ADHD is a term thrown around pretty loosely by many people, especially parents, teachers and doctors. The disorder has received a lot of hype in the media, and it may seem like every other child is being diagnosed with it these days. With all the information in magazines and on television, it can be very difficult for parents to know when to seek treatment for their child. So, what is ADHD and what behaviors should you be looking for?
First of all, ADHD stands for Attention Deficit Hyperactivity Disorder. In 1994, the diagnostic guidelines changed slightly, so that only the term ADHD is used, although we now have three subtypes of the disorder depending on specific symptoms. Prior to 1994, the terms ADD and ADHD were used depending on whether the child was hyperactive or not. This change still causes some confusion, so we’ll go into the subtypes a little bit more.
The first subtype is the inattentive subtype. These kids tend to be the quiet kids who are easily distracted. They may be the ones staring out the window during class instead of listening to the teacher. They often daydream or seem to not really be listening when you are speaking directly to them. Often they do not finish their assignments and start many projects that never get finished. These kids also have problems staying organized and frequently lose things like books, pencils, and lunchboxes because they are so easily distracted. Unfortunately, it is this group of kids who are the hardest to diagnose because they are not running around the room causing trouble. Girls tend to fall into this category more often than boys, although that is definitely not written in stone. The second subtype is the hyperactive-impulsive subtype. Usually these kids are easy to spot because they seem to have so much energy. They may fidget or squirm around a lot and seem to really have trouble sitting still. Teachers may complain to parents that they are always getting out of their seat during class and speaking out of turn. They seem to talk endlessly and run around like an Energizer bunny. It can be very difficult to get these kids to participate in quiet time activities like drawing or reading, because they seem to always need to be moving. Kids with hyperactive symptoms are much easier to recognize because they can be quite disruptive. As the saying goes, the squeaky wheel gets the grease!
The third subtype of ADHD is called the combined type. Just as it sounds, this subtype is a combination of the inattentive and hyperactive-impulsive subtypes. So, these children show many characteristics of both types of ADHD. This is the most commonly diagnosed version of the disorder because many kids with the hyperactive traits also have problems with organization and concentration. Boys tend to fall more frequently into the hyperactive-inattentive and combined subtypes than girls, but again this is definitely not always the case.
So, what happens next if a child has any of these symptoms? How do you know for sure if your child has ADHD? If you or your child’s teachers, daycare providers, etc, have any concerns about ADHD the first thing to do is schedule an appointment with either your family doctor or pediatrician. If your child already sees a child psychiatrist or psychologist for another reason, it would also be okay to mention your concerns to them. But, usually the primary care doctor does the initial workup. They will typically have both you and your child’s teachers fill out forms with questions about your child’s behaviors. It is important for the doctor to have both perspectives because sometimes children only have problems at home or only at school and can be a sign that issues other than ADHD may be going on.
Usually your doctor will ask you to bring the completed forms in with you to an appointment. Often the initial visit for possible ADHD is a little bit longer than a normal appointment so that the doctor has time to review the forms and discuss things with you and your child. Just like with any other medical condition, the doctor will want to know many things, like how long the symptoms have been going on, when you notice the symptoms, how often you notice them, etc. There are many rules for diagnosing ADHD that your doctor will be very careful about following, just as with any other disorders like strep throat or ear infections. The doctor may even order some labs to look for things like thyroid disorders and high lead levels since these issues can often cause symptoms similar to ADHD.
If your child’s physician feels that your child does have ADHD, there are many different treatment options that he or she will discuss with you. Usually it does involve a stimulant medication, but there are other options. You can refer to our article on ADHD treatment for more information about these therapies. ADHD can coexist with other disorders such as depression, anxiety, oppositional defiant disorder, among others. So, if you are concerned that there may be more going on than just ADHD it is important to bring this up with your doctor. Often times the family doctor or pediatrician will refer patients to a child and adolescent psychiatrist if your child doesn’t respond well to treatment or if they feel there may be more things going on than just ADHD. So, don’t worry if this happens. It just means that your doctor thinks a specialist could offer a different perspective. Every child with ADHD is different, but it is a treatable condition. It may take a little time to find the right treatment, so be patient and openly discuss your concerns and expectations with the doctor. Having ADHD does not mean that your child will never do well in school. It is important to remember that many children with ADHD grow up to be very intelligent and highly functioning adults.
