Whether your child has ADHD, depression, anxiety, or any other psychiatric or learning disorder, you as a parent are on a challenging path. First, you see your child struggling. It may take years of research and consulting specialists before you get the proper diagnosis. Then you become a tireless advocate for your child, to secure the help she needs. And in the midst of all your efforts you must decide if, when, and how to tell your child about her diagnosis.
This stressful scenario was played out beautifully on this week’sParenthood, an NBC show that is doing an excellent job of portraying a boy with Asperger’s and how it affects his family. Last week, 8-year-old Max first learned of his autism spectrum disorder when he overheard a heated exchange between his father, Adam, and his Uncle Crosby as his mother, Kristina, stood by. “Get it through your thick skull,” Adam yelled, “your nephew has Asperger’s!” A puzzled-looking Max, looking down on the scene from the stairs, said, “I have Asperger’s? What is…Asperger’s?” The stunned adults were speechless.
In this week’s episode, “Qualities and Difficulties,” an uncomfortable, unprepared Adam and Kristina attempt to explain things to Max. “Well, what’s Asperger’s?” he asks. Adam: “Asperger’s is a form of autism.” Max: “What is autism?” Adam, struggling for words, tells Max that his brain is wired differently, to which the literal-minded Max responds, “I don’t have wires inside me. I have muscles and I have capillaries and I have nerve endings and I have blood and I have bone.” The distressed parents keep talking over each other. Adam calls it a disability; Kristina says it’s not really; Adam terms it a syndrome. Max asks if his parents or sister have it. When they say no, he’s left feeling even more alone. Kristina cries throughout the conversation; Max escapes to his room.
This excruciating scene demonstrates why we urge parents to rehearse in advance how they will talk to a child or a teen about a psychiatric disorder, so they’ll be able to do it in a developmentally appropriate manner and frame it in a way he understands. This is true whether you are speaking to a 6-year-old about severe anxiety, a teen about depression—or an 8-year-old about Asperger’s. And these kids need to hear about their disorders, in order to understand and accept the reality of their condition. If they don’t understand, they can’t be partners in their own treatment; they can’t advocate for themselves; they can fall into even more problematic behaviors.
When a diagnosis is treated as a secret, children are often left painfully aware that they’re different, without knowing why. They may go to a special school or see therapists. They may be teased or bullied. They often lack friends, don’t get invited to parties and feel lonely. They probably know that they have a harder time sitting still, or reading, or remaining calm. All of this puts them at risk for anxiety and depression. Talking about disorders—not just naming them, but identifying what the feelings and behaviors are that are challenging for them, helps them make sense of their lives. You are likely offering relief: “This is why I behave the way I do, this is why things are challenging for me. This has a name and other kids have it, too.”
What you’re telling kids is that they are not “bad” or “damaged.” Rather, it’s that their brains work differently, so they may need to work harder, but there are therapies and strategies that can help them cope and succeed. You can also stress that they have strengths and weaknesses, just like everyone else. A child with ADHD can be extremely creative, while someone with a high-functioning autism spectrum disorder can apply their focus to excel in an area that interests them.
In the Parenthood episode, Adam and Kristina know they’ve failed miserably and seek out their family therapist’s advice. He advises them about being consistent, about being positive, about connecting with Max—and to get back in the ring and do a “redo.” I can’t emphasize this point enough. Parents have multiple chances to get it right when they share their child’s diagnosis, no matter what they have. Even moms and dads are allowed to make mistakes. This is not one conversation; it’s an ongoing dialogue.
Parents raising the 88 percent of kids who don’t have issues can get away with average—even less than average—parenting. Kids grow like weeds. But the rest who are raising special-needs kids have to work very, very hard. You’re going to strike out a lot. And you shouldn’t beat yourselves up about your mistakes. Bad parenting doesn’t cause these disorders, and superparenting doesn’t make them go away. You’re going to be learning as you go along what works best for your kid.
By the end of the episode, Kristina and Adam have grown enormously. Adam, who initially refused to see anything positive about Max’s diagnosis, is able to honestly tell his son all the great things about him, and because they are on the same page, their marriage is stronger than ever. They do a brilliant job of talking to Max again about his Asperger’s. This time they get it very right.
After reminding Max that he’d had occupational therapy and has been learning to play with other kids, smile when meeting people and look at others during a conversation, Kristina explains that he’s been working on these things because of his Asperger’s. Adam then lists all the strengths Max has because of diagnosis: Thanks to his incrediblememory and passion for insects, he knows everything about them. “You’re a rock star,” Kristina tells Max. He finally asks, “Am I going to have this my whole life?” The answer is yes; kids don’t “grow out” of this diagnosis. But again, Adam starts with the positive: “You will always have an amazing memory and be passionate about things that interest you. And those social skills your mom mentioned, those things will always be things you’ll have to remind yourself about.”
In this warm, instructive episode, Kristina and Adam evolve into wonderful models for all caregivers grappling with this issue. And the message is clear: Regardless of the diagnosis, a child has qualities and difficulties, but there is help out there, and hope.