Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be) and in some cases, are overly active.
Deciding if a child has ADHD is a several step process. There is no single test to diagnose ADHD, and many other problems, like anxiety, depression, and certain types of learning disabilities, can have similar symptoms. The physicians at Potomac Pediatrics are very comfortable diagnosing and treating most cases of ADHD. If your child is not performing as you expect or if someone has suggested that your child may have ADHD, we can help. First, download/print these Vanderbilt Scales. These are questionnaires to be completed by each parent as well as your child’s teacher. Once these are completed, please mail them to our office and make an appointment for a “behavior consult” to discuss the results.
Criteria for ADHD diagnosis
Inattention – 6 or more symptoms present for at least 6 months to an inappropriate extent developmentally
1. Often does not pay close attention to details or makes careless mistakes in schoolwork or other activities.
2. Often has trouble keeping attention on tasks or play activities.
3. Often does not seem to listen when spoken to directly.
4. Often does not follow through on instructions and fails to finish schoolwork or chores (not due to oppositional behavior or failure to understand instructions).
5. Often has trouble organizing activities.
6. Often avoids or dislikes things that take a lot of mental effort for a long period of time (e.g. schoolwork)
7. Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books)
8. Often easily distracted.
9. Often forgetful in daily activities.
Hyperactivity/ Impulsivity – 6 or more symptoms present for at least 6 months
1. Often fidgets with hands/feet or squirms in seat when sitting still is expected.
2. Often gets up from seat when remaining seated is expected.
3. Often excessively runs about or climbs when it is not appropriate (adolescents may feel very restless).
4. Often has trouble playing or doing leisure activities quietly.
5. Often “on the go” or often acts as if “driven by a motor”.
6. Often talks excessively.
7. Often blurts out answers before questions have been finished.
8. Often has trouble waiting one’s turn.
9. Often interrupts or intrudes on others (e.g. butts into conversations or games).
II. Some symptoms that cause impairment were present before age 12.
III. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home).
IV. There must be clear evidence of clinically significant impairment in social, school, or work functioning.
V. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder)
It is important for parents to remember that while ADHD can’t be cured, it can be successfully managed. Taking advantage of all the resources available will help you guide your child towards success. Remember, you are your child’s strongest advocate! In most cases, ADHD is best treated with a combination of medication and behavior therapy. Good treatment plans include close monitoring, follow-ups and any changes needed along the way. Click Here for the American Academy of Pediatrics Treatment Guidelines
Medication can help a child with ADHD in their everyday life and may be a valuable part of a child’s treatment. Medication is one option that may help better control some of the behavior problems that have led to trouble in the past with family, friends and at school. Several different types of medications may be used to treat ADHD:
- Stimulants are the best-known and most widely used treatments. Between 70-80 % of children with ADHD respond positively to these medications.
- Non-stimulants were approved for treating ADHD in 2003. This medication seems to have fewer side effects than stimulants and can last up to 24 hours.
Medications can affect children differently. When determining the best treatment, we might try different medications and doses to find the medication that works best for your child. Click here to learn more about Potomac Pediatrics policy for children taking ADHD medications.
Research shows that behavioral therapy is an important part of treatment for children with ADHD. ADHD affects not only a child’s ability to pay attention or sit still at school, it also affects relationships with family and how well they do in their classes. Behavioral therapy is another treatment option that can help reduce these problems for children and should be started as soon as a diagnosis is made.
Tips that might help with your child’s behavioral therapy:
- Create a routine. Try to follow the same schedule every day, from morning until bedtime.
- Get organized. Put schoolbags, clothing, and toys in the same place every day so your child won’t lose them.
- Avoid distractions. Turn off the TV, radio, and computer, especially when your child is doing homework.
- Limit choices. Offer a choice between two things (this outfit/meal/toy or that one) so that your child isn’t overwhelmed and overstimulated.
- Change your interactions. Instead of long-winded explanations and cajoling, use clear, brief directions to remind your child of responsibilities.
- Use goals and rewards. Use a chart to list goals and track positive behaviors, then reward efforts. Be sure the goals are realistic—baby steps are important!
- Discipline effectively. Instead of yelling or spanking, use timeouts or removal of privileges as consequences for inappropriate behavior.
- Help your child discover a talent. Finding out what your child does well — whether it’s sports, art, or music — boosts social skills & self-esteem.
Children with ADHD may not respond to the usual parenting practices, so experts recommend parent education. This approach has been successful in educating parents on how to teach their kids about organization, develop problem-solving skills and cope with their ADHD symptoms. Parent training can be conducted in groups or with individual families and are offered by therapists or in special classes. Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD) offers a unique educational program to help parents and individuals navigate the challenges of ADHD.
ADHD and the Classroom
Just like with parent training, it is important for teachers to have the needed skills to help children manage their ADHD. However, since the majority of children with ADHD are not enrolled in special education classes, their teachers will most likely be regular education teachers who might know very little about ADHD and could benefit from assistance and guidance.
Tips to share with teachers for classroom success:
• Use a homework folder for parent-teacher communications
• Make assignments clear
• Give positive reinforcement
• Be sensitive to self-esteem issues
• Involve the school counselor or psychologist
What Every Parent Should Know
As your child’s most important advocate, you should become familiar with your child’s medical, legal, and educational rights. Kids with ADHD might be eligible for special services or accommodations at school under the Individuals with Disabilities in Education Act (IDEA) and an anti-discrimination law known as Section 504.
*Edited by Dr. Lauren Zohler on 5/6/21