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Understanding ADHD

August marks the start of the back-to-school season for many families

.While some are excited about the start of school, many families with children who have been identified as having ADHD (Attention Deficit Hyperactivity Disorder) can feel increasingly anxious as school approaches. The children may have done well over the summer, but the start of school can mean more frustrations, more calls and notes, and sometimes even work interruptions with demands that a child be picked up. Some families report being told to send their child back to a doctor or mental health professional in order to be reevaluated or have their medications adjusted. There can also be fights over homework and side effects from the medications that impact sleep, diet, and mood.

The questions I have received most recently have all been some variation of this: My child has been diagnosed with ADHD and I don’t believe the diagnosis – what should I do? Or: What can I do to help make the school year easier for my child with ADHD?

This month, I’m going to share my advice for any parent of a child who has problems with focusing, attention, sitting still, boundary testing, fidgeting, constant talking, speaking out of turn, and/or getting along with peers at home or in the community. This will be part one of at least a two-part answer to this question.

The first thing I advise any parent to do if their child has been diagnosed with ADHD is to make sure that the child has had a comprehensive assessment done. Sometimes a doctor, psychologist, or counselor will look at the behavior that a child is demonstrating (or that they are told a child is presenting) and make a diagnosis. Of course, they will send an assessment along to the school or home to confirm their hypothesis but that is not the same as a comprehensive review of the ‘root causes of the problem.’ Most people are diagnosed with ADHD based on the behavioral symptoms, and many characterize ADHD as a behavioral or conduct disorder. However, current research and brain scans suggest that individuals with ADHD might have brains that are wired differently. While brain scans like MRIs and CAT scans are not broadly used to diagnosis ADHD today, it is hoped this technology will be used in the future to confirm a diagnosis. In the meantime, it is important to have a comprehensive assessment of needs done before a diagnosis of ADHD is given. The assessment will asks questions about the child’s development, health, anxiety, life changes, past and current stressors, and traumatic experiences (such as divorce, a caregiver’s incarceration, or the death of a loved one). Any of these issues could affect a child and result in behaviors that look like the ones that typically fall within the ADHD label.

For example, a child dealing with chronic stress as a result of a major loss or period of upset may have problems concentrating, be fidgety, and find it hard to focus. Sometimes, a child may only exhibit signs of ADHD at school. The assessor will then try to figure out what is happening in that school environment that is different from the home or community environment. After a thorough assessment, the assessor may realize that the environment is causing a behavioral response and that the child would thrive in another environment without the need for a label, diagnosis, medication, or therapy.

As with any diagnosis, if you receive a result that does not align with your assessment of your child’s needs, ask for a second opinion. If your insurance will cover it, a neuropsychological assessment can help rule out other possible causes and provide information to help you better understand your child’s needs. Next month, we will discuss the essential things that families raising children with ADHD/ADD need to succeed.

There are several resources locally, nationally, and online that can help families better understand how ADHD is diagnosed and what an ADHD diagnosis means.

A few resources:

  • CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder): - CHADD can also help you connect with and find local resources.

  • ATTITUDE – Inside the ADHD Mind:

  • In your local community there are frequently clinics at hospitals and mental health facilities.

  • You could also look for a neuropsychologist or provider that offers neurofeedback in your local community too.

For more information about ADHD please read part 2. Which will provide additional information about ADHD and helpful tips and strategies.

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