ADHD in Girls and Women

An interview with Dr. Julia Schechter, Co-Director of the Duke Center for Girls and Women with ADHD

Source: Pexels/Andrea Piacquadio

In today’s newsletter, I was fortunate enough to interview Dr. Juila Schechter. Dr. Schechter is a licensed psychologist and co-director of the Center for Girls and Women with ADHD at Duke University. Julia and I met when we were both working at Duke and now have a similar mission of getting research-backed information into the hands of people who need it— with her focus currently being helping individuals with ADHD and their caregivers. In our interview, we discuss common questions related to girls and women with ADHD and how parents can help girls and women with ADHD.

Read or listen to the full interview below:

Dr. Cara Goodwin: Hi, everyone. Welcome to the Parenting Translator newsletter. I'm Dr. Cara Goodwin, and I'm here with Dr. Julia Schechter. She is the co-director of the Duke Center for Girls and Women with ADHD. Dr. Schechter, could you please tell us a little bit about yourself and what you do?

Dr. Julia Schechter: Yes, thank you so much for having me, Cara. So. Yes. I'm Julia Schechter. I am a clinical psychologist and an assistant professor in the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine. I'm a clinician and a researcher, and I am also the co-director of the Duke Center for Girls and Women with ADHD. The center is really focused on promoting evidence based information about ADHD in girls and women, engaging in outreach with patients and the public, and also doing research.

Dr. Cara Goodwin: Wow, that is so needed. I feel like there's so little awareness about girls and women with ADHD. So that's so incredible. So first, before we jump into some very important questions I have about girls with ADHD, could you just tell us quickly, because there are so many misconceptions out there— What exactly is ADHD? How would a psychologist who's an expert on this, like yourself, diagnose ADHD?

Dr. Julia Schechter: So yes. So ADHD stands for Attention Deficit Hyperactivity Disorder, and it is a neurodevelopmental disorder, which just means it has to do with how the brain is developing. So it's a brain-based disorder. What research has found is that there really are brain differences in people of ADHD compared to those who don't have ADHD. It is a really common neurodevelopmental condition.

So estimates are about 10% of children and adolescents and about 4% of adults in the United States actually have ADHD. People with ADHD can experience high levels of inattention, high levels of hyperactive and impulsive behavior, or some individuals have challenges with both of these things. We really think of ADHD as a disorder of regulation. So this is like having challenges with regulating your attention and your behavior. So if you think about a child who has challenges with regulation, with attention, they might have a really hard time not paying attention to the exciting thing going on outside their window and re-regulating their attention to their teacher or inhibiting an impulsive behavior, such as stopping themselves from doing something they know they probably shouldn't do, or maybe regulating their really energetic behavior in a setting that it’s not appropriate for. So we really think about ADHD as a challenge with regulation that ultimately results in kind of really inconsistent behavior. So we see a lot of difficulties for people with ADHD in performing tasks consistently. Challenges first emerge during childhood, though they might not actually cause difficulties until adolescence and adulthood.

To get a diagnosis of ADHD, we really have to see that there is some sort of clear evidence that it is causing impairment— what we call functional impairment, which is really getting in the way for people in some capacity. We do know that ADHD is associated with a lot of functional impairment, especially if it's not well managed. So we actually know that ADHD can be related to social and emotional difficulties, academic underachievement in adulthood. We know that it can cause financial hardships and employment challenges. There actually was a recent systematic review that found, compared to the general population, that individuals living with ADHD were actually twice as likely to die earlier. So really this can be a really big deal.

I say this not to scare parents, even though I know this sounds scary, but I do think it's important to highlight that ADHD is real. It's a real biologically-based condition and it can have a really tremendous impact on lives if it's not identified and it's not properly treated and supported.

Dr. Cara Goodwin: Wow, that is also helpful. So when most of us think about ADHD, though, we think about a little boy who has a lot of energy and difficulty sitting still at school. This is kind of like the picture we come up with when we think about ADHD. So why is that stereotype out there? And is ADHD actually more common in boys than girls?

Dr. Julia Schechter: Yes, this is absolutely the picture that I think a lot of us have when we think about ADHD, this little boy, and usually it’s a little white boy, running around the room and not listening. I think we have this stereotype for a couple of different reasons. One is that our understanding of what ADHD looks like is based on research studies that have been done with mostly boys. So this has really centered our understanding of the clinical presentation of ADHD on males. If you think about it— what we were trained on when we were in graduate school or what medical providers were trained on were these research studies that were based on all male samples. So this is really kind of pushed along that myth that ADHD is really a boy disorder. Also, we know that females with ADHD often present with the less disruptive presentation. So they are more likely to have the inattentive symptoms compared to the hyperactive and impulsive symptoms that we see more often in boys. So boys ultimately gets more of the attention. They're more likely to be the ones who are sent to the principal's office or get calls home from teachers. So this influences who ultimately is referred for evaluation. We also know that assessing those inattentive symptoms that we see more often in girls is just harder. It's harder to evaluate those. It’s a lot easier to measure and evaluate those more overt symptoms. Then one other thing to mention here is that the girls with ADHD often do have more co-occurring mood and anxiety symptoms. This kind of further hinders our ability to really accurately diagnose girls with ADHD. There are these other things we have separate the symptoms from.

Ultimately, yes, boys are diagnosed more frequently with ADHD than girls. The rates here vary a little bit in the literature, but it is about three to one. So three boys to one girl at this point during childhood. Interestingly, once you get to adulthood, the rates even out actually— you get a more of a one to one ratio. There's different reasons for why this might be, but one of them is likely that adult women can report on their own symptoms and get their own referrals, right? But when you're a girl, a kid with ADHD, you're really depending on other people to notice these symptoms and they're just harder to notice and get that referral for.

Dr. Cara Goodwin: That's so interesting that you are saying that ADHD tends to look different in girls than boys. Can you break that down for us a little bit more and tell us, like, what other differences do you see - I know you mentioned mood, for example. What other differences do you see between girls with ADHD and boys with ADHD?

Dr. Julia Schechter: Definitely. So girls with ADHD do tend to look different than boys with ADHD generally, but not always. They do seem to have more of those inattentive symptoms. When I say inattentive symptoms, these are things like trouble staying focused for longer periods of time, easily getting distracted, and difficulty organizing. Those are kind of more of the things that we tend to see with girls with ADHD compared to the hyperactive and impulsive behaviors that we tend to see with boys. Inattentive girls— they might get labeled as spacey or seem really forgetful or just often appear overwhelmed. Girls can absolutely also have those hyperactive and impulsive symptoms, and those girls might get called “tomboys” because they're so active. What we also see with hyperactive, impulsive girls is more of the verbal impulsivity. They tend to have more intense verbal activity compared to the intense physical activity that we see with boys. So that's one thing to kind of think about for girls.

Girls are also, like I mentioned, more likely to have kind of those internalizing symptoms, like anxiety and depression compared to boys with ADHD. There's also some research that indicates that girls with ADHD are more likely to have what we call emotion dysregulation. So this is like the emotional “ups” and “downs,” right? They're more likely to have those kinds of symptoms. We also tend to see that they have lower self esteem compared to girls without ADHD. Another thing for girls too, is that the symptoms seem to present a little bit later, or at least are noticed a little bit later than in boys. So the symptoms of girls might be more obvious a little bit later into childhood. We also tend to see that around times of transitions, those symptoms might crop up a little bit more. When you think about it, a lot of times girls with ADHD have come up with these really amazing coping skills to work through these difficulties or mask these difficulties, and around these times of transitions, those masks are harder to uphold.

Dr. Cara Goodwin: Okay, that's so interesting. So are there any early signs that parents can be looking for, particularly in girls, that might be a sign that an evaluation for ADHD might be a good idea?

Dr. Julia Schechter: One of the things that we have to think about with ADHD that makes it kind of tricky is that all of these symptoms are on a spectrum. All of us experience some of these symptoms some of the time. So when we're thinking about ADHD, what we're really trying to understand are the frequency and intensity of these symptoms. Are these challenges happening more often for my child compared to what would be expected for their developmental level? So this is kind of hard to do, I think, as a parent, right? We typically only have our kid or maybe a couple of kids in the house to make those comparisons to.

I do think that in terms of just red flags, parents should trust their gut. So if they feel like they are having to give much more support to their daughter for things that they feel like their daughter should be doing at their age— those are red flags that they should really take heed of and think about. So maybe they're having to give so many more reminders around transitions or there's more injuries at home because their child is more active. So those are things that certainly parents should attend to. But I also really think an important red flag is the feedback that parents might be getting from other people in their child's lives who do have more of a regular comparison point to other kids. So this might be like your child's teachers or coaches if they start to approach you about having to give lots of extra feedback to their child because they're missing information or they're requiring a lot more repetition of instructions in the classroom. Or maybe they're having social difficulties with their friends, like they're being really intrusive and they're getting rejected on the playground. Or certainly academic difficulties are a big red flag that parents often say is kind of their first alert that something might be a little bit different. I will say with academics, again, girls are really great “maskers” and so they're working kind of extra hard oftentimes to compensate for any difficulties. So I would say that if you don't see those academic difficulties, it doesn't mean that there's not something there.

One tool that I do like to mention to families that can be helpful when you're just keeping track of potential red flags is something called Take Note, and it's from understood.org. I really like this tool. Essentially what it is, is a place to kind of gather your thoughts and your notes. It helps you keep track of any feedback that you have gotten along the way and just helps you keep it in one place so that when you do decide to approach a medical provider or pediatrician, you kind of have it all together.

Dr. Cara Goodwin: Okay, so Take Note— Is it an app or is it on their website?

Dr. Julia Schechter: It's just on their website and it's not a very complex tool, but it's nice to have a little bit of a framework to keep all of the information that you're thinking about and observing and also that you're hearing from others.

Dr. Cara Goodwin: Okay, that sounds very helpful. What age would you suggest that parents should start worrying about looking for these signs? Those of us who have toddlers know that it's very common for them to not listen to us, to have to repeat directions, and to jump from one activity to the next. So observing a two-year—old, you might think that they look like they have attention problems But what age should parents really start being concerned and looking for these behaviors that may not be developmentally in line with their peers?

Dr. Julia Schechter: Yes, this is so typical during these younger ages. Kids are jumping from thing to thing, sometimes quite literally from activity to activity. Ot it's really common for young kids to show impulsive behavior or have trouble focusing for longer periods of time. It does make it difficult to diagnose ADHD at these younger ages. Sometimes, however, these behaviors or attention problems really do stand out compared to other kids their age, and these challenges seem to persist over time. So it's not just one teacher making a one-off comment. It's maybe a couple of teachers over the course of several months or maybe even several years that are making observations. It’s also when these behaviors are really starting to cause some difficulties.

It's not uncommon that I talk to families where their young preschooler is getting kicked out of daycare or having a really hard time socially with peers and not getting invited to birthday parties and parents are starting notice these kind of things. So it is absolutely possible to diagnose ADHD beginning in the preschool period. Younger children probably will require a bit more of an evaluation that might be more like a specialist, like a child psychologist or a developmental pediatrician. But it is absolutely possible to diagnose at these younger ages— so before they even enter elementary school. I've heard some providers say that you can't diagnose ADHD until age six or you can't diagnose until age seven. That's not the case. We can diagnose earlier and it's really important that we do. Early identification and early intervention can make such a big difference. So I really encourage parents to talk to their medical providers as soon as they have any early concerns.

Dr. Cara Goodwin: Okay, that is so helpful. I'm wondering if you can give us a little bit of insight into what this evaluation and diagnosis process looks like. Because I think for a lot of parents it seems kind of daunting and a little scary. So could you give us a peek into what that might look like if you think that your child might need an evaluation?

Dr. Julia Schechter: Definitely yes. The evaluation process can absolutely feel overwhelming to families. Maybe the first overwhelming thing is where to go and where to start. The first step is usually talking with your pediatrician. The pediatrician hopefully is someone who knows your kid, who knows your family, who has an idea of the kinds of things that have been coming up over the years. Pediatricians can make diagnoses of ADHD. They don't always do it for different reasons, but it is very possible that they could. Pediatricians might also refer you to another specialist, like a psychologist or a developmental pediatrician or maybe a psychiatrist.

So what does an evaluation for ADHD look like? It will include rating scales. These are questionnaires that parents will fill out and you also will want to get questionnaires from someone else who also knows your kid well. So typically it's a teacher, but it could be somebody else in addition for these rating scales. The rating scales will be able to give you some numbers and scores that compare your child's behavior to other same-age children, which, again, is a big part of this evaluation— trying to figure out is whether what your child is experiencing is really different from what would be expected for their developmental level.

In addition to rating scales, a big part of the evaluation is talking. We do a lot of interviewing with parents and caregivers and also sometimes the child to get a really solid developmental history and understand what has been going on for your child over the years in terms of behavior and attention, but also just generally in terms of development, understanding how these symptoms have waxed and waned or what has been consistent over the years. Also, really understanding what symptoms are happening now and in what settings, because we do want to make sure or want to see that these symptoms happening in multiple settings.

Another piece that will come out of that interview too is are these difficulties contributing to that functional impairment that I mentioned. So are they really getting in the way for the child in some capacity— either socially, academically or emotionally?

Another component is that we have to see that there's no better explanation for these symptoms. So part of the evaluation might also include assessing for things like anxiety or depression, because if those might be better explanations, we certainly want to treat that first. So there may be some additional interviewing or rating scales around that.

One point I also want to make here is that I often get the question: Is there any kind of test for ADHD or some computer tests that we have to do? It's a really good question, but right now there is not one test that you do that tells you whether you have ADHD (not computer testing or pencil-and-paper testing). Sometimes we call this psycho-educational testing. It is actually not needed for an ADHD diagnosis. So if you look at the American Academy of Pediatrics, this is not something that they recommend needing for an ADHD diagnosis. Sometimes those things can be helpful to better understand your child. But again, what you really need are those rating scales and clinical interviewing.

Dr. Cara Goodwin: I think that really helps parents clear up exactly what it would look like. So I hear a lot of parents say I'm nervous to get an evaluation because I'm worried about my child being labeled, especially in school and by other children. I would imagine that's even more of a concern for parents with girls because it isn't as common. So what would be your advice to those parents who are concerned about ADHD but are also worried about their child having this potentially lifelong label?

Dr. Julia Schechter: First I'd say that's really valid. I think being a parent can be so overwhelming and you're just trying so hard to make sure that you're doing right by your kid. Putting a label on your child can feel scary. One of the things I talk to parents when this comes up is what would it mean to get this label? And also what would it mean to not get this label? Ultimately, the label or no label doesn't change your daughter, right? Your daughter is who she is— her fabulous self. But the label itself doesn't actually change your daughter. What the label could do is open some doors to really help support her. So I think that's where, as scary as it can be to get a label, I think it can also be actually somewhat scary and maybe to a certain extent dangerous sometimes not to get the label if it's not going to open those doors.

This is a really, really great conversation to have with someone like certainly your pediatrician, or another professional if you feel like you can’t talk to your pediatrician. Sometimes I talk to families who say “Well, I love our pediatrician, but we get these little bits of time with them.” So it might be finding a family therapist, even an individual therapist or someone you can talk to in order to really flesh this out a bit more.

I think one thing I want to mention here too is, as I said, some really scary things at the top of this interview about what it means or what could happen if we don't identify or we don't treat kids with ADHD. I think it is also important to mention, though, the flip side of ADHD. When it is identified and well-managed, people with ADHD can thrive. We hear a lot of people say that their ADHD brain allows them to see the world in a different way. We also know that this can allow people to have more energy to do things than it does when people don't have ADHD. So in some cases, it can really be an asset for people. ADHD is not a disorder of intelligence and it's not a disorder that limits what someone is capable of. There are highly successful, brilliant people with ADHD, but we know that that success is most likely when we can identify and manage it and support people with ADHD, because without that support, it really can be problematic.

Dr. Cara Goodwin: That makes a lot of sense. I think it's so important to remember those strengths associated with ADHD , especially when you're thinking about your own child. You've talked a lot about how ADHD impacts social-emotional development and I think that's so interesting how it has this unique impact in girls. Is there anything that you think parents can do to help girls with their social skills, with their emotional regulation skills, and maybe also prevent some of the bullying that might come along with being a girl with ADHD, particularly when it's less common and a lot of her girl peers may not have ADHD and be able to relate to her struggles?

Dr. Julia Schechter: Definitely. Yes, we have data to support that often that is the experience of kids with ADHD that they tend to have fewer friendships or less stable relationships. They are more likely to get rejected by peers and be the victims of bullying. We see this particularly when girls have that combined presentation— so that combination of inattentive symptoms and hyperactive/impulsive symptoms. But parents can certainly support this. One thing to think about is these challenges that we see socially related to ADHD limit a child's ability to have those positive social interactions that we know kids need both to feel good, but also to learn, right? To learn that this is what you do in a social interaction.

So one thing that parents might consider doing is basically doing a little bit of structuring to make sure that their child is getting those positive social interactions and getting that chance to learn from others. So for younger kids, this might look like some additional play dates with certain kids. It might also look like some additional kind of structured social interaction. So this could be clubs or sports, Girl Scouts, soccer, art club, things like that, that kind of gives a little bit more structure to the social interaction but allows girls to have that positive experience too.

Some kids might need a little bit more. Sometimes we talk about “didactic instruction” and essentially this is just getting some more specific feedback and learning around social interactions. So that might come from something like some schools have things like lunch bunches so they get together some kids at the lunchtime who might all be learning a little bit more about social interactions, or certainly there are social skills groups that mental health providers sometimes offer. This gives girls with ADHD as well as kids with similar sorts of presentations a chance to learn how to engage socially and appropriately.

As girls get older and move into adolescence, it is definitely harder for parents to do more management or manipulation around the social interactions. I think here part of it is just making sure that you're kind of keeping those lines of communication open with your daughter. So talking about their friendships, talking about what do they like in other people, what do they admire in their friends, and what do they look for in relationships. It certainly can also help finding an individual therapist for your daughter so that she has space to talk a little bit more about her social relationships. This again could be hard to do with a parent. So having this outside person can also be helpful.

Dr. Cara Goodwin: Okay, that is all very helpful. So is there anything parents should think about keep in mind as their girl with ADHD gets older? Are there any changes that occur over the lifespan, like with puberty for example, that parents should keep in mind?

Dr. Julia Schechter: So generally ADHD symptoms, they do seem to shift in terms of their kind of presentation over time. So what I mean by that is that when we look at the literature, oftentimes hyperactive and impulsive symptoms tend to tone down over the lifespan, while inattentive symptoms kind of tend to turn up a little bit over the lifespan. So that's just sort of a general picture, it doesn't apply to everyone, but that's what we see the most common patterns. So for girls, we still see that kind of fluctuation sometimes in symptoms.

When you get to adolescence with girls, what you might see are more challenges with academic functioning, more challenges with peer relationships, and potentially more risk taking behaviors. I mentioned earlier there is a higher co-occurrence of anxiety and depression. Since those conditions seem to tend to onset often during the teen years, definitely with your girl with ADHD, it'll be something to kind of keep an extra eye on. Also you mentioned puberty. There is some interesting emerging research looking at the role of hormones and ADHD symptoms. It's really early, so it's hard to draw any real conclusions at the moment. But there is data that's coming out that's indicating that ADHD symptoms do tend to fluctuate over the course of the menstrual cycle. Just something to think about with your adolescent, you may see some changes in their symptoms over the course of the month. It could be helpful for your daughter to kind of keep track of those things just so she's able to report on them herself.

As we think kind of older into adulthood, what we find is that these rates vary a little bit in the literature, but about 65% of kids and teens with ADHD will continue to meet criteria in adulthood. So the majority of children continue to be adults with ADHD. I will say though— I do want to make clear that we don't think of ADHD as a disorder that people typically “grow out of.” It really is something that we see as a chronic condition over time. There can be a variety of reasons why people might not meet criteria in adulthood, and one of them might be that adults with ADHD go into professions that really meet their needs. It's very common to see adults with ADHD who are in fast-paced, exciting work environments, so they no longer have that job of sitting in the classroom and listening to a lecture. Right. They're able to be an environment that is stimulating and move around. So I'll just say that these are symptoms that will probably wax and wane and change with their presentation. But it's likely that these symptoms will probably be present for your daughter to a certain extent as she gets older. And the hope is that she will continue to learn coping skills and have good intervention options at her disposal to help her manage over time.

Dr. Cara Goodwin: I love that positive perspective. I think that can be really helpful to parents. So let's talk about treatment. So we've all heard about medication for ADHD, but what else would you recommend in terms of treatment? Do you ever recommend that parents try these non-medical interventions before medication? How do parents know when it is time to consider medication? Because I think that's a big choice as a parent.

Dr. Julia Schechter: Definitely these are really good questions. So the good news is that we have multiple evidence-based treatments for ADHD, and our data tells us they work just as well in girls as they do for boys, which is great.

I do want to just highlight medication for just a moment, just because when we look at the American Academy of Pediatrics guidelines, their first step in treatment for kids six and above is to try a stimulant medication. So we do have a really strong evidence base to support using medication to reduce ADHD symptoms. For a lot of people, medication will likely be a part of that treatment puzzle. What I always recommend to parents is to talk with their providers and just get all of the information that they can to make an informed choice about that. That's just one thing to mention about medicine.

But we do absolutely have behavioral interventions that have a good evidence base too. One of the largest longitudinal studies (and that just means looking at the same sample over time) looked at this and tried to answer the question of what is the most effective treatment for kids with ADHD. What they found was they had kids who just took medicine, then they had kids who had combination treatment, which meant medicine plus behavior therapy, and both of those treatments were very effective at reducing ADHD symptoms. In addition, that combination group actually had some additional positive outcomes when compared to just the medication only group. So they saw reduced anxiety symptoms, improved academic performance, stronger parent-child relationships, and also better social skills. So that is also another plug for thinking about the role of behavioral therapy. That group also ended up taking lower doses of medicine over time, which is interesting.

Would I ever consider behavioral therapy first before medication? Definitely, in certain cases. I think this makes a lot of sense. I think the kinds of things that I would be thinking about as a clinician and that parents can be thinking about is just how much impairment, right? How much are these symptoms really messing things up right now for your child? How much are they getting in the way? I think for kids where symptoms are causing them to feel really down on themselves, to feel really anxious, they're really not able to show what they know in school and this is like really weighing on them. Those are the kids that I might say, you know what, I don't know if we want to wait for the effects of behavior therapy, we might need something a little sooner. But if those things are not at play, it could totally make sense to start with behavior therapy first.

Behavior therapy in general is going to take longer. So you might not see the effects until a little bit later. If you have that ability to wait a little bit longer, that might be something to consider. There's actually one study that I'm aware of that looked at this. They had one group start with medicine and one group start with behavior therapy. They saw how they were doing, and then if they weren't responding, they switched them in the end. Ultimately, the group that started with behavior therapy ended up with lower rates of challenges in the classroom, and also the families were more engaged in treatment, when compared to the folks who started with medicine. Now this is one study, it's just one. It'd be great to get more. Also, in that study the vast majority of the participants were male, so you have to interpret it with some grain of salt. But I do think there is absolutely times when starting with behavior therapy would make a lot of sense.

Just to be clear, when I'm talking about behavior therapy, what do I mean? So, for elementary school age kids, what I'm really talking about here is something called Behavioral Parent Training or Parent Management Training. What this is, is an approach to treatment which really works with parents and caregivers to help structure the environment in such a way to really help kids meet expectations more consistently. When I say environment, what I mean is it can be the actual physical environment, but it can also be what parents are saying in certain ways or how they do certain things. Again, that can help kids meet expectations more consistently. As kids get older, behavior therapy might be something called Organizational Skills Training. There also could be a role also for some individual therapy around some other types of things like anxiety and depression. We do have Cognitive Behavioral Therapy or CBT for ADHD for older adolescents and adults.

Dr. Cara Goodwin: Okay, that is so helpful for parents to know all these different treatment options and to know that there is a non-medical option out there, and it has been shown to be very effective by research. So thank you so much, Dr. Schechter. This has been so incredibly helpful. I think a lot of parents who are wondering about ADHD or have a child diagnosed with ADHD will really find this so valuable. Can you tell parents where they can find more information about your center or more information about ADHD in general if they do need some additional resources?

Dr. Julia Schechter: Absolutely. Our website is www.adhdgirlsandwomen.org. So on the website you'll find educational resources and links to other evidence-based materials. We don't offer clinical support at the center. It's just an educational resource and outreach. But we do have a link on our page that sends you to another really great resource that I love to promote, which is CHADD, and that stands for Children and Adults with ADHD. That is a really fantastic resource that can connect folks to clinical services, but also has just a wealth of information about supporting individuals with ADHD over the lifespan. So I would definitely recommend folks go there as well.

Dr. Cara Goodwin: Thank you so much, Dr. Schechter. I really appreciate your time and your expertise on this topic.

Dr. Julia Schechter: Thank you so much for having me.

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Welcome to the Parenting Translator newsletter! I am Dr. Cara Goodwin, a licensed psychologist with a PhD in child psychology and mother to three children (currently an almost-2-year-old, 4-year-old, and 6-year-old). I specialize in taking all of the research that is out there related to parenting and child development and turning it into information that is accurate, relevant, and useful for parents! I recently turned these efforts into a non-profit organization since I believe that all parents deserve access to unbiased and free information. This means that I am only here to help YOU as a parent so please send along any feedback, topic suggestions, or questions that you have! You can also find me on Instagram @parentingtranslator, on TikTok @parentingtranslator, and my website (www.parentingtranslator.com).

DISCLAIMER: The information and advice in this newsletter is for educational purposes only and is not intended or implied to be a substitute for professional medical, mental health, legal, or other professions. Call your medical, mental health professional, or 911 for all emergencies. Dr. Cara Goodwin is not liable for any advice or information provided in this newsletter.