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Does anyone have any advice or experience to share about how (or even if) you made your child aware of his/her diagnosis?

My DS10 has just received a diagnosis of ADHD, after several years of struggle and surveys and testing. He just doesn't know it yet. He is moderately gifted, has an oppositional streak, and has never been in an academically appropriate environment at school until this year in 4th grade, so in the past it was difficult to get meaningful teacher evaluations. We always ended up with high ratings on the ODD side, but just "elevated" on the H/I and Inattention. This year, he is in a full-day gifted program with teachers who are GT certified. They are occasionally noting behavior problems, but we are now hearing more comments like, "It's his focus. He just can't stay on track. He can't listen. We are always redirecting, but he seems to not be able to control it," and "When I am talking, he will stand up and call out to his friend across the room, often seems unable to control impulses". He can't keep up with belongings, can't remember what he needs at the end of the day and often gets home without his homework. We had the teachers do surveys recently, and wouldn't you know it, ODD rating from these teachers is completely within normal limits, but both Inattention and H/I ratings are clinically significant (very high, actually). We see the struggle at home too, all the hallmarks.

He did private testing two years ago, and the psychologist said he was "a hurricane" with his impulsivity, and although he did very well, he underperformed due to impulsive answering and would not stop despite several warnings. He also recently completed a computerized test to evaluate attention and did poorly on it. Until this year, however, we could not get any support from school for a diagnosis.

We are moving toward treatment decisions now, and I am wondering how I should talk to him about this. I think he will probably be relieved to know everyone is recognizing that he has been struggling for years, and that we are trying to help. He has even told me before that he thinks he has ADHD. But I'm not sure at his age how to approach this discussion. Any advice is welcome.

So my approach with my students (who are a little older than your DC) is to emphasize that ADHD does not mean that you are somehow "broken". It's a brain profile that often is a poor fit for traditional classrooms, but has many other places where it can be advantageous. I know he's young, but he's bright too, and he might appreciate the kind of discussion I typically have about dopamine responses. The simplified version of it is that people identified as ADHD often have a lower response to dopamine, which is a chemical naturally released in the brain under various circumstances, but especially under stress. Under normal circumstances, this lower response means it can be harder to pay attention than for other people, and also that you tend to seek out stimulating activities that cause dopamine to be released. Hence inattention and hyperactivity. But under stressful circumstances, the brain floods with dopamine, which for other people tends to make them panic (fight/flight/freeze response). The ADHD brain, in contrast, performs better under stress, because it can handle the high dopamine levels (actually, it kind of "likes" them). This is why this brain profile can be good for high-performance athletes, fighter pilots, entrepreneurs, wall street day traders, etc.

When hyperactivity, impulsivity, or dysregulated attention occurs, it's not a sign of moral failure, just your brain asking for what it needs.

I'd never heard it explained quite that way, great insight! He would understand all of that. This information also may explain why he does so well on most short-ish testing, despite his normal tendency to lose focus. He used to get SO excited to go to school on MAP testing days. It was the only time he got to see material that was difficult for him, new material, and really had to try to figure things out. He always wanted to compete with himself and do better than last time. Then when GT testing at school came (CogAT and Iowa), he was excited to prove himself, and he did. He would leave the house on those mornings like a fighter, amped up, and has always done well. But in the daily work that is now challenging, he really struggles to maintain that level of effort and focus all day every day, and is down on himself about it. He is absolutely capable of doing the work, but he's never had to maintain focus this long, keep it together and be listening all the time. He is also a talented, driven athlete, which was one of your mentions. All good food for thought. Thank you!

Great advice above! There are several threads about this question, but unfortunately they're not readily coming up in my searching, so I'll throw in a few more thoughts.

As parents, we tend to fear labels. I think the most important thing I've learned is that our kids already have labels. Your son has undoubtedly labelled himself, his schoolmates have labelled him, his teachers have labelled him. "Defiant" is probably the nicest of those; I would suspect the labels he's selected in his own head are far worse. Stupid, bad, and unlikable are pretty common, and were certainly on my kids' lists. With a diagnosis, you are replacing those destructive and inaccurate labels with labels that are both correct, and provide a pathway to effective support. Labels can be an extraordinarily empowering and positive thing when they lead to better support, and show a child that they are not a "bad kid".

I started our first conversation with, "We finally understand why school has been such a struggle for you: you have a brain that works differently from most of the kids in your class. When we teach you differently in a way that matches the way you learn, you learn really well." (In DD's case (ADHD + dyslexic), we told her it's because she was a demigod, and she was thrilled - if your son hasn't read Rick Riordan yet, I highly recommend him.) As aeh noted, we talk a lot about how there are some things you can do far more easily than other people, and some things which are much harder. There's neither credit nor blame attached to this, it's just neurobiology.

You're not responsible for how your brain works, but you are responsible for understanding those strengths and weaknesses, and making good choices for how to manage them. Especially with ADHD, I've found it really crucial to try and help my son understand that it is not his fault that he can't absorb oral instruction and is always late. He is not to blame. But - - - he must own these challenges. It is his responsibility to build (with help!) the back-up systems and scaffolds (alarms, lists, arranging reminders, taking photos of classroom boards, etc) that replace the functions his brain doesn't do naturally, and to learn how to recognize the impact that his behaviour - especially chronic lateness - has on other people. Blame is a heave load to carry through life, and removing (at least some of) it is incredibly freeing.

You have the benefit of already seeing what a difference the right environment makes, so your son can see how different it is for him when his learning needs are being better met. I've also spent a lot of time re-iterating the apocryphal Einstein quote, "If you judge a fish by how well it climbs a tree, it will spend its whole life thinking it's stupid." My DS is most definitely a fish in a school system designed for monkeys, and sometimes needs to be reminded that he's doing pretty amazing things for a fish, and oh by the way, do you remember what you did in that stream last weekend?

The odds are your DS has developed a pretty negative self-view, so look on the diagnosis is a chance to slowly start to replace and rebuild with a more accurate and helpful picture. ADHD is neither good nor bad, it just is. The more you can talk about it in an open, everyday, matter-of-fact way, and show how happy you are to have this insight, and make the explicit link to how you are using this new knowledge to better support him, the more he can hopefully respond to his diagnosis the same way. Without stigma, without shame, just with better self-knowledge and better ideas how to move forward. Sending tons of good wishes to you!

I'll echo Platypus101's sentiment: great advice on this thread.

One old thread which may be of interest: Explaining ADHD to DD11 (Aug 2016)

aeh, can you post some links to journal articles that discuss this? Thank you!

If you look at the resources I cited in the old thread linked by indigo above, you should find some references.

Here's a popular-level article by Dr. Ellen Littman:
https://www.additudemag.com/brain-stimulation-and-adhd-cravings-addiction-and-regulation/

Thank you all so much. This is all very helpful. We've started to have some of these discussions, and will continue to do so. I think explaining to him how his brain works will really help him process what he has gone through.

He has been ok socially for the most part, because he is fun for other kids to be around and he is a natural leader. He has unfortunately not always been leading in the right direction, but he is very likeable. I think what appears to be uber-confidence is actually rooted in insecurity though; we are finding out now that his opinion of himself is indeed very low (surveys from psychologist and other discussions). He uses his "cool kid" image to compensate for his behavioral failings. A couple years ago, we were at a school function and one of his good friends introduced him to his own parents this way: "This is !&#$. He always ends up on red." (Referring to behavioral clip chart in the classroom, red being the low) So even though this kid liked him a lot, and they played together every day, that child had given him the "red" label and that was the first thing he thought of when introducing him. His teachers have always said he shows no emotion to them at school, when he is actually a very emotional kid. We think he has developed an armor that he puts on before he walks in those doors every day. He knows that the truth of who he is, is not ok at school...but he can't help it, so he gears up for battle every day. Have fun, show no hurt, be cool. That has worn him down over the years I think.

A few days ago he told me that he'd read a book with a story line involving a bad guy taking over a good guy's body, and the good guy felt like he was a passenger in his own body. My DS said he feels the same way, a passenger who has very little control. We have agreed that we need to get him some tools to help him be the driver now. I love the idea of starting to replace his negative self-view with a new picture.

Thanks for the support and the links to helpful information!