The mother takes her daughter to her doctor because she is always tired and lethargic. The doctor notices that the insides of her eyelids are pale and concludes that she has iron deficiency anemia. The doctor prescribes iron supplements.
Another mother heard from her daughter’s teacher that her daughter was not sitting still and paying attention in class. The teacher created some rating scales that supported this observation. The mother took these comments and documentation to her doctor, who said, “Why don’t you put your daughter on Ritalin (or Adderall, Dexedrine, Strattera, etc.)?”
In both cases, the doctor has observed symptoms that suggest a problem. But before treatment can begin, it is important to determine its specific cause. Obviously, in the first case, the doctor will perform some diagnostic tests before concluding the cause of the anemia and beginning a treatment plan. This approach is equally important when making a diagnosis of Attention Deficit Disorder (ADHD or ADD).
Sure, your child or adolescent may be hyperactive, inattentive, or impulsive. But these behaviors could also be caused by anxiety, mood disorders, learning disabilities, family problems, or even pinworms (which can cause itching around a child’s bottom). It’s important for a doctor to explore and find the cause of the behavior (see “Diagnosis of ADHD” below).
[Free Resource: Is It More Than Just ADHD??]
More than just ADHD
While it is essential for doctors to make a definitive diagnosis of ADHD, it is equally important to look for other problems that often co-exist at the same time. These are called comorbidities. Once a diagnosis is made, it is important to begin treatment with appropriate medication. However, medication alone is not the only answer. In fact, children with ADHD who only take medication have less favorable treatment outcomes than children who are treated for other problems.
Your doctor may not know this, so they need to educate you on it in order to develop an evaluation process and treatment plan. To that end, here’s what you need to know about the most common symptoms associated with ADHD and the basic treatment plan for each:
Learning disabilities
Fifty percent of children and adolescents with ADHD also have some kind of learning disability (LD), such as dyslexia or auditory processing disorder. LD may explain why a child with medicated ADHD may be able to sit still and stay focused, yet still underperform academically. There may be other reasons for academic underachievement. If the diagnosis of ADHD is not made until the fourth or fifth grade, the child may have gaps in foundational skills, especially math and language arts, before receiving treatment for ADHD. This student may not have a learning disability, but will need academic intervention to catch up.
What to do: Talk to a professional at school about evaluating whether your child has a learning disability. If they refuse, you can request a private evaluation. If your child has a learning disability, he or she will need special education services in addition to appropriate accommodations in the classroom.
[Self-Test: Could My Child Have a Learning Disability?]
Emotional issues
50% of people diagnosed with ADHD have what are called control problems, i.e. difficulties regulating their emotions. Some suffer from anxiety and panic attacks, others experience mood disorders. Some children cannot control their anger, others cannot control their thoughts or behaviour, which may result in obsessive-compulsive disorder. Others have difficulty controlling motor behaviour (tics are a common symptom).
These problems are caused by faulty wiring in areas of the brain other than those involved in ADHD. If your child has these problems and they are chronic and pervasive, it is essential that they are diagnosed.
What to do: Talk to your doctor and ask for a referral to a mental health professional. (Medication may be needed, so it’s best to see a child or adolescent psychiatrist who, unlike a psychologist, can prescribe medication.) If your child is having regulation issues, selective serotonin reuptake inhibitors (SSRIs) may be of great help.
Behavioral problems
Unlike control problems, these behaviors do not become widespread or chronic. They usually begin at a specific age (third grade or middle school) and seem to occur in specific environments, such as in the classroom or while doing homework. They are often due to frustrations or failures that the child experienced before they were diagnosed with ADHD. Some children deal with their emotional pain by externalizing their problems; blaming others and not taking responsibility for their actions. This syndrome is called oppositional defiant disorder and, in more severe cases, conduct disorder. Some children internalize their pain and have a poor self-image. Clinical evidence of anxiety or mood disorders may appear.
What to do: If possible, talk to a mental health professional who specializes in ADHD. Treatment often requires the child to work with a therapist along with their parents and/or siblings.
[Screener: Could Your Child Have Symptoms of Oppositional Defiant Disorder?]
Social skills issues
If a child behaved oddly or inappropriately with friends or schoolmates before receiving treatment for ADHD, it is often difficult for classmates to overcome their impressions of the child. The child may need help relearning social skills. For other children, difficulty relating to classmates may have other causes that need to be investigated and diagnosed.
What to do: Again, talk to a mental health professional who is knowledgeable about ADHD. Interventions may include counseling, group therapy, or participation in groups that focus on teaching social skills. School counselors often play an important role in these interventions.
Family issues
Parents of children with ADHD symptoms may feel overwhelmed managing their child’s behavior or conflicted about a course of action. Stress often causes marital problems, which can have a negative impact on children.
What to do: See a mental health professional who specializes in couples or family counseling.
Diagnosis of ADHD
Make sure your doctor reviews your child’s medical history thoroughly before making a diagnosis. This is crucial in distinguishing between ADHD and co-occurring ADHD disorders. Here are some guidelines to keep in mind when speaking with your doctor and before starting ADHD medication:
Symptoms and behaviors of anxiety or mood disorders (not ADHD) may start at a certain time or occur only in certain situations. Symptoms of ADHD are chronic and pervasive. You probably noticed your child’s behaviors as early as preschool. A diagnosis of ADHD requires three steps: 1) demonstrating the presence of the behavior, 2) demonstrating the behavior has been present since at least age 6, and 3) demonstrating the behavior occurs in two or more life situations (home, school, work, relationships).
[When It’s More Than ADHD: A Guide to Related Conditions]
Save previous post Save next post
Source link