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As a parent, ADHD (Attention Deficit Hyperactivity Disorder) is a disorder that has been discussed at great lengths in my varied communities. From soccer practice and swim team to online parenting communities, the subject frequently arises during conversations about our kids. These conversations are often expressions of concern about their child’s hyperactive or inattentive behaviors. Some of the parents in my communities have children diagnosed with ADHD, while others are simply looking for answers. The amount of information and misinformation available can be overwhelming, which is why it is important for parents to understand what the disorder is and what it is not. To understand the disorder and how parents can begin helping their child with ADHD, I spoke with Dr. Grace Mucci, a board-certified pediatric neuropsychologist and coordinator of the Neuropsychology Program at CHOC Children’s.
What is ADHD?
ADHD is a psychiatric disorder with primary symptoms of inattention and/or hyperactivity and impulsivity. While the exact cause of the disorder is unknown, we do know that disruption in the neurotransmitter dopamine is associated with its symptoms. Dopamine is important for emotional regulation and feelings associated with rewards and pleasure. Dr. Mucci states that according to DSM-V, which provides standard criteria for classifying mental disorders, there are 4 types of ADHD including inattentive, hyperactive/impulsive, combined, and undifferentiated (for those who may not meet the criteria for other types). In order for a child to be diagnosed, symptoms have to be present before the age of 12. Additionally, Mucci further clarified that ADHD is a disorder of emotional regulation. The brain regions that are involved with this disorder are the regions that help regulate emotion. Children with ADHD can have difficulty inhibiting their responses to things and the result is a child who may get upset easily or exhibit impulsive behaviors.
How Prevalent is ADHD?
According to the recent statistics from the National Resource Center on ADHD, nearly 10% of children between the ages of 4 and 17 are diagnosed with the disorder.
Is ADHD Genetic?
This disorder tends to run in families and so “we believe there is a definite genetic component,” Mucci said. (Mucci). A parent who has been diagnosed with ADHD increases the chance that their child will also exhibit the same symptoms. Additionally, environmental factors such as smoking during pregnancy and other pregnancy complications can lead to symptoms of ADHD. Neurological illnesses, such as epilepsy and traumatic brain injury, can also produce symptoms associated with the disorder, according to Dr. Mucci.
What are the Signs of ADHD?
Symptoms will vary depending on the type of ADHD. A child with hyperactive-impulsive type may be very active, have difficulty sitting still, blurt out answers in a classroom setting, and/or have trouble with self-restraint (i.e. keeping hands to self). This child is often described as “driven by a motor.” Children with inattentive ADHD will often exhibit disorganization, experience difficulty following through with tasks such as homework, struggle with reading and/or writing, or appear unmotivated. This child may also appear forgetful or easily distracted. It is important for parents to understand that some of these behaviors may be expressed by children who do not have ADHD and can be considered normal or might be associated with other issues, such as anxiety or depression. For a child to be diagnosed with this disorder, the symptoms have to be present in more than one setting such as school and home, and must cause functional impairment.
What Should I Do If I Believe My Child Is Exhibiting Signs of ADHD?
If you believe your child is displaying signs of ADHD, the first step is to obtain an evaluation. Speak to your child’s pediatrician, who may refer you to a pediatric psychologist. According to Mucci, ADHD is a symptom-driven diagnosis. While it does not always require a full neuropsychological evaluation to diagnose, this evaluation can be helpful in ruling out other conditions or circumstances that may mirror the signs and symptoms of this disorder. Mucci suggests obtaining an exam that includes tests of intelligence, achievement, attention, memory, processing speed, visual and motor skills. Additionally, it is helpful to obtain reports of behavior from both the parent and the teacher to identify if a child is displaying signs and symptoms in more than one location. In some instances, a classroom observation can be helpful. Lastly, it is important for a provider to obtain the child’s input. Mucci suggests providing the child with a questionnaire to gain their perception of what is going on, as well as a good clinical interview.
What Should I Do If My Child Has Been Diagnosed With ADHD?
After a child has been diagnosed with ADHD, parents should work with their provider to develop a treatment plan that can include both medication and behavior strategies. Early intervention is key, as children who go untreated are at risk for depression, anxiety, substance abuse and social problems. Treatment should always include the parents as behavioral parent training has been proven to help children develop habits that they will carry with them into adulthood. For parents who are concerned about using medication, Mucci first suggests a 2-4 month period of time to allow behavioral strategies to work. If changes are not evident after that time period, parents should consider the use of medication. Additionally, a treatment plan should include school interventions such as a 504 accommodations plan or an IEP, depending on whether or not a child is also exhibiting a learning disability. While it was once hypothesized that kids grew out of ADHD around puberty, we now know that over half of children diagnosed experience symptoms into adulthood. While they may not need medications for the rest of their lives, environmental changes and behavioral interventions will help achieve long-term academic, social and professional success. Parents should consult with their pediatrician, a neurologist and/or a psychiatrist if they believe their child is exhibiting signs of the disorder.
What Support and Resources are Available for ADHD?
A diagnosis of ADHD can be overwhelming for the child and his/her parents. One of the best resources for families with children suffering from this disorder is CHADD. This organization provides a wealth of information and local support and educational groups. ADHD and You is another valuable resource that offers strategies and examples of behavioral charts. Apps, such as Google Calendar, can help the child with ADHD with scheduling and organization. ChildDevelopmentInfo.com provides valuable resources for families such as Your ADHD Child Easy Parenting Techniques such as how to get organized at home and how to be consistent with parenting. Lastly, parents who have a child diagnosed with this disorder may benefit from reading the book titled The Gift of ADHD by Lara Honos-Webb and Scott Shannon. This inspiring book recognizes the creativity of those with this often misunderstood disorder and encourages families to channel their child’s strengths into something positive. Another excellent book is Driven to Distraction by Edward Hallowell and John Ratey.
Visit www.choc.org for additional support and information, which provides information on Diagnosing ADHD and the pediatric mental health services provided at CHOC Children’s.
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