ADHD Support for Children, Teens & Young Adults in St. Albert & Edmonton
Assessment, diagnosis, and comprehensive therapy — speech, occupational therapy, counselling, and literacy & tutoring support — all under one roof.
Ruby’s Multidisciplinary ADHD Approach
Ruby Therapy Services offers comprehensive ADHD support across speech-language therapy, occupational therapy, counselling, psychoeducational assessment, literacy and tutoring support — all under one roof.
If your child has been diagnosed with ADHD, or you suspect something more is going on behind the struggles at school, the meltdowns at home, or the social difficulties that keep showing up, you are in the right place.
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Many children with ADHD benefit from speech-language therapy to address the communication challenges that often accompany this condition.
What Our SLPs Address:
Pragmatic language and social communication: Learning the unwritten rules of conversation — turn-taking, reading facial expressions, understanding tone of voice, staying on topic, and adjusting communication style for different situations
Listening comprehension and following instructions: Strategies for processing and retaining spoken information, especially multi-step directions at school and at home
Narrative skills and conversational abilities: Building the ability to tell stories, recount events, and express ideas in an organized, coherent way
Reading and writing support: Addressing the overlap between ADHD and literacy challenges — including reading fluency, comprehension, written expression, and sustained reading attention
Classroom communication strategies: Practical tools for participating in class discussions, asking for help, and communicating needs to teachers
Delivered by:
Registered Speech-Language Pathologists (SLPs)
Approach:
Play-based for younger children, skill-focused and functional for older children and teens. Therapy goals are developed in collaboration with families and coordinated with other members of the Ruby Therapy Services team.
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Occupational therapy is one of the most impactful interventions for children and teens with ADHD, addressing the executive functioning, sensory processing, and daily living challenges that affect every part of their day.
What Our OTs Address:
Executive functioning strategies: Practical, hands-on approaches to planning, organization, time management, and task initiation — the skills that children with ADHD find most challenging
Sensory processing and self-regulation: Identifying sensory needs and building a toolbox of regulation strategies — helping children understand their own nervous system and what helps them feel calm, alert, and ready to learn
Handwriting and fine motor skills: Addressing the messy, slow, or effortful handwriting that is common in children with ADHD, along with fine motor challenges that affect school participation
Classroom strategies and environmental modifications: Fidget tools, movement breaks, seating options, visual schedules, and other practical accommodations that support focus and engagement in the classroom
Daily living skills and routines: Building independence in morning routines, homework habits, personal organization, and self-care tasks
Delivered by:
Registered Occupational Therapists (OTs)
Approach:
Evidence-based, functional, and collaborative. Our OTs work closely with families and schools to ensure that strategies learned in therapy carry over into daily life.
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ADHD is not just a cognitive challenge — it is an emotional one. Children and teens with ADHD often carry frustration, low self-esteem, anxiety, and social hurt that deserves as much attention as their attention difficulties. Our counsellors specialize in helping children and teens build emotional strength alongside practical skills.
What Our Counsellors Address:
Emotional regulation: Using CBT (Cognitive-Behavioural Therapy), DBT-informed skills, and mindfulness approaches to help children and teens identify, understand, and manage their emotions — including the intense frustration, irritability, and mood swings that often accompany ADHD
Building self-esteem and confidence: Helping children rewrite the internal narrative from "I'm broken" to "my brain works differently, and I have real strengths"
Managing anxiety and frustration: Evidence-based strategies for the anxiety that frequently co-occurs with ADHD, including worry management, cognitive restructuring, and relaxation techniques
Social skills development: Practising friendship skills, conflict resolution, perspective-taking, and navigating the social challenges that children with ADHD commonly face
Family counselling and parent coaching: Supporting the whole family — helping parents understand ADHD, reduce conflict, build positive routines, and strengthen the parent-child relationship
Play therapy for younger children: Using the natural language of play to help young children process emotions, build regulation skills, and develop social competence
Delivered by:
Canadian Certified Counsellors
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Assessment is the foundation. Without a thorough evaluation, families are left guessing — and guessing leads to the wrong supports, wasted time, and continued struggle. Our psychoeducational assessments provide the clarity you need to move forward with confidence.
What Our Psychologist Provides:
Comprehensive ADHD diagnosis: A thorough, multi-source evaluation that meets the clinical standard for ADHD diagnosis
Identification of co-occurring conditions: Learning disabilities, anxiety, giftedness, autism spectrum, and other conditions that may coexist with or mimic ADHD
Detailed recommendations: Specific, actionable strategies for school (IPP accommodations, classroom modifications), home (routines, strategies, environmental changes), and therapy (which disciplines and what to target)
A report that opens doors: Our assessment reports are recognized by schools for IPP development, by FSCD for funding applications, and by the Canada Revenue Agency for Disability Tax Credit applications
Delivered by:
Registered Psychologist
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Reading and writing challenges are among the most common academic struggles for children with ADHD — and they deserve targeted, specialized support that goes beyond standard tutoring.
What Our Literacy Specialists Address:
ADHD-related reading challenges: Difficulty sustaining attention during reading, losing place on the page, struggling with reading comprehension, and reluctance to read independently
Evidence-based literacy intervention: Structured, systematic approaches to phonological awareness, decoding, reading fluency, and comprehension — the same evidence-based methods used for children with reading disabilities, adapted for children with ADHD
Writing support: Helping children organize their ideas, plan written work, sustain effort through longer writing tasks, and develop confidence in written expression
Phonological awareness and decoding strategies: Building the foundational skills that support accurate, fluent reading
Sustained attention for reading: Strategies and scaffolding that help children with ADHD build reading stamina over time
Delivered by:
Speech-Language Pathologists or Therapy Assistants with literacy training
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For children with ADHD in Pre-K through Grade 6, Specialized Tutoring bridges the gap between therapy and the classroom. This service is designed by registered SLPs and OTs and delivered by experienced therapy assistants who help your child practise ADHD management strategies — focus techniques, self-regulation skills, organizational tools, and communication strategies — during real academic tasks in reading, writing, math, and science.
How It Works for Children with ADHD:
Applying OT strategies to homework: Your child's occupational therapist teaches self-regulation and focus strategies. The therapy assistant helps your child practise those strategies while working through actual school assignments — turning therapy skills into classroom habits.
Applying SLP strategies to academics: If your child struggles with reading comprehension, following written instructions, or understanding math word problems, the underlying challenge may be language processing. The SLP identifies the barrier and creates a plan. The therapy assistant provides the repeated practice needed to build those skills using academic materials.
Executive functioning in action: Many children with ADHD know what they need to do but struggle with starting, organizing, and completing tasks. Specialized Tutoring provides a structured environment where therapy assistants help your child build these executive functioning skills through real schoolwork — not abstract exercises.
Coordination with your child's therapy team: Because the therapy assistant works under the same roof as your child's SLP, OT, and counsellor, goals are aligned, strategies are consistent, and progress is communicated across the team.
Delivered by:
Experienced therapy assistants, supervised by registered SLPs and/or OTs
Strongly Recommended For:
Children with ADHD who need regular practice applying therapy strategies to academic tasks, at a more accessible rate than direct clinician sessions.
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ADHD — Attention-Deficit/Hyperactivity Disorder — is one of the most common neurodevelopmental conditions in childhood, affecting approximately 5 to 9 percent of children and adolescents in Canada. It is not a behaviour problem. It is not a result of poor parenting. And it is certainly not something children simply "grow out of."
ADHD is a brain-based difference in how a person regulates attention, impulses, and activity level. Research shows that ADHD involves differences in the development and functioning of key brain networks, particularly those responsible for executive functioning — the brain's ability to plan, organize, manage time, control impulses, and shift between tasks.
When we talk about ADHD, we are really talking about a brain that is wired differently. For many children and teens, that wiring brings genuine strengths — creativity, energy, out-of-the-box thinking, and the ability to hyperfocus on things that interest them. But it also means that everyday tasks like getting ready for school, following multi-step instructions, completing homework, or managing emotions can feel genuinely harder than they do for peers.
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ADHD is not one-size-fits-all. It presents in three recognized ways:
Predominantly Inattentive Presentation: Difficulty sustaining attention, following through on tasks, organizing activities, and keeping track of belongings. These children are often described as "daydreamers" — they may seem like they are not listening, lose things frequently, and struggle with tasks that require sustained mental effort. This presentation is frequently missed, especially in girls.
Predominantly Hyperactive-Impulsive Presentation: Excessive fidgeting, difficulty staying seated, talking excessively, interrupting, and acting without thinking. These are the children who are often noticed first because their behaviour is more visible in classroom settings.
Combined Presentation: A combination of both inattentive and hyperactive-impulsive symptoms. This is the most commonly diagnosed presentation.
Understanding which presentation your child has is essential because it shapes the type of support that will be most effective. A child who primarily struggles with inattention needs different strategies than a child who primarily struggles with impulse control — and many children need support for both.
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One of the most persistent misconceptions about ADHD is that it only looks like a child bouncing off the walls. In reality, many children with ADHD — particularly those with the inattentive presentation — sit quietly, appear compliant, and slip under the radar for years. They may be described as "spacey," "unmotivated," or "not reaching their potential." They often internalize their struggles, developing anxiety or low self-esteem long before anyone considers that ADHD might be the underlying cause.
At Ruby Therapy Services, we take a neurodiversity-affirming approach. That means we recognize ADHD as a genuine neurological difference — not a character flaw — and we focus on building skills, strategies, and self-understanding so your child can navigate the world with confidence.
Understanding ADHD
Signs & Symptoms of ADHD by Age
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At this age, ADHD-related behaviours can overlap significantly with typical development, which is why professional assessment is so valuable for clarifying what is going on. That said, some early signs may include:
Excessive motor activity that goes beyond what is typical for the age — constant climbing, running, inability to sit for even brief activities
Difficulty with turn-taking in play, games, or conversation
Intense emotional reactions — meltdowns that are more frequent, more intense, or longer-lasting than what peers experience
Difficulty following simple instructions even when they appear to understand
Delayed speech or language development — ADHD and speech-language delays frequently co-occur
Short attention span even for preferred activities (though some children with ADHD may hyperfocus on favourite activities while struggling with everything else)
Difficulty transitioning between activities, especially when asked to stop a preferred task
Frequent accidents or injuries due to impulsive behaviour
Important note: Many of these behaviours can be part of typical toddler and preschool development. The difference with ADHD is that these behaviours are more intense, more persistent, and more impairing than what is developmentally expected. A comprehensive assessment can help determine whether early intervention would be beneficial.
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The early school years are often when ADHD becomes most apparent, because the structured demands of the classroom highlight difficulties with attention, organization, and self-regulation that may have been less noticeable at home.
Attention and Focus:
Difficulty sustaining attention during lessons, homework, or reading
Frequently loses track of what the teacher is saying
Makes careless mistakes in schoolwork
Struggles to follow multi-step instructions
Easily distracted by background noise, movement, or their own thoughts
Organization and Task Completion:
Messy desk, backpack, and bedroom
Loses or misplaces school supplies, homework, permission forms
Starts tasks but struggles to finish them
Difficulty managing time — does not understand "how long things take"
Needs frequent reminders for daily routines
Hyperactivity and Impulsivity:
Fidgeting, squirming, difficulty staying seated
Talks excessively or blurts out answers
Difficulty waiting their turn
Acts without thinking about consequences
Interrupts conversations or games
Social and Emotional:
Difficulty reading social cues or respecting personal boundaries
Frustration and emotional outbursts that seem disproportionate
Low self-esteem, especially if they are aware they are "different" from peers
Emerging anxiety related to academic performance or social acceptance
Difficulty making or keeping friends
Academic Impact:
Reading struggles — difficulty with sustained attention for reading, comprehension challenges
Handwriting difficulties — messy, slow, or effortful writing
Incomplete assignments and missing homework
Test performance that does not match what they seem to know
Widening gap between ability and achievement
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ADHD in teenagers often looks different from ADHD in younger children. The physical hyperactivity may decrease, but executive functioning challenges often intensify as academic and social demands increase.
Executive Functioning Challenges:
Significant difficulty with planning, prioritizing, and organizing — for schoolwork, extracurricular activities, and daily life
Chronic procrastination, especially on tasks that feel boring or overwhelming
Poor time management — frequently late, underestimates how long tasks will take
Difficulty starting tasks, even when they want to complete them
Working memory challenges — forgets instructions, assignments, or commitments
Academic Struggles:
Grades may drop as course complexity increases and independent work is expected
Difficulty with long-term projects, essay writing, and studying for exams
May do well in classes they enjoy but struggle significantly in others
Inconsistent performance — "brilliant one day, failing the next"
Social and Emotional:
Rejection sensitivity — strong emotional reactions to perceived criticism or social exclusion
Emotional dysregulation — mood swings, irritability, difficulty calming down
Increased risk-taking behaviours (impulsive decision-making)
Social difficulties related to impulsivity, interrupting, or missing social cues
May withdraw from activities or peers if self-esteem is low
Internalized Symptoms:
In many teens, especially girls, ADHD symptoms become more internalized — appearing as anxiety, depression, or perfectionism rather than obvious hyperactivity
Chronic feelings of being "lazy" or "stupid" despite being capable
Burnout from years of compensating for undiagnosed ADHD
Why This Stage Matters:
The teenage years are a critical window. With the right support, teens with ADHD can develop self-advocacy skills, executive functioning strategies, and emotional resilience that set them up for success in post-secondary education and beyond. Without support, the accumulation of academic frustration, social difficulty, and low self-esteem can have lasting effects.
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For many young adults, ADHD symptoms that were manageable in high school become significantly more challenging when the structure of school is replaced by the independence of post-secondary education or the workforce.
Post-Secondary Challenges:
Difficulty managing time without external structure (no parent reminders, no daily schedule)
Procrastination on assignments, especially long papers or projects
Difficulty sustaining attention during lectures, especially in large classes
Poor study habits — not because of lack of intelligence, but because of difficulty with sustained focus and organization
May change programs or drop courses frequently
Workforce Transition:
Difficulty meeting deadlines consistently
Challenges with workplace organization — managing emails, tasks, and priorities
Trouble with sustained attention in meetings or repetitive tasks
Interpersonal challenges related to impulsivity or emotional reactivity
May change jobs frequently or feel unfulfilled
First-Time Diagnosis:
Many young adults — especially women — are not diagnosed until their late teens or twenties
The transition to independence often removes the external supports (parents, structured school environment) that were compensating for undiagnosed ADHD
Seeking assessment as a young adult is both valid and increasingly common
A diagnosis can bring clarity, relief, and access to strategies and accommodations
Self-Advocacy:
Learning to communicate needs to professors, employers, and healthcare providers
Understanding personal strengths and building systems that work with their brain
Accessing disability services at colleges and universities
Building sustainable routines for independent living
ADHD in Girls & Women
Girls and women with ADHD are diagnosed on average five years later than boys and men - and many are not diagnosed until adulthood, if at all. This delay has real consequences for self-esteem, mental health, and quality of life.
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Girls are more likely to present with the predominantly inattentive type of ADHD — quietly daydreaming, losing track of conversations, or struggling to keep up with assignments. Because they are less disruptive in the classroom, they are less likely to be flagged by teachers.
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Girls often develop sophisticated coping strategies early on — working twice as hard, people-pleasing, staying up late to finish work, memorizing social scripts. These strategies can hide ADHD symptoms for years but come at a significant personal cost.
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Girls with ADHD are frequently misdiagnosed with anxiety, depression, or mood disorders. While these conditions may be genuinely present, they are often secondary to the underlying ADHD.
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Cultural expectations around behaviour, organization, and emotional expression can lead girls and women to internalize their struggles rather than express them outwardly.
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Appears to be "smart but not trying hard enough"
Highly anxious, perfectionistic, or a chronic people-pleaser
Messy room but neat schoolwork (or vice versa) — inconsistency is key
Difficulty maintaining friendships despite strong social desire
Emotional sensitivity and intense reactions to perceived rejection
Chronic lateness, forgetfulness, or feeling overwhelmed by daily tasks
Internal restlessness rather than visible hyperactivity
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Research consistently shows that earlier identification leads to better outcomes. Girls who are diagnosed and supported in childhood develop stronger self-understanding, healthier coping skills, and more resilient self-esteem. At Ruby Therapy Services, our psychologists are trained to recognize the nuanced presentation of ADHD in girls and women, ensuring that no one slips through the cracks.
When to Seek Help
It can be difficult to know when typical childhood behaviour crosses the line into something that warrants professional assessment. Here are some signs that it may be time to seek help:
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The behaviours you are concerned about are not just bad days — they happen consistently, across multiple settings (home, school, extracurricular activities)
They have been present for at least six months
They are not better explained by a temporary stressor (move, divorce, new school)
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Your child's academic performance does not match their ability
Friendships are suffering — your child is being excluded, has difficulty making friends, or frequently conflicts with peers
Self-esteem is declining — your child is saying things like "I'm stupid," "I can't do anything right," or "nobody likes me"
Daily routines (getting ready, homework, bedtime) are a constant battle
Your child seems significantly more frustrated, overwhelmed, or anxious than their peers
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Teachers, coaches, or daycare providers have raised concerns
Report cards consistently mention issues with attention, behaviour, or social skills
Family members have noticed patterns
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You know your child best. If something feels wrong — even if you cannot pinpoint exactly what it is — that is worth exploring
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A comprehensive psychoeducational assessment is the gold standard for identifying ADHD and any co-occurring conditions. At Ruby Therapy Services, our Registered Psychologist conducts thorough assessments that give you clear answers and actionable next steps. You do not need a physician referral to book an assessment — you can submit a referral directly to our clinic.
ADHD vs. Anxiety vs. Autism — The Importance of Differential Diagnosis
One of the most important reasons to invest in a comprehensive assessment is that ADHD symptoms overlap significantly with several other conditions. Without careful differential diagnosis, children can be misdiagnosed — or have co-occurring conditions go unrecognized.
Ruby Therapy Services offers both ADHD and autism assessment in-house, so your child can be evaluated for the full picture under one roof.
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Both can cause difficulty concentrating, restlessness, and avoidance of tasks. A child with anxiety may appear inattentive because they are consumed by worry, not because they have an attention deficit. Conversely, many children with ADHD develop anxiety as a secondary response to chronic frustration and underperformance.
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ADHD and autism share features such as difficulty with social communication, sensory sensitivities, and challenges with transitions. Research shows that 50 to 70 percent of autistic children also meet criteria for ADHD, making dual diagnosis common. Understanding which condition (or conditions) is driving your child's challenges is essential for effective support.
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A child with a learning disability in reading (dyslexia) may appear inattentive during reading tasks — not because of ADHD, but because the task is genuinely harder for them. Alternatively, a child may have both ADHD and a learning disability, each compounding the other. Comprehensive cognitive and academic testing can tease apart these overlapping presentations.
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The effects of adverse childhood experiences can mimic ADHD symptoms — difficulty concentrating, emotional reactivity, hypervigilance. A thorough developmental history helps differentiate between trauma responses and ADHD.
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Research indicates that 50 to 70 percent of children with ADHD have at least one co-occurring condition. This is why a brief screening or a single checklist is not enough. At Ruby Therapy Services, our psychologists are trained to identify the full picture — including conditions that co-occur with ADHD — so your child receives support that truly matches their needs.
How ADHD Affects Daily Life — Co-Occurring Conditions
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Research shows that 17 to 38 percent of children with ADHD also have speech or language difficulties — a rate significantly higher than the general population. These challenges can affect academic performance, social relationships, and self-confidence.
Common Speech and Language Challenges in Children with ADHD:
Pragmatic language difficulties: Trouble with the social rules of communication — taking turns in conversation, staying on topic, reading body language, understanding sarcasm or implied meaning. These challenges are a leading cause of social difficulty in children with ADHD.
Listening comprehension: Difficulty processing and retaining spoken information, especially multi-step instructions. A child may appear to "not listen" when they are actually struggling to process what they have heard.
Expressive language: Difficulty organizing thoughts into clear, coherent sentences. May go off on tangents, struggle to get to the point, or have difficulty retelling events in sequence.
Narrative skills: Trouble telling stories or recounting experiences in a logical order — which affects both social communication and academic writing.
Reading fluency and comprehension: Difficulty sustaining attention during reading, losing their place, or struggling to extract meaning from text — challenges that bridge speech-language therapy and literacy support.
How Ruby Therapy Services' Speech-Language Pathologists Help:
Our SLPs work with children and teens with ADHD to strengthen pragmatic language skills, improve listening comprehension, build narrative and conversational abilities, and support reading and writing. Therapy is play-based for younger children and skill-focused for older children and teens, always tailored to each child's specific profile.
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Many children with ADHD experience sensory processing differences and significant executive functioning challenges that affect their ability to manage daily life. Occupational therapy addresses both.
Sensory Processing:
Sensory seeking: Constantly touching things, craving movement, seeking intense input (spinning, crashing, chewing)
Sensory avoiding: Overwhelmed by loud noises, certain textures, bright lights, or crowded environments
Difficulty with self-regulation: Trouble calming down when overstimulated, or revving up when under-stimulated
Proprioceptive needs: Craving heavy work activities (pushing, pulling, carrying) to feel organized in their body
Executive Functioning:
Executive functioning is often described as the brain's "command centre" — and it is one of the primary areas affected by ADHD.
Planning and organization: Difficulty breaking large tasks into steps, organizing materials, or knowing where to start
Working memory: Holding information in mind while using it — forgetting instructions mid-task, losing track of multi-step processes
Time management: Poor sense of how long things take, difficulty meeting deadlines, chronic lateness
Cognitive flexibility: Difficulty shifting between tasks or adjusting when plans change
Emotional regulation: Difficulty managing frustration, disappointment, or excitement in proportion to the situation
How Ruby Therapy Services' Occupational Therapists Help:
Our OTs use evidence-based strategies to help children and teens with ADHD develop self-regulation skills, build executive functioning strategies, address sensory processing needs, improve handwriting and fine motor skills, and create routines and systems that support independence at home and school.
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Up to 50 percent of children with ADHD also experience clinically significant anxiety, and rates of depression are similarly elevated — particularly in adolescence. Understanding the relationship between ADHD and mental health is essential for effective treatment.
Why ADHD and Anxiety Often Co-Occur:
Years of struggling to keep up academically and socially can create chronic stress
Repeated experiences of failure, criticism, or social rejection build a pattern of anticipatory anxiety
Children with ADHD may develop perfectionism or avoidance as coping strategies for their underlying attention challenges
The unpredictability of ADHD symptoms ("I never know if I'll be able to focus today") can generate constant worry
Why ADHD and Depression Often Co-Occur:
Persistent frustration and feelings of inadequacy
Social isolation or peer rejection
The gap between a child's potential and their performance
In teens, accumulated years of difficulty can lead to hopelessness
The Importance of Treating Both:
Addressing ADHD without addressing the accompanying anxiety or depression often leads to limited progress — and vice versa. When a child is both anxious and inattentive, interventions need to account for both. At Ruby Therapy Services, our counsellors work alongside our OTs and SLPs to ensure that emotional well-being is part of the treatment plan, not an afterthought.
How Counselling Helps:
Cognitive-behavioural therapy (CBT) for managing anxious thoughts and building coping strategies
Emotional regulation skills — identifying, expressing, and managing feelings
Building self-esteem through strengths-based approaches
Social skills development in a safe, supportive environment
Parent coaching to support emotional well-being at home
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ADHD and learning disabilities frequently co-occur. Research estimates that 30 to 50 percent of children with ADHD also have a specific learning disability — and when both are present, each condition amplifies the impact of the other.
Common Overlaps:
Reading difficulties (dyslexia connection): Children with ADHD may struggle with reading fluency, decoding, and comprehension — sometimes due to attention challenges, sometimes due to a co-occurring reading disability, and often due to both. Distinguishing between these causes is critical because the interventions are different.
Writing challenges: Difficulty with handwriting (dysgraphia), organizing written ideas, spelling, and sustaining the mental effort required for writing assignments. Many children with ADHD describe writing as their most hated school task.
Math difficulties: Challenges with working memory affect mental math, multi-step problem solving, and remembering mathematical procedures. Some children have a specific math learning disability (dyscalculia) alongside their ADHD.
Why Psychoeducational Assessment Is Essential:
A comprehensive assessment differentiates between academic struggles caused by ADHD (attention-related) and those caused by a learning disability (skill-based). This distinction matters because:
A child with ADHD but no learning disability may benefit most from executive functioning strategies and classroom accommodations
A child with both ADHD and a reading disability needs targeted literacy intervention in addition to ADHD support
Without proper identification, children often receive the wrong kind of help — or no help at all
How Ruby Therapy Services' Literacy Support Helps:
Our SLPs with specialized literacy training provide evidence-based reading and writing intervention for children with ADHD and co-occurring literacy challenges. This includes phonological awareness training, decoding strategies, reading fluency practice, and written expression support — all delivered with an understanding of how ADHD affects the learning process.
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The relationship between ADHD and autism is one of the most important areas of understanding in neurodevelopmental care. Research consistently shows that 50 to 70 percent of autistic children also meet diagnostic criteria for ADHD — making dual diagnosis the rule rather than the exception.
Overlapping Features:
Attention differences (though the nature of the attention challenge may differ)
Sensory sensitivities (both over- and under-responsivity)
Social communication challenges (though the underlying reasons may differ)
Difficulty with transitions and changes in routine
Executive functioning challenges
Why Differential or Dual Diagnosis Matters:
A child who has both ADHD and autism may be diagnosed with only one, leaving the other untreated
ADHD interventions alone may not address the social communication and sensory needs of an autistic child
Autism interventions alone may not address the attention, impulse control, and executive functioning needs of a child with ADHD
Understanding the full diagnostic picture ensures that therapy targets the right underlying challenges
Ruby Therapy Services' Advantage:
Ruby Therapy Services offers both ADHD and autism assessment in-house. This means your child does not need to be referred to multiple providers for different assessments — we can evaluate the full picture under one roof and develop an integrated treatment plan.
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Up to 70 percent of children with ADHD experience significant sleep difficulties — making sleep one of the most common and most under addressed co-occurring challenges.
Common Sleep Difficulties in Children with ADHD:
Difficulty falling asleep: A "busy brain" that will not turn off at bedtime — racing thoughts, replaying the day, or difficulty transitioning from wakefulness to sleep
Restless sleep: Frequent tossing and turning, restless legs, or waking during the night
Resistance to bedtime routines: Difficulty transitioning from evening activities to the bedtime routine, frequent stalling or avoidance
Delayed sleep phase: A circadian rhythm that is shifted later than typical, making it biologically harder to fall asleep at a conventional bedtime
Difficulty waking up: Hard to rouse in the morning, excessive grogginess, difficulty transitioning to the morning routine
The Impact on ADHD Symptoms:
Poor sleep does not just make children tired — it directly worsens ADHD symptoms. Research shows that sleep deprivation increases inattention, impulsivity, emotional reactivity, and hyperactivity. For some children, addressing sleep problems leads to meaningful improvement in daytime ADHD symptoms.
Strategies That Help:
Consistent bedtime and wake time — even on weekends
A predictable bedtime routine (same steps, same order, every night)
Reducing screen exposure at least one hour before bed
A cool, dark, quiet sleep environment
Physical activity during the day (but not close to bedtime)
Relaxation techniques — deep breathing, progressive muscle relaxation, or guided imagery
Weighted blankets for children who benefit from proprioceptive input
How Therapy Can Help:
At Ruby Therapy Services, our occupational therapists can help develop sensory-based sleep strategies, and our counsellors can address anxiety-related sleep difficulties. When sleep is part of the picture, our team incorporates it into the overall treatment plan.
Ready to Take the Next Step?
You have already taken the most important step — learning about ADHD and exploring what support looks like. Every one deserves to be understood, supported, and set up for success.
Ruby Therapy Services is here to help.