How to Explain a Child's ADHD to Grandparents

Say that on Friday the child's maternal grandmother picks the grandchild up from school. As soon as the child comes home the bag is dropped at the door, one shoe comes off halfway, the child runs to the kitchen and asks three things, then moves on to the living room before an answer comes. The grandmother says nothing, but something settles on her face. In the evening when the mother comes home, the sentence "this child was never like this with us" comes out. The mother either apologizes or goes on the defensive. Neither gets anywhere.

This scene is an example, but it may sound familiar. Before building a bridge between the child and the older relatives, we need to look at what that sentence is saying.

What the sentence "We didn't have it in our day" says

The information on the surface of the sentence is partly true. In those years there was no word such as ADHD in everyday language. But inattentive, active and impulsive children have been described in the medical literature since the 19th century (Lange et al., 2010). Those children existed, and they were called other names: naughty, rowdy, absent-minded, lazy. I wrote about this history and the objection "everyone has it now" in detail in the article telling your family about your ADHD, and I will not repeat it here.

When it comes to a grandchild, I look at the feeling underneath the sentence. For a grandmother, the sentence "your grandchild has ADHD" can mean that the child she raised, that is the mother or father, has missed something. Or it is heard as a criticism of the way she raised them. And there is the question of heredity. The heritability of ADHD is reported at about 74 percent in twin studies (Faraone & Larsson, 2019). So while describing the grandchild's picture, the older relatives can somewhere hear themselves or their children. This is not a comfortable feeling. That is why the reaction sounds to me more like worry than denial.

From a paternal aunt, an uncle or a maternal aunt, this sentence can come: "My child was like this too, they grew out of it." This is the wish to share their own experience. Accepting that this sentence is not immediately wrong makes the conversation half as hard: in some children, restlessness really does decrease with age, but difficulties with attention and regulation largely continue.

A plan for the conversation: ten minutes, without the child

This is the order I would follow in your place. Let the conversation happen when the child is not there, not at the holiday table but on the phone or over coffee. Ten minutes is enough; if it goes longer, it falls apart.

I start with a behavior. The sentence "our grandchild has ADHD" opens the "is it real or not" argument right away. Instead, I say something the older relative has already seen: "When they come home from school and sit down to homework right away, they struggle a lot. Once they have moved around for twenty minutes, starting is much easier." The older relative recognizes this sentence from their own observation too. The name comes later: "Our doctor said this has a name."

Then I make a single request. When three or four requests are made at once, none of them sticks. For example: "When they come in, first put the bag in its place and have something to drink, then homework." Or: "Let's give them a heads-up five minutes before leaving."

Finally, I state the good intention openly: "You get along with them so well, that is why I wanted to tell you." This sentence can reduce defensiveness, because the conversation stops being an accusation and turns into a sharing of tasks.

Sentences you often hear, and my answers to them

When you hear these sentences, keeping a short answer ready works better than arguing. I go in order.

"A bit of firmness is needed, they're spoiled." Knowing the rule and being able to apply it in that moment are different things. Behavioral parent training programs rely not on increasing firmness but on having fewer, clearer rules and giving feedback immediately (Daley et al., 2018). This is not a "softer" way, it is a clearer way.

"You were like this too, and nothing happened." It may be true. I answer this with "maybe you were, we didn't know then, now we do." That is the way to talk about today without opening up the past for debate.

"It's the sugar." In controlled studies there is no finding that sugar causes ADHD. I gathered this and similar claims in the article the most common misinformation about ADHD, a useful list to send to an older relative.

"Don't give medication, they'll get addicted." I do not see this as something the older relative decides. The medication decision is between the parent and the doctor. If the older relative is worried, coming to the doctor's appointment as a listener and asking questions is a good way. Discuss medication adjustments with the doctor.

Shared rules at the grandparents' house

If an older relative looks after the child, the rules do not have to be the same. It is enough for a few core things to be similar. Let me add an explanation here: I do not know of a study done specifically on the grandparents' home with grandchildren who have ADHD. What follows comes from the general principles of behavioral parent training, and the evidence for these principles rests on parent reports in children, with their effect on core symptoms being debated (Sonuga-Barke et al., 2013). The guidelines still recommend it as a first step (NICE NG87).

The three core things I suggest:

• Transition warning. "We're leaving in five minutes" should be said with the same sentence in both homes. The child finds it hard to tear away from the middle of a task, and when they are told in advance the resistance is lower.
• Reward the same day. "We'll get it next week" does not work. A small reward that comes straight away does. The details are in the article on the reward system.
• The same response in a moment of anger. Neither shouting back nor a heavy punishment that comes later works. Let it be talked about once the child has calmed down. I wrote about this in the article how to treat a child with ADHD.

Apart from these, let the grandparents' house stay the grandparents' house. Screens may be a little longer there, mealtimes may be more flexible. Screens are a separate debate, and I wrote that part in the article screens and ADHD in children. Not everyone has to say the same sentence, but the picture in the child's head should be consistent in both homes.

Leaving the rule to words is not enough either. Putting a three-line sheet of paper on the grandparents' fridge, in a place the child can read too, sticks better.

A two-minute handover note at the end of the day

There is also a small habit that I think does the most good. When you pick up or drop off the child, a two-minute, four-line note: how the child slept today, what they ate, which moment was hard today and what went well. If the child takes medication, the time and the method, as the doctor said, in writing. The note can be a message too.

Why is this note good? With a note, the information "slept badly today" sounds not like an excuse but like an explanation. Writing down what went well also gives the older relative something: a sentence like "Today they put their shoes on by themselves" makes the child's good sides visible in the eyes of the older relatives too.

Crowded visits need to be planned separately. Say there is a table of fifteen people at the holiday. Do not expect the child to sit at the table for twenty minutes; give the child a task (such as carrying plates) that lets the child get up from the table and do something. Decide on a quiet room or a balcony beforehand. Talk about a plan for leaving early. The aim of these is to reduce the load of noise and intensity, and to leave no need for anyone's face to fall.

What the older relatives have: time

Always seeing older relatives as an obstacle is unfair. Many of them have something that working parents find hard to find: time and a slow pace. Walking in the garden with the grandchild, preparing food together, listening to the same story for the third time. Most of the ideas in the article on activities at home for children with ADHD can be done with an older relative too.

I do not know whether this has a measured effect in grandchildren with ADHD. But I think a shared task that is not finished in a hurry is good for both the child and the older relative, and I count it as a resource.

Talking in front of the child

The parents decide how and when to tell the child about the diagnosis, and I talked about this in the article telling your child about the ADHD diagnosis. There are two things to ask of the older relatives: not to argue in front of the child and not to put labels on the child. The sentence "here we go again" looks as if it describes a day, but the child records it as a sentence about their identity.

What I take from it

My own diagnosis came at twenty-two, so having a version of this conversation as a child was not possible. That is why the attitude of the older relatives who speak in front of the child today feels especially important to me: the more every adult who looks after a child comes close to the sentence "this child is not broken, this child needs help with some things," the easier the work becomes.

I do not see convincing the older relatives as a goal. The goal is for the child to find a similar ground in both homes. A grandmother or a grandfather may never use the word "ADHD" and that is fine. If they follow the rule of putting the bag in its place, give the transition warning, and give the reward the same day, the job has been done.

And let the conversation stay short. Everything is not solved in one evening. A few weeks later, the older relative telling you on their own "today they put their shoes on by themselves" is a sign that the conversation has taken hold. If it has not, it should not be counted as a defeat against anyone. What the child really needs is that in that house at least one adult is trying to understand the child.