“I think my child has ADHD” is a remark often heard in the pediatrician’s office. It reflects, in my experience, the most common belief parents arrive at when their school age child’s behavior first gives rise to concern. The high incidence of ADHD – Georgia parents report 9.2% of children 4-17 years of age have been diagnosed with it1 – ensures that many parents will have heard about ADHD from someone with a diagnosed child, from educators, doctors, or the media. Someone might even chip in, “I think your child has ADHD.”
Widespread usage of a term such as Attention Deficit/Hyperactivity Disorder (ADHD) comes with benefits and risks. Benefits include that children with this neurobehavioral condition are more likely to be identified and given the care they need, as more parents and educators are aware of it. Risks include that children who in fact do not have this condition get labeled and treated in error. Such errors are not trifling since treatment can include powerful drugs that may have undesirable side effects, even when prescribed correctly.
Symptoms of ADHD divide into two main groups or criteria; one that reflects inattention and one that reflects hyperactivity-impulsivity. The criteria come from ongoing research that enables scientists and practitioners to continue to improve the standards that are used to identify ADHD. The latest set of standards was published in 2013 by the American Psychiatric Association in a volume identified for short as DSM-5.2 Only trained professionals can diagnose and treat ADHD, but the Centers for Disease Control and Prevention (CDC) provide a summary of the most recent diagnostic criteria for information purposes.3
In order for your child to be accurately diagnosed and correctly treated, your health care provider should have each of the following: good training, plenty of experience, and time to interact with you and your child. When one or more of these nuts and bolts requirements are missing, your child could be diagnosed and treated in error. For example, the behaviors included in the symptoms for ADHD can mask conditions other than and, sometimes, in addition to ADHD: A child who experiences anxiety may display restlessness, difficulty concentrating, and irritability. Or a child with depression may be unable to concentrate and have difficulty making decisions. These behaviors are sometimes seen to point to ADHD, when this diagnosis in fact is erroneous and a disservice to the child.
Another error occurs when normal variations in behavior mistakenly are seen to point to ADHD. As the complex marvel of your child’s development unfolds, newly developing skills may result in situations that can look like inattention or hyperactivity-impulsivity. For example, as children gain confidence in a growing set of capabilities, they may initially apply these skills in imperfect ways that can make their behavior look impulsive, disorganized, and scattered. Yet, this is most often a part of a normal, broader trend where initially fragile new skills are strengthened over time. Such improvements are supported both by neurological developments that promote your child’s maturation and by your child’s growing ability to learn from interacting with people and resources in the environment. For example, parents who facilitate or “mediate” their child’s ability to plan and achieve goals (so-called cognitive skills) may find that their learner, previously “on the go” and unable to sit still, becomes more focused and absorbed in rich and meaningful work.
If you think your child has ADHD, we encourage you to contact Focus Forward, where providers can perform the necessary diagnostic evaluations to determine your child’s needs and make sure appropriate treatments are identified and implemented.
1CDC. Increasing prevalence of parent-reported attention-deficit/hyperactivity disorder among children — United States, 2003 and 2007 – November 12, 2010/59(44); 1439-1443. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5944a3.htm?s_cid=mm5944a3_w
2American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). American Psychiatric Publishing, Washington, DC.
3 CDC. Attention deficit/hyperactivity disorder: Symptoms and diagnosis. http://www.cdc.gov/ncbddd/adhd/diagnosis.html
For more information: http://www.cdc.gov/ncbddd/adhd/