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Do you think your child may have ADHD? Here are the next steps to take.

February 23, 2015

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common medical issues affecting children, with an estimated 5 to 11% of children in the U.S. diagnosed with the disorder. Despite its prevalence (or perhaps because of it), an ADHD diagnosis for a child often brings with it feelings of stress, frustration, confusion and fear for parents. There are multitudes of conflicting opinions floating around about ADHD, and many parents find it difficult to decide which voices to listen to and how to make the right decision for their child.

ADHD is a developmental problem that affects a child’s learning, behavior and attention. These children may be easily distracted, impulsive, fidgety or full of energy. They may have trouble concentrating, be prone to daydreaming and have difficulty with organizational and sequencing activities. While each of these things may be normal at different stages in a child’s life, it can be a problem when these things occur outside the normal stages of development.

If you or someone else in your child’s life wonders whether your child may have ADHD, here are some things that you should think about:

Consider your own feelings and biases regarding an ADHD diagnosis

Parents have varying reactions when considering the possibility that their child may have ADHD. On one end of the spectrum, some refuse to acknowledge that there may be something “wrong” with their child. They may say things like, “Oh, he’s just being a boy. He’ll settle down as he gets older.” Parents may feel (even if they aren’t aware of it) that if their child has this disorder, it must mean that they’ve done something wrong or that it is their fault.

A child that has ADHD and remains undiagnosed can suffer many serious consequences. They will likely continue to struggle in school, and they may wonder why academic pursuits seem to come easier to their peers than it does for them. If the pattern continues, over time they may simply come to the conclusion that they aren’t very smart and shouldn’t pursue academic goals. They will likely struggle in their social and emotional development and have trouble maintaining healthy relationships with their family, peers and teachers. They may be more prone to injuries and hospitalizations, as a lack of impulse control and inattention can become deadly once children reach adolescence and begin to operate motor vehicles or are exposed to alcohol or illicit drugs.

At the other extreme, sometimes the disorder can be taken too lightly. If a child has shown some discipline problems or has a lot of energy, parents may self-diagnose their child with ADHD even if they’ve never been diagnosed by a healthcare provider. Labeling a child with a diagnosis that isn’t theirs can be harmful as well. It may prevent parents from seeking help for the real issue, and the child will continue to struggle

If there are concerns about your child’s inattention or hyperactivity, bring those questions and concerns to your child’s healthcare provider. If you suspected that your child had a broken arm, you would bring her to the doctor and want her to be taken care of appropriately. While a disorder involving development of the brain is harder to see and harder to diagnose, the same principle still applies. If there is something that is hindering your child’s ability to reach their full potential, be open to figuring out what is wrong and how it can be addressed.

Commit to the process, one step at a time

It’s important to know that there isn’t one specific test to diagnose ADHD. It is a several-step process that takes place over time. The conversation may begin with one teacher or one healthcare provider, but should ultimately involve several key people in the child’s life: parents, teachers, relatives, caregivers, coaches, and healthcare providers.

As you begin this conversation, you may find it helpful to know how this condition is diagnosed. A trained healthcare provider will use a standardized set of criteria to determine whether your child has this disorder. Below you will find a shortened list of the criteria (as explained by the Centers for Disease Control and Prevention):

Criteria for ADHD

People with ADHD show a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development:
  1. Inattention: Six or more symptoms of inattention for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level:
  • Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
    • Often has trouble holding attention on tasks or play activities.
    • Often does not seem to listen when spoken to directly.
    • Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
    • Often has trouble organizing tasks and activities.
    • Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
    • Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
    • Is often easily distracted
    • Is often forgetful in daily activities.
2. Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level:
  • Often fidgets with or taps hands or feet, or squirms in seat.
  • Often leaves seat in situations when remaining seated is expected.
  • Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
  • Often unable to play or take part in leisure activities quietly.
  • Is often "on the go" acting as if "driven by a motor".
  • Often talks excessively.
  • Often blurts out an answer before a question has been completed.
  • Often has trouble waiting his/her turn.
  • Often interrupts or intrudes on others (e.g., butts into conversations or games)
*Note that children may be diagnosed with or without the hyperactivity component*

In addition, the following conditions must be met:

  • Several inattentive or hyperactive-impulsive symptoms were present before age 12 years.
  • Several symptoms are present in two or more setting, (e.g., at home, school or work; with friends or relatives; in other activities).
  • There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
  • The symptoms do not happen only during the course of schizophrenia or another psychotic disorder. The symptoms are not better explained by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).
As you begin this conversation with your pediatrician, you may find it helpful to download this form, fill it out and discuss it with your child’s doctor. To get a well-rounded look at your child in different settings, consider giving this form to your child’s teacher, caregivers, adult relatives, or coaches as well. As you document other people’s independent observations of your child’s behavior, you’ll have better information to guide your decision-making.

Weigh the risks and benefits of treatment- when it’s the right time

Many parents forgo or delay the necessary steps to diagnose their child with ADHD because they fear the medications that often go along with the diagnosis. However, the importance of taking this process step by step can’t be overemphasized. Don’t jump into assuming things about your child’s treatment before you’ve even determined whether they have a problem.

While ADHD cannot be cured, it can be effectively managed. Once you have a diagnosis, look at the treatment process as a long-term partnership with your child’s doctor to find a treatment that will give your child the maximum benefit with the least amount of side effects. Many families have found that a combination of medication, behavioral therapy, parent education and school support have afforded their children the opportunity to thrive academically, socially and emotionally.

When it comes to weighing the treatment options, be sure you are engaged in an open and honest dialogue with your child’s doctor. Ask questions, express your concerns and work through the tough decisions together.

It will be worth all of the hard work in the end.

To learn more about ADHD and its treatment, here are some excellent resources:

Healthy Children

Centers for Disease Control and Prevention

National Institute of Mental Health

 

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