Attention Deficit Hyperactivity Disorder (ADHD)

Perhaps your child’s teacher has raised concerns that your child has difficulty focusing and paying attention. The teacher may have even suggested that you have your child evaluation for ADHD. What does this mean? People can have ADHD and it can look very different from person to person. Some children have difficulty sitting still. They get up and move around when they are not supposed to do so. This is referred to as hyperactivity. Other children are not restless in this way. Instead they sit in the classroom and daydream. This kind of behavior can reflect difficulty with paying attention. Parents will often tell me that their child can’t have ADHD no matter what the teacher says because they can play video games or watch TV for hours.

A hallmark feature of ADHD is difficulty sustaining attention on tasks that require sustained mental effort. Watching TV does not require sustained mental effort, but for many children doing a page of math problems does.

Diagnosis

Diagnosis of ADHD is based on history as well as test data and observation. I meet with parents first to take a careful history of the child and the family. ADHD is something one is born with; it is thought to be a genetically linked disorder, so I look for family history as well. People can develop similar symptoms due to other problems, such as brain injury and that is also something that needs to be taken into account. I often like to observe the child in school before meeting the child in person so I can observe the child’s behavior with my own eyes. Then I meet with the child in 2-3 sessions and administer a series of tests that help to clarify the child’s strengths and weaknesses in terms of learning and memory, attention, language functions as well as emotional functioning. I want to make sure that I don’t diagnose ADHD when something else is actually causing the same symptoms.

Treatment

The most recent research suggests that we often need make changes in several areas of a child’s life. First of all we must provide education about ADHD and about the child’s particular pattern of abilities to him or her as well as to parents and teachers so they understand how best to work with the child. Changes in the school setting may need to be made. Perhaps the child would benefit from accommodations in learning or test taking. After the evaluation I offer to accompany parents to meet with school personnel to determine what is possible. Sometimes parents want to consider medication for a child. While I don’t prescribe medication, I will consult with pediatricians and make referrals to doctors who do prescribe such medication.

Psychotherapy can be helpful to assist with any social or emotional consequences of growing up with ADHD. Children with ADHD often have difficulty understanding subtle nuances of social behavior and this difficulty can cause many problems for them. This is an area of great interest to me. I enjoy integrating Cognitive Behavior Therapy with social thinking principles in my treatment approach for children and teens with ADHD.

Additional Resources

For more information about ADHD please visit:
CHADD
About ADHD – Overview
Attention-Deficit/Hyperactivity Disorder (ADHD): The Basics

Illustrations by:
Charles Beyl