Walt Karniski: 0:44

First question I would ask the parents is, how happy is your child? And the second question I would ask the parents, how happy are you with your child's ability to learn in the classroom and to develop appropriate friendships. If the parent identifies the child as having difficulties that he's aware of the difficulties he's having in school Or if he or she as a parent is aware of those difficulties, then I can't see how you would not want to at least try the medication.

Simon Currigan: 1:12

Welcome to the school behaviour secrets podcast. I'm your host, Simon Currigan. My co host is Emma Shackleton. And we're obsessed with helping teachers, school leaders, parents, and of course, students. When classroom behaviour gets in the way of success. We're going to share the tried and tested secrets to classroom management, behavioural Special Needs, whole school strategy and more, all with the aim of helping your students reach their true potential. Plus, we'll be letting you eavesdrop on our conversations with thought leaders from around the world. So you'll get to hear the latest evidence based strategies before anyone else. This is the school behaviour secrets podcast. Hi there and welcome to school behaviour secrets. My name is Simon Currigan. And true fact, I didn't learn to tie a balloon until I was in my late 30s. A fact that brought my daughter great joy when I shared it with her last week. I'm joined as ever by my co host, Emma Shackleton, who is a grown up. Hi, Emma.

Emma Shackleton: 2:09

Hi, Simon. And I believe I learned to tie a balloon probably in my sixth or seventh year. Anyway, moving on

Simon Currigan: 2:17

This podcast is supposed to be a safe space. Emma I'd like to open the show by asking you a quick question. Have you ever dreaded having to do something like tying a balloon? And then in the end? It turned out okay.

Emma Shackleton: 2:31

You mean like going to the dentist? Yeah, that's never a cheery prospect is it? And actually I've realised over the years that most things are not as bad as you think they're going to be. Sometimes the buildup and the worrying about any event turns out to be much worse than the actual event itself, doesn't it?

Simon Currigan: 2:49

Yeah, absolutely.

Emma Shackleton: 2:50

What about you? Can you think of any examples of things that you've dreaded, that turned out fine in the end?

Simon Currigan: 2:56

Yeah, I think speaking to lots of adults, I mean, when we started doing this, we had to speak to you know, large groups of head teachers and large groups of teachers. And I think as teachers, we get used to speaking to large groups of children, but actually addressing a roomful of adults is a different game entirely. And I think, you know, you do it enough, and you learn actually, nothing bad happens, hopefully, still fingers crossed, and it's not as bad as you expected it to be. It's all about confidence. And you know, building up with that experience over time.

Emma Shackleton: 3:21

It gets easier the more you do it, I think doesn't it?

Simon Currigan: 3:24

Yeah,

Emma Shackleton: 3:24

Okay, so why are you asking this week?

Simon Currigan: 3:27

So this week, I'm interviewing Dr. Walt Karniski, who is a developmental paediatrician, who has lots of experience of diagnosing and supporting kids with ADHD. And he's coming on the show to talk about ADHD medication specifically, to clear away some of the myths and misconceptions people may have heard about medication.

Emma Shackleton: 3:47

And lots of parents of kids with ADHD feel uncomfortable starting their children with ADHD medication, right?

Simon Currigan: 3:54

Yeah, that's absolutely right. And in the end, it often turns out absolutely fine. And it's a positive thing for the child. So we've invited Walt onto the show to get the facts, because there's lots of pseudoscience and half truths about ADHD medication on the internet.

Emma Shackleton: 4:09

Perfect. But before we get to that, I've got a quick favour to ask, please, could you share this episode with three friends or colleagues who you think would find this information useful? All you've got to do is open your podcast app, hit the share button, and then send a direct link using the method of your choice. It's really easy a 30 second job and will help more people get the information that they need. And now here's Simon's interview with Walt Karniski.

Simon Currigan: 4:40

Today I'm pleased to welcome Dr. Walt Karniski to the podcast. He is a developmental paediatrician, and for over 20 years, Walt has evaluated and treated children with ADHD, autism, anxiety, learning disabilities, and other developmental difficulties. During that time, he's developed and operated through private schools for children with ADHD, anxiety and learning disabilities. And in the 40 years he's been practising, he has evaluated and treated close to 10,000 children, and conducted numerous studies of brain activity and kids. Dr. Karniski approaches each child as a unique individual with distinct strengths and weaknesses, where the diagnosis does not matter as much as understanding the specific needs of that child. Walter, welcome to the podcast.

Walt Karniski: 5:25

Thank you. Wonderful being here today.

Simon Currigan: 5:28

And I'm really excited to have someone from the medical profession actually to help sort of dispel the myths that people may have read on the internet or through gossip so we can get the full facts about what ADHD actually is and how the medication works.

Walt Karniski: 5:41

Let me start by describing a little story Imagine that you are cavemen 100,000 years ago in a tribe of say 30 or 40 individuals. And your job is to go out every morning and to pick berries off this one bush, bring them into the tribe for their breakfast. So one morning, you're bent over this bush picking berries, and all of a sudden you hear a rustling in the bushes behind, what should you do?

Simon Currigan: 6:07

You should probably run or pay great attention to what's happening in the bush, okay,

Walt Karniski: 6:12

If you run and you run back to the cave, all of your cave mates are going to be angry at you for not bringing breakfast back. And especially when they say well, it was just

Simon Currigan: 6:21

That's true. kind of windy out. And that's what caused the rustling in the bushes. So that the important thing that that person will do is as he's hunched over that bush picking berries, he would be distracted by the sound behind him if he turns and looks and it's just the wind he can go back to picking the berries. If he turns and he sees the tail of a sabre toothed Tiger then he should pull his knife or run, but in either case, that distractability, saved his life and allowed him to mate more frequently have more children, and carry that distractability gene to the next generation. So what I'm describing is really a process that occurs in the normal process of evolution and is not necessarily a disease until we get to the 20th century or the 19th century. And in the 19th century, things suddenly changed in the world because it used to be that children would learn how to farm by working on their father's farm from the day that they were five years of age more than they would work in their father's blacksmith shop. And they would learn those skills that way. And suddenly we forced kids to go to school and for some children have that distractibility gene that's not productive for them. So they could have been productive member of society for 100,000 years. But then we get into the current day and age. And we require children to sit quietly in a chair with their hands folded to their feet on the floor, and their eyes focused on the teacher and those children have difficulty doing it. So as a developmental paediatrician, I had three choices when I was presented with a child with distractibility, hyperactivity, impulsivity, difficulty focusing attention, difficulty with memory. When I was presented with a child with those behaviours, I had to ask myself, well, is this just part of the normal process of evolution? Well, if it is, then what I really should do is invent a time machine and send that child back 100,000 years so that he can be a leader of this tribe? Well, I haven't been very successful. With time travel, that option didn't work. The second option would be if I could change the entire educational structure in the country. And actually, I tried to do that we developed three schools for children with ADHD and learning problems. These schools are specifically designed to address the individual learning styles of each child rather than the entire classroom. So each child is treated as an individual with a unique set of needs. However, I can't do that across the entire country. And so my next option was to add a medication, which increases a child's ability to focus and attend and to decrease their distractibility, and it doesn't seem fair, that I should take a normal condition and have to medicate that child. But the bottom line is, once that child is on medication, he's happier, he's more alert, he learns better, his grades improved, his self esteem improves, and the side effects are minimal to non existent. How can I not treat that child when that child was having so much difficulty with an IQ of 140 and failing in So how does ADHD actually sort of impact on the school? way the child's brain is functioning? What is it doing, that's different?

Walt Karniski: 9:37

Well, you mean, what is it happening in the brain?

Simon Currigan: 9:39

Absolutely. How is it affecting the brain that's affecting the way they're able to focus their concentration, those kind of evolutionary difficulties? Well, differences, not difficulties. Okay. What do you see when you look at children's brains? You know, do brain imaging and scanning and that kind of thing? What have we learned about the way the ADHD brain works?

Walt Karniski: 9:56

Well, there are three areas of the brain in children with ADHD that seem to be smaller than in children who do not have ADHD. And I won't go into the technical names of those three areas. But those three areas are responsible for planning, organisation, attention, avoiding distractibility, and impulsivity and memory and so on. And those are the main symptoms that we see in ADHD. The striking finding was, that occurred about 10 to 15 years ago was when people started scanning the brains of children with ADHD sophisticated scanning tools, they found that those three areas of the brain were smaller in children with ADHD. Now, that doesn't necessarily mean that they're not functioning as well. It's simply means they're smaller. However, what was really striking about those studies is that they kept track of those children that they had scanned, and 20 years later, they scanned them again, as adults. Now some of those adults had been treated with medication. And some of them had not been. So what the researchers did was they compared the scans now of the adults who had been treated with medication versus those who had not been treated. And lo and behold, what they found was those three areas of the brain that had been shrunken, as children had now become the appropriate size in the adults who had been on medication. But those adults who have not been treated with medication as children continued to have smaller areas of the brain in each of those three areas.

Simon Currigan: 11:30

So this is really interesting, because as a teacher, or someone works in schools, I associate ADHD medication is having a really short term impact you give it them in the morning, its effects have worn off later in the day, what you're saying is, the research shows that over time, there's like a some sort of cumulative impact that actually changes the brain structure in some way.

Walt Karniski: 11:48

Exactly. Let me give you an example of the way that they work. If you break your arm, and the doctor puts a cast on your arm for six weeks, you don't use the muscles in that arm for six weeks. And when he takes the cast off, those muscles will have atrophied. By atrophy, I mean, they will have shrunk and out of misuse and the appropriate treatment, that is to start using them again, and the muscle grows back and increases in size. That's true of brain structures as well. In animal studies, we have taken for instance, theyve taken a mouse and cut the nerve from the ear to the brain. So everything else is functioning fine, the ear's functioning fine, but it's not transmitting a message to the brain. And what we find in those mice is over time, the area of the brain that is receiving the information from the ear starts to shrink, because it's not being used. And if the hearing is restored to that mouse, then that area of the brain starts to increase again. So we know that use causes increased brain structure in misuse causes structures to atrophy, or deteriorate in a

Simon Currigan: 12:57

So are we saying here, that the medication way. enables them to use these parts of their brains where they weren't necessarily being used so much before gives them the opportunity to go to the gym and build that muscle? Whereas before that option wasn't available to them. Is that the kind of analogy or..?

Walt Karniski: 13:13

That's exactly the analogy and I had a 10 year old child one time who told his teacher to shut up because he was tired of listening to her. But he got in big trouble. I've sent to the principal's office. The next day, he brought in a letter to the teacher, it said Dear Mrs. Smith, I apologise for telling you to shut up yesterday, I don't know what happens. But sometimes my brain just blurt out things without me controlling them. So this 10 year old child understood exactly what was happening, and he couldn't control it. When he was on medication, he was able to control those impulses and didn't tell his teacher to shut up.

Simon Currigan: 13:50

And this is one thing that tallies in my experience of working with lots and lots of kids with ADHD is they often engage in behaviours in the moment, and then really regret it afterwards. And they almost get into a shame spiral sometimes about that behaviour in school, because it's something that's kind of beyond their control.

Walt Karniski: 14:06

Exactly. It is beyond their control. And yet, their continually able to do all of the functions that you would expect them to do, they can listen and attend and focus on something as highly interesting, like a video game. And parents say, well, that's a sign that this is not medically related, because they can focus on the video game. But the video game is giving them constant feedback, or the book that they have in front of them, is just sitting there waiting for them to process the information, it takes a different way of thinking. The other thing I should mention is that how the brain communicates, is by sending messages from one nerve cell to another. And at the end of those nerve cells are chemicals called neurotransmitters. And there are two neurotransmitters in the three areas of the brain that we talked about that are predominant norepinephrine, and dopamine. And it's been found in children with ADHD, both areas of the brain have a decreased activity of those two substances that don't have the same amount. It don't seem to be working as well. The medications that are used today look almost exactly like those two neurotransmitters that are normally functioning in the brain. So when you take the medication, all that is happening is that that area of the brain is getting an increase in those chemical substances back to the level that you would expect them to occur so that the child can focus and attend. These medications are not suppressing a child. They're not sedating a child, they're not changing the brain activity. As a matter of fact, what they're really doing is bringing the brain back to a more average normal functioning state. Medication doesn't teach your child anything. But it gives the child the ability to learn from normal teaching methods.

Simon Currigan: 15:51

And if you're listening in the UK think you use the term epinephrine. Now I think we use adrenaline and I think norepinephrine, we call that noradrenaline in the UK,

Walt Karniski: 15:58

There's actually about 200 different neurotransmitters in the brain. And the way that medication affects just certain functions in the brain is by targeting certain neurotransmitters. So we know that those two neurotransmitters are dysfunctional in the brain. And when medication corrects that it only only changes the activity of those two neurotransmitters, not the other 199. As a result, you can use the medication to focus on just specific brain

Simon Currigan: 16:29

So you've touched on this already, you've activity. talked about sedatives, and I think there is sort of a popular belief out there that medications are for ADHD or like sedatives, and sometimes parents talk about their kids, you know, becoming like zombies. But you've touched on that that's not the case. So what are the substances that are used to medicate ADHD?

Walt Karniski: 16:48

When we treat children with ADHD with medication, we have two major choices of medication, either the stimulants, or the non stimulants. The stimulants are more effective than the non stimulants, they're highly effective in treating the symptoms of ADHD. Whereas the non stimulants are moderately affective. The difference is that all of the side effects that occur with the stimulants and we can go into what those side effects are are minimised by the non stimulants. So if a child develops significant side effects on a stimulant, then we can switch to a non stimulant to minimise the side effects. If we go back to the stimulus versus the non stimulus. There are two main stimulants, methylphenidate and amphetamine. Methylphenidate is the main ingredient in Ritalin, Concerta, metrodate, and a number of different medications. And Amphetamine is the main medication involved in Adderall, Vyvanse. And many other medications as well.

Simon Currigan: 17:45

When you say amphetamine to me as a layperson, a non medical person, the first thing I'm thinking of a street drugs,

Walt Karniski: 17:51

Well, street drugs are similar in structure to these medications, they do work on the brain, but what you call speed amphetamine on the street is really met-amphetamine, which is a different chemical substance. And yes, it shares the same basic molecular structure, but it has something to added on to it to change the activity of those neurotransmitters in the brain. So they're not acting in a normal way. So we have amphetamines that are used in treating ADHD, or bringing the brain back to an average type of neural functioning, where if somebody who takes the street drugs are getting an enhanced effect, on pleasure areas in the brain, and so on. And of course, that leads to addiction and other problems. These medications are not addictive, they do not give highs. As a matter of fact, one of the biggest problems I have in treating adolescents with ADHD is keeping them on their medication, if the medications were giving them a high, they would be glad to take it. In reality, when they're on their medication, they just feel normal.

Simon Currigan: 18:53

So these are safe, researched, chemicals that don't have sort of adverse impacts on the brain, we're not putting anything particularly foreign to the body and side effects can be well managed?

Walt Karniski: 19:03

Yes, there's actually no serious long term side effects of these medications. All of the side effects that do occur, occur while the medication's in the body. So for instance, Ritalin only lasts about three and a half hours. So if there are side effects to Ritalin, it's going to occur during those three and a half hours. And once the Ritalin has worn off, it no longer has a positive effect, and no longer has a side effect either. So there are no long term side effects. Let me give you an example. I had another child who is diagnosed with ADHD, he was about nine or 10 years of age, and we started him on medication. Mother brought him back in two weeks that for the first follow up visit, and I asked him, Well, how are things going? And he said, well, the teacher thinks that he's doing fabulous, he's focusing better in school. He's not hitting other children. He's learning better, his grades have improved for the better, but at home, I said, Well, that sounds great. What's the problem? And she said, well, at home, he's depressed. Oh, really? What? Why do you think he's depressed? And she said, Well, he comes home from school every day. He goes to his room. He opens up a book and he reads for two hours. And I said, Yes. And what's wrong with that? And she said, Well, he's never been that way before. He's usually running around the house pulling the cat's tail, knocking over the lamp, yelling at me, running out the door when he's not supposed to be. Now he's just sitting. I said to her, I said, if he had been born that way, would you have been concerned? She looked at me like I was crazy. She said, Well, of course not. I said, then what you're seeing when your child is on medication, is what he would have been like if he hadnt been born with ADHD. And so the fact that he sits and reads for two hours is not an abnormality. It's not a sign of depression, it's a sign of that the medication is working and doing what it's supposed to be doing.

Simon Currigan: 20:54

Just how effective are these medications in general? That's one sort of anecdotal story. But when we look at the statistics, what's the impact kind of on a wider scale when we look at hundreds or 1000s of children?

Walt Karniski: 21:04

Okay, well, first, I should mention that for every year, for the last 20 years, there have been approximately 350 research studies published in the world, concerning these medications, most of those studies are looking at the effect of the medication on children's behaviour. And those 350 studies overwhelmingly show every year that the medications are safe and effective. So that's the first thing that's important. The second thing that's important to remember is what happens if you do not treat somebody with ADHD. And I could probably spend the next hour talking about some of the problems that occur. But in just about every area, adults with ADHD who are not treated with medication as children are more likely to be in a car accident, they're more likely to have been fired from a job, they're more likely to have been arrested, they're more likely to have gone bankrupt, they're more likely to have abused drugs, they're more likely to smoke or drink excessively. And the amazing thing is that in the studies that have looked at the differences in adults, is that those adults that were treated with medication have about the same problems in those areas as people who don't have ADHD. So they still get into car accidents, but at the same rate as somebody does not have ADHD. What it seems to be implying is that the medications, whether they're treated with medication as adults or not, but if they were treated with medication as children, their outcome is far better than if they were diagnosed with ADHD and not treated with medication.

Simon Currigan: 22:39

So I find this research absolutely fascinating, because I've not come across it before the first time I came across this over the long term impact of medication was when I read your book, which I thoroughly recommend, by the way, do we know we talked about children being treated sort of in the long term, and that's bringing long term changes in their sort of brain structure? What do we mean by long term? Are we talking about three or four years? We're talking all the way through their childhood? Was there any sort of idea of how long the medication had to be administered to get those long term changes?

Walt Karniski: 23:06

Great question. You know, I had a 73 year old woman come to see me, she said, You know, I've been having trouble with keeping organised all my life, and I had been reading about ADHD. And sometimes I wonder if I had ADHD. So we ran her through all the tests and she came back positive for ADHD. She elected at 73, not to be treated with medication. But she came back and said, well, at least I know now what's causing all those problems. The difference between how a child works in a school classroom setting versus an adult who's working in a work setting, dealing with other people. And so long term studies, usually the distance between a 10 year old and how that child is doing maybe as a 30 year old, so 15 to 20 years would be considered a long term follow up study.

Simon Currigan: 23:55

Okay, that makes perfect sense. And, you know, I think if more parents knew about this research, they might be a lot less reticent, often I think parents and teachers see ADHD medication as a last resort. And we'll try other things first, but from what you're saying, it sounds like that the sooner children are supported in this way, actually, the more benefits they may experience.

Walt Karniski: 24:14

Absolutely. And let me give you a little personal insight into how I got involved in this. The thing that I think is so striking is that when I was in college, and one of my professors read an article from the Omaha Tribune, in that article, he said that 40% of children in the Omaha school districts are on medication for treatment of attention problems, and everybody in the classroom, including the professor, including me, were up in arms saying, that's horrible. We're medicated all of our children. And at that point, I remember it saying I think I need to become a doctor and stop this over abuse of medication. That was actually the one of the single biggest driving factors to get me into medical school and then to become a developmental paediatrician. However, what happened along the way, first, I learned that the original article that was written in the Omaha Tribune, back in the 1970s, was wrong. And in error, it was 40% of the children in special education classrooms, were receiving medication. In other words, all those children with ADHD were put in special education classrooms, and therefore there was a higher percentage of children were treated with medication as well. It's not because they were having trouble learning in school that they were given the medication who has to treat that underlying condition. So over time, my feelings went from this is an outrage, we're over medicating children, we're abusing children by giving them medications that is affecting brain function, when they're perfectly normal functioning children, to the present. Where I feel that if we do not treat children, we're doing them a disservice, we are cheating them of the lifestyle that every other child experiences. We grow by being successful, by being happy, by impressing other children as well. And if we're not able to do that, we don't grow and our self esteem suffers.

Simon Currigan: 26:10

Do we know compared to say, behaviour modification programmes, how successful medication is, which is more successful? what the figures are for parents and teachers who are listening to this thinking, well, maybe we should try a behaviour modification programme first. What sort of likely success rates do you see with medication as opposed to that kind of approach?

Walt Karniski: 26:28

15 years ago, there was a study performed that was really kind of the hallmark study to answer that question. What they did in the study was they looked at I believe was four groups of children and all the children were diagnosed with ADHD. And they took these children from six different medical centres across the country, a total of about 500 children total, some of those children were put into a group that were treated with medication, they were at a height treated the medication until they got the optimum dose, another group, a fourth of those children were not treated with anything, another group of children received behaviour modification treatment only. And a fourth group received behaviour modification plus medication. What they found in that study was that the group that was on medication had the best results, the group that was on behaviour modification and medication were slightly better, not significantly better. And as a result, basically what that was showing was that the behaviour modification techniques were helping the children but not helping the original symptoms of ADHD. And so overall, they found that medication was the most effective treatment and behaviour modification while effective at treating some of the other behaviours, they weren't necessarily treating the behaviours of ADHD. And they further found out that if they were treated with behaviour modification alone, they didn't respond at all, if they were on period with behaviour modification and medication, they did respond better. In other words, they could learn the behaviour modification techniques, if they weren't on medication, they couldn't focus and attend. And the behaviour modification techniques had no effect.

Simon Currigan: 28:08

So the medication kind of unlocked the capacity they needed to respond to those programmes.

Walt Karniski: 28:12

Absolutely. That's well put.

Simon Currigan: 28:14

So if you're a parent listening to this podcast, who's worried or on the fence about using ADHD medication to support their child, maybe they've just got a diagnosis. Maybe their child had a diagnosis for a while, and they've been worried about their progress in school, say at home, what would you say to them right now?

Walt Karniski: 28:29

I would ask them a couple questions. First First question I would ask them is how happy is your child? And the second question I would ask the parents are, how happy are you with your child's ability to learn in the classroom and to develop appropriate friendships? If the parent identifies the child as having difficulties that he's aware of the difficulties he's having in school, or if he or she as a parent is aware of those difficulties, then I can't see how you would not want to at least try the medication. Give them a high bar to perhaps say I will only continue this medication, if I see that he is learning, focused, happy, attentive, without significant side effects. And if that criteria is met, then continue the medication. If it's not met, try some alternatives.

Simon Currigan: 29:18

Yeah, I mean, that brings us on to another interesting question. I've worked with lots of parents over the years, and they've tried some medication, and they've said it's not really worked for my child. So they've stopped giving it to them, instead of just giving up on that and just stopping the medication. Should they be contacting their paediatrician or whoever works with them on that medication and talking about that? What should they do if it's not working?

Walt Karniski: 29:37

Actually there are 36 brand name medications approved by the Food and Drug Administration in the United States for the treatment of ADHD. And those 36 medications are all knockoffs of the original two medications methylphenidate and amphetamine. So even though there's 36 brand names, there's really only two main medications this done so that the drug companies can charge a larger amount for brand name drugs than they can a generic. But then in the process of that event occurring. Each one of those medications is slightly different. It wears off more gradually and it's less likely to cause irritability. So basically, what I'm saying with this is, we now have so many different options, that if side effects do occur, we can switch to a different medication that might be more or less likely to cause that same side effect. Because of the way the medication is delivered to the body. Just about every side effect that occurs can be mediated or reduced or eliminated with a change in medication or a change in dose or a change in the time of day when the medication is given.

Simon Currigan: 30:43

So we need to adapt and not give up, Walt. We're really just scratching the surface here. And I've mentioned your book already in passing. And I want to say that I've been on lots of training courses for educators about ADHD. And I think I've probably learned more from your book in a couple of evenings than I did on all those training courses. Can you tell us the title? Can you tell us how people get a hold of the book? Because I really do recommend that if you're a parent or a teacher working with a child with ADHD or your child has ADHD, this book is more than just about the medication as well. It's got so much interesting background information about the condition. Can you tell us the title of the book and how we can get hold of it?

Walt Karniski: 31:15

Sure. The title of the book is ADHD medication. Does it work? And is it safe? I think those are the two really most important questions that parents have about the medication. And that's the main topic of the book. The book is available through amazon.com. It's available through the publisher Rowman and Littlefield. It actually if you go through the publisher, price is a little bit reduced compared to the Amazon price. It's currently in hardback and with the paperback edition to be coming out probably in the next year and a half.

Simon Currigan: 31:49

And I'll put some direct links to the book in the episode description. So if you're listening now you can open your podcast app, and the direct links will be there. One last question. And we ask this of all our guests. Who's the key figure that's influenced you? Or what's the key book that you've read that's had the biggest impact on your approach to working with children?

Walt Karniski: 32:08

I think the person that has had the biggest impact in my life is the 10 year old child that sits across my desk and that I talk to on a daily basis. I think it's the children that have really had the impact more than anything, I can talk about professors that I have had an in my fellowship training programme in Boston. I can talk about people that I've met along the way, but it's really the children and their parents that have made my life what it is. They're the ones that come to me in tears. And they're the ones that walk away with smiles at the end of the day,

Simon Currigan: 32:45

I can't think of a better way to end that interview. Because it's all about the kids, isn't it?

Walt Karniski: 32:50

Absolutely.

Simon Currigan: 32:51

Thank you for being on the podcast today. And you've shared so much knowledge with us so much valuable insight about medication and the myths and misconceptions. And you know how it can be used in a way that really supports children in their development and leads to positive outcomes.

Emma Shackleton: 33:04

Okay, so there was lots of new information there to support parents whose children have ADHD. And of course, as teachers and educators, we are often helping parents to help their kids. So it's important that we've got this information too.

Simon Currigan: 33:20

And I'll put direct links to Dr. Karniski's resources in the episode description.

Emma Shackleton: 33:25

And if you're working with kids whose behaviour can be challenging, and you're not sure why they're behaving in that way, we've got a download that can help. It's called the SEND handbook, and it will help you to link behaviours that you're seeing in the classroom with possible causes like autism and ADHD.

Simon Currigan: 33:45

The idea here isn't for teachers to make a diagnosis, we're not qualified. But if we can link classroom behaviours to possible causes quickly, it means we can get the right help and get the right professionals involved and get early intervention strategies in place.

Emma Shackleton: 34:00

The handbook is a free download, so go over to our website beaconschoolsupport.co.uk. click on Free Resources near the top and we'll also put a link in the episode description.

Simon Currigan: 34:13

And if you've enjoyed today's episode, make sure you don't miss this podcast in the future. Open up your podcast app now and hit the subscribe button or follow as it's called in Apple podcasts. And your podcast app will automatically download each and every episode of school behaviour secrets as it's released. So you never miss a thing. It's like Series link on your TV. And to celebrate subscribing to the show. Why not tie a balloon? You put it off all your life and it turns out to be surprisingly easy. Just don't bring loads to me because I'm still really slow at it.

Emma Shackleton: 34:45

All that leaves us to say is we hope you have a brilliant week and we look forward to seeing you on the next episode of school behaviour secrets. Bye for now.

Simon Currigan: 34:54

Bye