At one time or another, I’m sure we’ve all used the terms ADD or ADHD in conversation to refer to our quirky moments of distractibility or hyperactivity. In that context, those acronyms are used colloquially, taking advantage of their ubiquity to communicate the frustration with that passing moment. For some families, though, these terms have real meaning in their lives because their children have to deal with those disorders every day, their symptoms affecting many aspects of the child’s and thus the family’s lives. Parenting ADHD presents some real challenges.
This month’s column will look at ADD and ADHD, the symptoms parents should look for, and the process of diagnosis, and then dealing with the disorder in everyday life.
Not ADD Anymore
Over the years, we’ve heard the terms ADD and ADHD used almost interchangeably in talking about children with symptoms such as hyperactivity, distractibility, inattentiveness, and more. Recently, the DSM-V (2013) absorbed ADD under the umbrella of ADHD, instead dividing ADHD into three types:
- Inattentive – Once known as ADD, this type of ADHD refers to people who are inattentive or easily distracted. They have a difficult time finishing tasks or following directions, among other symptoms.
- Hyperactive-Impulsive – This is what most people think of when they think of ADHD. Symptoms of this disorder include hyperactivity and impulsivity. Children with ADHD might have interrupt or intrude on conversations or activities or have difficulty waiting for a turn in a game, among other behaviors.
- Combined – As the term implies, children with this type of ADHD will have symptoms of both Inattentive & Hyperactive-Impulsive types of ADHD.
All children will show some of these issues from time to time, but the diagnosis of ADHD depends on the developmental appropriateness of the behavior. Sure, three-year-olds might not stay in their seats at preschool, but that doesn’t mean that all three-year-olds have ADHD.
Here is a short list of symptoms to look for if your spidey-sense is telling you that this might be an issue for your child:
- Ages 6-12 – appears easily distracted; submits poorly organized homework with careless errors; tends to blurt out answers in class; interrupts or intrudes on others’ conversations; often gets out of seat; has difficulty completing tasks, like chores.
- Ages 13-17 – seems to be restless internally; submits poor homework or schoolwork; has inconsistent or poor follow-through on tasks.
- Ages 17 & beyond – shows problems with concentration; is not able to plan ahead or organize; makes impulsive decisions; underestimates available time for tasks; has difficulty initiating and completing projects.
For children under 16, displaying six or more of the symptoms listed are usually the criteria for an ADHD diagnosis. For children over 16, only five symptoms are needed. Children as young as four can be tested, according to the American Academy of Pediatrics, but, typically, most children are school age before the need for a diagnosis arises.
Girls & ADHD
So often in talking about issues like ADHD and autism, boys are the central focus of these discussions because boys tend to demonstrate the more overt symptoms. Hyperactivity and the behavior issues accompanying ADHD tend to hurt others and thus gain more attention. For girls, though, ADHD affects the girls themselves more than others, making it far easier to miss this disorder in girls.
They might be daydreamers, having difficulties getting out of their own heads long enough to pay attention to the task in front of them. Challenges with homework also arise, though some girls will figure out how to compensate. Attention and focus become issues, but, because girls might be less inclined to manifest these outwardly, it is easy to miss these symptoms. Girls with ADHD may be more self-critical and thus self-esteem issues as well as anxiety and depression might occur.
Because girls’ symptoms may be less overt than boys, it is important to pay close attention when issues with focus or distractibility arise in a girl. If you suspect your daughter might be struggling because of an issue like ADHD, talking to your pediatrician can be the first step to getting her the interventions she needs to alleviate her symptoms and enjoy her childhood as much as possible.
The Diagnostic Process
If you suspect that your child is demonstrating symptoms consistent with ADHD, talk to your pediatrician about your concerns first. Some pediatricians will conduct the diagnostic process themselves or may recommend a psychiatrist or a child psychologist for testing. Once you meet with the diagnosing professional, you will be asked to fill out a behavior assessment; your child’s teachers or caregivers will also need to fill out assessments. Those assessments will help with confirming symptoms and their severity. You may also need to have your child’s hearing or vision checked to rule out issues with either. If your child is school age, the diagnosing professional will also look at school records to see what your child’s past teachers and other educators may have noted about behavior as well as grades.
Using the criteria set forth in the DSM-V, all of the information gathered from assessments, physical exams, school records, and more will help the diagnosing professional determine if your child has ADHD. Once the diagnosis comes down, then you can start working with your pediatrician and others to decide how to treat your child’s symptoms.
ADHD Treatment and Beyond
Like other developmental issues such as autism, ADHD treatment is based on your child’s symptoms and the best way to mitigate them. Usually treatments will include behavior modifications, educational interventions, and medication. Children with ADHD benefit from having a 504 plan in place, where the parents work with their child’s school system to outline ways the school can modify environment, schoolwork, and other aspects of the school day to adapt to your child’s needs. Additionally, behavior modifications such as interventions to alleviate impulsivity, for example, are often part of the treatment plan. These interventions typically are done with a psychologist and involve working on behavior both at school and at home.
Medication is often part of the treatment plan and, for many parents, causes the most consternation. Because medications affect children in different ways, your diagnosing professional may recommend a specific medication, but, if that doesn’t work, parents may need to try more than one medication before finding one that works for their child.
Even though the idea that your child might have ADHD is frightening at first, the good news is that we now know so much more about diagnosing and treating it. You and your child have a number of treatment options once you have a diagnosis and the odds of your child’s long-term best life are good with behavior modification, medication, and educational interventions.
The key here is to be as proactive as possible; if you suspect your child might have something like ADHD, speak up. No matter the age, no matter the gender, your child will benefit from your advocacy. Talk to your pediatrician and find out what you need to do to stop your spidey-sense from tingling and start down the road to answers. Effective parenting ADHD is a lot more common that it used to be – take heart![themify_box style=”lavender announcement”]EDITOR’S NOTE: We are in no way presenting ourselves as experts or professionals in the field of child psychology. This series is part of a parenting column about Special Needs Parenting, and any action you seek to diagnose your child we urge you to talk with your pediatrician or family doctor. [/themify_box]
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Jennifer Kelly grew up in the Birmingham area, but migrated to Huntsville for graduate school and put down roots after meeting her husband, Jamie. In addition to being a mom to her two boys, she is a tennis ninja, trivia nerd, freelance editor, and aspiring writer. You can visit her at The Sir Barton Project, a blog about her upcoming book.