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A child’s eyes dart from one part of the classroom to another. He blurts out answers before his name is called by his teacher. He fidgets with his hands and will not keep his legs still while seated. He loses concentration when someone new enters the room. He fails to finish school work despite demonstrating initial interest and even proficiency in the material.
Are these signs of Attention-Deficit/Hyperactivity Disorder (ADHD)? Parents and teachers may wonder whether they should accept some distractibility as part of a child’s personality during development or whether they should seek help. When should parents seek an evaluation for ADHD and when should teachers suggest it?
As with many mental health problems, a key to answering this question is whether the behavior interferes with the child’s ability to meet developmentally appropriate demands placed on him or her in the classroom and at home. Does the inattention, hyperactivity, and/or impulsivity affect the child’s ability to function reasonably effectively in multiple environments? Another important criterion for seeking help for possible ADHD is the length of time such behaviors have been observed. Inattentiveness and/or hyperactivity must have been present for at least six months prior to a diagnosis being made. In addition, in the case of adolescents and young adults, at least some of the symptoms of inattention, hyperactivity, and/or impulsivity should have been present before 12 years of age.
ADHD symptoms are not the same for every child. Some children who are diagnosed with ADHD appear hyperactive, while others tend to stare off into space, unable to attend to a given task for extended lengths of time. If a parent decides to seek evaluation for ADHD, a clinician will determine if the child meets criteria for one of three possible subtypes of ADHD: a primarily inattentive type, a primarily hyperactive and impulsive type, or a combined type. A child’s behavior must include a number of specific characteristics to meet diagnostic criteria for a particular subtype.
There are multiple medications used to treat ADHD effectively. These fall into two primary categories: stimulants and non-stimulants. The choice of medication typically depends on whether there are co-existent medical or psychiatric conditions, and whether adverse side effects are experienced. Counselors and therapists also may provide guidance by helping individuals diagnosed with ADHD to organize their daily lives so that they may work or perform more effectively and successfully. A specific form of psychotherapy called cognitive behavioral therapy can be effective in helping young people learn how to think before they act, and to resist impulsive urges.
It is rare for a student to attend school without hearing about a friend or a friend of a friend who “has ADHD.” ADHD has become the most commonly diagnosed behavioral disorder of childhood, affecting an estimated 3-5 percent of children, according to the National Institute of Mental Health (NIMH). If a parent is concerned about the possibility of his or her child being adversely affected by ADHD, the parent should see a clinician with expertise in ADHD. Accurate diagnosis and subsequent treatment are best determined by an expert in the field. A child psychiatrist, child psychologist, or pediatrician with specific training in ADHD will determine the best approach to addressing an individual child’s struggles with inattention, hyperactivity, and impulsivity.
Rebecca L. Marshall, Ph.D. (firstname.lastname@example.org) is a Licensed Psychologist and Staff Therapist at the Summit Counseling Center in Johns Creek, Georgia.