Ask HN: My 12 year-old nephew just got diagnosed with ADHD, any advice?

Taking medication _now_ may be counter intuitive for future development, as the brain never gets a way to fully (under)regulate/calibrate dopamine release on it's own until maturity.

Finding ways to learn that help him. Ex: - Short attention span? short repetitions of digestible chunks that he can relate to. - After school classes where someone is available for questions and some 1-on-1 help gets a long way.

I figured out systems and tools to succeed in school and work (I was largely a C student testing in the top 0.1% of CA school kids on the standardized tests -- found that tidbit cleaning out my mom's things).

It was the rejection I experienced in peer friendships that scarred me deeply, and as someone who has been unmedicated into my 40s, still impacts my adult friendships and professional relationships.

ADHD: Essential Ideas for Parents - Dr. Russell Barkely https://www.youtube.com/watch?v=YSfCdBBqNXY

Some key tidbits to sell you (and your nephew's parents) on spending the full two hours with this:

"... it also helps families to understand some of the other life course risks 50 to 70% of ADHD children are utterly rejected by close friendships by second grade it is in fact one of the more devastating consequences of this disorder is this inability to make and keep close sustained friendships with others their children and it is heartbreaking for parents to see this happening that their child is not as liked as other children that the sleepovers the going to the movies and the other social events in which other children celebrate their peer relationships are shut off for this child why is it there the single best predictor of peer rejection is that symptom the emotional impulsiveness friends forgive you your distractability your forgetfulness your working memory problems and even your restlessness they will not forgive your anger your hostility the quickness with which you emote to other people because it is offensive it is socially costly so now we can begin to understand the numerous social problems that ADHD children are prone to because it arises from this aspect of the inhibitory deficit"

"explains the road rage during driving the job dismissals which are not the result of inattentiveness but of being too quick to anger too quick to express raw emotion in the workplace of which employers are not tolerant especially if it occurs with a customer and it also explains to us the marital difficulties and the parenting difficulties these children may be prone to because the single best predictor of marital problems in the adult with ADHD is not distractability it is emotion so we can begin to paint a better picture of understanding ADHD and its life course risks by understanding the nature of the inhibitory problem..."

Do you have any specific examples of what that could look like? I have tasks I’m motivated to do, but introducing rewards for ones that I’m not motivated for always feels artificial

ADHD and other spectrum disorders have in the past been used as a catchall diagnosis for certain groups of symptoms.

For example, heavy metal poisoning often presents as ADHD or ADD misdiagnoses and was not simple to test in years past.

Mercury may leech from silver fillings (depending on where in the world you live), this naturally happens when kids drink soda (which is acidic/caustic for dental amalgams, or may be contaminated through High Fructose Corn Syrup, where mercury is used in its production).

Lead from inhalation may cause similar issues where lead-based paints may shed chips or dust when its deteriorating even when it looks stable.

Arsenic from water as well.

The problem with heavy metals is they don't stay in the blood so a blood test absent a chelator may not properly indicate the issue. These metals get bound up almost immediately in tissue to prevent damage, and you don't know how much gets stored until you take a chelator which may cause acute poisoning (when its bound up, and suddenly gets released into blood).

Eating cilantro (a good chelator) for example has caused migraines and headaches in people who have chronic exposure to such, like mercury. These toxic conditions may also result in poor learning outcomes, brain fog, and other disadvantages that seem to constantly change where finding the words to describe them are quite difficult for the person afflicted.

There are also studies which suggest some of these related symptoms may be linked with high exposure to unsafe levels of PFAS, microplastics, or high levels of flouride.

Its important you first get a proper diagnosis. If you don't bring up the possibility/concern, few doctors will make a connection. Acute poisoning presents very differently from chronic low-level poisoning.

There are some very good medicines that treat the symptoms for ADD/ADHD, but when the cause is toxic exposure; more damage is done by only treating the symptoms.

There are also some significant side-effects related to ADHD treatments, that may be permanent, which may result from those treatments for children who are still developing.