As we move toward a more inclusive understanding of neurodiversity, one thing is clear: experts like Dr. Paula Conforti are leading the charge. With a career dedicated to working with children and families, including working as Chief of Psychological Services at the Toronto Catholic District School board, Paula’s approach combines clinical knowledge with heartfelt empathy.
Paula is not only helping kids with ADHD thrive—she’s also deeply dedicated to redefining how society views neurodiversity as a whole and advocating for a reduction of mental health barriers within educational systems.
We’re excited to welcome Dr. Conforti as the Director of Clinical Services at our new ADHD clinic in Oakville, Ontario. Recently, we had the opportunity to sit down with her to discuss everything from practical strategies for parents and educators to the evolving views on neurodiversity and how the stigma is finally starting to shift.
Q: Paula, you’ve spent a lot of time working with children who are neurodiverse and have ADHD. What drew you to this field, and what are some key lessons you’ve learned from working with these kids?
Early in my career, I had the privilege of working with ADHD experts such as Dr. Russell Schachar, a renowned psychiatrist and scientist at the Hospital for Sick Children in Toronto. I spent my time there and years after that, developing a deep understanding of the complexities associated with children and youth who are neurodiverse and bringing the same wisdom, knowledge and tools that I had learned at Sick Kids into the school system. My experience at Sick Kids also taught me the importance of multidisciplinary teams, as diverse perspectives and knowledge significantly assist in practicing effectively within a biopsychosocial model. Collectively, these experiences are fundamentally what drew me to pursue a Doctorate in Medical Science after Registration and join Springboard. I am incredibly proud of my diverse training, as I believe it is what practitioners need to tease apart what’s happening clinically for the individuals we serve.
The understanding people sometimes have of Attention Deficit Hyperactivity Disorder (ADHD), Autistic Spectrum Disorder (ASD), and Obsessive Compulsive Disorder (OCD) is you either have it or you don’t. On the surface, classification systems, such as the diagnostic and statistical manuals, seem to lend themselves to such an impression. The truth is that neurodiversity, like many facets of mental health and well-being, is on a continuum. Hence, this lends itself to important messaging: children and youth are not alone in their experiences with or without a diagnosis, as everyone has unique strengths and areas, we can all work on to different degrees. Neurodiverse challenges manifest to some degree in many individuals, some of whom do not meet the threshold for diagnosis. I think kids forget that or do not know this. A good example, and a key lesson that stands out for me, was when I began to work with a young boy who asked me at the onset, “Do I really have a disorder? People tell me that I struggle with concentration; why do they call this a disorder?” This really drilled home for me the importance of language, using language appropriately, ensuring a comprehensive understanding of one’s experiences, and highlighting personal strengths.
Q: Neurodiversity is a broad term. Could you briefly explain what it encompasses and how ADHD fits into this spectrum?
Broadly speaking, neurodiversity covers inattention, emotional regulation, sensory sensitivities, planning, organizing, social interaction, working memory, executive functioning, understanding of nuances, activity levels, impulsiveness, and individual experiences of the same, all of which are tied to the brain. ADHD fits in as it is a manifestation of a specific set of observations that stand out as challenging for the individual who experiences it.
Q: Parents often face a unique set of challenges when raising children with ADHD. What advice would you give to parents who are trying to create a supportive home environment?
Pick one goal to work on; if it’s the first goal you are implementing, make it something your child can succeed at and build difficulty level. Have a good understanding of the function of a behaviour and remember to give ten pounds of praise in other areas that are not only specifically related to the goal. Our brains are wired to remember what is not working for us and kids know what they struggle with! It takes effort to remember what is working, and often, this needs to be pointed out. Discuss with your child how you manage (or don’t!) the same challenges; this helps normalize it, sets the stage for dialogue, and takes the pressure off when children are unsuccessful.
Q: Are there any common misconceptions about ADHD or neurodiverse individuals that you still see lingering, and how can we work to correct those?
Unfortunately, misconceptions remain. A common one is educators’ belief that ADHD is really a learning disability and if we close the gaps in learning then the ADHD will no longer be present. What often happens is a child’s learning improves and the ADHD is still there. Meanwhile, years have gone by, and there has been no early intervention other than educational remediation. If desired, members of the Royal College of Physicians and Surgeons and College of Psychologists of Ontario can diagnostically inform the underlying concerns for precision care. To everyone’s credit, I find there is a deep desire to work together in partnership with schools, community services, those involved in clinical research in hospital settings and various agencies in the service of youth to untangle complex cases. Parents have options when they sense something they see in their children is not working or not fully understood.
Q: You spent several years working in the school system, how important is collaboration between educators and healthcare professionals in supporting children with ADHD? What does an ideal partnership look like?
An ideal partnership is curious and supportive, working together to help one another and the individual. Collaboration between educators and healthcare professionals is incredibly important. Streamlining support eliminates redundancy and therefore, speeds up implementation of appropriate recommendations. Educator perspectives permit an understanding of how kids are doing in the environment in which they often spend the most time, which is tantamount to how pervasive and critical a concern is. I can certainly empathize with parents who can express frustration with repeating the same story or history over and over to various professionals. Keep a folder of all correspondence and please do pass it along!
Q: In your experience, what changes would you like to see in how schools and workplaces accommodate neurodiverse individuals?
I would like to see more prevention and interventions in school systems tailored to the qualifications of the professionals best suited to deliver it for all children and youth. These supports could be driven by the professionals who are in the building in partnership with the school principal and, as such, uniquely understand the community. I would also welcome a less reactive, more patient, communicative, evidence-based, data-driven and responsive system. This is by no means a criticism of schools or educators. Regulated professionals such as social workers, psychologists, and educators know too well that the school system is a victim of ‘system spillover.’ This means that the needs of all students and all the recommendations that go along with each and every one of their students require sensitivity and implementation into the correct classroom environment. No small task. However, this comes full circle to the importance of coordinated care from the onset and parental understanding of why such an approach is being taken. I work with children and youth (not adults), but presumably, the same approach would apply to the workplace. Intervene early by encouraging self-care, supporting mental health days and promoting stopping stigma with required accommodations; healthy staff are happy workers. Healthy kids are happy learners.
Q: What excites you about the future of neurodiversity and ADHD research and advocacy?
I am excited to enhance collaborative clinical research in the service of neurodiverse children. There are many clinical research studies that happen all the time in hospitals and universities where it would be advantageous for neurodiverse youth to participate. Often, referrals to these studies are elicited from a very narrow pool, such as youth who present to hospitals. This narrows scientific understanding and generalizability. I want to promote increased awareness of the research happening in the area as I believe this is an untapped resource for youth to ask questions and find answers. While many of these studies require a diagnosis, some do not, and while one would not ‘jump the cue’ through research to receive clinical services, some research programs do provide a clinical service.
In addition, I have research interests in mental health literacy and suicidality from an early intervention lens. We are only beginning to understand the relationship between impulsivity and suicide. Studies have highlighted an association between females diagnosed with ADHD and suicidality, presumably manifesting from underlying depression and anxiety, although this is not fully understood. I hope to make this a focus of some of my work at Springboard.
Q: Finally, tell us something surprising about you that we wouldn’t guess from reading your resume?
In my spare time, I love to dabble in architecture and design. Some of my colleagues say I have high energy, which makes me laugh. My daughter thinks I should be on Love It or List It. I tend to use my house as my creative muse, tearing down walls, reorganizing rooms, and adding various elements of colour to match the seasons. It drives my husband crazy! I see this as an element of flow—I have a deep enjoyment in this, and releasing my creative energy is relaxing. Recently, a friend of mine cited a book that described “downtime” as not necessarily having to go to the beach (I do that too!) but simply a shift from the everyday. I’d second the latter idea.
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