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When do your child’s behavioral issues mean something else?

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ADHD childThe first months of school inevitably require adjustment for any child; a new teacher, a new classroom dynamic, new rules & expectations and new things to learn – that’s a lot of new all at once for a child to process. But what if the troubles don’t seem to be getting easier, and your child is still having trouble paying attention for long periods of time? How you do know when it is something more serious, like ADHD?

Attention-deficit/hyperactivity disorder or ADHD is the most common neurobehavioral childhood disorder and, if left untreated, can profoundly affect the academic achievement, well-being and social interactions of children. It is usually first diagnosed in childhood and can last well into adulthood.

ADHD is characterized by having trouble paying attention or staying focused, controlling impulses and/or being overly active. Some of the symptoms include forgetting or losing things often, constantly squirming or fidgeting, having trouble taking turns, making careless mistakes and having difficulty getting along with others.

With ADHD affecting so many children and young adults in the United States — as many as 11% of children aged 4-17 — it is important that parents, guardians, educators, and the general public stay informed on this topic.

There are three different types of ADHD. Diagnosis can depend on which types of symptoms are noticed most strongly in a child, or what “presentation” of behaviors a child exhibits. These 3 types are:

  1. Predominantly Inattentive Presentation
  • Hard for a child to organize or finish a task, to pay attention to details or to follow instructions or conversations
  • Easily distracted or forgets details of daily routines

(As an aside, this presentation is typically what people are referring to when they use the term “attention deficit disorder” or ADD, but ADD is now an outdated term with the release of the Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5) in May 2013.)

  1. Predominantly Hyperactive-Impulsive Presentation
  • Child fidgets and talks a lot
  • Hard for a child to sit still for long (e.g., for a meal or while doing homework)
  • Smaller children may run, jump or climb constantly
  • A child feels restless and may have trouble with impulsivity
  • May interrupt others often, grab things from people or speak at inappropriate times
  • Hard for the child to wait his/her turn or listen to directions
  • He or she may have more accidents and injuries than others
  1. Combined Presentation
  • Symptoms of the other two types are equally present

It is important to remember that it is normal for children to be inattentive, hyperactive or impulsive at one time or another. It’s natural for preschoolers to have short attention spans and for young children to be naturally energetic. However, if your child is constantly exhibiting multiple symptoms from the above list and it’s affecting their well-being, talk to your doctor about what you have noticed. The Center for Disease Control and Prevention has created an ADHD symptom checklist which you can complete and discuss with your child’s pediatrician.

At this time there is no single test to diagnose ADHD. Moreover, a clear diagnosis can be complicated as problems such as anxiety, depression, and certain types of learning disabilities can have similar symptoms.

The diagnosis is usually made on the basis of carefully reviewing symptoms, your child’s medical, developmental, and school history, and in some cases, further evaluation by a behavioral or learning specialist. If you are concerned that your child is showing signs of ADHD, talk with his or her doctor.

If your child is diagnosed with ADHD, there are treatment options available. Here are some good questions to ask at your next doctor appointment:

  • What are the various types of treatments used for children with ADHD? Has one been shown to be better than the others? Which of these do you think would be best for my child and why?
  • Does ADHD change with age? Do kids ever outgrow it?
  • How will ADHD affect my child over the long term?
  • What are the key components for successfully managing the challenges of ADHD?

Discuss treatment options with your healthcare provider, including medication, behavioral therapies, and school and home supports. You can work together to successfully manage and even improve ADHD symptoms as your child ages. The important thing is to stay informed. The earlier you can recognize symptoms, the sooner you can speak with a doctor about your concerns and seek treatment to help your child continue to succeed academically and maintain a positive well-being.


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