Tuesday, February 4, 2014

What to do when you think your child may have ADHD.

     I realize that I have written long handouts about ADHD and its treatment, but it might not be quite clear what to do if you suspect your child has ADHD. First, look at this list of the symptoms that fit for ADHD. If a child is 6 years old or above and the symptoms on the form are interfering with home, school, and other activities and it has been going on for more than 6 months, we should look into the possibility of ADHD. That does not mean that all of those children have ADHD or need medication. In fact, over the years many families where this question of whether or not their child has ADHD comes up, most of the times the child does not.
     If they are showing symptoms of ADHD and do not have ADHD, what could it be? Whole books have been written about this topic. A short list: hearing loss, learning disability, vision problems, absence seizures, medications, and thyroid disease. I have had patients who have had classic ADHD symptoms (but something seemed different about the story) where we found they had profound hearing loss, hyperthyroidism, or a medication side effect causing the symptoms. In addition, there are children with some of the ADHD symptoms who do not quite fit the diagnosis of ADHD that in the "gray zone" between "no ADHD" and "ADHD". Many of these children will be watched to see how they do over the coming months and years. We can re-evaluate things depending on how they do in school and at home.
     For children who have symptoms that we want to further check into, we have you the family and the school fill out the Vanderbilt form for Teachers and the Vanderbilt form for Parents. It is very helpful to have each teacher complete the form. At home, having each parent complete the form is helpful. For teens, they can complete one also. When those forms are returned to us by you, the doctor will review the forms and we will get back with you shortly (usually within a couple days and sometimes sooner). At this point, if the scores on the Vanderbilt forms show that we should have a discussion about the diagnosis of ADHD and possible treatment for it, we set-up a saved time appointment (these can take 30--45 minutes) sometime soon to discuss it in the office. Is it helpful to have your child there at this appointment? It depends. For many young kids, they may feel that so many people have gotten frustrated with their symptoms, that hearing their parent(s) and pediatrician discuss it may be stressful and not productive. For older kids, it can helpful to be part of the discussion. Based on the scores on the Vanderbilt forms, the history of the problems, and our discussion in the office, the diagnosis can be made of ADHD. We can discuss medication treatment for ADHD, which I can tell you has about a 80-90% chance of making a big impact on the symptoms. Why is it the doctors talk about stimulant medications? Because they work. Although special diets, cognitive-behavioral therapy, and specialized computer training has all been tested, there is less than a 20% chance of these helping by themselves. Please see my blog post on ADHD and diet here.

No comments:

Post a Comment