You may have seen the recent New York Times article by Paul Tough: “Have We Been Thinking About A.D.H.D. All Wrong?”
As someone who has spent nearly two decades working with parents, educators, and professionals to support children with ADHD and Executive Function challenges, I appreciate the broader discussion this article invites—but it doesn’t tell the whole story.
That’s why I wrote a detailed response:
Beyond the Diagnosis: What Kids with ADHD Really Need
Response to NY Times: Have We Been Thinking About A.D.H.D. All Wrong?
By Cindy Goldrich, Ed.M., ADHD-CCSP Founder, PTS Coaching, LLC www.PTScoaching.com
In reading Paul Tough’s thoughtful article, Have We Been Thinking About A.D.H.D. All Wrong? (NY Times, 4.13.2025), I was struck by the range of truths it holds—and yet how much more still needs to be said. As someone who has spent nearly two decades supporting thousands of parents and professionals navigating the realities of ADHD, I welcome the shift in perspective he highlights. And I believe it offers an opportunity to clarify what kids with ADHD really need: not just medication, but understanding, skill- building, and empowered caregivers.
Let me say clearly: Pills don’t teach skills. Medication, when appropriately prescribed and monitored, can be a helpful tool. It may support focus, reduce impulsivity, or improve emotional regulation. But it is not a standalone solution. It does not teach children how to manage time, cope with frustration, or navigate the complex social and emotional demands of daily life. And it certainly doesn’t replace the need for parents to gain the insights and strategies required to support their child’s growth.
That’s where ADHD Parent Coaching comes in.
ADHD is not just about attention. It’s about executive functioning—the brain’s ability to manage emotions, plan ahead, shift gears, and stay organized. These are skills, not simply traits. And when kids struggle in these areas, it impacts the whole family system.
When parents understand the social and emotional impact of ADHD, everything changes. They learn how to communicate in ways that reduce power struggles. They learn how to create structure without rigidity, how to set boundaries that feel loving rather than punitive, and how to support their children in developing real-life coping tools.
Parenting a neurodivergent child often requires skills that are neither intuitive nor obvious. It means:
- Knowing how to ask powerful questions and when to stay quiet
- Understanding the role of working memory, processing speed, and task initiation – Recognizing that a child’s meltdown isn’t defiance but a signal of dysregulation
- Adjusting expectations based on brain-based realities, not outdated norms
As I always say: we must “Parent the child we have”, not the child we thought we were getting.
It’s true that our diagnostic systems are imperfect. It’s also true that for many people, stimulant medications offer relief. Some adults take medication only when needed—to write a brief, study for an exam, or prep for trial—and rely on other tools at other times. That’s valid. It’s nuanced. It’s human.
But the danger lies in over-reliance. Medication may support attention, but it won’t automatically teach a teen how to plan a research paper or navigate rejection from a friend. These are skills that must be taught—by parents, teachers, coaches, and mentors who understand the wiring underneath the behavior.
Take the often-discussed issue of stimulant medication and appetite suppression. Rather than viewing it as an inevitable trade-off, let’s equip parents with practical strategies: Let kids eat a full meal after school, even if it throws off the dinner routine. Save their plate for later—and sit with them when they eat, so they don’t feel punished for being different.
Because that’s what ADHD support is really about: creating environments of connection, compassion, and skill-building that meet children where they are.
To that end, I believe every parent whose child is diagnosed with ADHD should receive not only a prescription (if needed), but a recommendation for ADHD Parent Coaching. Imagine if our system viewed parent support not as optional, but as essential.
I’m not a doctor. I don’t diagnose. I don’t medicate. I educate. I support. I help parents understand their child’s brain, shift their expectations, and build tools for resilience.
That is what real treatment looks like.
Cindy Goldrich, Ed.M., ADHD-CCSP
(Mental Health Counselor, Certified ADHD Coach, Founder of PTS Coaching, LLC, Author of 8 Keys to Parenting Children with ADHD, Creator of the ADHD Parent Coach Academy, Worked with thousands of parents, educators, and clinicians to help children with ADHD and Executive Function challenges thrive.)
In addition, Dr. Russell Barkley—one of the leading voices in the ADHD field—has created a powerful four-part video series directly addressing the claims and implications of the New York Times piece.
Watch the video series here
Let’s Keep the Conversation Going
If you’re a parent, a professional, or an educator supporting families, you know that ADHD is about so much more than attention. It’s about emotion regulation, motivation, and how kids experience the world—and support must go beyond medication.
I’d love to hear your thoughts. Please reach out if this topic resonates or if you’d like to discuss ways to support your child—or the families you work with.
Upcoming ADHD Leadership Summit
This is a critical moment for meaningful conversation and change. I encourage you to join the National Leadership Summit on the Appropriate Use of ADHD Treatments, a timely and solutions-focused virtual series bringing together clinical experts, policy leaders, and individuals with lived experience.
Three-Part Virtual Event
- April 24, 2025: The Real Impact of ADHD and Care Management
- April 29, 2025: Multifaceted Approaches to ADHD Management
- May 13, 2025: What’s Next: The Evolution of Care
Learn more and register: https://adhdappropriateuse.org
Want to Take Action Now?
Explore how ADHD Parent Coaching and professional training can make a difference:
ADHD Parent Coaching Services
ADHD Parent Coach Academy
ADHD Teacher Training
ADHD School In-Service Programs
Together, let’s make sure kids with ADHD get the skill-building, structure, and compassion they truly need to thrive.
Warmly,
Cindy Goldrich, Ed.M., ADHD-CCSP
Founder, PTS Coaching
Hi Cindy,
My daughter has ADHD and ASD. We put her on medication in fourth grade to help her appear more typical to others. She always only took it on school days. We believe it helps her focus so that real learning can happen, but we absolutely agree that the mainstream classroom would not have been enough support for her. No classroom has helped her retain what she she learned as working memory is one of her weaknesses. But with our support and an understanding of her need for a body double for assignments and another pair of eyes and ears on her work, she is getting an associate’s degree this spring. I do sometimes wonder how much of it she’s earned and how much we have. But that’s part of being family. We have to support the adult child we have too.
Now she only medicates for driving, which automatically means she is medicated for school and work. There are enough studies that show medications saves lives for us to warrant this. Also, she had an accident when she wasn’t medication compliant. The Times article left this aspect out of the conversation. But it is very important.
I hope you’ve submitted your response as a potential editorial.
Sincerely,
Debbie Vilardi
Thank you so much for sharing your story—and your daughter’s journey. It’s clear how much thought, intention, and love have guided your decisions as a family. What you described resonates with so many of the families I work with: the balance between external expectations and internal needs, and the way real support goes far beyond what a classroom—or a prescription—can offer.
I especially appreciate your point about working memory, and how important it is to acknowledge the ongoing support that some students need to truly learn and thrive. That “extra pair of eyes and ears” you mentioned isn’t a crutch—it’s a compassionate adaptation. It’s what allows the learning to stick.
And yes—medication and safety, especially when it comes to driving, is such an important part of this conversation. Thank you for raising that. I agree wholeheartedly that The New York Times article missed that nuance, and I’m glad you brought it forward.
Your daughter’s success, and your partnership in helping her reach this milestone, is something to be proud of. As you said so beautifully: we must support the adult child we have, too.
Warmly,
Cindy