Does Your Elementary School Child Have ADHD?
As the school year takes off, and the first progress reports trickle in, teachers will ask some parents to have their child tested for Attention Deficit Hyperactivity Disorder or ADHD. Your child’s teacher may recommend that you make a trip to your pediatrician’s office or see a child psychologist.
What does this mean? Why is your child being singled out? Sure, Billy is a busy kid, but does that mean that he has ADHD? What is it anyway? Today’s post will discuss some of the important components of an ADHD diagnosis. In future posts, I will discuss treatment options.
Attention Deficit Hyperactivity Disorder is most commonly identified by teachers. But when children are severely hyperactive, their parents know it from the get go. They notice that their son or daughter is “different” than other kids their age—and they can be a handful at home. Constantly fidgety, in to everything, racing around, impulsive, distractible, and always on the go, these children can tax the patience of Mother Teresa. But that kind of severity may be more the exception than the rule.
More typically, children are identified in third or fourth grade when students have to sit and pay attention to the teacher for longer periods of time. This is when experienced teachers begin to identify kids that are outside of the norm of other same aged children. These youngsters are fidgety and restless, often interrupt the teacher and others, can’t keep their hands to themselves, are easily distracted by noise or activity, can’t seem to stay on task, and frequently forget to hand in their homework. Trust me, elementary school teachers have seen thousands of same-aged children over many years—they know who is within the “normal range” and who isn’t.
ADHD is a neurodevelopmental condition that is most often genetic or connected to some kind of gestational trauma (premature babies are more prone to have ADHD) or infant illness. There are numerous theories and some suggestive evidence as to its actual neurochemical basis. While theories abound, we still don’t have a clear understanding of how the brain really works. Neuroscience is a rapidly developing field, but it has a long way to go.
Unfortunately, despite advances in brain scanning technology, there are no definitive tests (blood tests for example) for ADHD. Typically, health care providers collect information from parents and teachers which describe the child’s behavior at home and at school. We use extensive questionnaires which ask parents and teachers to rate their observations of your youngster, and then we look for patterns of behavior which will lead us to a diagnosis. Your pediatrician has to rule out a variety of other medical causes of these behaviors (hearing impairment for example).
Hyperactive children are most easily identified. I watch them in my office as they zoom around touching everything, standing up, interrupting, and moving about like the energizer bunny that never runs out of juice! Children with Attention Deficit Disorder without hyperactivity are much harder to identify. They are often quiet and polite. They are not disruptive or challenging. But they have difficulty maintaining their focus and attention in school and at home. They tend to struggle more in middle school and high school.
Parents still try to understand what this condition really means. They ask—“Joey is able to have a laser focus when he is playing his x-box or Pokemon, but he can never remember to bring out the garbage! I don’t get how he can have outstanding attention for one thing and completely blow off another! Maybe he is just lazy!”
This common observation reflects the mystery of ADHD. Children (and adults) with this condition can focus very well on high interest and high satisfaction tasks. But their brains turn into mush when they are working on low interest, low satisfaction, and boring tasks. For these duties, they feel like they are swimming through molasses. They will tell you that their brain just doesn’t seem to work—they are quickly distracted or exhausted.
But don’t all kids and adults have to expend more “mental energy” for low interest jobs? Of course they do. It takes more mental gas for me to do paperwork then to talk with a patient. But it is still relatively easy for me to complete the low satisfaction tasks of my everyday life without becoming overly distracted or fatigued.
Children can struggle with what we call “input” problems (remembering what the teacher or parents says or what they have read) and/or “output” problems (completing a low interest/satisfaction homework assignment).
So, don’t panic if your child’s teacher suggests an evaluation. It is important to identify children with this condition so we can help them succeed in school.
Share your ADHD experiences!