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Posted by Dr. Monica Wonnacott | August 8, 2016

Does My Child Have ADHD?

Every parent has asked themselves at some point the magic question: Does my child have ADHD? It is impressively frustrating to have to ask your child a hundred times to do something. I know as a parent, I have often thought, “If I have to ask you one more time to …x, y, z… head is going to explode.” But there is a definite difference between kids who simply don’t listen and those who have true ADHD.

What is ADHD?

ADHD is attention deficit, hyperactivity disorder. There are essentially three types of ADHD:

  1. The kid who can’t focus and has just the attention component.
  2. The kid who is all over the place hyperactive
  3. And the kid who has the two combined symptoms.

There is an official set of diagnostic criteria (outlined in the Diagnostic and Statistical Manual of Mental Disorders). In short, the criteria requires that the child has symptoms in more than one setting (e.g., at home and at school). If the child is great at home, but only has trouble at school, then the child needs school help (or may be related to poor teaching). If the child is great at school, but terrible at home, then the child needs help at home (it may be related to poor parenting). If the child has trouble in both home and school, chances are the problem is the kid.

ADHD Signs and Symptoms:

When you read through the list, don’t pick and choose (your child would need most of the symptoms to get a diagnosis). Keep in mind that some of these behaviors are pretty normal. With kids who have ADHD, it’s often extremes of these and very frequent. Here’s a sampling of observed symptoms.

  1. Inattention
    1. Has a hard time paying attention
    2. Doesn’t seem to listen
    3. Easily distracted
    4. Is forgetful in regular daily activities
    5. Makes careless mistakes in schoolwork
    6. Loses things (e.g., homework, books, etc.)
    7. Has trouble organizing tasks and activities
  2. Hyperactivity/impulsivity
    1. Can’t stay in a seat (constantly running and climbing on everything)
    2. Is constantly moving
    3. Blurts out answers before the question is completed
    4. Has trouble waiting for things (e.g., in lines)
    5. Fidgets in a chair
    6. Talks excessively
    7. Interrupts conversations
    8. Easily looses temper

How is ADHD diagnosed?

ADHD is diagnosed by a qualified health care professional (e.g., pediatrician or psychiatrist). In addition to clinically evaluating the child and taking a good history, there is usually formal testing done. Commonly this is done with measures like the Vanderbilt or Connors tests. These are forms that the parents and teachers both fill out and the doctor will score. It is worth noting that even if a child has symptoms of ADHD, if the child is not having impairment (e.g., the child has a hard time focusing, but is still a straight A student), then the child will not meet a diagnostic criteria. The child has to be having problems as a result of the ADHD.

How young is ADHD diagnosed?

As a general rule, kids are usually school-aged when diagnosed. This is when most kids are regularly in a second environment during the day, the requirements are increased on them, and problems really come to a head. Officially, a diagnosis can be made as young as 4, but typically medications aren’t recommended in that early age group. Most kids get diagnosed in 1st or 2nd grade.

How is ADHD treated?

There are a handful of approaches to treating kids with ADHD. The first is behavioral therapy. This can be effective in some kids, but is generally not the cure all that parents hope and want it to be. The second option is medications. Typically this is with the stimulant drug class. Contrary to what you may think (my kid is already stimulated enough, right?), the medication is stimulating the part of the brain that helps with control and focus. The medications won’t make your kid more hyper. There are a number of medications in this drug class and deciding which is best for your child is a decision you and your doctor should make together. It is worth mentioning that the medications have side effects, most notably: suppressing appetite and causing trouble sleeping.

(Note: there is a small, but significant involvement with the heart in some select patients. Before starting your child on meds, your doctor should discuss it with you).

It is important to remember when you are discussing treatment that you do not have to medicate kids who have ADHD. Most people opt to medicate because it often improves the quality of life, but it is not required. Scientifically, medication has been proven to be the single most effective treatment for ADHD. It is worth mentioning that there are lots of other popular alternative treatment options out there. While most of them don’t have a lot of scientific background, they are not usually harmful either (there’s nothing wrong with improving a diet or making sure children get more regimented sleep, etc.). Unfortunately, there isn’t a cure for ADHD, but there is significant improvement that can be made in the lives of those dealing with it.

If you are concerned your child may have ADHD, discuss it with your pediatrician. But remember, some failure to listen and crazy behavior out of kids is normal.