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In this episode of the Mother of Boys Survival Guide Podcast, hosts Cheryl Bohn and Suzy Shaw discuss the overwhelming journey of motherhood, particularly focusing on the challenges faced by first-time moms. Joined by pediatrician Dr. Barnaby Starr, they explore essential topics such as newborn care, feeding, sleep patterns, recognizing illness, and preparing siblings for a new baby. The conversation emphasizes the importance of trusting maternal instincts and seeking professional advice when needed, while also providing practical tips for navigating the early stages of parenting.
Dr. Barnaby Starr is a highly respected pediatrician based in Baltimore, known for his decades of dedicated service to children’s health and well-being. With extensive experience in pediatric medicine, he has earned a reputation for his compassionate care, deep medical expertise, and commitment to community health initiatives. Dr. Starr has worked closely with families to address a wide range of childhood health concerns, from routine checkups to complex medical conditions. Beyond his clinical practice, he has been actively involved in public health advocacy, striving to improve healthcare access for underserved communities. His passion for pediatric care and his unwavering dedication to his patients have made him a trusted figure in the Baltimore medical community.
After retiring from his practice in 2024, Dr. Starr turned his energy and passion to writing a book for young adults. Switch Hitter: A Tennis Novel is a compelling sports fiction story that blends the excitement of tennis with themes of perseverance and personal growth. The novel follows a young athlete navigating the challenges of competition, self-discovery, and the pressures of the game. With his deep understanding of both medicine and sports, Dr. Starr brings authenticity and insight to the world of competitive tennis in a way that is insightful for young adults.
High energy in children is often normal until age six.
Physical activity is crucial for managing high energy levels.
Positive reinforcement can improve behavior and self-esteem.
Dietary factors may influence behavior, but not always as expected.
Sleep hygiene is essential for maintaining good behavior.
Routine helps children feel secure and manage expectations.
ADHD diagnosis requires observation across different environments.
Medication can significantly improve a child’s performance and self-esteem.
Social skills can improve with proper treatment for ADHD.
Understanding the complexity of behavior is key to effective parenting.
The information provided in this podcast is for general informational purposes only and does not constitute professional advice. Consult with a qualified professional for specific guidance.
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Cheryl Bohn: Understanding Energetic Boys and ADHD. Insights from a pediatrician with guest Dr. Barnaby Starr.
Welcome to the Mothers of Boys Survival Guide podcast, where we dive into the real challenges mothers of boys, who we call the MOB, face every day. I’m Cheryl Bond, and joining me is Suzy Shaw, the author of the companion book and the force behind the MOB movement. Hey, Suz.
Suzy Shaw: Hi, Cheryl. In today’s podcast, we’re going to delve into the world of high energy kids. In my book, I call my boys Earnest and Exuberance. And one thing I did with them to get some energy out was to get them to race, run from here to there, run around the house. And all I’d have to do is say, I’ll time you. Ready, set, go.
Chery Bohn: That works. My one son was having very high energy as well. And something that I would do, he went through this stage when he was about four, where he loved to break dance. So I would record him and let him break dance for hours until he sort of got tired out. And then we’d watch it together. It was just a very effective way to channel his energy level.
Suzy Shaw: Yeah, that was a very, very good idea. Win-win, right?
Cheryl Bohn: Yeah.
Suzy Shaw: So today we’re joined by a special guest to talk about high energy kids and when to recognize that your child might need some support with their energy and attentiveness. Dr. Barnaby Starr is a retired pediatrician with a long history of taking care of families in the Baltimore area. Welcome, Dr. Starr.
Dr. Barnaby Starr: How’s it going?
Cheryl Bohn: Thanks for being here to talk about this topic because it’s something that, you know, especially I think if you have a couple kids, you typically end up having at least one child that has this very, very high energy level.
Dr. Barnaby Starr: It was a question that came up every day. Every day. Does my kid have ADHD or are they just all boy or are they just very hyperactive but they don’t have anything wrong. Constantly, every day we dealt with that issue. And I think the important things for parents to realize is, first of all, age. You really can’t call a four-year-old ADD except in very unusual circumstances where you have such a strong family history that you just know they’re probably going to grow into that. But the diagnosis itself really shouldn’t be rendered until age six or so. So the expectation that all kids under the age of six should be able to sit still or it just is unrealistic. So a certain amount of high energy is normal until around age six.
And then if it’s true hyperactivity, it’s going to permeate every environment. That’s very important. If they’re just hyper at home but they’re able to sit stiller at school, that’s probably not true hyperactivity. And then the other thing about attention disorders that’s very important is in boys, they tend to be picked up earlier, usually by second or third grade, because they have impulsivity and hyperactivity more often than girls who, when they have a focusing issue, don’t have the concomitant hyperactivity. They just have what’s called the inattentive form. So they’re not disturbing other kids in the class. They’re just not focused as well as they should be. And sometimes they’re not doing as well as they could be doing. But because the boys are disturbing other people, it gets brought to the parents’ attention at an earlier age.
Suzy Shaw: So Dr. Starr, you know, Cheryl and I talked about some of our strategies, which is to get some of the energy out of the kid. You know, when parents are having a problem with impulsivity and difficulty following rules, you know, what are the strategies that you recommend to deal with high energy?
Dr. Barnaby Starr: Well, it’s a really good point. Your strategy makes a lot of sense. And it’s one of the pities that physical education is often being left out of our kids’ school schedules to make more room for academic subjects. And then they don’t have that outlet in the school day. And so I really think that’s a good strategy.
Another one is to reward them, give a positive reinforcement for small chunks of time where they can behave in the more desired, still manner, and not to look for too big of an expectation. So they’re set up for failure, but a smaller. You know, if you can do your homework for 15 minutes, then we’ll take a break and do something fun and not have real high expectations of long periods of time of extended focus.
Cheryl Bohn: Yeah, that’s, that’s really good. Just little bites, little, little bites of time to get them to focus.
Dr. Barnaby Starr: And then really reward them for it. And they learn that they’re capable of that.
Cheryl Bohn: And I feel good about it.
Dr. Barnaby Starr: I think that’s very important. We tend to get in a pattern with hyperactivity of a lot of negative reinforcement. Oh, no, you shouldn’t, oh.
Cheryl Bohn: And yeah, settle down or stop, you know.
Dr. Barnaby Starr: And that ends up affecting self-image. And it’s much better to find small chunks that the child can accomplish and reward them for them.
Cheryl Bohn: Do you have any advice for sort of boundaries to be put up to model like appropriate behavior when they can kind of appear more aggressive? You know, sometimes high energy can, can also come out as being seeming like aggressive behavior.
Dr. Barnaby Starr: Yeah. Again, you want to find the moments where you’re seeing the behavior you’re, you’re, you’re liking and interested in and reward those instead of, this again, where you’re in the scenario of negatively reinforcing a bad behavior. Everyone prefers learning what it is you’re looking for and then being rewarded for. And with the hyper child, uh, you just see the pattern over and over again where it becomes almost a self-fulfilling prophecy of bad behavior.
Suzy Shaw: So Dr. Starr, what are some things that we should think about regarding diet and nutrition when it comes to hyperactivity and how that might affect the energy level of our kids?
Dr. Barnaby Starr: Well, a lot of people are convinced that, that sugar does something crazy to their child and studies that have been done where the parent is blinded as to whether or not the child is getting a sugar containing compound or not have not really borne out a high correlation between high sugar and behavior.
However, there is a subset of children who really are sensitive to either food colorings or reactions to sugar or food allergies that can’t present with behavioral issues. So you have to be a little careful. It’s probably not as common as people think.
I found a much stronger correlation to the parent’s family history. Was there a hyperactive or ADHD in either parent’s experience in their family? Some relative who was treated for ADHD with some of the medications almost always came up when I was dealing with a true diagnosis of ADHD.
Suzy Shaw: But avoiding things like caffeine, obviously, you know, like a, like a drink with caffeine.
Dr. Barnaby Starr: Well, ironically, though, in a true ADHD, the stimulants like caffeine can actually help them. So I had two families in my practice who were afraid to go with the stimulant drugs and treated their kids with Mountain Dew because of the high caffeine. And it actually helped their kids focus.
So you have to be a little, little careful because paradoxical reactions to medications is quite common in true ADHD. You might even use it as a diagnostic aid. I gave my kid Benadryl and he was off the wall instead of sleepy. That could be a clue to ADHD.
Cheryl Bohn: Any advice for keeping them at the table to eat?
Dr. Barnaby Starr: Yeah. Pick your battles carefully. If the child really has trouble with that, like we were talking about before, just keep them there for five minutes and reward that. Little steps at a time are much better than setting the child up for failure, which is you’re going to sit here until we finish and, and then, you know, falls apart and then the child feels the failure.
Cheryl Bohn: It is really good as parents to keep reminding yourself of that.
Dr. Barnaby Starr: Exactly.
Cheryl Bohn: You know it definitely makes sense, but sometimes as parents, I think you don’t even, you’re not, you’re not repeating those patterns in your head. Like, okay, I, I need to give them, you know, reward them for five minutes. I need to, you know, it’s really important to keep reminding yourself of these small things that make a big difference.
Dr. Barnaby Starr: And, it goes back to expectations. Also, if you, I really want to have the whole family sit down and be together for a long dinner and it’s not realistic these days. So you got to pick off little pieces that the child can succeed at.
Cheryl Bohn: How about bedtime?
Dr. Barnaby Starr: Same idea. Having a routine is very good. A predictable routine starting as early as age two, where we’re going to read two stories. We’re going to put on our jammers, get in bed. And then after the two stories, that’ll be at, and the child will really react and, you know, be oppositional. And then within a couple of days when they see there, they know what to expect, things can often get a lot better.
A star chart where you reinforce, Hey, you did so well tonight. I’m putting a star on here. And if you get four in a row, we’ll give you a prize. That kind of behavioral modification, very useful where the child actually likes the reward and starts thinking about that more than the behavior or the negative attention that they’re perversely appreciating.
Suzy Shaw: My kids had two very, very different person, you know, personalities. Ernest was ADD with not really any hyperactivity whatsoever. So he was not a problem in the classroom, you know, but he wasn’t paying attention either.
Dr. Barnaby Starr: Right, inattentive form.
Suzy Shaw: Whereas, Exuberance was ready to, you know, take off like a rocket ship at any given second. And one of the things that we had to do was negotiate with the teacher because when especially Exuberance didn’t finish his daily work, he was not allowed to go out and play during free play. That was the punishment for him was that he would have to stay in the classroom. And I went in and talked with the teacher to negotiate a better solution and promised that we would do it that night and turn it in. And that really improved his overall behavior.
And so if you could just, are there any other recommendations like that that you might have for parents?
Dr. Barnaby Starr: Well, I think make a really good point is what, what he really needed was getting more activity. Another one that I found a lot was that the children just weren’t getting enough sleep. And, so trying to improve sleep hygiene where you sleep the same amount of time and a similar bedtime, seven days a week, as opposed to Monday through Thursday, one thing, and then a totally different lifestyle Friday through Sunday, uh, that tended to ruin behavior Monday, Tuesday, and sometimes even Wednesday.
So, I mean, uh, believe it or not, I think we as humans underestimate the importance of a good quality of sleep and consistency in sleep hygiene it’s called, where the weekend is not too different. You don’t want to sleep until 11 on the weekend, and then suddenly have to get up at 6:30 on Monday and expect behavior to be smooth.
Cheryl Bohn: So assuming it’s high energy and not ADHD or ADD, is it something that kids grow out of this high energy personality?
Dr. Barnaby Starr: Definitely. I mean, certain amounts of high energy, if it’s enthusiasm, Exuberance, as Suzy calls one of her characters, um, certain amount of that will always be present, but actually needing the body in motion, that does tend to grow out of, usually in the early teens.
Okay. And at what point should a child be evaluated then for high energy levels? You said around age six?
Dr. Barnaby Starr: Yeah. Age six or seven, if it’s consistent, like teachers have talked about since kindergarten, its very important to ask them to fill out checklists. The most famous is called a Connors checklist, but there are several checklists. These are very important because the true diagnosis is based on the appearance of behaviors in all different environments that the child is in. So what’s going on in school is very important. What might be going on from a sports coach? I mean, the kid who’s able to focus completely on his football coach, but not on his teacher might just be bored with what’s going on in school. The child who’s not seeming to listen in all his different or her different environments, that’s where we get more worried. So checklists on the child’s behavior in their different environments are very important.
Cheryl Bohn: So that’s how it’s diagnosed.
Dr. Barnaby Starr: Correct.
Cheryl Bohn: It’s diagnosed with these check, these checklists in all these different areas.
Dr. Barnaby Starr: Those are probably the most helpful. There’s all kinds of new diagnostic tests that can also be used. And there are psychologists now who specialize in, is it simply hyperactivity or is it part of an ADHD picture? Sometimes things it’s traveling with OCD, Obsessive Compulsive Disorder, tics and hyperactivity is a triad that you’ll often see in combination in certain children. So it’s very important to get the checklist and have a parent fill them out also based on the behaviors at home and then have the pediatrician or a psychologist review them.
Suzy Shaw: You know, Dr. Starr, we sort of wrestled with this on and off, whether or not we should use drugs to help, you know, the ADD part, the inattention, inability to concentrate. And we did do that at one point. And, and so can you help us understand what the advantages and disadvantages are and when you should really look into that?
Dr. Barnaby Starr: Well, it’s a complicated issue, but the fact of the matter is when you do find the right drug for the right child with ADHD, their performance will dramatically improve, which will have a direct reflection on their self-esteem. And it’s just almost miraculous to see a child who’s consistently been a failure academically, suddenly start doing really well, take pride in it, and a year or two into the treatment, we sometimes take a holiday, drop, stop the treatment and see if they’re ready to go without it.
And I really think parents shouldn’t be afraid of using medication because it can often help with the self-esteem of a child who’s done poorly and is so used to doing poorly. So don’t be afraid of it, but there are a lot of different medicines and different drugs work differently in different children. So you have to be a little patient if you decide to take that route, but don’t be afraid to try that.
Suzy Shaw: One of the things I was surprised about when we took that route was the social benefits and that I hadn’t realized that part of the, you know, at least the flavor of ADD that my son had made him not remember people’s names very well.
Dr. Barnaby Starr: Not only that, the children who have ADD often aren’t picking up on the social cues that other children are giving them. They tend to get a little too close to another child, perhaps in a game or playing or something. And, and they don’t pick up on the response that that’s eliciting from that other child. And so we do see a lot of children functioning better and getting more accepted after they’re on treatment.
Cheryl Bohn: Well, what are some of the less obvious aspects of raising or supporting children with ADHD? Like social struggles or, you know, like you mentioned, self-esteem, you know, what are there less obvious aspects that we don’t maybe think about?
Dr. Barnaby Starr: Well, it’s important to recognize that all that looks like ADHD is not necessarily ADHD and that bipolar disorder and depression in childhood can present with hyperactivity and poor impulse control. So if we’re not getting anywhere and your child is under treatment for ADHD, you have to consider a psychiatric evaluation if you think it may be something else going on, or if your family history is such that nobody had ADHD, but there was some depression or bipolar disorder.
Human behavior is very complicated. And in children, the final common denominator of hyperactive impulsivity might not always be ADHD.
Suzy Shaw: Do you have a motto for moms who are going through this hyperactivity period?
Dr. Barnaby Starr: This too shall pass.
Cheryl Bohn: That’s a good one.
Suzy Shaw: Perfect. And it does. So, Dr. Starr, we really appreciate you joining us today and talking about this really important topic. And I just want to let our listening audience know that you’ve written a book since you’ve retired for young adults. Can you tell us a little bit about that?
Dr. Barnaby Starr: Sure. It’s a book about a teenage tennis player who is dealing with a lot of heavy duty issues, the death of her father at a pretty young age, her own ADHD, her own unorthodox style of playing tennis, where she has two forehands. She’s ambidextrous. And a lot of people think she’s going to fail. And she shows with hard work, even doing something in an unorthodox style.
Suzy Shaw: For those interested in Dr. Barnaby Starr’s book, Switch Hitter, a Tennis Novel, please visit the motherofboys.life website. We will post a link to the book and additional resources related to this podcast.
Mothers of Boys Survival Guide is also available on the website, and the book makes a great gift.
Cheryl Bohn: Thank you for joining us. Please follow the mob community on Facebook, Instagram, YouTube, and your favorite podcast platform. Be kind to yourselves, moms, and have a great week.
Mothers of Boys Survival Guide is a production of Flame Digital Communications and author Suzy Shaw. This episode was edited by Adam Radtke. Our theme music is by Raphael Fierro-Valerio of Pond5. Join the mob online at mothersofboys.life. See you next week.
