It’s 9 p.m. and you open the school portal, the way you do now. An assignment is marked missing — the one your teen told you at dinner was turned in. By 9:04 you’re arguing about honesty, and by 9:10 you’ve both quietly decided the other one can’t be trusted.
That fight is where this episode starts. I sat down with Dr. Kristin Edwards, licensed psychologist and founder of Tampa Pediatric Psychology, to talk about what attention-deficit/hyperactivity disorder (ADHD) actually looks like in a teenager. She and I went to grad school together, and her answer changed what I think that 9 p.m. fight is about.
My teen is smart. So why are there so many missing assignments?
Because the material usually isn’t the hard part. Keeping track of it is.
I put it plainly on the show: “It’s not that the material is necessarily too hard. It’s just that keeping track of all of it is the hard part, right? Kids will have a million missing assignments. They know all the answers.”
High school is where that gets exposed. The demand for executive function skills jumps: multiple teachers, multiple expectations, projects due in different classes, online portals with assignments and due dates. What parents notice first is almost never hyperactivity. It’s that “the effort that they’re putting into something isn’t really matching what the output.”
Which is why the video game argument falls apart: ten hours of gaming and a page of missing assignments are the same brain, doing fine with what grabs attention and badly with what doesn’t.
The National Institute of Mental Health describes the same shift: “As academic and social demands increase, symptoms of inattention often become more prominent.” The hyperactive kid everyone is watching for may never have been the version you had.
1. "Life Wide"
Dr. Edwards reached past “lifelong” for a better word: life wide. ADHD doesn’t stay in the backpack. Socially it can look like “saying something to a friend that you would have rather thought through before saying it.”
It lands hardest on how a kid sees themselves, and she has a name for that part: “I always refer to it as like the consequences of ADHD.” Years of being the one who forgot or didn’t finish become a story about who you are. She sees it “as young as like second, third grade,” and calls it “a self-fulfilling prophecy.” By high school it sounds like this: “why bother? Like what’s the point of even trying hard now?”
So when you talk about the problem, talk about the problem. In her framing, “we’re talking about the behavior rather than talking about them.” The unsubmitted worksheet is a thing that happened, not evidence about your kid.
2. The Portal Truce
That 9 p.m. scene is one Dr. Edwards walked through on tape. A parent checks the portal. “You didn’t turn in this assignment. I thought you told me that you did.” You “go check their backpack and it’s still there, or they never hit submit.” Then the sentence that turns homework into character: “Okay, well now you’re being dishonest.”
Both people are telling the truth. The teen is somewhere in “how did I forget to do that? And that shame.” The parent is somewhere reasonable too. But “both parties can kind of dig their heels in on both sides of that,” and what erodes isn’t the grade. It’s trust.
So take the ambush out. Call it the Portal Truce: one agreed day and time each week when you look at the portal together, out loud, and nothing checked behind their back in between.
3. Shifting the Executive Functioning System Off You
Executive functioning is what gets a task started and brings it back after a distraction: in Dr. Edwards’s words, “helping us get started on tasks, follow through with something. If we get distracted, can we get back on task?” Those are the weak spots in ADHD, so somebody else ends up doing that job. Usually a parent. “For a lot of parents, they are the executive functioning, like they’re the reminders and checking the portal.”
The work is shifting that system off you and onto things in the teen’s own environment: alarms they set, a place where everything lives. Not because your reminders don’t work. Because they work, so the system never has to get built.
One condition, and she is firm about it: “having that conversation prior to throwing all these strategies to them is so important.” Not “here’s a planner,” but “how can we come up with a system together.” So this week, move one reminder you say out loud to an alarm your teen sets, picked with them.
4. Intervention, Accommodation, Treatment
Asked where to start, Dr. Edwards sorts the answer into three piles. Intervention is direct work on the skills. Accommodation is what changes at school, usually through a 504 plan or an Individualized Education Program (IEP). Treatment is the medical piece.
The accommodation pile is where families get stuck, because the list is generic and your kid isn’t. Extra time is her example: “just more time on testing was giving more time to get distracted off task.” A student can come out worse when “everyone’s giving them extra time, and it’s really not it’s kind of making things worse.” Call that the Extra-Time Trap. As I said on the show, “not all of them are helpful and they can sometimes do a disservice to the kid.”
Before your next 504 or IEP meeting, ask one question about every line item: which of my kid’s measured weaknesses does this target? If nobody can answer, that’s what a comprehensive evaluation settles. Afterward, she said, “the recommendations are gonna be so much more targeted and specific.”
5. Multimodal
Dr. Edwards translated a word parents are going to hear. Multimodal, she said, means “there is no single treatment.”
Her summary of the evidence: “the evidence-based treatment options are medication and therapy, or like specifically some kind of behavioral therapy.” That matches the guidance: the Centers for Disease Control and Prevention says for children 6 years of age and older, the recommendations include medication and behavior therapy together, and the American Academy of Pediatrics tells parents that stimulants “may be used alone or combined with behavior therapy.”
ADHD also rarely travels alone: in CDC survey data, nearly 78% of children with ADHD had at least one other condition, and about 4 in 10 had anxiety. Anxiety can even hide ADHD for a while, because “the anxiety can sometimes keep some of those ADHD symptoms in check.” The grades hold. The kid is exhausted. Risk doesn’t sit on only one side of the ledger either. Dr. Edwards raised driving, where NIH-summarized research found a crash rate 37% higher for young drivers with ADHD across their first four years of licensing.
This is not intended for medical advice. Those questions belong with your child’s prescriber.
Her answer to what she wishes every parent knew is the one I’d put on a sticky note: “They can be genuinely putting in their best. And it might not look like that.” Separate the ADHD from the child.
Resources
Most of what we covered here is executive functioning, and a lot of it gets better with the right support at home and at school. Working out what is driving the pattern is a different job, and that’s what an evaluation is for. At Integrated Behavioral Health, our doctoral-level team works with children, teens, young adults, and families in Denver and Greenwood Village: comprehensive evaluations, including ADHD, psychoeducational, learning, and gifted testing, with a written report in four to six weeks, plus therapy for ADHD, anxiety, and behavioral difficulties. We have no waitlist for therapy or assessments.
- Tampa Pediatric Psychology — Dr. Kristin Edwards’s practice: evidence-based therapy and psychological assessment for children, adolescents, and young adults. https://drkristinedwards.com/