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Sunday, September 15, 2019

Inattentive, impulsive, fidgety, and restless are just a few adjectives used by some parents to describe their child’s behavior. When these behaviors are present, parents may question: Does my child have Attention Deficit/Hyperactivity Disorder (ADHD)? How do I know? What can I do to help?

According to the Centers for Disease Control (CDC, 2013), approximately 11% of children in the United States ages 4-17 have been diagnosed with ADHD since 2001…and the trend is increasing. What most people are not aware of is that the commonly known Attention Deficit Disorder (ADD) is no longer a contemporary diagnosis. Presently, the diagnosis of ADHD is defined by different “subtypes” or presentations. The three subtypes include (1) Predominately Inattentive, (2) Predominately Hyperactive-Impulsive, or (3) Combined Presentation. “Combined Presentation” includes behaviors from the both of the other specific subtypes.

Identifying ADHD:

When deciding if your child should be evaluated for ADHD, there are a few symptoms to consider. If your child is having problems with attention and distractibility, ADHD Inattentive subtype features might include an inability to focus on a task for a sustained period of time, difficulty listening to and following directions, failing to pay attention to details, making careless mistakes, having organizational problems, or being forgetful in daily activities, among other issues.

Fidgety hands and feet, difficulty remaining seated, trouble waiting for one’s turn, running or climbing excessively, blurting out answers, and interrupting may reflect ADHD Hyperactive-Impulsive presentation.

If many of these behaviors or symptoms are present in two or more settings (e.g., school and home) and result in social, academic, or other complications, then it is possible your child may have ADHD. If this is the case, you should consider having your child evaluated by a professional.

An accurate diagnosis of ADHD often requires the expertise and input from multiple professionals, such as a neurologist and a neuropsychologist, in order to identify and exclude other biological causes of inattention or over-activity, such as sleep disorders, epilepsy, various medical and neurological conditions, learning disorders, or emotional problems.

Addressing ADHD

Treatment should initially be targeted to an identifiable underlying cause or contributor of ADHD, such as sleep issues, aberrant electrical activity or metabolic abnormalities. If there is an identifiable mood or emotional disorder, cognitive behavior therapy should be considered. If none of these interventions apply, behavioral and educational strategies and accommodations are the next step.

ADHD is often associated with reduced academic performance, difficulty in social situations, and, in adults, poor occupational performance and interpersonal relationships. There are strategies parents, teachers, and children can implement that can help manage these symptoms.

For young children through adolescents it is important to maintain a daily routine. This allows for awareness of the required timeframe to complete tasks and helps establish the expectation for staying focused. Depending on the child’s level of distractibility, working in a quiet environment may improve his or her focus during tasks. Keeping the area “clutter free” makes for fewer distractions also.

“Divide and conquer” or allowing for short breaks for the child to rest or walk around may improve their productivity. This can be helped by setting a timer that signals a break after a fixed period of work.

At school, front row seating is generally best for students with ADHD because it allows for more teacher-student interaction.

Encouraging children to take complete notes will help them maintain their focus and improve study skills. Creating “to-do” lists for daily objectives and assignments can be very helpful.

When giving directions, be sure the child is attending and then have them repeat back what is required of them.

If behavioral and educational strategies are insufficient to achieve success, and ADHD is affecting your child’s ability to achieve his/her academic and social potential that is appropriate for his/her developmental level, medication therapies should be considered. If such a step is being considered, you should consult with your health care provider.

Through accurate diagnosis, management of any associated medical or neuropsychiatric issues, implementation of behavioral and cognitive strategies, and in select cases, medications, children with ADHD can succeed and thrive!

Michael Roberts has his MS degree in both Experimental Psychology and Clinical Psychology. He is a Doctoral Candidate in Clinical Psychology at Philadelphia College of Osteopathic Medicine and a Doctoral Intern at The Center for Neurological and Neurodevelopmental Health (CNNH). CNNH has locations at MALO Health and Wellness in Rutherford, NJ and in Monmouth and Camden Counties in NJ and King of Prussia PA. (Center for Disease Control and Prevention. (2013). Attention Deficit / Hyperactivity Disorder (ADHD). Retrieved from: http://www.cdc.gov/ncbddd/adhd/data.html)

By Michael Roberts, MS, MS