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Diagnosis: ADHD

Attention Deficit Hyperactivity Disorder (ADHD) has become a household term in recent years. According to the National Institute of Mental Health, an estimated three to five percent of children suffer from ADHD. Statistically speaking, for every classroom of 25 to 30 students, one child has ADHD. If you suspect your child suffers from the disorder, you likely Googled the term only to be instantaneously inundated with information on the subject. It can be difficult to know where to begin. To help you wade through this barrage of information, we have assembled a panel of local experts in the fields of psychology, medicine and education, each with helpful advice for your family.

The Psychology Perspective
by Kevin Weis PhD

ADHD is the inability or difficulty to appropriately regulate attention, not the inability to pay attention. For example, a child with ADHD can sit and play Nintendo for hours upon hours, so attentive that they are “hyper-focused.” Yet, when they are called to dinner, the child claims, “You never called me!” Although parents commonly believe this is a case of willful disobedience, the child is exhibiting difficulty regulating his or her attention.

There are 3 primary types of ADHD:
• Predominantly inattentive type, which may include: careless errors, difficulty sustaining attention, not listening when spoken to directly, failing to finish assignments or chores, difficulty organizing tasks, often misplacing things, easily distracted and frequent forgetfulness.
• Predominantly hyperactive-impulsive type most likely involves: fidgeting, difficulty re-maining in seat, difficulty participating quietly and excessive talking.
• Combined type, when many impulsive and inattentive behaviors are occurring simultaneously.

Please note, the above information is not a diagnostic guide for you to determine whether your child suffers from ADHD, but an education on the various types of ADHD to increase your awareness and hopefully allay anxieties regarding the mystery and misconceptions that often surround ADHD. A parent should not conclude from this article or any other article that their child suffers from ADHD. Symptoms need to be observed in multiple areas of a child’s life such as school, home and extracurricular activities and evaluated by a professional.

The American Medical Association states that a diagnosis of ADHD should not be established without objective testing. Quite often other things impinge upon a child’s ability to effectively utilize appropriate attention skills, such as dealing with anxiety, sadness or anger. ADHD is often difficult to diagnose accurately because when children are preoccupied, their attention is frequently the first thing to suffer.

If you suspect your child is suffering from symptoms consistent with ADHD, you should first contact a psychologist and request standardized testing. The process is often a lengthy one (one to two weeks). An assessment allows you to view your child’s behavior against other children of the same age through normative data and not someone’s opinion. There are more tests available to assess ADHD in children who are age 6 and older. It is difficult to assess children younger than 6, as a fair degree of inattention and hyperactivity is inherent in very young children.

Make sure you are comfortable with the psychologist. You should be given the opportunity to ask questions before and especially AFTER the assessment. If it is not offered, you should request a “feedback session” to review the final report. Professionals can use jargon that is only meaningful to other professionals, and you don’t want to get home with a report that you don’t understand. A psychologist will help you in first correctly identifying whether your child meets the criteria for an ADHD diagnosis.

After an assessment is complete, a psychologist can, if you choose, assist your child and family in making transitions to more effective methods of communicating (i.e., not talking over your child, but talking and listening to your child) and assist you in developing more educational disciplinary meth- ods rather than those which are punishment driven.

Whether your child has ADHD or not, it is most important that you make efforts to “normalize” your child’s behavior, as often times children repetitively hear negative statements such as, “What are you doing?” “How many times have I told you?” or “You are not working to your potential!” The repetition of negative statements provides children not with realistic feedback, but with constant reminders that they are not doing or behaving as they should. A psychologist can assist families with changing their “culture” to focus on positive rather than negative behavior.

By reminding children, who suffer from ADHD or any other difficulty, of their strengths instead of their weaknesses, you will foster higher self-regard, greater academic performance and most importantly, greater feelings of self-efficacy. This often takes great practice for parents, particularly when a family is struggling. It is also difficult for many parents to manage in the hustle and bustle of everyday life, but it is essential for a child’s healthy and balanced development.

Dr. Weis is a Licensed Psychologist and Clinical Child Psychologist at Columbus Psychological Associates. He performs comprehensive psycho-educational assessments to determine multiple problems common to children. He can be reached at (706) 653-6841, ext. 305.

The Medical Perspective
by Kathleen Roberts, MD

If your child exhibits signs of ADHD, there are many things you as a parent can do to help your child and possibly avoid the need for a formal diagnosis and the ensuing medical treatment altogether. To make things better for her initially, you should give her a written schedule for daily activities so she knows what to do at home and at school.

When providing instructions, give her one step at a time. Repeat your self often. Be patient and allow more time to complete tasks including homework. See if your child’s teacher is willing to help. Ask about potential opportunities to let him out of the classroom seat often to dispel some of his energy. Ask if allowances can be made to give him additional time for tests. Homework assignments should be written in an assignment book daily and reviewed by the teacher for accuracy. Reward systems at home and school for appropriate behavior can also be helpful.

If your child is still experiencing problems after these things are in place, then an evaluation for ADHD is appropriate. Remember if this is necessary, ADHD is a medical disorder and has a medical basis for treatments.

Each of us has an attention pathway in our brains, which is run by chemicals called neurotransmitters. People with ADHD do not have enough of these chemicals available to their attention pathway. As a result, the pathway malfunctions. When this malfunction occurs, you get a combination of the signs and symptoms associated with ADHD. Luckily we have medicines available that replace the missing neurotransmitters. Despite what you may hear, the medicines are quite safe and effective. The goal is for your child to grow up happy with healthy self-esteem.

If ADHD is not treated, your child will not be able to grow up with a positive outlook on school and life in general, but if treated, then he will be much more likely to succeed at home and at school.

Dr. Roberts graduated from the Duke University School of Medicine and trained at the Emory University School of Medicine in Child neurology and at Emory University Hospital in pediatrics. She now practices as a neurologist at Rivertown Pediatrics in Columbus, 706.327.1281.

The Educational Perspective
by: Tami Jones, Educator

“He is not working to his potential.”
“She daydreams in class.”
“He is a behavior problem.”
“She is just lazy.”

These are all familiar statements about students with ADHD. Students with ADHD usually have above-average intelligence, but they are not “typical” learners. Asking these children to sit at a desk while listening to a lecture or to complete pencil and paper assignments for hours at a time is infeasible. As educators, it is our responsibility to find the modifications needed to tap into that intelligence. We must discover each student’s mode of lear ning and use that information when developing lesson plans.

Very of ten students with ADHD are perceived as behavior problems. They are unable to sit still and will find any reason to move. Consequently, they are often sent out of the classroom. With out proper intervention, this becomes a losing situation for all parties involved. The teachers become frustrated, the ADHD students miss the content being taught while they are gone, and the other students are robbed of learning time as the teachers deal with the ADHD students.

Due to large classroom sizes, teachers do not have the time needed to identify and implement the modifications needed to engage these students in the learning process. At St. Patrick’s School, the Promise Program is designed to serve atypical learners. Although St. Patrick’s School has a disproportionately high number of children with ADHD, most of these students are taught in the regular classroom, rather than in the Promise Program setting. Teachers throughout the school are trained to identify the learning style of their students and to develop the appropriate lesson plans to accommodate learners with ADHD. Smaller classroom size offers teachers the opportunity for one-on-one time, so they can get to know each student.

Most children with ADHD are hands-on learners. They need tactile stimulation in order to attend to the lesson. Getting these students actively involved in learning allows them to focus on the infor mation being taught. This might happen through a game, a manipulative, an experiment or other engaging activity. Science can be taught through experiments. The students can build things such as a rain barrel or a human digestive system. Math can be lear ned through games and songs. These are all ways to connect with the ADHD learner.

For any parent, trying to make certain a child is successful in his endeavors is taxing. For parents of children with ADHD, it is especially challenging. For this reason, it is imperative that parents become proactive, working with the school and the teachers to ensure that the needs of the child are met. To find an appropriate academic setting that is conducive to the intellectual development of the child, research available programs and meet with teachers to develop a strategy for reaching your child, stimulating his or her mental and social growth. Most importantly, parents and teachers must understand they are working on the same team and have the same goals, as it is counter-productive to fight against each other.

Tami Jones has accumulated 26 years of teaching experience in both the regular classroom and for the atypical learner. She is the founder and teacher of the Promise Program at Saint Patrick’s Catholic School in Phenix City and the mother of three children, two of which were diagnosed with ADHD.