Does my child have ADHD or are they just an energetic kid?
(SACRAMENTO)
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition. Studies estimate more than 11% of children in the U.S. — about 1 in 9 — have been diagnosed with ADHD at some point.
ADHD symptoms usually include inattention, distractibility, impulsiveness, and possible trouble regulating emotions. For some children this also includes a high level of activity.
You may be thinking that many kids are easily distracted and have a lot of energy. How do you know if your child has ADHD? Catrina Calub, psychologist at the UC Davis MIND Institute and the Department of Psychiatry and Behavioral Sciences gives you some signs to look for and advice for parents.
What does ADHD look like?
ADHD can look different in each child. Some children have more challenges paying attention. Others show more hyperactive and impulsive behaviors. There are three main types of ADHD:
Hyperactive-Impulsive: People with this type of ADHD often act without thinking and move around a lot.
Inattentive: People with this type of ADHD have trouble paying attention and are easily distracted.
Combined: People with this type of ADHD tend to be impulsive and hyperactive and have trouble paying attention.
Both boys and girls can have ADHD, but it can show up differently in each. Boys tend to be treated more often than girls for ADHD. They are also often diagnosed earlier. This is because they more commonly have the hyperactive or combined type of ADHD, which may show up when they’re younger. Girls are more likely to have the inattentive form of the condition, and this may not be noticed until later elementary school.
We know that ADHD traits are present in almost all children and are closely related to their developmental level. How can we determine which children actually meet the criteria for ADHD?
Consider the following questions when looking at a diagnosis of ADHD:
How extreme is the behavior?
How much harm or trouble does it cause?
How far outside of typical development does it fall?
How much do the behaviors affect learning?
How much do the behaviors affect relationships with family and peers?
Are the behaviors limited to certain settings, or do they occur constantly?
Are the behaviors present most of the time?
ADHD diagnosis
The diagnosis of ADHD can be made by several kinds of professionals, such as psychologists, social workers, nurse practitioners, neurologists, psychiatrists, and pediatricians. No matter who does the evaluation, they must use the official DSM-5 guidelines to decide if someone meets the criteria for ADHD. Typically, the process for diagnosis includes:
Complete medical and family history
Physical examination including assessment of hearing and vision to rule out other medical conditions that may cause symptoms similar to ADHD.
Interviews with parents and child
Behavior rating scales completed by parents and teachers
Observation of the child
Psychological assessment if there are concerns about learning (However, psychological testing is not required for a diagnosis of ADHD.)
Brain imaging techniques are used in research to understand the disorder, but they are not used as a part of standard assessment.
There are nonstimulant medications to treat ADHD that may be used if your child experiences the following:
Side effects from stimulants
Other symptoms that contradict the use of stimulants
Other symptoms that are not addressed by the stimulants
There's not enough scientific evidence to support the use of herbal combinations, special diets and megavitamin therapies. If you're considering trying such interventions, discuss it with your child's physician. Some of these treatments may be harmful.
In addition to medication, behavioral treatment and counseling is also helpful. While medications can help reduce impulsiveness and distractibility, behavioral strategies focus on building skills. Counseling or therapy may help the child deal with features often associated with ADHD, such as depression or anxiety.
Parents can also benefit from a therapist who has experience with ADHD. Parents can learn techniques that work well with ADHD children through Parent Management Training. These can include:
Developing a reward program
Learning how to give instructions effectively
Keeping a regular schedule
Limiting over-stimulating activities
Using timers or other organizational tactics to help the child stay on task
It's important to always start with a positive reward program and then adapt it as needed depending on the child's age and level of development. It's just as important to give plenty of encouragement and clear positive feedback daily to help the child develop a good self-image.
Rewards given soon after appropriate behavior are likely to be most effective especially for children with ADHD for whom delayed rewards are less effective. For instance, it's better to give a child a reward for doing homework every night, rather than waiting for a good grade on a report card.
The good news about ADHD is that many children can succeed, especially with the right opportunities and support. ADHD will persist into adulthood for about 60% of people who are diagnosed as children. With intervention, many have the chance to make positive use of their enthusiasm and skills to think outside the box.
Recognizing the disorder and providing treatment early may help reduce the negative outcomes of ADHD, like poor academic or job performance.
Parents and health care providers should ensure that these children are given positive reinforcement for their successes. They must also must ensure that they have opportunities that match their strengths and have the encouragement and treatment they need to reach their full potential.
For more information about seeking an ADHD assessment for your child, talk with your primary care physician. To make an appointment at UC Davis Health, call 916-734-2700 or 800-252-3456.
The UC Davis MIND Institute in Sacramento, Calif. is a unique, interdisciplinary research, clinical, and education center committed to deepening scientific understanding of autism and other neurodevelopmental conditions. It is a highly collaborative center, bringing together families, researchers, clinicians, community leaders and volunteers with the common goal of developing more personalized, equitable, and scientifically proven systems of support and intervention. The institute has major research efforts in autism, fragile X syndrome, chromosome 22q11.2 deletion syndrome, attention-deficit/hyperactivity disorder (ADHD) and Down syndrome. More information about the institute and its Distinguished Lecturer Series, including previous presentations in this series, is available on the Web at https://health.ucdavis.edu/mind-institute/.
