"All children exhibit the behaviors that characterize ADHD some of the time," says ADHD specialist Dr. Ashley Gorman of Morris Psychological Group. "The keys to an accurate diagnosis are the extent of the symptoms and their duration. Are these behaviors interfering with your child's ability to function at home and at school? How long have they been present?"
ADHD, one of the most common childhood brain disorders, is characterized by inattention, hyperactivity and impulsivity, which are also hallmarks of normal childhood behavior. Even when the behavior is severe, the diagnosis may be missed. Not all children exhibit all three behaviors and children who are primarily inattentive, for example, are sometimes not flagged for ADHD evaluation because they tend to sit quietly and not be disruptive. The prototypical "off the wall" behavior is more easily identified but the child may be thought to be lacking discipline or simply be "high-spirited." Conversely, normal childhood behaviors - getting distracted, acting impulsively, or having trouble concentrating - can be mistaken for symptoms of ADHD.
"Signs of ADHD often show up between the ages of three and six," says Dr. Gorman, "but diagnosis is difficult at that age. Children mature at different rates and delays in language development, for example, may cause frustration that looks like ADHD. Also, other medical and psychological conditions, learning disabilities or major life changes might cause behaviors that mimic ADHD. By around age seven, a qualified professional can generally confirm or rule out a diagnosis."
While there is no single test that definitely identifies ADHD, a clinical psychologist or other specialist will examine a combination of factors to formulate a diagnosis - a complete medical history and exam, interviews or questionnaires for parents, teachers and others who interact regularly with the child, and possibly an ADHD rating scale that helps collect and evaluate information.
Tips for parents: Signs and symptoms
The child who is inattentive...seems not to be paying attention even when spoken to directly, makes careless mistakes, loses things, has difficulty completing a task, is easily distracted, has trouble following instructions and staying organized, is forgetful.
The child who is hyperactive...runs around at inappropriate times, fidgets and squirms when forced to sit, seems to be in constant motion, talks nonstop, has trouble with quiet tasks, has a volatile temper.
The child who is impulsive...interrupts, blurts out answers without waiting to be called on, can't wait his or her turn, acts without thinking, intrudes on others' activities, overreacts emotionally.
Tips for parents: When to seek help
"All children will exhibit some of these behaviors once in a while or for short periods," says Dr. Gorman. "And while most parents don't want to be alarmist or subject their child to unnecessary examination and testing, it's important to recognize that if the child does have ADHD, early intervention can forestall problems as he or she matures and is exposed to more complex social and educational situations." Dr. Gorman suggests the following guidelines for parents considering seeking help:
- Are the symptoms consistent across all settings - home, school and play? If the behavior is exhibited in only one environment, chances are something other than ADHD is causing it.
- How long have the symptoms been present? A persistent pattern of behavior for six months or more is generally a criterion for a positive diagnosis.
- How severe are the symptoms? Are they negatively affecting the child at home, at play or at school? Is he or she falling behind academically? Isolated socially? The impact on a child's life is the most important consideration in seeking an evaluation.
"There is no cure for ADHD," says Dr. Gorman. "but it is treatable. The family pediatrician can usually recommend a qualified mental health professional who can perform a complete evaluation and recommend a course of treatment. Often a combination of medication and behavioral management is the most effective way to reduce symptoms and improve functioning. Some children grow out of ADHD and for some, it continues into adulthood. But at any age appropriate treatment and support can enable those with ADHD to reach their full potential."
Ashley Gorman, PhD., A.B.P.P., specializes in comprehensive neuropsychological evaluations of a wide range of cognitive problems.
Morris Psychological Group, P.A. offers a wide range of therapy and evaluation services to adults, children and adolescents. www.morrispsych.com
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