“In my experience both personally and professionally, ADHD is less of a problem than the people who misunderstand it. People with ADHD want to do their best.” Dr. Edward Hallowell, psychiatrist, Harvard instructor, author with ADHD
It is hard – even for loving parents – to remember that ADHD kids want to be good. We have to remind ourselves on occasion. Or several times a day! But they really do want to do well in school and on the soccer team. They want to have friends and go to parties. They want to go to the grocery store, and maybe have mom or dad buy them a treat if they behave. Their intentions, like those of other children, are mostly good; but they are fighting against brain structure and chemistry. Understanding is the first tool that parents have in their toolbox. Here is a quick look at some essential ADHD info.
A neurobiological condition, ADHD affects the areas of the brain that control our ability to organize, plan, strategize, remember, pay attention, and manage time, space, and behavior. This shows up differently in every child and adult with ADHD. If you gather 10 kids with ADHD in a room, you will have ten different stories from their parents about their behavior! That being said, there are some characteristic ADHD symptoms:
- ADHD-Predominately Inattentive: Typically, kids with this type of ADHD are easily distracted. They may seem like they’re spacing out or not paying attention. They miss out on things, whether instructions or just bits of casual conversation, because they are thinking about something else. It is common for kids to have challenges with working memory, which is where we normally manipulate memory and decide where to store it. This can make school, as well as a host of day-to-day activities, very difficult. You may notice your child is forgetful, lacks follow-through, is disorganized, and tends to procrastinate.
- ADHD-Predominately Hyperactive: These are your Energizer Bunnies. They just go, and go, usually at a rapid pace. Incessant talking, impulsivity, fidgeting, restlessness, impatience, and frustration are hallmarks of ADHD kids that are hyperactive. Many activities are difficult because these kids have a hard time sitting quietly; they often can’t help interrupting, and they have a hard time waiting for their turn. These kids often concentrate better when they are allowed to move around, but this is not always possible at school, and they may act out. These behaviors can make it difficult for ADHD kids to make friends and strong peer connections.
- ADHD-Combined: All of the above characteristics of inattentive and hyperactive behaviors apply to these kids, too. We might see difficulty following instructions, constant talking, poor grades, racing through homework, open cabinets, toys, clothes, or belongings scattered, and unfinished projects.
The Diagnostic Process
Before diagnosis, there is usually a parent or teacher who recognizes that there is something “not quite right” going on with a child. Often, a parent might feel that there is something amiss, something not like other children, but they don’t know what. Sometimes, a teacher will identify behaviors that are concerning. Frustratingly, it can take quite a while to get answers. But the diagnostic process starts when a question is raised: is there something interfering with this child’s social or academic development?
There isn’t a single diagnostic test for ADHD. Unfortunately, we can’t take our kids in for a blood test or a swab and be done with it! So, how is ADHD diagnosed?
The “Gold Standard” for diagnosis includes:
- Detailed history from parents
- Observations from parents and educators
- Physical examination (to rule out other medical conditions that could be causing symptoms and behaviors)
- Behavioral testing and evaluation
- Psycho-educational testing evaluation (to rule out learning disabilities)
A diagnosis of ADHD should be made by a trained clinician. Sometimes it is diagnosed by a primary care physician, such as a pediatrician or a family practitioner. Other times, it’s identified as a result of a battery of extensive testing done by a psychologist or neuropsychologist. Sometimes, specialists such as a psychiatrist or neurologist are the lead diagnostician, but usually by the time a child gets to that level of specialty, there is a strong suspicion, if not a diagnosis.
It sounds like quite the team – and it might sound a little daunting. But ADHD is not a quick sidebar to your child’s yearly wellness checkup. ADHD is a serious neurobiological condition, and trained professionals need to be involved in making the clear, medical diagnosis.
In a great Real Simple article, parents Jessica and Lew Harstead, talk about their difficulties diagnosing their ADHD son, Matthew. Jessica says, “By the time Matthew turned five, we’d been told he had autism, Asperger’s, bipolar disorder, oppositional defiance disorder, pervasive development disorder—you name it. Each time, I would freak out and read everything I could about the condition before realizing there was a piece of the puzzle that didn’t fit. And we would be back where we started.”
A correct diagnosis can be a significant relief for parents. As much as you don’t want to hear your child has a medical condition, with a diagnosis, you know what you’re dealing with, and you can move on to explore treatment and management options.