Dear Bess: My Grandkids Have All Been Diagnosed with ADHD. I’m Not Sure I Believe It’s Real. How Do I Deal With This?

Dear Bess,

ADHD didn’t exist when I was younger. Now all three of my grandkids have been diagnosed with it. I’m not even sure I believe it’s real. How do I deal with this as a grandmother?

Signed, Sceptical Nan

Sceptical Nan, I want to start by taking your observation seriously, because I think it’s more reasonable than you’ve perhaps been given credit for. You’re right that almost nobody was being diagnosed with ADHD when you were raising your own children. That’s not a false memory. It’s a genuine, well-documented fact.

So let’s separate two things, because I think they’ve become tangled together in your mind, understandably.

The first is whether ADHD, as a real, biological difference in how a brain works, actually exists. The second is why so many more children are being diagnosed with it now than in your day. Those are genuinely different questions, and I think the honest answer to the second one is actually what’s fuelling your doubt about the first.

Here’s what the research genuinely shows. ADHD is one of the most heritable conditions in psychiatry, with studies putting the genetic contribution at around 80 per cent. Twin studies have found identical twins share an ADHD diagnosis around 81 per cent of the time, compared to just 29 per cent for fraternal twins, which is about as strong a signal of a real, biological basis as you’ll find for almost any condition. Researchers have also identified specific genes involved in dopamine regulation that show up consistently in people with ADHD. This isn’t a fashionable label invented to explain away ordinary childhood behaviour. It’s a genuine, inherited difference in brain function, sitting alongside things like eye colour or a family tendency toward migraines, mostly out of anyone’s control.

What has genuinely changed is who gets identified.

The diagnostic criteria themselves have been broadened more than once, most notably in 1994 and again in 2013, when the age by which symptoms needed to first appear was pushed out from seven to twelve. Awareness among doctors, teachers and parents has grown enormously. And it’s now well understood that girls and quieter, less disruptive children were routinely missed for decades, because the original picture of ADHD was built almost entirely around loud, hyperactive little boys. A very recent Danish study of more than two million children, published just this week, found that children diagnosed with ADHD today actually resemble the general population more closely than those diagnosed a decade ago, suggesting the diagnostic net has genuinely widened to catch milder, previously overlooked presentations, not that the condition has been invented from nothing.

So my honest answer, Nan, is this: the condition was almost certainly always there. What’s changed is that we’ve finally built the tools, and the willingness, to actually see it.

Now, the more important question. What do you actually do with this, as a grandmother?

Here’s where I’d gently steer you. Your grandchildren’s parents have presumably gone through a genuine, often lengthy assessment process to arrive at three separate diagnoses. That’s not something families pursue lightly, and it’s worth trusting that process, even if the framework itself is unfamiliar to you.

Your scepticism, if it’s shared openly with your grandchildren or spoken about within earshot, risks landing as a quiet message that their diagnosis, and by extension, their struggles, aren’t real or aren’t taken seriously. That’s a genuinely painful thing for a child to absorb from someone they love, even unintentionally.

What I’d suggest instead is holding your questions privately, or raising them directly and respectfully with their parents, rather than with the children themselves. Ask what you can do to support them, practically, day to day. Ask what helps and what doesn’t. You don’t need to fully understand the science to be a genuinely steady, loving presence in their lives, and honestly, that steadiness matters far more to a child than whether their grandmother has fully come around on the diagnostic criteria.

One last thought, Sceptical Nan.

You raised children in a world that simply didn’t have this language yet. That’s not a failing on your part, and it doesn’t make your instincts wrong to question something new. But I’d encourage you to let your genuine curiosity lead here, rather than your doubt. Ask questions. Read a little. You may find, as so many grandparents eventually do, that what you’re really looking at isn’t something new at all, just something that finally has a name.

Have a question for Bess? Write to her at [email protected] with “Dear Bess” in the subject line.