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Managing the Overwhelm in Neurodiverse Families

with Kelly Fradin, M.D.

It’s easy to get overwhelmed by your child’s behavior, numerous possible interventions, school struggles, medication trials, and your feelings about all those things when you have a child with ADHD or autism. And we can’t live our best lives, or help our children live their best lives, when we’re overwhelmed and trying to do too much at once.  “We’re living in systems that make it hard for [parents of ND kids],” says Dr. Kelly Fradin. That inherently brings more difficulty to parenting complex kids. In this episode, Dr. Fradin shares strategies on both coping with the emotional aspects for parents and helping our kids develop and grow in their own time. It’s a process, and Dr. Fradin is here to help you with it.

Resources in this Episode

NOTE: Some of the resources below may be affiliate links, meaning I receive a commission (at no cost to you) if you use that link to make a purchase.

My Guest

Kelly Fradin, M.D.
Dr. Kelly Fradin is a graduate of Harvard College and Columbia College of Physicians and Surgeons, Dr. Kelly Fradin is a pediatrician and mother of two from NYC. She is the Director of Pediatrics at the Atria Institute in NYC where she works with leading experts to bring innovations in preventive care to their members and underserved populations. During her time working in public health in the South Bronx she launched her instagram account @ adviceigivemyfriends to provide calm, realistic, and evidence-based advice to families. Pursuing this mission she wrote Parenting in a Pandemic to help give parents the tools they needed to interpret the news and support their family during the peak of the pandemic. Her new book, Advanced Parenting will be published in April 2023, seeks to support parents in navigating their children’s challenges.

Thanks for joining me!

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Kelly Fradin 0:03

I often find that parents are very forgiving to allow their children to adopt a growth mindset of like, oh, he hasn't figured out how to make friends yet. That's okay. But then when it comes to their own mastery and parenting, and we don't give ourselves the same grace, it's like, yeah, just haven't figured out what parenting techniques work best for him yet. But that's okay. Because that's part of the process of learning to be this unique child's mother.

Penny Williams 0:30

Welcome to the beautifully complex podcast, where I share insights and strategies on parenting neurodivergent kids straight from the trenches. I'm your host, Penny Williams. I'm a parenting coach, author and mindset mama, honored to guide you on the journey of raising your a typical kid. Let's get started. Welcome back to the beautifully complex Podcast. I'm really excited to bring Dr. Kelly Fradin to you today. And we're going to talk all about managing the overwhelm in neurodiverse families. And boy, can there be a lot of overwhelm? For sure. So I think we're really going to learn some great strategies from Dr. Fradin, and be able to do a little better in our day to day and helping our kids to thrive. So if you would, please start by introducing yourself just let everybody listening know who you are and what you do.

Kelly Fradin 1:27

Yes, so I am a pediatrician based in New York City. And I have two kids, five and nine. And my practice has sort of centered on children who have chronic medical conditions, whether you know, in the Bronx, I was working for a hospital and then the school system. And now I have a smaller practice where I can kind of go deeper with my patients. So it's that context in which I've kind of explored all that the parents have to do in these situations when they're trying to help their children to thrive.

Penny Williams 1:59

Yeah. And you want to mention your new book and let us know a little bit what it's about.

Kelly Fradin 2:05

Oh, yeah, it's like it started as a hobby that I shared based on social media under the Instagram handle advice they give my friends, and it was something that I really enjoyed doing. And then, you know, led to the opportunity to write my book advanced parenting. I was also a childhood cancer survivor, which is part of what like led me to pursue this line of work. And understand, like the impact of diagnoses on the whole family unit and structure. Wow. Yeah, you know, so the book is about what to do when your child faces a challenge, whether it's developmental, or a diagnosis, or a mental health challenge, or how to make a plan and cope with the stress and communicate and all the things that parents are kind of on their own to figure out.

Penny Williams 2:45

Totally on our own to figure out, I know, when my son was diagnosed in 2008, there was almost nothing. I was desperately searching for some guidance, like, somebody tell me what to do first, what to do next, what do I need to know? Right? And it didn't really exist at the time. And so yeah, it sounds like your book is a great sort of guide, step by step and how to manage and what to pay attention to, I think there's a lot of noise when our kids are diagnosed with developmental disabilities, there's so much extra that comes with it that isn't really part of the diagnostic criteria. And nobody really tells you about like, one big thing for me with an ADHD diagnosis was emotions and regulation.

You know, I didn't learn about that until probably a couple years into it, that that was really part of what he was struggling with and what was going on. So it's so needed. Let's really focus on overwhelm. Because I, every day, see so many parents, comments on social media and in coaching calls, who are just so overwhelmed. And a lot of times it's really paralyzing. We don't know where to start. We get overwhelmed that it feels like it's not doable. A lot of times, how do we sort of cope with that feeling? And then how do we get moving? How do we even know where to start? And get that sort of inspiration, almost, to take a step and be brave enough to take a stab? It's a little scary, right?

Kelly Fradin 4:17

Absolutely. I can't tell you how many times this has happened to me that I helped the parent make the connection that what they're facing is, you know, neurodiversity and their child, and things sort of shift as they understand who their child is and what their child might need, through a different lens of having a diagnosis. And all of a sudden, it's like, it can be disorienting. Yeah, you know, because you have so many avenues you can explore whether it's changing the educational circumstances or the parenting structure of your day or working with psychologist or therapist or occupational therapist. There are just so many choices for the next step. But I think what's really important for parents to understand is that you know your child best, right? And the diagnosis and the diagnostic process doesn't change that, that your intuition and your judgment about what your child needs, it still holds so much weight.

And I think that when the jargon starts getting thrown around, sometimes parents can lose sight of that. And it's important because it gives you that confidence to know that, even if you're not an expert on whatever diagnosis it is, you're an expert on your child. And so your voice really matters. And your opinions really matter. So, you know, no two kids with neurodiversity are the same and what they need, right? So the parent is the one who's going to help guide the treating team to knowing what the priority is, whether it's, you know, working on emotional regulation, or on school study skills, or on behavior management, or, you know, there's just so many ways you could go with it, and you don't have to do them all at the same time. So that confidence about being the leader of your family unit, and choosing the priorities of where to put your energy is really important. The other one that's really important is to give yourself some grace that like, you're not going to be an expert on this overnight, you're not going to fix anything, right? We're not fixing this, we're learning what works best for our child, and trying different situations or techniques to help them to thrive. And that's going to take a long time. Yeah, like this is like a three to six months to a year, kind of looking for improvements. This is not a like I stay up all night tonight researching and have a plan next week, and I'm crossing it off the list kind of thing. Yeah, along with understanding, the longer timeline comes like, you know, giving yourself a moment to cope with that stress of like that you're in this for a bit longer than maybe expected at first.

Penny Williams 6:48

And we get so desperate to help our kids, I remember when my son was first diagnosed, I was spending all of my time, all of my time, I had stacks of books from the library, stacks of books I had ordered, I was carrying them everywhere I went in case I had a few minutes somewhere to read them. Like I was just almost obsessed, really because I was just so desperate to help him. And it took me a while to realize that you can't do it all at once. You can't focus on a lot of things all at once and actually make progress, right? Because your efforts are too diluted, right? And so those priorities, setting those priorities and just sort of I think having permission to do that. Somebody like you saying, you can't do it all at once. And that's okay, figure out what you can do. First, what is most important and start there? And do you have some advice on kind of how to figure out those priorities?

Kelly Fradin 7:43

Yes, I'm a little bit biased in this because I'm seeing it through the pediatrician lens. But often the first place I start is with sleep. Because we know that if a child isn't getting adequate rest, it's going to worsen their symptoms either related to focus or behavior or emotional regulation. And so while it's a very difficult topic to address, I think you'll get a lot of bang for your buck. If you can get your child to sleep another 20 or 30 minutes, you might see like a huge difference in their behavior during the day. So I normally explore sleep. I also like to think about physical activity, because sometimes especially when children are struggling academically, or we end up putting more therapy or more tutoring or more ot on their schedule, we inadvertently decrease the amount of physical exercise they have, which then can like worse than their focus worse than their emotional regulation or worse than their sleep. So it's a basic that was often under prioritized in my experience. And I'm glad you mentioned the emotional piece too, because I worry a lot about the self esteem and anxiety and depression that can come in children who maybe haven't been in the right environment. So sometimes by the time they get diagnosed, there's already pieces of that. And so I often will recommend thinking about how we're going to address those factors early on, because it's just all interrelated.

Penny Williams 9:09

Yes. That's just what I was thinking, as you were saying that, that piece that emotional intelligence, really impacts a lot of their day to day, their peer interactions, so many things that they're struggling with, building that emotional intelligence can really help with that. And it's something I wish I had known earlier. For my own child. We could have maybe gotten to being more able to self regulate a little bit earlier. Had I known to do that way back then. I think yeah, it's so important. And I, I want to touch too a little bit on what you said about having all these different appointments. I see so many families who are like, Okay, we have this diagnosis. We have to do all the things and you know, your kids go to school all day and then you're running them to OT and maybe playing therapy or behavioral therapy and You know, you're trying all these different things, again, out of that desperation, I think, but our kids only have so much to give in a day, right? And they're giving a lot at school when they are developmentally delayed. And so we're asking so much of them with all of these extra things to do. And then we wonder why they're crumbling. Every evening, I think, to want to speak to that a little bit about where where do we find that balance between doing the things that we know will help, but not doing too much?

Kelly Fradin 10:33

I think it's really essential, because, you know, I will say that my son is somewhere in the neuro diverse spectrum of things i He doesn't have any diagnoses, but But I learned actually a lot through being his parent, that he wasn't like other kids and his ability to do more things like he needed at least an hour of downtime in order to like regulate himself after school, like he couldn't just do a lot of activities. And he couldn't go to multiple activities. On the weekends, he was a kind of kid that really needed quiet and peace and free play as part of like how he coped with stress and thought through things. And so I do think it's part of that in terms of like, listening to your intuition as a parent, and like parenting the child in front of you, you know, if your gut is telling you that your child needs more downtime, there are a fair number of children that like need to move in the morning before they go to school to function well in a classroom setting.

And if that's what you need to do, it may require like changing the schedule and prioritizing it. And it may have really big impact. But there can be a lot of pressure and guilt, like if a professional is telling you, you should do OT and you should do social skills group. And you should do all this other stuff to somewhat be like, No, I'm not going to do that. So instead of thinking about it as in like a yes or no answer, be like, No, I'm not going to do that yet. Maybe Maybe you know, this three month period, we're gonna do OT and then the next three months we'll do the social skills group, or whatever it is, it doesn't have to be forever commitment. And things can gain priority, you know, because also kids as they get older, their bedtimes typically go back, and there is more room in certain seasons, like maybe summer is more flexible. timewise. So just because you say not now, doesn't mean you're saying that ever.

Penny Williams 12:30

Yeah. And it doesn't mean that you're not doing everything you can for your kid either. Right? You know, again, going back to giving ourselves grace and being kinder to ourselves, you know, when professionals are recommending these things, it's so hard to say not yet sometimes. And I love that use the word yet. It's one of my go twos with parents, because our kids tend to be delayed right in a lot of ways. And we're saying, Oh, my gosh, you know, my nine year old can't tie his shoes, what is gonna happen is you're gonna graduate from high school, like, we go from 0 to 60 in our heads, right about these things that our kids struggle with. And so I am constantly telling parents just add yet to the end of these statements. They're not there yet. It doesn't mean they won't be. We're just not there yet. And I think there's so much value to that. And I love using that too, for, you know, these different interventions that we may not have the bandwidth for. It's okay to say we're not there yet. But we will get there. We will do that. At some point in time. A lesson I learned around that really early on was that we could not go straight from school and do anything else. It was always meltdown, every single time it didn't matter where we were trying to go. The grocery store ot I mean, it was always meltdown, we had to have that downtime. And I think it's so important to take those signals from our kids, right? To see that behavior and go, Okay, what is going on here? How do I pivot to help them?

Kelly Fradin 13:58

Yes, and I'm so glad you like yet. Yeah, it is also one of my favorite words. And I think, you know, it comes from this growth mindset idea that we are works in progress, even the adults, right that, that we're still figuring things out, and that's okay. Like, even once you figure things out, things will change, you know, so it's going to be an evolution. And I often find that parents are very forgiving to allow their children to adopt a growth mindset of like, oh, he hasn't figured out how to make friends yet. That's okay. But then when it comes to their own mastery and parenting, we don't give ourselves the same grace. And it's like, yeah, just haven't figured out what parenting techniques work best for him yet. And I love that and that's okay. Like, I'm trying, but I haven't got it down yet. But that's okay. Because that's part of the process of learning to be this unique child's mother is that it's gonna take some time and it's going to take trying different things. And it takes that confidence that like, if I keep trying, I will get to a better place.

Penny Williams 14:56

Yeah. And to really keep at it for longer than I think Most of us feel like we should, if that makes sense, you know, when we try a new intervention, or were, you know, switching something up for a challenging behavior, I remember saying, Okay, if it hasn't worked by now, you know, two weeks, three weeks is never gonna work, I'm done with this, right. And for our kids, it tends to take longer. So we really have to have some faith in some of those things. And just to keep at it, because it is that process, it's a journey, you know, to it, it changes a lot, right? It changes as our kids change what they need from us what we need to focus on. Again, we have to take those signals, right, and our follow our intuition, as you were talking about.

Kelly Fradin 15:43

Yes, and, you know, I feel like a lot of times comparison can add stress to the process, right. Because you might have envisioned, you know, what it would look like your child's school weak, or your ability to do other things while being their parent, and you might have kind of thought it was going to go one way. And then you might be kind of like, also accepting the reality that your kid is not somebody who can handle you know, at nine or 10 years old, doing a sports team on top of school three days a week, you know, that maybe that's just too much for them. And there's a kind of like, frustration that parents face when it's like, but this kid can do it. And this kid can go to bed in five minutes, and my kid needs 90 minutes to wind down. And it's like, it can be hard to accept the reality of that, like the implications on your life as a parent that you're facing more, it's more work, but then you'll you know, you love your kids so much, you don't even talk to anybody about the fact that it's hard to be their parent, but it's okay to struggle with it. It doesn't mean you love them less like it can just be the reality that your child might have more needs than another child. And that's okay. It's just that your parenting looks different than somebody else's.

Penny Williams 16:58

I always think about the quote from think it's Roosevelt Comparison is the thief of joy. I have reminded myself of that a lot in my parenting journey. You know, I see other people plus, you know, people share what they want you to know, on social and things like that, it can be really difficult. Even for me now, you know, my son is 20. And he graduated high school a couple years ago. And he's on his own sort of trajectory, right in his own timeline. And I see, like, right now, there's photos of kids doing prom, and they're all dressed up, and it was COVID, they didn't even have prom, and he probably wouldn't have wanted to go anyway, like, that really wouldn't have been his thing. But I still I see that still, even now, after 14 years of practicing this acceptance and accepting the journey, I still have that sort of little twinge of seeing other kids doing it. And so it's, I think, a constant practice of acceptance and not comparing yourself and your journey. And it's okay that sometimes you're going to go back to that place. It's okay to grieve it more than one time, I think this is what we're talking about, too.

Kelly Fradin 18:13

And I do find, it's also really important to look for opportunities for gratitude and joy. Because along with the hard part's often there are like, really unique special things about our children that, you know, sometimes the intensity that makes it difficult to be their parent also makes them really interesting people to get to know and to see like what they come up with. And so in the small moments, I think, finding a naming that it can also be really rewarding and directly beneficial to the child's self esteem. Because they know right, most children are very sensitive to how they're perceived. And they know when they're frustrated, their parents are frustrated, their teachers are not doing what they're supposed to do and make him feel bad about it. And we don't want them to feel bad about it. And one way that we can help promote that is by naming the positives that they bring, whether it's their sense of humor, or their creativity, or their perseverance in the areas where they're really interested, or, you know, their friendship skills, whatever it is, most children have something that we can point to as like something we really appreciate about them. And I think it's really important in terms of fostering a positive relationship between the parent and the child to lean into those things.

Penny Williams 19:28

Yeah, I remember when my son was really little, probably age seven or so. Newer diagnosis for us. It was an ADHD only at the time and his therapist one day put out a big piece of paper on the floor, a big roll of paper, and she traced him and she said, I want to tell you to tell me all the things about you right, and she was writing them all down on him and he will you know, open the door from her office, just beaming, beaming so happy, happier than I had seen him in a long time because he was really struggling and he said You know, there's so many things about me, Mom, there's so many things, you know, and it was so wonderful for him to get a chance to think about something other than what he was struggling with. And for me as well, you know, I sort of took from that this lesson that I needed to make sure every day, I was thinking about the greatness, the things that made him awesome. And noticing them with him, and really trying to foster better self esteem, because he was going to school and getting so many messages that he didn't measure up, that he couldn't do things easily. Like other kids, you know, they're so aware of those discrepancies between them and their peers. They're so aware. And so little activities like that can make all the difference, I think, for both not just our kids, for us, and our mindset, too, as a parent.

Kelly Fradin 20:53

Yes, it takes conscious effort, but I think it's really worth it. And it makes me want to go home and point those out. But, you know, I think what happens, it comes from a good place, right? Like we're trying to help our child grow and help them learn new skills and help them adapt more productively to the environments or in you know, the classroom performance. But what that leads to practically is, Do this, do this, you're not doing this correct this. And sometimes in my head, I keep like a little tally, about like, the ratio of positive things I say to my children versus negative or corrective things. And honestly, most days, I skew heavy and the negative just because it's immediate, right? It's like, no, don't open the umbrella and hit me in the head with it. Like, no, don't bother your sister. She's trying to do something. And so I think most parents do skew to the negative, but just the awareness of it helps me remember to say like something positive, whether it's like, you seem really proud of like, you know, yourself, you seem like really cheerful today, you seem like you were really friendly to that guy on the street is like nice things. Small things.

Penny Williams 22:02

Yeah, small things. I love that you bring that up, because that's really what we need to focus on as parents. And our instinct is to focus on big picture, right? We want to raise this happy, successful adult. And we're constantly like, looking so far into the future and future casting, but really celebrating the little tiny steps that we're taking toward that makes the journey so much easier, in my opinion, because we are focusing more on the positive that way, right? We're not saying, you know, kind of star, my kid is 19 can't tie his shoes. We're saying home look, this week, he made a lot of progress there. Like he's making that loop and he's able to hold it, you know, and like, that is so much of a different place for us to live in. It's such an easier, more rewarding mindset and mind space to me, and I think, and it was something that I had to learn for sure. As time went on. I'm so glad that you brought that up, though, I think it's so important. Do you want to share just a couple of strategies of what do we do when we are overwhelmed? Like, everything's challenging, we're getting calls from school, we're having struggles with homework time, or getting to bed or getting ready in the morning. And you know, the pediatrician or the doctor, the developmental doctor saying, you know, maybe you should do OT or you should do this. And everything. It's just sort of building, what can we do? Even if it's just five minutes, right, or three minutes to sort of help ourselves to dig out of that overwhelm?

Kelly Fradin 23:38

Yes, I, you know, I think it's important to acknowledge that most of the overwhelm comes because we're like, trying to live in systems that make it hard for us, right that like, you know, it's impossible to get medication, it's impossible to get stuff covered by insurance. There's never enough access to good therapists in the community, at times that work for children, like, I think to acknowledge that it's like, not you. It's not that you're doing a bad job. It's that the system makes it hard for everyone. Yes, I think that's an important thing to be like, I'm doing the best I can. I like to use imagery too. So I like to think about like hurdles, you know, so it can be very daunting if you look out and you see like 20 hurdles in a row, but it's just like, What is my hurdle today? What can I get past today? And I think the other strategy I often recommend is like, whenever you're thinking about adding something in terms of responsibility, like adding in taking your kid to OT and finding an OT, for example, you should also think about what you're going to let go up to make room for that.

I love that because that's the reality. It's like we're not just like sitting on our sofas Netflix thing all day, right? We have full lives, right? So when we have to add something, it's like, what can we let go of? Because it will be necessary to let go of something To make this happen, and the only situations when it's not necessary, is when you're able to find more help, right? If it's a neighbor who can take care of another child, so you can do it, or if there's, you know, grandparent out there who you can lean on to add to your support network. But assuming that you don't have the luxury of this, like community supporting you in a way that you need, you probably will just have to do less. And that's okay. You know, it sometimes makes us sad, or annoys us that we have to do less, but kind of the reality of the situation is, it's not fair to ourselves, to have these expectations, so we can just do more and more and more, and that energy comes out of the ether.

Penny Williams 25:40

Yeah. And I think really asking, like, what is doable? without stressing everyone? What can we do in a day, where we aren't going to have meltdowns or intense emotions? Or, you know, shutting down, that sort of can be a good measure? I think, you know, if you're doing OT and every day, at the end of OT, your kids melting down, maybe it's not the right time, right, maybe it's that signal, again, that you need to sort of peel back pare back a little bit for now. Not yet. Right. Again, using those, those terms that give us permission to feel like we're enough, you know, and part of that is cultural. We're so driven as parents to give every ounce of ourselves as sacrifice for our kids and our culture. And, you know, I've worked for years, myself, and just giving myself permission to not have hustle mentality, hustle culture, you know, like to enjoy things. And that's okay. That works for us, you know, so many great strategies.

Kelly Fradin 26:51

Yeah. Yeah. I think also, we tend to be sort of fatalistic about, when we feel overwhelmed, it's like, you know, this week, like, if my child isn't able to get the homework done, that they're supposed to do, like, that's a marker for the fact that their future is going to be limited, you know, yeah. And it's not true in most cases. And sometimes it can be really helpful to just vent to a friend or a co parent, or, you know, a trusted loved one, what you're thinking, because when you're honest about like, and you say, the thoughts that are sometimes in your head, increasing the pressure and the overwhelm, when you say them out loud, sometimes it reminds you that like, this isn't the fact that like, if you fail Elementary, or middle school, or even a high school grade, like life is long, and you know, it's gonna be okay. And that perspective is very easy to see when it's not your child, when it's your child, it's basically impossible to see. That's why sometimes you need help from others at maintaining a perspective on things.

Penny Williams 27:53

Yeah, I think community is so important when you're raising a child with differences or medical issues. We need that perspective from others who have also been in it. And just that support, you know, you need to be able to say, Wow, this is really hard, and not have that other parent that you're talking to sort of be like, Why is that so hard, or you need to just discipline more those things that are such good intention, but so painful for us to hear, we need to surround ourselves with other parents who get it who are in that sort of same space to

Kelly Fradin 28:31

Yes, and it takes some bravery to open up to other parents about what you're facing. Because a lot of people fear that kind of judgment like that if your child's having behavioral difficulties, which is reflected on you as the parent and that you might be judged for that. But in my experience, the fear of that is typically outweighing the potential benefit, and overestimating the likelihood of having a negative response. So many times, you just don't know. And often the person that you think has thought together, when everybody opens up, they're struggling to in their own way, even if it's not with the same thing. But you can be a leader in your community, when you're brave enough to have a little honesty, and then increase everybody's support.

Penny Williams 29:18

Yeah. And the weight is a little less heavy when you share it with other people. I don't know where I would be without the community of other parents who get it. I can't imagine and I didn't have that. At first. I wasn't even on Facebook yet. That's how long ago my son was diagnosed. It wasn't even on Facebook. Yeah, but man when I got on there, and I found the other parents who are like me, oh my gosh, like I just could breathe truly. I just felt like I could finally breathe. It's so amazing. And you know, books like yours as well, are really, really helpful. The messaging that you're sharing with us here and giving ourselves grace and being kind to ourselves. It's so important to have that on this journey. And so I really encourage everyone who's listening And to check out your book, advanced parenting, and I'm sure there are many, many more strategies that we were possibly able to talk about here today and a lot more guidance there. And we'll have links to that in the show notes for everyone, as well as to Kelly's website and social media and lots of ways to learn from her. And to be able to just grow in this parenting and help our kids grow, as well. And those show notes are accessible to everyone at parentingADHDand autism.com/222 for episode 222. And again, I want to thank you so much for the work that you're doing and for sharing a little bit of your time and your wisdom with us today. It's so valuable and help so many families and I thank you,

Kelly Fradin 30:46

thank you so much. I really appreciate the work that you're doing and helping form a community for parents of children with differences. Thank you. I think it's a really powerful resource. So it was great meeting you and speaking with you about

Penny Williams 30:58

all this new as well you as well. And I will see everyone on the next episode. Take good care. Thanks for joining me on the beautifully complex podcast. If you enjoyed this episode, please subscribe and share. And don't forget to check out my online courses and parent coaching at parentingADHDandautism.com and at thebehaviorrevolution.com

Transcribed by https://otter.ai