Back-to-school time brings with it many emotions. For some, it’s a time of excitement and joy as they anticipate another school year with new teachers and classes. For others, it’s a time of anxiety and fear as the new year brings with it the loss of everything familiar. For still others, going back to school means the return of stressful situations. Maybe your child is so easily distracted that he can’t concentrate at school. Maybe she talks too much or blurts out answers before the question has even been asked. Maybe he is angry and resentful.
If these symptoms sound familiar – or if your child has other symptoms that inhibit her from succeeding in daily life – it might be time to investigate further. We turned to our friends at Liberty Sharonville Pediatrics for more information on ADHD and other learning-related issues.
ADHD – Attention Deficit Hyperactivity Disorder – is one of the most common problems that parents bring to pediatricians. In fact, new data shows that approximately 10% of children now have a diagnosis of ADHD. The most common symptoms in children are inattention, hyperactivity and impulsivity, though not every child will have all three symptoms. For a true ADHD diagnosis, these symptoms need to occur in more than one setting. Not only do they occur often, but the symptoms have an adverse effect on the child’s daily life, such as their academic performance, behavior, or relationships with other children and family members. Some children have predominantly just inattention, others predominantly just hyperactivity, and many a combination of both.
What is Attention Deficit Hyperactivity Disorder?
ADHD is a brain disorder marked by an continuing pattern of inattention and/or hyperactivity-impulsivity that interferes with daily functions or development.
What causes it?
The exact cause of ADHD is unknown, but there is definitely a genetic component and it frequently runs in families. According to Lauren Peck, M.D., a Liberty Sharonville Pediatrics physician, “It is not uncommon at our office to diagnose and treat a child for ADHD, only to then help parents realize that they have also struggled with ADHD their whole life.”
Environmental factors may also contribute to the cause of ADHD. There is absolutely no evidence indicating that sugar or other foods cause ADHD, but parents should monitor their individual child’s response to different foods, and of course, a healthy diet, low in sugar, is still recommended for all.
What age does ADHD show up?
Since toddlers and young preschool children are naturally poorly attentive and very active, it is difficult to accurately make the diagnosis of ADHD until children are in grade school. However, since ADHD is actually present since birth, early symptoms can be apparent in younger children, especially those greatly struggling in a preschool setting. Concerns typically arise when children are not only exhibiting ADHD symptoms, but also having true problems or difficulties in life due to behavioral symptoms.
How will the doctor determine if my child has ADHD?
Most commonly, pediatricians use a standardized scoring system such as the Vanderbilt Assessment Score, with both parents and teachers completing a questionnaire. These questionnaires ask about both inattention symptoms and hyperactivity symptoms.
In addition, it is not uncommon for kids diagnosed with ADHD to have other coexisting diagnoses that doctors call comorbidities. These may include problems such as depression, anxiety, OCD, Oppositional defiant disorder, conduct disorder and learning disabilities. The Vanderbilt Assessment does have questions looking for some of these conditions that may coexist with ADHD symptoms.
Be sure to talk to the pediatrician if your child is not only having trouble with focus, but with reading and writing. These could be indicative of a reading comprehension issue or an expressive writing delay. Symptoms of these issues mimic ADHD, such as a tendency to squirm, fidget or an unwillingness to complete homework.
According to Otilia P. Fernandez, M.D., a Liberty Sharonville Pediatrics physician, “Making sure the child is properly diagnosed and receives the necessary school modifications is an important job of the pediatrician as the child’s advocate. These children will struggle with reading or writing or math their entire lives and sometimes go undiagnosed or misdiagnosed for years. So sad when a child tells me they do not like school because no one has diagnosed their problem.”
Why is there so much ADHD? Is it being over-diagnosed?
While there are probably some kids being over-diagnosed (especially younger, immature and poorly-behaved children), pediatricians are likely just getting better about recognizing the signs and symptoms of ADHD. Many children who could benefit from treatment still slip through the cracks including those well-behaved, quiet kids, as well as those with higher intellect who are just getting by rather than performing up to their potential.
Can you outgrow ADHD?
About 2/3 of patients treated for ADHD in childhood will continue to have symptoms and need treatment as adults. As a neurobiological disorder, ADHD is believed to be a lifelong disorder. For those patients who lead successful lives as adults without treatment, it is likely they learned strategies to adapt and compensate for their condition.
How to treat ADHD:
A combination of medicine and behavior techniques has been proven to work best. Studies have shown that for most kids, behavior techniques alone are far inferior to medication management. The medicines most commonly used fall in a category called “stimulants” and can control all major aspects of ADHD (inattention, hyperactivity and impulsivity). In children with ADHD, these medicines do not stimulate like caffeine. In fact, they actually have a positive calming effect on kids with the disorder. Doctors also do not expect the kids to be extremely subdued or as some stereotypes suggest, “act like zombies,” while on medications. They should still be personable and happy kids. Different kids respond to various medications differently and at different doses, therefore dosage is based on success and not based on weight. There is a fair amount of trial and error to find the best medicine and the best dose for each child.
For preschool children diagnosed with ADHD, behavioral therapy rather than medication is considered the most appropriate first line of treatment. Untreated ADHD can lead to poor self-esteem, academic and school delays, and difficulties with relationships with both peers and family members.
What can I do at home to help my child succeed?
- Maintain a daily schedule.
- Create a homework space that is free of distractions.
- Provide charts or checklists to aid with organization.
- Stick to a healthy diet as much as possible.
- Exercise! (Especially in children with a hyperactivity component, physical exercise can help manage symptoms.)
- Help your child get enough sleep. (Inadequate sleep can definitely exacerbate symptoms – or even mimic ADHD in those who don’t have it.)
Who can diagnose and manage Attention Deficit Hyperactivity Disorder?
Pediatricians are well trained in both the diagnosis and treatment of ADHD and manage the vast majority of children with the condition. For patients with more complicated cases, concerning coexisting diagnoses, or poor response to treatment, they will then be referred to a specialist.