Telling a Child About an ADHD Diagnosis, by Age

The diagnosis has been made, the report has been issued, perhaps medication has been planned too. Now one question remains: what are we going to tell the child?

There is no single method with firm evidence on this; there are common recommendations based on clinical experience and the principles of psychoeducation. This article summarizes those recommendations with examples by age. There is a separate article for an adult telling the people around them about their own diagnosis: disclosing an ADHD diagnosis.

Why tell

The child already feels that something is different. They know they are struggling compared to their friends, they know about the teacher's warnings and the tension at home. When there is no explanation they write their own story, and that story is usually of the form "I'm lazy, I'm bad, I'm stupid."

A correct explanation changes that interpretation: the sentence "I'm struggling because my brain does some things differently" takes the blame off the child. This is a basic step for self-esteem, and it is also important for the process after diagnosis.

The main message

Whatever the age, four ideas stay fixed:

1. Your brain does some things differently. ADHD is not a defect, it is a difference in the way of working.
2. It is not your fault, and it is not the family's fault either.
3. There is help for this. Structure, support and, if needed, medication.
4. You have strengths too. Not only the places where they struggle but also the places where they are good should be named. The article on the question of strengths handles this without exaggerating.

Telling by age

Ages four to six. Comparison and short sentences: "Your brain is like a car that goes very fast, but the brake is pressed a bit late. The doctor is going to show us how to help with the brake."

Ages seven to twelve. A more open and brief honesty: "Your brain works a little differently when it comes to paying attention and waiting. This is called ADHD. Because of this some things feel harder to you than to other children. But there are things we can do about it, and there are things you do really well."

Age thirteen and over. Talking about the diagnosis, asking questions and taking part in the decision process: A joint conversation with the doctor, reading the diagnostic criteria, weighing medication and other options together. In adolescence, when the diagnosis is "talked through with me" rather than "told to me," cooperation increases. For what is particular to adolescence, see the article on ADHD in adolescence.

Before the conversation

• Choose a calm and unhurried time; not at a moment of punishment or argument.
• Form a clear message for yourself beforehand. Speak the same language as your partner.
• Predict the questions the child will ask: "Am I sick?" "Will it go away?" "Are we going to tell my friends?"
• You can ask the doctor to talk with the child as well; children sometimes listen better to a doctor's voice.

Phrases to avoid

• "There's something wrong with you." The child sees themselves as the problem itself.
• "We're going to the doctor to fix you."
• "If you do that again we'll increase your medication." Medication is not a tool of punishment.
• "You have ADHD, that's why you can't." A diagnosis used as an excuse enlarges the difficulties.
• Telling the diagnosis like a secret to be kept hidden. Its being a secret gives the message that it is something to be ashamed of.

The child's reactions

Reactions can vary, and all of them are normal:

• Relief. "So I'm not stupid."
• Anger. "Why me?"
• Denial. "There's nothing wrong with me."
• Sadness. Especially in adolescents and after the diagnosis.
• Indifference. There may be no reaction at all at that moment; the questions come later.

What to do is not to fix or suppress the feeling; it is to say "I heard you." "It's very understandable that you feel that way."

Not letting it become an excuse

The most common worry is this: what if the child starts saying "I have ADHD, so I won't do it"? For this it helps to set up the sentence from the start like this: "Your ADHD makes this job harder, but it doesn't mean you can't do it. Come on, let's see how we can do it."

Responsibility and support go together. The child gets support in the area where they struggle, but is not exempted from the consequences.

Telling others

It is important to tell the child that they are under no obligation to tell others about their diagnosis. Who needs to know (the teacher, a close friend, the family) can be decided together. If the child feels this is under their own control, shame decreases. For sharing with the teacher, the article on meeting the teacher is a guide.

A conversation not once but many times

Telling the diagnosis does not end with a single conversation. As the child grows they ask more questions and understand more. Do not try to tell everything in the first conversation; leave the door open and add one more step each time.

This article is for information; for an approach specific to your child, take into account the recommendations of the doctor or the child psychiatrist.