Supporting the Mental Health of Neurodivergent Kids and Teens
In my last post, I talked about some reasons why neurodivergent kids and teens often have co-occurring mental health concerns. If you missed it, you can find it here. This week, I will focus on how to support neurodivergent kids who have a co-occurring mental health concern.
Receiving a Diagnosis
First, if you are concerned about your child’s mental health or think they might be neurodivergent but they have not been assessed, I encourage you to consider an evaluation. Getting an accurate diagnosis (if one is warranted) will help you navigate getting the most appropriate supports and accommodations for your child. Neurodivergent and mental health diagnoses often have overlapping symptoms, which can make an accurate diagnosis difficult. A complete evaluation with a psychologist will provide the most complete picture of what is occurring for your child.
If you want information about evaluation, check out my course Understand and Access Evaluation for Your Child, which will walk you through the school and medical evaluation processes step by step.
Ways to Support Your Child
Now, let’s look at some ways to support neurodivergent kids and teens who have co-occurring mental health concerns. The strategies below work for all those with mental health concerns. However, they can be essential for neurodivergent kids and youth who are often misunderstood and under-supported in our society.
Foster an Understanding and Supportive Environment
Fostering an understanding and supportive environment might sound obvious, but when done well, it is life-changing for kids with co-occurring neurodivergent and mental health concerns. These diagnoses are often invisible disabilities, meaning that they may not be apparent to people interacting with your child. This invisibility frequently leads to behaviors being misinterpreted as signs of laziness, disinterest, rudeness, or anger. However, behavior is a form of communication. We can get to the root concern by seeking to understand instead of controlling or changing their behavior. Over time, addressing the root concern, not just the behavior, will allow for real change and growth.
Here is an example that I often see in my practice to illustrate what an understanding and supportive environment looks like.
James frequently does not turn in assignments and sometimes lies when his teachers or parents ask about classwork. James will say he turned things in when he did not, say his teacher never gave him the assignment, or claim that the file he needs has disappeared from his Google Docs.
One way to perceive James is that he is lazy, defiant, and doesn’t care about school. He doesn’t mind lying and seems willing to say anything to avoid taking responsibility for his actions. Under this perception, James' teachers and parents might talk to him about the importance of school and following through on things, the need to improve his grades, and the issues he could face if he continues lying. He would likely have consequences like detention and missing fun activities. He might also be expected to finish a long list of missing work to avoid further consequences.
However, James is not lazy or defiant. He cares about school, knows lying is wrong, and tries his best to complete his work. James has ADHD and depression. His ADHD makes it difficult to keep track of multiple assignments' locations and due dates. His depression causes a brain fog that makes it even harder for him to plan for and remember tasks. James often finds completed work days or weeks after it was due. When he tries to complete his homework, he realizes he doesn’t have all the necessary materials and struggles to remember which assignments are online and which are on paper. Whenever he forgets an assignment, his depression makes him feel an unbearable amount of shame. He sees all of his peers turning their assignments in and doesn’t understand why doing so is impossible for him. He feels like a complete failure. When his parents or teachers confront him about missing work, he can’t handle the embarrassment and doesn’t know how to explain what’s happening, so he says whatever he can to make the conversation end.
Once we know the root of James' behavior, it’s easy to see that reprimanding him for lying, explaining the importance of doing well in school, and giving him an overwhelming list of work to complete is not only not going to solve the problem, but could easily make things worse. He already feels like a failure, so outlining his shortcomings will only increase this feeling. Additionally, without executive functioning support, he will be unable to complete the list of makeup work, further harming his academics and sense of self.
What James needs is executive functioning and mental health support in addition to support for his ADHD. He needs to hear, “Organizing and tracking assignments can be SO hard. Sometimes ADHD and depression can make it extra hard.” With structured support to prioritize, organize, and complete his tasks, James would be more successful in his classwork and gain self-awareness and confidence, supporting his mental health.
If you have specific questions about creating a supportive environment, I would love to hear them! You can let me know here. I will be covering some specific examples on Instagram later this month.
2. Provide Supports & Accommodations
When we grasp the intricacies of a child’s brain and their unique strengths and struggles, we are empowered to provide meaningful accommodations that pave the way for their success. For children with co-occurring mental health diagnoses, these accommodations can be tailored to acknowledge how their mental health diagnosis and neurodivergence may be interacting with or amplifying each other.
James, for example, would benefit from ADHD accommodations, depression accommodations, and accommodations that take into consideration how his ADHD and depression impact each other. With the understanding of his co-occurring diagnoses, teachers, and staff could correctly identify something like missing an assignment and then lying about it as a sign that James needs support, not that he is a bad kid or doesn’t care.
Some example supports and accommodations that might help James:
A trusted adult at school to co-create routines with, such as a weekly turn-in time to clean out his folder and turn in any forgotten assignments while listening to a favorite playlist.
A parent or trusted adult at home to co-create routines with, such as a weekly backpack and desk cleanup followed by a favorite activity or snack
Using a single folder instead of a folder for each subject
Having a second set of textbooks at home
Support breaking larger tasks into smaller chunks
Access to a calming space as needed
Receiving feedback in private
Regular meetings with a school counselor
3. Find Therapeutic Supports
Therapy is a common and helpful support for any type of mental health concern. This is even more true for young people with a co-occurring diagnosis. Therapy can help children and youth process experiences, better understand themselves, build skills, problem-solve, and set goals. Various therapies and providers are available to meet your child's and your family's goals. It can be helpful to find therapists who are neurodivergent affirming and who have specific knowledge of how neurodivergence can impact daily life, social relationships, school, and regulation.
If you are interested in finding therapeutic support for your child but are unsure what type of therapy or therapist would be best for your child, check out my webinar Finding the RIGHT Therapist for Your Child.
I also have a free reflection guide available here to help you decide what you think about the goals and focus of your child’s therapy.
4. Lean Into Their Strengths & Interests
Even with appropriate supports and accommodations, school can be a lot for neurodivergent kids with co-occurring mental health concerns. Between getting ready for school, going to school, navigating social dynamics, and doing homework, it is easy for kids to feel like school is the only big thing in their life. Finding activities that support your child’s strengths, interests, and passions outside of school can benefit their mental health and sense of self. It also gives them a chance for lower-pressure social interaction, often in smaller groups and with peers with similar interests. Exploring niche interests and skills can also be an excellent way for your child to find friends who think and experience the world similarly. These activities include video game groups, anime clubs, sports teams, art classes, Lego meetups, or robotics cubs. The important thing is not the topic. The important thing is that your child has time to do something they care about while being in a space that allows them to be unapologetically themselves.
5. Consider Other Supports
In addition to the supports I outlined above, other specific supports might be appropriate for your child. A few other common support avenues to consider are:
Tutoring
Academic tutoring can help students fill gaps and catch up. For neurodivergent students with mental health concerns, one-on-one instruction without peers present is sometimes lower stakes and allows them to focus on academics without as many social considerations.
When choosing a tutor, find someone with experience with your child's specific diagnosis. This is particularly true for students with learning disabilities who benefit from a tutor with particular training using a specific curriculum. For more information, see my blog on Learning Disabilities and my free download on Effective Interventions for Your Dyslexic Child.
Coaching
Coaching can help build social, life, and executive functioning skills. You may find that it is helpful for your child or teen to have support in these areas from someone in addition to a parent. Coaches can have a variety of qualifications, including psychologists, counselors, social workers, and teachers. Some also have no specific training. When selecting a coach, be sure to find someone with qualifications and experience related to your child’s specific diagnosis. Note: if your child is struggling with a co-occurring mental health condition, a coach does not replace the need for a highly qualified mental health provider.
You may also find that a parent coach would be helpful for you. Parenting a neurodiverse child with a co-occurring mental health condition often requires a unique set of parenting and self-care strategies. Many coaches and therapists will provide limited consults or ongoing support to help you on your parenting journey. If you are looking for some online resources to get you started, parent coach and behavior analyst Mandy Grass also has lots of great videos. You can find one of my favorite videos of hers and her other work here.
Medication
For some diagnoses, medication treatment options are quite helpful, especially when used in conjunction with therapy. Some of these medications can have side effects so children and teens must be closely monitored so that medications can be adjusted or changed if necessary. If you are considering medication treatment options, ask your child’s pediatrician if a referral to a psychiatrist would be appropriate. Psychiatrists have the most training in mental health medications and are often the best professionals to prescribe and monitor them.
I hope this was helpful! And, as always, if you are looking for support on a specific topic and can’t find it, let us know here. My team and I are always looking for more ways to support this community :)