The Diagnosis Isn’t The Parenting Plan by Dr. Michelle Alden
I want to say something that may make some people uncomfortable.
We need to stop using diagnosis as the end of the conversation. Not because the labels aren't real. Not because ADHD isn't real. Not because executive-functioning challenges aren't real. Not because some children genuinely struggle with demands, transitions, flexibility, impulse control, emotional regulation, or frustration tolerance.
Those things are real.
And understanding them matters.
But somewhere along the way, I think we've gotten confused about what the information is supposed to do for us. Because a diagnosis should help us understand a child. It should not become a reason we stop teaching the child. It should not become an excuse for not parenting. And it should never become the entire plan.
“My child has demand avoidance.” Okay. That's information. Now what? What are we going to teach?
How are we going to help this child tolerate a demand?
How are we going to help them handle the discomfort that comes with hearing no?
How are we going to build flexibility?
How are we going to help them learn to do something they don't want to do?
Because the world is full of demands, even if you have delays or lags in functioning.
Don’t we want kids that handle being told to:
Get dressed.
Go to school.
Turn off the electronics.
It’s time to go.
Do your homework.
Take a shower.
Get in the car.
Sit down.
Keep your hands to yourself.
These demands look different at different levels, ultimately I look at what it takes to function. We want to raise people that can: Go to work. Show up for other people. Be in a relationship.
There are going to be demands. Our job isn't to create a demand-free childhood. Our job is to help our children develop the skills to navigate the demands of life.
And sometimes that means we have to parent differently. It’s not just as simple as some people make it seem. “Oh, well if that was my kid I would just make them do it!” Really? Don’t you think these parents have tried that? But it also doesn’t mean we give up on being able to parent challenging kids. It actually means we do it differently. It may mean fewer words, or more structure. It often means anticipating problems instead of reacting to them. Or breaking things into smaller steps, even though all the other kids could do it at their age. It may mean helping a child regulate before expecting them to just cooperate and it usually means practicing a skill when everyone is calm instead of trying to teach it in the middle of a meltdown.
But we don't stop teaching. And we still need parents to parent.
The brain matters. A lot.
This is one of the things I've written and taught about extensively in Parenting Emotionally Distressed Kids. You have to understand the child's brain if you want to understand the behavior.
Children with ADHD, trauma histories, neurodevelopmental differences, and other emotional or behavioral challenges may have significant difficulty with executive functioning and self-regulation.
Dr. Russell Barkley has spent decades explaining ADHD through the lens of executive functioning and self-regulation. His work emphasizes that ADHD involves developmental difficulties in the brain's ability to regulate behavior toward goals and not simply a child who isn't paying attention or doesn't know what they're supposed to do.
That distinction matters.
Because if your child genuinely has difficulty stopping, thinking, shifting, planning, remembering, delaying gratification, or regulating their emotions, yelling,
“You KNOW better!”
isn't going to magically build that skill.
But here's where I think we sometimes go wrong. We hear:
“This is an executive-functioning problem.”
And we accidentally turn that into:
“So there's nothing we can expect them to do.”
No.
It means we have identified something that needs to be taught, practiced, supported, and developed.
That's a very different message.
Dr. Ross Greene's Collaborative & Proactive Solutions model focuses on identifying the specific skills a child is struggling with and the specific expectations they're having difficulty meeting the “unsolved problems”, rather than stopping at the child's concerning behavior or diagnosis.
I like that distinction. Because “he's oppositional” doesn't tell me enough.
“She's demand avoidant” doesn't tell me where the resistance is.
“He's impulsive” doesn't tell me if his behavior is also a safety concern.
“She's dysregulated” doesn't tell me if she is emotionally distressed or overly excited.
Those may all be useful pieces of information.
But I want to know:
What exactly can this child not do yet?
Can they transition from one activity to another? Can they tolerate frustration? Can they stop an activity? Can they accept a limit? Can they recover when they hear no? Can they wait? Can they shift their attention? Can they think about the consequences of their actions? Can they repair after they've hurt someone?
Now we're getting somewhere. Because skills can be built.
This is where parenting comes in.
I have a very strong belief about this: Understanding your child's limitations does not eliminate your responsibility to parent. In fact, it increases it. We know that if our child is lacking a skill, then we need to become more intentional about helping them develop it. But sometimes with a diagnosis, we don’t see the lack in skill, and so we don’t realize that:
If I know my child becomes dysregulated quickly, I need to learn how to help them regulate.
If I know transitions are hard, I need to learn how to teach transitions.
If I know frustration tolerance is low, I need to help build frustration tolerance.
If I know my child cannot yet handle a certain level of freedom safely, then I need to provide the structure they need until they can.
That's parenting.
And it's one of the reasons I talk so much about structure and safety. In my work, I don't want parents simply reacting to the behavior after it happens. I want parents to understand what's happening underneath it and create the conditions where their child can actually succeed.
That's part of building the bridge. We find the gap. Then we build the skill.
And this matters at school, too. I hear parents say things like:“My child's teacher knows he's ADHD.”
“My child's school knows she's demand avoidant.”
“They know he has ODD.”
Okay.
I'm glad they know.
But your child's diagnosis cannot be handed to a teacher as though it is a behavior-management plan.
Because here's the reality: Your child's teacher has a classroom full of children. They have to teach your child. And they have to teach everybody else's child, too. Your child's teacher cannot be expected to become your child's therapist, behavior specialist, executive-functioning coach, and parent.
And they shouldn't have to. Teachers absolutely need information, accommodations, support, and appropriate school-based interventions when a child needs them. And some schools are doing a great job with accommodations and special teams. But parents have a job that teachers cannot do.
You are the parent.
Your home is where many of these skills get practiced over and over again. At home is where kids learn how to respond when someone says no, how to handle frustration, limits, following directions, managing our bodies when we are angry, tolerating disappointment, and how to live with other people.
Those are life skills.
And parents are uniquely positioned to teach them because parenting isn't something that happens once a week for fifty minutes. It happens in the middle of real life. At every age and every stage.
And I want to say this carefully because parents are already carrying enough shame.
When I say parents have a job to do, I am not saying:
“This is your fault.”
Those are not the same thing.
Some of the parents I work with have been working harder than anyone will ever know.
They've tried consequences.
They've tried rewards.
They've tried gentle parenting.
They've tried being strict.
They've tried therapy.
They've tried talking.
They've tried explaining.
They've tried taking things away.
They've tried giving choices.
They've tried staying calm.
They've tried everything they can think of.
And they're exhausted. Many of them are scared. Some are wondering whether their family can stay together. Others are considering residential treatment because they are worried whether they can safely keep their child at home.
These parents don't need someone to say, “You need to parent better.”
They need me to say, “Let me show you what to do.” That's a completely different conversation.
Your child's brain may explain the behavior. It doesn't mean we surrender the behavior.
This is where I want to land. If your child has ADHD, let's understand ADHD.
If your child has trauma, let's understand trauma. If your child has autism, let's understand autism. If your child struggles with demand avoidance, let's understand what is happening for that child. If your child has ODD, let's understand the patterns and skills involved.
But then let's ask the more important question:
What does this child need to learn?
And then:
How are we going to teach it?
Because I don't want parents to walk away from a diagnosis thinking, “Well, that's just how my child is.” I want them thinking, “Okay. Now I understand what we're dealing with. What do we do next?”
That's the difference. Understanding is not the opposite of accountability.
You can say:
“I understand that this is hard for your brain.” and still say: “We're going to work on it.”
You can say:
“I know you don't like what I am telling you.” and still say: “It's still happening.”
You can say: “I know you're angry.” and still say: “You don't get to hurt people.”
You can say: “Your brain has a hard time stopping.” and still teach your child how to stop.
That's not being harsh. That's not being punitive. And that's not ignoring your child's needs.
That's parenting.
And honestly, I think our kids need us to be willing to do both:
Understand them deeply. And parent them intentionally.
Listen, if we love children, we have to cherish their parents, too.
And parents need more than a label or a diagnosis. They need understanding. They need tools. They need confidence and they need support.
Sometimes they need someone to say, “Yes, your child's brain is part of this. And yes, you're still the parent. Let's figure out what to do next.”
That's the work I do. Not to fix your child. But also, not to blame you.
I help you understand what is happening, create safety, build regulation, strengthen connection, and teach the skills your child needs to function in the world.
Remember, the diagnosis can give us information. It cannot do the parenting for us. And it cannot build the bridge to better behaviors.
We still have to build the bridge.
I want to say something that may make some people uncomfortable.
We need to stop using diagnosis as the end of the conversation. Not because the labels aren't real. Not because ADHD isn't real. Not because executive-functioning challenges aren't real. Not because some children genuinely struggle with demands, transitions, flexibility, impulse control, emotional regulation, or frustration tolerance.
Those things are real.
And understanding them matters.
But somewhere along the way, I think we've gotten confused about what the information is supposed to do for us. Because a diagnosis should help us understand a child. It should not become a reason we stop teaching the child. It should not become an excuse for not parenting. And it should never become the entire plan.
“My child has demand avoidance.” Okay. That's information. Now what? What are we going to teach?
How are we going to help this child tolerate a demand?
How are we going to help them handle the discomfort that comes with hearing no?
How are we going to build flexibility?
How are we going to help them learn to do something they don't want to do?
Because the world is full of demands, even if you have delays or lags in functioning.
Don’t we want kids that handle being told to:
Get dressed.
Go to school.
Turn off the electronics.
It’s time to go.
Do your homework.
Take a shower.
Get in the car.
Sit down.
Keep your hands to yourself.
These demands look different at different levels, ultimately I look at what it takes to function. We want to raise people that can: Go to work. Show up for other people. Be in a relationship.
There are going to be demands. Our job isn't to create a demand-free childhood. Our job is to help our children develop the skills to navigate the demands of life.
And sometimes that means we have to parent differently. It’s not just as simple as some people make it seem. “Oh, well if that was my kid I would just make them do it!” Really? Don’t you think these parents have tried that? But it also doesn’t mean we give up on being able to parent challenging kids. It actually means we do it differently. It may mean fewer words, or more structure. It often means anticipating problems instead of reacting to them. Or breaking things into smaller steps, even though all the other kids could do it at their age. It may mean helping a child regulate before expecting them to just cooperate and it usually means practicing a skill when everyone is calm instead of trying to teach it in the middle of a meltdown.
But we don't stop teaching. And we still need parents to parent.
The brain matters. A lot.
This is one of the things I've written and taught about extensively in Parenting Emotionally Distressed Kids. You have to understand the child's brain if you want to understand the behavior.
Children with ADHD, trauma histories, neurodevelopmental differences, and other emotional or behavioral challenges may have significant difficulty with executive functioning and self-regulation.
Dr. Russell Barkley has spent decades explaining ADHD through the lens of executive functioning and self-regulation. His work emphasizes that ADHD involves developmental difficulties in the brain's ability to regulate behavior toward goals and not simply a child who isn't paying attention or doesn't know what they're supposed to do.
That distinction matters.
Because if your child genuinely has difficulty stopping, thinking, shifting, planning, remembering, delaying gratification, or regulating their emotions, yelling,
“You KNOW better!”
isn't going to magically build that skill.
But here's where I think we sometimes go wrong. We hear:
“This is an executive-functioning problem.”
And we accidentally turn that into:
“So there's nothing we can expect them to do.”
No.
It means we have identified something that needs to be taught, practiced, supported, and developed.
That's a very different message.
Dr. Ross Greene's Collaborative & Proactive Solutions model focuses on identifying the specific skills a child is struggling with and the specific expectations they're having difficulty meeting the “unsolved problems”, rather than stopping at the child's concerning behavior or diagnosis.
I like that distinction. Because “he's oppositional” doesn't tell me enough.
“She's demand avoidant” doesn't tell me where the resistance is.
“He's impulsive” doesn't tell me if his behavior is also a safety concern.
“She's dysregulated” doesn't tell me if she is emotionally distressed or overly excited.
Those may all be useful pieces of information.
But I want to know:
What exactly can this child not do yet?
Can they transition from one activity to another? Can they tolerate frustration? Can they stop an activity? Can they accept a limit? Can they recover when they hear no? Can they wait? Can they shift their attention? Can they think about the consequences of their actions? Can they repair after they've hurt someone?
Now we're getting somewhere. Because skills can be built.
This is where parenting comes in.
I have a very strong belief about this: Understanding your child's limitations does not eliminate your responsibility to parent. In fact, it increases it. We know that if our child is lacking a skill, then we need to become more intentional about helping them develop it. But sometimes with a diagnosis, we don’t see the lack in skill, and so we don’t realize that:
If I know my child becomes dysregulated quickly, I need to learn how to help them regulate.
If I know transitions are hard, I need to learn how to teach transitions.
If I know frustration tolerance is low, I need to help build frustration tolerance.
If I know my child cannot yet handle a certain level of freedom safely, then I need to provide the structure they need until they can.
That's parenting.
And it's one of the reasons I talk so much about structure and safety. In my work, I don't want parents simply reacting to the behavior after it happens. I want parents to understand what's happening underneath it and create the conditions where their child can actually succeed.
That's part of building the bridge. We find the gap. Then we build the skill.
And this matters at school, too. I hear parents say things like:“My child's teacher knows he's ADHD.”
“My child's school knows she's demand avoidant.”
“They know he has ODD.”
Okay.
I'm glad they know.
But your child's diagnosis cannot be handed to a teacher as though it is a behavior-management plan.
Because here's the reality: Your child's teacher has a classroom full of children. They have to teach your child. And they have to teach everybody else's child, too. Your child's teacher cannot be expected to become your child's therapist, behavior specialist, executive-functioning coach, and parent.
And they shouldn't have to. Teachers absolutely need information, accommodations, support, and appropriate school-based interventions when a child needs them. And some schools are doing a great job with accommodations and special teams. But parents have a job that teachers cannot do.
You are the parent.
Your home is where many of these skills get practiced over and over again. At home is where kids learn how to respond when someone says no, how to handle frustration, limits, following directions, managing our bodies when we are angry, tolerating disappointment, and how to live with other people.
Those are life skills.
And parents are uniquely positioned to teach them because parenting isn't something that happens once a week for fifty minutes. It happens in the middle of real life. At every age and every stage.
And I want to say this carefully because parents are already carrying enough shame.
When I say parents have a job to do, I am not saying:
“This is your fault.”
Those are not the same thing.
Some of the parents I work with have been working harder than anyone will ever know.
They've tried consequences.
They've tried rewards.
They've tried gentle parenting.
They've tried being strict.
They've tried therapy.
They've tried talking.
They've tried explaining.
They've tried taking things away.
They've tried giving choices.
They've tried staying calm.
They've tried everything they can think of.
And they're exhausted. Many of them are scared. Some are wondering whether their family can stay together. Others are considering residential treatment because they are worried whether they can safely keep their child at home.
These parents don't need someone to say, “You need to parent better.”
They need me to say, “Let me show you what to do.” That's a completely different conversation.
Your child's brain may explain the behavior. It doesn't mean we surrender the behavior.
This is where I want to land. If your child has ADHD, let's understand ADHD.
If your child has trauma, let's understand trauma. If your child has autism, let's understand autism. If your child struggles with demand avoidance, let's understand what is happening for that child. If your child has ODD, let's understand the patterns and skills involved.
But then let's ask the more important question:
What does this child need to learn?
And then:
How are we going to teach it?
Because I don't want parents to walk away from a diagnosis thinking, “Well, that's just how my child is.” I want them thinking, “Okay. Now I understand what we're dealing with. What do we do next?”
That's the difference. Understanding is not the opposite of accountability.
You can say:
“I understand that this is hard for your brain.” and still say: “We're going to work on it.”
You can say:
“I know you don't like what I am telling you.” and still say: “It's still happening.”
You can say: “I know you're angry.” and still say: “You don't get to hurt people.”
You can say: “Your brain has a hard time stopping.” and still teach your child how to stop.
That's not being harsh. That's not being punitive. And that's not ignoring your child's needs.
That's parenting.
And honestly, I think our kids need us to be willing to do both:
Understand them deeply. And parent them intentionally.
Listen, if we love children, we have to cherish their parents, too.
And parents need more than a label or a diagnosis. They need understanding. They need tools. They need confidence and they need support.
Sometimes they need someone to say, “Yes, your child's brain is part of this. And yes, you're still the parent. Let's figure out what to do next.”
That's the work I do. Not to fix your child. But also, not to blame you.
I help you understand what is happening, create safety, build regulation, strengthen connection, and teach the skills your child needs to function in the world.
Remember, the diagnosis can give us information. It cannot do the parenting for us. And it cannot build the bridge to better behaviors.
We still have to build the bridge.
