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Signs Your Child Has ADHD

Posted 12/7/2017 by UHBlog

If your child spins around like a tornado and has a hard time sitting still, it may be more than excess energy. Talk to us about how to recognize signs and symptoms of a bigger health issue.

Couple with toddler consulting doctor

According to the Centers for Disease Control and Prevention (CDC), approximately 11 percent of children between the ages of 4 and 17 have attention deficit hyperactivity disorder (ADHD) – a common disorder characterized by ongoing problems with attention and/or difficulties with impulse control.

But not everyone with ADHD is hyperactive. Sometimes, children who are able to sit quietly but have a hard time focusing or getting started on their schoolwork may also have ADHD, says pediatric neuropsychologist Susan Bowen, PhD.

Medical terminology has changed in recent years and more patients are now being placed under the umbrella of ADHD. In fact, the term ADD is no longer being used.

“Right now we call everything ADHD,” Dr. Bowen says, “but we describe it as having differing kinds of presentations. So it can be ADHD with an inattentive presentation, which is what people previously called ADD. Or it can be ADHD with a predominantly hyperactive and impulsive presentation, which is rarer. Or, it can be ADHD with combined inattention and hyperactivity and impulsivity.”

The latter is what many people think of when they hear the diagnosis ADHD, Dr. Bowen explains.

The specific ADHD diagnosis is based upon the pattern of symptoms that are present, which can be within one of three categories:

  • Primarily inattentive, which includes these signs:
    • Trouble sustaining attention
    • Poor attention to detail or careless mistakes
    • Easily distracted
    • Difficulty with follow-through or task completion
    • Avoids tasks that require effort or delays starting on them
    • Tendency to lose things
    • Forgetfulness
    • Poor organization
    • Trouble listening
  • Primarily hyperactive/impulsive, which presents as:
    • Being fidgety or squirmy
    • Unable to remain seated when it’s expected
    • Running about or climbing, or being restless
    • Trouble working or playing quietly
    • Always being “on the go”
    • Excessive talking
    • Interrupting and/or blurting out answers
    • Difficulty waiting for their turn
  • Both inattentive and hyperactive/impulsive

According to Dr. Bowen, there is no single medical or physical test that can diagnose ADHD. Rather, making a diagnosis involves:

  • Evaluation of the type and severity of symptoms and their impact on your child’s ability to function
  • Extensive interviews with you and your child
  • Collection of rating scales from parents and teachers
  • Observing your child
  • Cognitive testing

To be considered ADHD, children – or adults – must exhibit six of the symptoms of inattention and/or hyperactivity-impulsivity in at least two settings over six months or more – and the symptoms must be negatively impacting their life.

Though signs of ADHD often show up in the early years, ADHD is most often diagnosed in elementary school-aged children when their symptoms begin interfering with learning. That’s because “inattentiveness and excess activity is normal for preschoolers,” she says, making it harder to make a definitive diagnosis of ADHD at that age. For some high-functioning children, the symptoms only really start to become disruptive in high school when the demands of life and school intensify.

“Really what we’re looking for are pervasive patterns of impairment,” Dr. Bowen says.

Although there’s no cure for ADHD, there are treatments that can help manage the symptoms. Patients may benefit from behavioral/psychological therapy, medications or a combination of the two.

“The goal with behavioral treatment is to try and work on strategies to increase the positive behaviors we want from kids while reducing the more problematic ones,” Dr. Bowen says.

Though ADHD is a life-long disorder, doctors believe that with enough reinforcement early on, children can develop the compensatory coping mechanisms that they need to take them into adulthood successfully.

What can you – as a parent or caregiver – do in the meantime? Dr. Bowen offers these six suggestions to help a child with ADHD thrive:

  1. Develop and stick with routines. “Kids with ADHD really benefit from routines,” Dr. Bowen says.
    Make sure to have predictable schedules throughout the day to provide much-needed structure, which helps your child focus and manage her time better.
  2. Contact your child’s school. Children with ADHD may be eligible for academic accommodations, Dr. Bowen says. As a parent, you can request an evaluation by the school to determine if your child is eligible for support under a Section 504 plan or individualized education program.
  3. Maintain order. Using simple organization strategies, such as hanging hooks on the wall for jackets or baskets for shoes, helps kids with ADHD maintain a sense of order in an accessible and maintainable way.
    “That way you’re not spending every morning trying to track down shoes or book bags,” Dr. Bowen says.
  4. Make eye contact. “As busy parents, we often have a tendency to talk to each other from different rooms,” Dr. Bowen says. “But if you are shouting directions from across the room, you can’t be certain that your child understands what you’re saying.”
  5. Keep directions simple. Kids with ADHD sometimes have a hard time keeping loads of information in their head at one time.
    “That’s why it’s important to speak directly and only give them one – or maybe two things – to concentrate on at a time,” she says.
    Simple checklists can also help children to keep track of what they need to remember.
  6. Reinforce the positive. Instead of focusing on the behavior you want to stop – for instance, throwing their jacket and bag on the floor – try praising your child for hanging them up properly.
    “Research shows that kids with ADHD tend to benefit from systems that focus on positive reinforcement, such as praise and rewards,” Dr. Bowen says.

Susan Bowen, PhD is a pediatric neuropsychologist at University Hospitals Rainbow Babies & Children’s Hospital. You can request an appointment with Dr. Bowen or any other doctor online.

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