To complement ADDitude magazine’s Spring 2026 cover story on autism, we invited readers to share artwork that captures the diversity and depth of life on the spectrum for them. Here, we spotlight seven artists whose artwork is as varied as the autistic community itself.

“My art is as detailed as my cluttered brain folds, and the detailed artworks that conceal things in the nooks and crannies are most representative of how this autistic person sees the world.”

Kimberly Gerry-Tucker
Connecticut

“I painted this piece to understand myself better, to feel free and renewed. This piece represents strength and humility talking with each other in my inner universe.”

Marcele Silvina Rodrigues White
Epsom, United Kingdom

“I originally painted this piece to explore colors and textures and to capture the magic I see in nature. As a neurodivergent person, this painting is me: bright, bold, beautiful, and sometimes, a little chaotic, just like Mother Nature.”

Casey-Lee Flood
Hai’kū, Hawaii

“I drew this image because, my whole life, I felt like an alien who didn’t belong. Today, this alien stands proud in a sea of other neurodivergent folks. I finally feel seen and accepted for who I am.”

Cat Contillo
Newburgh, New York

“Many people are under the false understanding that individuals with autism are restricted by their diagnosis and act according to their prescribed identity. The sky here is visible and asks for attention, just as autism is still characterizing and relevant but isn’t the most important thing on the canvas.”

Lilly Corradetti
Ontario, Canada

“There is beauty and vibrance in embracing neurodivergence. I have learned to move with the dance of darkness, light, and color, in the emergence of self, and integrating who I am.”

Angela Taylor
Winnipeg, Manitoba, Canada

“I wanted to portray the complexities of what it is like for neurodivergent people to mask, and how much of ourselves we lose in the process. It is my first piece of work, and, because of that, I found it cathartic to finally put my experiences of masking down on canvas. As chaotic as it looks, it’s very real.”

Lilya Taylor
Portsmouth, United Kingdom

Understanding Autism: Next Steps

• Free eBook: The Truth About Autism in Adults
• Read: “My Art Style is Expressive, Bold, and Moving — Like Me.”
• Read: “A Big Part of Unmasking Is Honoring Your Limits”

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Today, Vittert is a NewsNation TV anchor and author of a book with Don Yaeger. Born Lucky: A Dedicated Father, A Grateful Son, and My Journey with Autism (#CommissionsEarned) illuminates the ferocity of parental love and support in the face of adversity. Here, he speaks with ADDitude.

Q: Why did you write this book with your dad, and why now?

LV: We wrote this to give parents the hope that my parents didn’t have when I was diagnosed. I had behavioral issues and sensory issues. My parents were told by an expert that it was difficult to know what was going on in my mind and that they couldn’t do much for me.

Born Lucky is a love letter to my dad, who encouraged me to reach my full potential. It follows the arc of my development from not being able to understand human interaction to being able to get along and function in the real world. We want parents to know that they have enormous agency and power to affect the outcomes of their kids’ lives.

Q: Can you talk more about the challenges of growing up autistic and how, as you say in the book, it led you to become resilient?

[Is My Child on the Autism Spectrum? Take This Test To Learn More]

LV: I was in and out of four schools by fifth grade. Two weeks into seventh grade, the principal told my parents, “Everyone in this school thinks Lucky is weird and, frankly, I do too.”

I had lots of meltdowns. If a kid touched me in line, I’d turn around and hit them because touch felt very threatening to me. If kids were being serious, I’d tell a joke. I didn’t understand how to interact, and the rejection was so persistent and stinging that I cried myself to sleep every night.

My dad was my best and only friend. He gave me an immense amount of love and care, and he always made me go to school the next day. My parents were very clear that I could not expect the world to change for me. This made me resilient. I always say the best training for the Washington newsroom was middle school!

In 2021, I had just been asked to leave by my employer, Fox News, had broken up with my longtime girlfriend, and was living in my parents’ guest bedroom. My dad and I were talking one night, and I was feeling sorry for myself. He said, “If you could get up and go to school day after day as you did in eighth grade, you can get through this.”

[Get This Free Download: What Are Your Teen’s Weakest Executive Functions?]

Q: How did you build the social skills you felt you needed to interact with people? 

LV: I still struggle every day with the things my dad and I worked on for 15 years: how to listen, how to understand where someone else is coming from emotionally, how to match that emotion.

My dad used to take me to lunch with his friends, and, when I was talking too much, rather than say, “Be quiet,” he’d tap his watch as a cue for me to stop. Later, we’d talk about it. He’d say, “When you interrupted Mary to talk about something else, why did you think that’s what she wanted to talk about?” I’d say, “Well, that’s what I wanted to talk about.” Then we’d role-play. He was teaching me how to interact with others. Social dynamics are innate for other people. For me, they’re a learned skill.

Q: What qualities do you credit for your success as a TV anchor and now author?

LV: I was taught that you can control just two things in life: your character and your hard work. I was taught to work like hell. When I started in journalism, my quest was to outwork everybody. It’s hard to beat a man who won’t quit.

Parental Love: Next Steps

• Free Download: Help Your Child Develop Positive Self-Talk
• Read: Your Positive Parenting Toolkit Has Arrived
• Read: Autism and ADHD: The Complete Playbook for Social Challenges
• Read: A Dad’s Role in Modeling Social Skills

Leland Vittert is the anchor of On Balance with Leland Vittert at NewsNation.

Carole Fleck is Editor-in-Chief at ADDitude magazine.

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This quiz is designed for you and your partner to take together. You’ll take turns answering questions specific to your role.

Use this scale for both sections:

• Never = 0 points
• Rarely = 1 point
• Sometimes = 2 points
• Often = 3 points

Note: This quiz is not scientific. It is intended to help couples identify some of the key issues and ways in which ADHD might impact their relationship negatively and positively.

Melissa Orlov created this quiz. She is the founder of ADHDmarriage.com and the author of The ADHD Effect on Marriage.

Time's up

Can’t see the self-test questions above? Click here to open this test in a new window.

Healthy Relationships and ADHD: Next Steps

• Free Download: Manage ADHD’s Impact on Your Relationship
• Read: Stop Walking On (or Throwing Down) Eggshells in Your Relationship
• Read: “My Partner Is Refusing an ADHD Evaluation”

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The steep out-of-pocket costs of ADHD care today — on average, more than $8,500 per child and $4,700 per adult annually — are driving families to ration medication, delay or skip medical appointments, and forgo interventions they rely on to function well, according to ADDitude magazine’s new Cost of ADHD Diagnosis & Treatment survey.

Of the 1,970 survey respondents, about 25% cited out-of-pocket medical costs as a limiting or determining factor in accessing ADHD care; 21% said ongoing care is not covered by their insurance, and 16% said their ADHD medication costs are not covered at all.

“I just go without medication when I run short of money,” said one mother. “My adult child has skipped doses to be able to pay for her psychiatrist, and this has brought a lot of unsavory people into her life.”

“I never take my clinician-recommended dosage because I can’t afford it,” said another. “We are paying out-of-pocket for medication, so our kids don’t take it on weekends or vacations,” another mother commented.

[Free Report on Out-of-Pocket ADHD Costs]

ADDitude asked survey participants how they are covering or reducing the cost of ADHD care. Here’s what a few people said:

“I’ve had to take disbursements from retirement accounts to pay for psychotherapy.”

“I have two jobs at this point.”

“I switched jobs to one that is closer to home. I now bike to work. I also joined a nearby affordable community center pool. I swim and arrive at work already having exercised and feeling refreshed.”

“I’ve split the cost of ADHD coaching with another client.”

“It’s hard to pay premiums and pay for doctor visits and maintain a household.”

[ADDitude Directory: Find Affordable Care Near You]

Uneven Insurance Coverage

About half of the people surveyed said their health insurance plan partially paid for an ADHD evaluation for themselves, another adult in the household, or their child(ren). More than one in four said their insurer paid nothing toward evaluation and diagnosis; one in five said those costs were covered completely.

Many of the survey participants expressed frustration about rising health care costs — 10% said their ADHD care costs exceeded 10% of their income — and voiced deep anxiety about potentially steeper hikes and even less coverage in 2026.

The High Cost of Prescription Meds

One-quarter of survey respondents said they reluctantly switched medications because insurers dictated cheaper alternatives or covered prescriptions only partially or not at all, or because the cost of their preferred drug increased substantially.

A significant number said they had to meet their deductible, which was typically more than $1,000, before insurance would cover medication costs.

When asked if their health insurance plan covered the medications they take for ADHD:

• 19% said their prescriptions were fully covered
• 65% said their prescriptions were partially covered
• 16% said their insurer did not cover their prescriptions

Medications Covered

Regarding the medications covered:

• 32% said their insurance covered generics only
• 1% said their insurance covered brand names only
• 35% said generics and brand names were covered
• 32% said they weren’t sure

Types of Providers

Pediatricians and developmental pediatricians were the most common medical professionals seen for ongoing ADHD care (63% for children). Other providers include:

• 62% psychiatrist
• 50% other therapist or counselor
• 50% primary care provider
• 31% psychologist
• 9% occupational therapist
• 6% neurologist

Many survey respondents lamented about the shortage of psychiatrists and the impact of presumably less experienced providers who dismissed their symptoms of adult ADHD.

“I worked with an online provider to get my diagnosis because it was cheaper and quicker.”

“I had to see several different practitioners because they believed I couldn’t have ADHD as an adult since I was never diagnosed as a child.”

Finding Providers Who Take Insurance

The odds of finding a psychiatrist or therapist who accepts your insurance plan are becoming slimmer by the day.

One in four ADDitude survey respondents said that at least one of their medical providers has stopped accepting their health insurance. They voiced worry over a shrinking pool of affordable psychiatrists and therapists.

This provider shortfall was also documented in an investigation by ProPublica, which found that hundreds of mental health providers nationwide have stopped accepting insurance plans in recent years. They blamed insurance network practices that forced providers to chase down payments that were meager or late, and some reported that their services were denied coverage altogether.

The providers also criticized insurers for increasingly interfering with patients’ treatment, sometimes denying it, or pushing generic prescription medications that were cheaper but not optimal.

As the availability of mental health providers who take insurance continues to worsen, ADDitude survey participants shared their experiences.

“This has happened throughout my child’s life. His occupational therapist left the insurance network, his psychiatrist left, my therapist left, our family primary care provider left.”

“It took almost two years to find and start seeing a new therapist. The wait list was nine months long.”

“My psychiatrist is semi-retired and takes cash only. I have not found a new one who will follow my treatment plan, which was working great.”

“I had to call around and ask a bunch of psychiatrists, and it was such a pain. They think that you’re seeking medication when you just want appropriate care. It took me six months to find someone new.”

“I was referred to a nurse practitioner from a psychologist about nine months ago because the practice said my insurance didn’t reimburse them enough. I chose to stay with the practice, rather than start somewhere new, and now I pay out-of-pocket.”

ADHD Medication Cost: Next Steps

• Free Download: What to Ask Before Starting ADHD Medication
  
• Read: These Prescription Assistance Programs May Help You Save Money on ADHD Medication
• Read: How Does Health Insurance Work? A Primer for Patients with ADHD
• Watch: “Cracking the ADHD Medication Maze: How to Get, Afford, and Refill Your Prescriptions With Minimum Hassle”

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1. Is my dissatisfaction due to boredom with routine?

ADHD brains crave novelty. Could shifting projects or responsibilities add enough variety to re-energize you? Might there be a more stimulating role in your company, such as consulting as a problem-solver for coworkers when they feel stuck or responding to phone queries from clients?

2. Should I consider a career assessment?

A career assessment can clarify whether you’re in the wrong field or in the right field by the wrong job. It might also help discern whether your job could be a mismatch for your personality.

[Free Career Assessment: Find Your Passion with a Brain Blueprint]

3. Should I ask for accommodations?

Workplace accommodations can make a difference, but you only get what you research and request. Talk with your human relations department or your supervisor to uncover supports that could enhance productivity while lightening your load. These might include access to time-management and task-organization tools, a quiet workspace, flexible hours, or noise-cancelling headphones.

4. Am I creating my own stress on the job?

The emotional dysregulation of ADHD impairs both personal and professional relationships. If you explode in frustration, express resentment, or disagree harshly with colleagues or a boss, interpersonal stress can build until leaving feels like the only option. But before you reach that conclusion, remember: If you don’t address the patterns that created the stress, they will follow you into the next job too.

5. Pause and look inward. Mull over these questions:

• Can I repair strained relationships by clearing the air?
• Can I show that I’m building systems to meet deadlines more reliably?
• Can I acknowledge my past slip-ups and let coworkers know I’m working to change?
• Could shifting responsibilities allow my strengths to shine?
• Can I start focusing on the positives, appreciating the good things about my job, acknowledging the successes of my colleagues?

Sometimes, leaving really is the right move. But slowing down to consider these questions will help you choose wisely and with clarity.

“Should I Quit My Job?” Next Steps for ADHD Brains

• Free Download: What to Ask Yourself to Find the Perfect Job
• Read: 4 Steps to Claiming the Career You Deserve
• Read: “My ADHD Unleashed a Workaholic. ‘Quiet Quitting’ Is Saving Me.”

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The United States is the only first-world nation that does not provide basic health care to all its citizens. The roadmap to universal health care exists and public opinion largely supports it. However, health care is so incredibly profitable for American insurance companies and political campaigns that proposed reforms are practically guaranteed to fail time and time again.

Health insurance companies use the worst possible system to fund patient care. The only way to perpetually increase the profits demanded by shareholders is to deny legitimate claims or otherwise create obstacles that prevent or delay payments to providers. This system does not incentivize efficient care; it disincentivizes delivering care altogether.

How Insurers Dictate Physician Care

In the 1980s, as technology made the delivery of care more efficient, insurers sought ways to increase profits. This was largely accomplished by obstructing the delivery of care or denying care outright – and it changed physician behavior. If a clinician knew that a prescription for the cheapest immediate-release ADHD medication  would be approved swiftly and without question, but a superior and more expensive time-released formulation would be contested or denied, the clinician would prescribe the insurance-preferred medication, even if it were not what was in the best interest of the patient.

In Colorado, where I live, a majority of private mental health practitioners no longer accept any insurance plans largely because the insurance companies don’t pay parity rates or pay for care that was pre-authorized. It can take months for insurers to pay claims.

These insurance company practices have made access to patient care difficult, if not nearly impossible. In Colorado, few clinicians have the training and experience necessary to adequately manage ADHD in children and adults. If a patient cannot find an experienced clinician and access good care, they stop running up clinical office and pharmacy charges — a win for the insurance company and its profits, and a loss for people who go untreated.

[Download: The Soaring Cost of ADHD Care]

For every practicing clinician who still deals with insurance, there are likely one to two people in their office who do nothing but fight to get their legitimate claims submitted and paid. This extra cost gets passed on to the patient in the form of higher out-of-pocket costs at the point of service.

Being obstructive and slow to pay claims is profitable in other ways, The longer the insurance company can hold onto billions of dollars of premiums, the more investment interest those premiums will earn. Insurers also know that people with mental health conditions are much less likely to appeal a denial of care.

Life is hard enough for people with an ADHD nervous system. They can become overwhelmed by the intentional complexity and obstruction of legitimate care, A single complaint by a patient to a lawmaker or regulator is rarely noticed. A million complaints could start a revolution.

[Read: Bottom Line – Reduce the High Cost of ADHD Treatment]

Jumping Insurance Hurdles

What can patients do to fight insurance abuses?

• Contact your federal and state representatives about the problems you are having with your insurance company.
• Report issues with your insurer to your state’s Department of Insurance and copy your governor’s office.
• Report complaints about your insurance company to your human relations department, which chooses employee benefits.
• When a claim is denied, immediately demand a peer-to-peer review between your clinician and the company’s medical directors.

How can practitioners advocate for their patients?

If you are fighting to get your clients the best care you can provide (not the cheapest care that the insurance company can force you to provide), you must be aggressive. Each time you contact the insurance company, keep a log and do the following:

• Ask for a phone number to re-establish contact if the call is dropped.
• Get the person’s full name and professional licensure. Find out in which state they are licensed in case you want to make a complaint about practicing outside the scope of their license or for obstruction of appropriate care.
• As you get passed from person to person, ask each one for their credentials and what gives them the training, knowledge, and experience to make decisions about your patients’ care. How many people with ADHD have they diagnosed and treated in the last five years?

William W. Dodson, M.D., has been a board-certified adult psychiatrist for more than 27 years. He does not accept insurance.

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But structure and boundaries are important for any child, especially one who has ADHD and is prone to boredom. As the school year winds down, start thinking about summer guardrails and expectations that will benefit your child. As a family, discuss these boundaries (think chores and video game limits) and set up an environment to promote desired activities (like borrowing books from the library or playing board games that keep math skills fresh).

Consider these strategies as you develop your summer plan:

1. Save the best for last.

Have your child do chores, academic work, and other “non-preferred” activities during peak focus periods. Reserve fun activities — video games, sports, friend time —for later in the day to teach kids with ADHD to persist.

2. Give kids a choice.

Offering options reduces friction, gives your child control, and encourages cooperation. Provide a menu of activity choices for their morning, afternoon, and evening blocks.

Teens with ADHD need even more choice and control. As summer begins, discuss what you want them to accomplish (e.g., college essay drafts, volunteering) and what they’d like to do or get in return. This might be an extended curfew, a higher allowance, or more friend time, for example. Establish check-in dates to monitor their progress.

3. Know the upside of downtime.

Don’t feel pressured to fill every moment of your child’s summer schedule. Occasional understimulation is beneficial in today’s era of constant stimulation, especially for impulsive, sensory-sensitive children.

4. Prepare a meltdown kit.

Outbursts don’t take summer breaks. Big emotions will decrease as your child’s emotional regulation matures, but you can prepare for them by:

• Remaining calm. It may not seem like it, but your child looks to you for guidance on navigating emotions.
• Staying firm. Meltdowns are ways for children to get adults to reshuffle the deck and present more favorable options. Avoid giving in. Instead, stay with your child’s big emotions. Validate their feelings. Say, “I know it’s hard to stop playing video games and get ready for bed.”
• Developing a pre-meltdown plan. Ask your child, “What should you do when you feel upset?” Keep their answers in an easy-to-see place, along with a list of calming strategies like deep breathing, taking a drink of water, stepping away, or listening to music.
• Delivering consequences. Reserve timeouts and privilege losses for serious behaviors like hitting or throwing. Communicate your rules ahead of time so your child isn’t caught by surprise.

5. Enforce screen time rules.

Ask your child about their favorite apps or games to spark conversations about smart technology use. Incorporate screen time practically and with reasonable limits.

Once you’ve set boundaries for your kids over the summer, think about ways to make space for your own rest and self-compassion — so you can show up as your best self for your children.

Dave Anderson, Ph.D., is a senior psychologist at the Child Mind Institute’s ADHD and Behavior Disorders Center.

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Many autistic people hear this as they get to know their true selves better and intentionally begin to unmask. This observation is often followed by the equally unhelpful, “You used to be able to do it; why can’t you do it now?”

In the process of unmasking, some neurodivergent people experience “skill regression.” This is the term many clinicians use when a person with autism and/or ADHD suddenly has trouble with routine tasks like self-care, attending events they once seemed to enjoy, or managing executive functions like time management. The term skill regression, however, is quite pathologizing and a bit misleading.

[Take This Self-Test: Signs of Autism in Women]

Why ‘Skill Regression’ Is a Misleading Term

When I was in college, I went for a hike in the woods by myself and fell, rolling my ankle. It stung but held my weight, so I walked the rest of the way back. As soon as I got home and sat down, I couldn’t get up again. It’s not that the pain suddenly hit at home, but that I pushed myself past my limits, ignoring the pain until it was safe to acknowledge it.

When someone is high-masking, they exert a lot of energy presenting as neurotypical. Masking your authentic self involves disregarding your own needs, sensory sensitivities, and communication style to meet society’s expectations. A big part of unmasking is getting back in touch with these needs and recognizing the unhealthy or even unsafe ways you have overextended yourself.

In other words, it is misleading to call this a skill regression. I prefer to say that the individual has recognized their limits and begun to honor them. If you are in the process of unmasking, you may notice that some previously palatable situations and tasks now seem exhausting or even impossible. In my case, I realized how overwhelming I found my in-person office setting. Spending 40 hours in that setting was suddenly unsustainable. Learning what is sustainable has helped me discover hidden strengths and capabilities.

If someone you love seems to be experiencing skill regression, please be patient with them. Know that they are not trying to give you a hard time; rather, they are getting to know themselves better. If they trust you enough to show you how they are struggling, recognize that this is an honor. They feel safe telling you about their needs and newly identified limitations. Support them and encourage them to be honest and open about all of it.

Unmasking in Autism and ADHD: Next Steps

• Free Download: The Guide to Autism in Adults
  
• Read: 10 Steps to Unmasking Your ADHD
• Read: “I Thought I Sucked at Life. But I Was High-Masking Autism All Along.”
• Watch: “Understanding AuDHD Burnout: How Neurodivergent Masking Sparks Stress, Exhaustion”

Amy Marschall, Psy.D., is a licensed psychologist, author, and speaker.

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During this time, I was diagnosed with autism and ADHD. I wasn’t expected to show up to work or social gatherings due to the pandemic, and that left more space to focus on drawing — something I did for up to 10 hours a day. I made my own schedule, added physical therapy to reduce my chronic pain, adapted my clothing and home to better suit my needs, and engaged in my special interest full time, all of which deepened my relationship with myself.

[Read: ADHD & the Interest-Based Nervous System]

“The illustration I created for the cover of this issue was inspired by movement and repetitive movement, something that autistic people do as a form or regulation and communication. To me, the illustration shows a person spinning in their own world, and I wanted to illustrate the feeling of vestibular movement.”

I started to draw on the computer and eventually moved to an iPad, which allowed me to create works at the speed of my thoughts and impulses. As I began to truly understand my autism, I was able to find a path to the art of illustration.

A friend recommended that I try illustrating articles in magazines and newspapers, and that really sparked my interest. It felt like a perfect way to combine my love for drawing scenes and for creatively telling a story.

[Read: On the Awesomeness of ADHD Creativity]

I also began posting my works online. Viewers’ reactions to my work gave me the confidence to approach retail stores and pitch my designs for greeting cards and prints, and to create more art around storytelling. An art director saw my work at a bookstore and hired me for my first editorial assignment.

All the hours I spent on my special interest helped to develop my skills and allowed me to fully dedicate myself to illustration – and get paid for it. My style is expressive, bold, and moving – a lot like me.

Emcie Turineck, an artist in Montreal, Canada, created the artwork that appears on this issue’s cover.

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Movement and dance engage and align disparate neural regions — sensory and motor, cognitive and creative, social and emotional — resulting in a synchronized brain that works more smoothly and efficiently. The mind-body benefits of dance matter greatly in the context of autism and ADHD — forms of neurodivergence linked to differences in neural connectivity, functioning, and social interaction.

The Science of Movement

Dance and related practices — even a single movement session — spark myriad effects that are important for neurodivergent minds and bodies:

Coordination

Learning complex choreography, twirling on one leg, or improvising to a favorite song all recruit and strengthen motor skills, even in people with developmental coordination disorder — common in autism and ADHD. Dance also improves one’s ability to tune in to internal bodily signals and sense the body’s position in space.

Neurotransmitter Flutter

Dance stimulates the production of dopamine, serotonin, and norepinephrine — neurotransmitters implicated in motivation, attention, coordination, stress, and mood that often behave differently in neurodivergent brains.

[Watch: Movement As Medicine – How Music, Movement, and Dance Transform the Neurodivergent Brain]

Mind Bending

Dance is a mental workout. Moving the body generates activity in neural regions associated with cognition and executive functioning. Notably, dance can improve a person’s ability to adapt to changing situations and think about things differently, which may offset rigid thinking in autistic individuals. It is also associated with better learning and neuroplasticity.

Flow State

Experienced dancers slip into theta brain wave states, which are associated with heightened creativity and divergent thinking, more readily than do novice dancers, according to a study.

Mood Boost

Beyond neurobiological effects, dance provides an outlet for expression, alleviates depression and anxiety, and boosts emotional resilience, research shows.

[Read: The ADHD Playlist Prescription]

Ultimately, dance enhances the coordination of neural activity that allows different parts of the brain to “talk” to each other more seamlessly. This state may help regulate the atypical brain activity and connectivity commonly seen in neurodivergent individuals.

Dance Eases Social Stress

When we slow dance with a partner or rehearse with a troupe, our brains begin to coordinate rhythmically with the partner or the group. That is, dance enhances inter-brain synchrony, a phenomenon of social interactions that leads to deeper connection and collaboration.

For its role in stimulating social elements of the brain, dance is a promising tool for supporting autistic individuals. Indeed, my research team observed significant inter-brain synchrony among autistic children and adults who engaged in an eight-week musical theater program. Parents reported that their children showed lower levels of social phobia and separation anxiety after the program. Participants and parents also described brighter moods, higher self-esteem, and a stronger sense of belonging — factors that strengthen mental health.

All dance styles and forms of movement are healthy but revisiting the movement patterns illustrated below — innate to human development and codified in dance styles across the world — can reinforce brain-body connections and improve wellbeing. Neurodivergent dancers may reap particular benefit from practicing these foundational movement patterns, which are shown to repattern oscillatory activity and promote better cross-connectivity of brain regions.

How To Get Moving

• What’s around you? Check out a local dance, theater, or yoga studio with a friend.
• Start small. Set a goal for five minutes of daily rhythmic gestures. (Take inspiration from the patterns below!) Pair movement with a favorite TV show or album.
• Dance at home like no one’s watching. Follow an instructional dance video or take part in our research lab’s free movement series on Instagram (@embodiedbrainlab).
• Movement should be joyful, so choose the mode that’s most fun for you.

Julia C. Basso Ph.D., is an assistant professor in the Department of Human Nutrition, Foods and Exercise at Virginia Tech and Director of The Embodied Brain Laboratory.

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Increasingly, cognitive behavioral therapy (CBT) is being used to support executive functions and reshape environments to encourage behavioral change. At the same time, it works to reduce the shame, avoidance, and perfectionism that so often accompany ADHD.

Unlike other therapies, CBT measures patients’ outcomes in relation to their goals rather than ADHD symptom reduction. It supports patients’ time management, organization, emotional regulation, and other skills – not by encouraging them to change who they are, but by providing tools to improve functioning in ways that are meaningful to them.

CBT is most effective when it is designed collaboratively and personalized to meet a patient’s needs. For therapists, these guidelines for delivering neurodiversity-affirming care are a good place to start:

CBT Techniques for ADHD: Guidance for Therapists

💡Free Guide! 10 Things I Wish Someone Had Told Me About ADHD

1. Normalize ADHD

To aid patients in breaking unhelpful patterns, you must first understand and explain how ADHD impacts thoughts, behaviors, and emotions, Make the connection clear from a framework of difference, not deficits. Here’s an example:

PATIENT: I should be starting my report, but I keep thinking, I can’t do this. I’m a failure. I get anxious, scroll through my phone, and feel worse.

PRACTITIONER: That loop makes sense. With ADHD, large tasks demand a lot of executive functioning. When the first step isn’t clear, the brain sends an “avoid” signal. With that said, what’s a more balanced thought that still feels honest?

PATIENT: Starting is hard when the task is vague, but I’ve handed in reports before. I can begin if I make the first step tiny.

2. Follow the Patient’s Lead

When a patient tries to broadly suppress their ADHD symptoms, they end up consciously or unconsciously masking their identity. While most people mask to some degree, constant camouflaging leads to lower life satisfaction.

Abandon preconceived notions about impairing symptoms or challenges. Instead, ask your patient about their goals and the behaviors they want to change. Say:

• What would you prefer to focus on – career, health, relationships, or something else?
• What are your goals in this area?
• What tasks put you in line with your goals?

💡Read: What Makes a Life Fulfilling? Pursuing Goals Important to You, Not Others.

3. Watch Your Language

Does your patient prefer identity-first language (“ADHD person”) or person-first language (“person with ADHD”)? Do they have a preferred term for their neurotype? For example, Variable Attention Stimulus Trait (VAST), coined by Edward Hallowell, M.D., and John Ratey, M.D., is an alternative term for ADHD that has grown in popularity. Use non-pathologizing terms (also based on patient preference):

4. Look Beyond the Individual

Is your approach centered on making individuals meet neurotypical standards? Are you exploring opportunities to reshape their environment to help them thrive? For instance, you might suggest that a patient relocate to a quieter corner of their office and schedule brief, daily check-ins with their supervisor.

5. Provide Supports

The skill-building and between-session tasks associated with CBT can be difficult for people with ADHD, possibly triggering rejection sensitivity. To address this barrier to care:

• Supply tools. Provide a timer, for example, rather than asking your patient to buy one.
• Gauge what can be done. Ask, “On a 10-point scale, with 10 being a done deal, how likely are you write in your thought journal every day?” If their answer is less than eight, adjust the task.
• Plan frequent check-ins for accountability and opportunities to troubleshoot.
• Suggest options. A paper checklist may help one patient stay organized, while a to-do list app may work better for another. Always give choices and allow patients to experiment autonomously.

Saskia Van Der Oord, Ph.D., is a professor of clinical psychology at KU Leuven in Belgium.

Michael Meinzer, Ph.D., is an associate professor of psychology at the University of Illinois, Chicago.

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Chronic pain — twice as common in neurodivergent youth — is as real as it is invisible and misunderstood. (Veterinarians receive more education about the neurobiology of pain than do human doctors!) As awareness grows, so has our understanding of why autism and ADHD place children at higher risk for chronic pain, and of the supports that help their unique nervous systems feel safe and heal.

The Neurobiology of Pain

Chronic pain, which is defined as pain that lasts for more than three months, is often the result of a nervous system imbalance rather than ongoing tissue damage.

The brain and nervous system work to keep us safe by shifting between two branches: the sympathetic system, which activates the fight-or-flight response to mobilize the body during challenges, and the parasympathetic system, which calms and regulates us.

Chronic pain occurs when the fight-or-flight system stays activated, amplifying pain signals, intensifying danger perception, disrupting sleep and mood, and further dysregulating the body – creating a cycle of overactivation.

But what triggers overactivation?

The Chronic Pain-Neurodivergence Overlap

Pain is influenced by biological, psychological, and social factors, as described by the fear-avoidance model of pain.¹ This framework also illustrates how neurodivergence can make children more susceptible to sympathetic activation and chronic pain.

Neurodivergence and Pain

• Sensory sensitivity amplifies pain and discomfort in response to everyday sensory input.
• Differences in interoception heighten awareness of bodily sensations.
• Emotional dysregulation intensifies worry, distress, and overwhelm caused by pain.
• Hyperfocus, cognitive inflexibility, and perseveration lock attention on pain.
• Uncertainty intolerance undermines coping beliefs and fuels hypervigilance.
• Social challenges increase stress and trigger the fight-or-flight response.
• Co-occurring conditions — sleep disturbances, anxiety and depression, developmental conditions, migraines, autonomic dysregulation and more — predict and contribute to chronic pain.^{2 3 4 5 6}

About 16 percent of autistic children experience frequent or chronic pain — nearly twice the rate seen in neurotypical peers — and the rate rises to 20 percent among those with developmental conditions.⁵ In our study, we found:⁶

• About 30 percent of pediatric pain clinic patients are autistic.
• More than half report widespread rather than localized pain.
• About 60 percent are girls, reflecting the higher chronic pain rates found in women likely due to factors like hormones, co-occurring conditions, stress, and medical bias.

About one-quarter of youth with chronic pain have ADHD, while 65 percent of children with ADHD report chronic pain.⁷ Women diagnosed with ADHD in childhood show higher chronic pain rates in adulthood.

Signs of Chronic Pain

Expressions of pain may include:

• Guarding a body part or favoring one side
• Avoiding movement or reduced range of motion
• Tenderness to light touch
• Increased sensory sensitivity
• Sudden or increased irritability or meltdowns
• Sudden or increased anxiety, clinginess, or fear of being alone
• Needing help with tasks previously done independently
• Frequent nurse visits, requests to go home, or school refusal
• New or worsened sleep problems
• Fatigue, low stamina, need for frequent breaks
• Reduced engagement with special interests and enjoyable activities

Pain Management: Regulating the Nervous System

Managing chronic pain requires coordinated approaches that calm a dysregulated nervous system over time and restore function. Treatment must be tailored to each child’s needs, abilities, and context.

Pain Management Programs

Chronic pain programs include pediatric anesthesiologists, pain psychologists, occupational and physical therapists, and other specialists. Many programs are housed in pediatric hospitals with specialists who have experience with neurodevelopmental differences.

These programs focus on function beyond pain reduction, helping kids return to daily activities. Most are outpatient, but inpatient or day treatment options exist for severe cases.

For neurodivergent children, treatment plans should address:

• Sensory regulation
• Executive function challenges
• Activities of daily living (e.g., bathing, dressing, eating)
• School-based behavioral and social supports

School Advocacy

Educators will benefit from understanding chronic pain and how the school environment influences it. A pain psychologist can explain the chronic pain and school connection, provide documentation of your child’s needs, and advocate for accommodations supporting gradual school participation, including:

• Quiet space for short breaks
• Sensory-regulating tools (noise-reducing headphones, sunglasses)
• Reminders to use pain-management strategies (deep breathing, muscle relaxation)
• Alternative seating options
• Excused absences, tardies, and extra transition time between classes
• Note-taking accommodations (access to notes, speech-to-text, typing)
• Adapted physical education with low-impact options

What Caregivers Can Do

1. Validate your child’s pain.
Most of us equate pain with acute, nociceptive forms — broken bones, cuts, burns. But that is just one type of pain. Nociplastic pain, common with chronic pain, can occur without tissue or nerve damage. Believing your child helps to calm their nervous system. Remember that neurodivergence alters pain processing. Avoid viewing your child as noncompliant or attention-seeking, as this leads to power struggles that can increase stress and dysregulation.

2. Start low and go slow.
Begin with tiny steps to help your child heal and regain function. Increase demands only when manageable. If walking to the driveway is challenging, start with a few steps, gradually increasing. Use fitness trackers and rewards for motivation.

3. Redirect.
Shifting focus from pain can reduce its intensity. Say, “It makes sense that you’re experiencing pain and that hyperfocus makes it hard to think of anything else. Let’s try taking a smaller step this time.” Psychologists can also help shift your child’s thinking patterns related to pain and come up with replacement behaviors.

Other ways to redirect your child:

• Ask for help with a task (e.g., deliver a message to a family member, think of grocery list items, brush the family pet)
• Count objects by color
• Name things they can see, touch, hear, smell, and taste

4. Create a comfort toolbox with calming activities:

• Breathing exercises
• Music, coloring, puzzling
• Guided imagery and meditation
• Special interests

5. Provide visual cues to remind your child of preferred coping strategies.

6. Maintain routines to establish predictability and reduce anxiety.

7. Prioritize quality sleep.

Quality sleep reduces pain and supports self-regulation. Ensure your child is screened for sleep disorders and receives adequate treatment. Support healthy sleep habits, too:

• Dim lights and turn off screens one hour before bed
• Follow a short bedtime routine with a visual schedule
  (e.g., bath, brush teeth, put on pajamas, bedtime story or relaxation exercise)
• Use timers to indicate transitions
• Choose comfortable pajamas and bedding (remove scratchy tags)
• Keep the bedroom dark, cool, and quiet
• Maintain consistent sleep-wake times, even on weekends
• Reserve the bed for sleep only

8. Educate others.
Help family and friends understand how chronic pain is different. This explanation works well for children: My body is like a pot of water. Sometimes, the water boils and overflows, which hurts. I’m getting help to keep water from overflowing!

9. Keep calm.
Chronic pain is highly treatable. You did not cause your child’s pain — we all have different nervous systems and are shaped differently by life’s experiences. However, your calm presence can significantly influence how they respond to pain over time.

Gradual exposure to uncomfortable activities is part of healing — it’s how fear subsides and pain fades. A pain psychologist can help you understand how to best support and encourage your child in breaking the fear-avoidance cycle and regaining their life.

Gloria T. Han, Ph.D., is a pediatric pain psychologist at Vanderbilt Children’s Hospital in Tennessee and an assistant professor at Vanderbilt University Medical Center.

Anna C. Wilson, Ph.D., is a pediatric pain psychologist at Oregon Health & Science University Doernbecher Children’s Hospital and a professor at OHSU.

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Sources

^{1 Asmundson, G. J., Noel, M., Petter, M., & Parkerson, H. A. (2012). Pediatric fear-avoidance model of chronic pain: foundation, application and future directions. Pain Research & Management, 17(6), 397–405. https://doi.org/10.1155/2012/908061}

^{2 Jain, S. V., Panjeton, G. D., & Martins, Y. C. (2024). Relationship between sleep disturbances and chronic pain: A Narrative Review. Clinics and Practice, 14(6), 2650–2660. https://doi.org/10.3390/clinpract14060209}

^{3 Velly, A. M., & Mohit, S. (2018). Epidemiology of pain and relation to psychiatric disorders. Progress in Neuro-psychopharmacology & Biological Psychiatry, 87(Pt B), 159–167. https://doi.org/10.1016/j.pnpbp.2017.05.012}

^{4 Groenewald, C. B., Murray, C. B., & Palermo, T. M. (2020). Adverse childhood experiences and chronic pain among children and adolescents in the United States. Pain Reports, 5(5), e839. https://doi.org/10.1097/PR9.0000000000000839}

^{5 Whitney, D. G., & Shapiro, D. N. (2019). National prevalence of pain among children and adolescents with autism spectrum disorders. JAMA Pediatrics, 173(12), 1203–1205. https://doi.org/10.1001/jamapediatrics.2019.3826}

^{6 Han, G. T., Heavner, H. S., Rains, T. R., Hoang, A. H., & Stone, A. L. (2024). Chronic Pain in Autistic Youth: Clinical Prevalence and Reflections on Tailoring Evidence-Based Interventions from an Interdisciplinary Treatment Team. Children (Basel, Switzerland), 11(3), 312. https://doi.org/10.3390/children11030312}

^{7 Battison, E. A. J., Brown, P. C. M., Holley, A. L., & Wilson, A. C. (2023). Associations between Chronic Pain and Attention-Deficit Hyperactivity Disorder (ADHD) in Youth: A Scoping Review. Children (Basel, Switzerland), 10(1), 142. https://doi.org/10.3390/children10010142}

Today, we know that ADHD affects every life domain and that medication alone is usually not sufficient. Most people need multimodal care, and the sequence of treatments matters; however, few patients benefit from these insights because ADHD care is fragmented in the following ways:

• Its quality hinges on who diagnoses the ADHD, when, and which services are available and utilized.
• How and when care is delivered.
• Untreated or undertreated ADHD is far too common.

Providing a Structured Approach

There is no one-size-fits-all approach to ADHD. An effective ADHD treatment plan for children begins with a comprehensive assessment that considers the following:

Co-occurring Conditions and Mimics

ADHD coexists with at least one psychiatric, learning, or behavioral disorder about 80% of the time. Anxiety, depression, sleep disturbance, and other conditions can imitate or amplify symptoms.

Unique Impairments

Treatment should be tailored to each child’s unique impairment and context (e.g., severity, presentation, family dynamics, parental health, care access, etc.) while simultaneously highlighting the child’s strengths. Identifying and building on a child’s talents promotes self-esteem and resilience.

💡Free Guide! Parent-Child Therapies for Better Behavior

Sleep Comes First

Sleep problems and ADHD often overlap and are mutually exacerbating; stimulants can disrupt sleep, and poor sleep can worsen ADHD symptoms. Baseline sleep history and screening for sleep disorders should precede medication trials. If sleep deteriorates, clinicians should adjust the dose or formulation, add melatonin, or reinforce sleep-hygiene routines.

Multifaceted Treatment Is Best

Research has focused extensively on monotherapy — typically medication alone — but this approach rarely suffices beyond the short term. For one, ADHD can change over time. The medication that helps a hyperactive kindergartener may not serve a high school student. Monotherapy is especially inadequate for patients with multiple symptoms, comorbidities, and residual impairments not addressed by medication, like behavioral challenges when a medication wears off.
Multimodal therapy — medication used in conjunction with new behavioral interventions — is not new. The landmark Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) study observed children assigned to different 14-month approaches:

• individually titrated medication
• intensive behavioral intervention
• combined treatment
• community care

Medications improved core symptoms, but parents and teachers rated the combined approach highest for overall functioning.

💡Free Download! A Parent’s Guide to ADHD Medication

Sequence Matters

Multimodal treatment works, but sequencing is important. In one study, children were treated during a school year and assigned to different sequences. Starting with behavioral treatment and then adding medication, if needed, produced the best outcomes, including fewer classroom rule violations and disciplinary events. Conversely, starting with medication and adding behavioral treatment later was less effective. ¹

Dosing for Non-Stimulants

For patients who do not respond to stimulants, choose not to take them, or whose comorbid conditions (e.g., tics, sleep disorders) are worsened by stimulants, non-stimulants are an option, and there are several with different mechanisms of action. Finding an optimal dose requires working closely with your provider. Often, combining stimulants with non-stimulants can improve tolerability and mitigate dose-related side effects.

What constitutes effective ADHD treatment will continue to be a central topic of research. Scientific evidence supports care that is personalized, sequenced, and measurement-based. Children respond best to treatment plans that include psychoeducation, behavioral and pharmacological interventions, and a focus on building their strengths to improve functioning not just in school but in life.

Mark A. Stein, Ph.D., is a professor of psychiatry and behavioral sciences at the University of Washington.

SUPPORT ADDITUDE
Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing. Your readership and support help make our content and outreach possible. Thank you.

Source

^{1 Pelham, W.E., Jr., Fabiano, G.A., Waxmonsky, J.G., Greiner, A.R., Gnagy, E.M., et al. (2016). Treatment sequencing for childhood ADHD: a multiple-randomization study of adaptive medication and behavioral interventions. J Clin Child Adolesc Psychol. https://doi.org/ 10.1080/15374416.2015.1105138}