. We're not saying they're malicious or have a bad character. All kids and teens do that to test limits with their parents. Neurotypical kids get addicted to screens. ADHD kids get really addicted to their screens. Deeply, deeply addicted. Can I ask you about rejection sensitivity dysphoria, which is something that ADHD, it's a behavior they can exhibit.

9:41Little rejections really get to them and they really have a hard time shaking it. They might really act out. You know, RSD, rejection sensitivity dysphoria, is not a separate add-on diagnosis. It's really just stating that this individual's person with ADHD, their number one issue is emotional dysregulation, which really is most of them. Because ADHD is not attention deficit disorder. It's self-regulation deficit disorder. And it's all about emotions. And if you look at the brain, the ADHD brain, it's the amygdala, the anterior cingulate, the cortical networks that all revolve around emotions.

10:13This is an emotion management disorder. So rejection-sensitive dysphoria is one of those things that's kind of run wild on the internet. But it's not a separate diagnosis. It's not a separate thing. It's that exact thing. Neurotypical kids have a hard time dealing with rejection. All human beings have a hard time dealing with rejection because human beings are social animals. We want to feel accepted. We want to feel like people like us and accept us. And when we get rejected, we feel it and we're going to feel it. ADHD kids are going to feel it 100 times more. It makes so much sense. OK, we're talking to Michael McLeod, the founder of Grow Now ADHD, and we'll be right back.

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14:19Go to myskylight.com slash WFH for $30 off your 15-inch calendar. That is M-Y-S-K-Y-L-I-G-H-T dot com slash W-F-H. Okay, I'm back with Michael McLeod. We're going to talk about the Grow Now ADHD approach to executive function, which you would argue is the ballgame. It's the ballgame for ADHD, has four pillars that need to be addressed. So let's talk about those. Yep. So these are the four pillars of internal skills. This is exactly what the Grow Now model is all about. You know, we're moving past this external hyperactivity, external inattentiveness, external time management, external organization.

15:00And we have to look at the internal skills that are lacking that create those external symptoms. So the first we already mentioned is self-awareness, which is the very first executive skill to develop when you're a little tiny baby. When you're a baby, you realize, hey, wait a second. When I cry, what happens? Someone comes and helps me out. I get changed. I get held. I get sunk to. I get milk, whatever it may be. And then when I smile in mom's face, mom smiles back. And then that's the beginning of self-awareness. But over time becomes more delayed. And we see this happening in the middle school years where the lack of self-awareness can really impact them socially.

15:36And this is the true heartbreak of ADHD when they're rejected by their peers. And their lack of self-awareness really impacts them. And they're not able to build and maintain social relationships. So that's a very sad part of ADHD because in elementary school, it's a lot of that. We're all friends. We're all family. But then middle school is when you start to build the cliques and the groups and, you know, self-image and reputation and popularity. And that's where the ADHD kids get left out. And can I ask you a question about that, too? Like kids with ADHD, they do develop executive function. It's just a flatter trajectory than their peers.

16:08Is that right? So is it that like in first grade, they're more paired up and then it starts to split or are they always behind? So it tends to be a three to five year delay. executive functions are strengthened through two specific ways, varied experiences and interpersonal relationships. So it's doing as many different things as possible, experiencing as many different things outside of your comfort zone as possible, and having real face-to-face social interactions. This is another one of those huge downfalls of screens and big tech and screens are marketed as a social tool, but we know they're not social at all.

16:41If anything, they make kids more antisocial, that is marketed as social. That's the real problem there. So it all depends on between birth to 18, birth to 19, how many different experiences and relationships they have to set them up for future success. But ADHD stays with you. It doesn't go away, but you can do enough work in your childhood and adolescence to the point where the symptoms are not significantly impacting your quality of life. And time blindness, which I've heard about before we've talked about that on the show, is part of this self-awareness pillar? It's part of everything. That's the foundation of all of it.

17:16So we have the four pillars. We talked about number one so far, but then under the four pillars is the foundational skills. And those are the two foundations of the four pillars. Pillars always need a foundation to stand upon. And the foundational skills are nonverbal and verbal working memory. So nonverbal working memory is the visual imagery system of the brain, the ability to make mental movies, hold images in mind and manipulate them. And there's two aspects of nonverbal working memory. There's our hindsight, our mental movies of the past that give us competence and confidence from past experiences.

17:51We remember similar things we went through. We remember times we made good choices, bad choices. We learn from them and we use that information in the present. So we use our memories of the past, our mental movies of the past to give us competence and confidence now. Then we have our nonverbal working memory foresight into the future where we can use our imagination because executive functioning is a fancy term for the imagination. It's just the imagination. We make a mental movie of what the future might look like. So we know what to do now to prepare for that future and delay gratification and plan, prioritize and problem solve.

18:27And that's the foundational skill that's missing in ADHD, hindsight, foresight, which causes them to be stuck in the present moment, time blind, which brings the impulsiveness. What gives me dopamine right now, which is what hardwires them towards instant gratification. What gives me gratification right now? What gives me dopamine right now? And that's why they're time blind. And that's why they're so easily screen addicted. The now and not now thing that is part of ADHD, understanding that has really helped me to understand, like, we're leaving in two hours and you need to pack your suitcase.

19:02It's like, that's two hours from now, right? That's oceans of time. And there is no, oh, okay, so if I'm leaving in two hours, that means I need to have taken a shard in this, then this, gotten everything I needed, it won't fit in the suitcase, that you can't sort of project what needs to happen. Yeah, it's too far into the time horizon. So you can't see that far into the future. So that's what needs to be scaffolded and broken up and chunked out in towards working towards that image and building there. So that's another reason why saving your kid isn't a very good idea. So other times before them, are you helping them get out the door in the morning?

19:35Are you not allowing them to experience being late? Is there no consequences at school if they're late? Is there other adults not holding them accountable if they're late? Is there a reason for them to have a sense of urgency? If they have a phone, video games, Snapchat, YouTube access, then they're probably going to be doing those things instead of getting ready in two hours. So that's why the environment is so incredibly important. So there's so many factors involved, which is why parent training and working with a student is so important. We had Dr. Hallowell on the podcast and he was talking about how it has to give you dopamine to want to do it.

20:07So I don't want to pack when we're leaving in two hours. But when we're leaving in 10 minutes, now I can get dopamine from packing. The urgency kicks in and it becomes interesting. Presenting that as an example of a kid who's working on this pillar of self-awareness, how do you create a world in which they want to pack without yelling? Well, yeah, you definitely don't want to yell more because their time-blind, instant gratification brain is constantly at baseline seeking out two things, screens or conflict. The ADHD brain is a negative attention-seeking brain. They get dopamine through arguing, negotiating, yelling, fighting, all of that prompting you're doing, all of the verbal prompts, do this, do that.

20:50All ADHD behaviors need an audience. If they don't have someone to get an emotional reaction out of, why bother doing it? You know what I mean? Like they want you in their face, prompting them. They want to stay prompt dependent, not intentionally, but they just want that audience. They want the prompts. So the best way to build that sense of urgency to get them to pack that bag is to have them experience being late previously. They have to experience that negative emotion of being late to school and having a consequence there or being late to a doctor's appointment and the doctor having a conversation with them about, hey, you kind of wasted my time today or you were late to the appointment.

21:26You don't get to have what you have or having more built in consequences in the past. So if they're constantly saved by their parent or there is no consequences, this whole idea that like you mentioned earlier from Dr. Hallowell, that you need the dopamine. Sure. Yeah, you need the dopamine, but that's not always realistic. Right. Eventually, you're going to have a job where you're going to be asked to do things. And the only dopamine is going to be getting off at five o 'clock. You know, how are you going to build dopamine from nine to five o 'clock? That's not, I totally understand that concept and I agree with it, but that's not realistic.

21:56So we can't teach people to just make the dopamine. It's more about we have to have the consequences. Totally makes sense. Okay. The second pillar is self-regulation. Let's talk about that. Yes, and this is what it's all about. So ADHD is self-regulation deficit disorder, the inability to regulate yourself in various environments towards various stimuli. So regulating your emotions, your language, your body, your behavior. All the parents listening to this podcast right now, if you have an ADHD child, self-regulation is probably why you're listening to this right now. The ADHD brain responds best to structure and condition, which is school, not home.

22:34So chances are you're seeing the majority of ADHD behaviors at home. And we were told for decades, ADHD is a school-based problem. It will affect them at school. They won't be able to pay attention. They won't be able to focus. They won't be able to take notes. They won't be able to get good grades. Then why are all the symptoms at home? Why do I call my teacher and describe my kid at home? And they're like, hey, are we talking about the same person here? Yeah, that happens. He's an angel here. Why is that happening? Because they respond to structure and condition. And that's what school is. It's structured.

23:03It's predictable. There's patterns and there's conditional relationships. This peer could choose not to be my friend. And this teacher I could easily get in trouble with at home. It's the opposite. It's unstructured. It's not predictable. There's very little patterns. It's a lot of downtime, a lot of boredom. And there's also unconditional relationships. So in their mind, it's, hey, wait a second. here's this person that I could say absolutely unspeakable things to and say no to every single thing she asks me to do. And she's still going to tuck me in at night and buy me my favorite snacks and give me the Wi-Fi password every day.

23:41You know, who gets the worst of ADHD behaviors? The mom. Yeah. Because if you open a dictionary and look up unconditional love, it's a picture of a mom. Let's be honest. Yeah. So parents get the worst of it. And parents have been told, oh, only meds on school days, not over the weekend, not over the summer. But it's home executive functioning, that is by far the biggest problem. You say in the book, and I think it's important to make the point, this is not conscious. This is not these, you know, these little troublemakers understand how to manipulate you. It's not that. It is their brain seeking dopamine.