Diagnosing ADHD in Children

Attention Deficit/Hyperactivity Disorder (ADHD) is a complex condition that can impact a child or adult’s academic performance and social acceptance. This diagnosis is particularly interesting to me because as a therapist I see patients come in frustrated and deflated that they or their child is struggling and is being labeled as a “bad kid”. There are no bad kids, simply misunderstood kids who are struggling to learn and act similarly to their peers. Like many mental health disorders, someone typically struggles in several areas in their life before getting diagnosed.

Imagine the following scenario:   
Your child, prior to kindergarten, has always been happy, energetic, and excited to play outside. He was fun and frequently ready for an adventure. He would talk a lot, share stories about several different topics, and was so eager that he would interrupt you or others. You did not think much about it because you were busy working and felt good that he was happy. Then, on the weekends, you began noticing that his energy never stopped and he would refuse to take naps. Your patience shortened as you started struggling to slow him down and you noticed he rarely understood the lesson of your consequences. He began getting conduct marks in school, phone calls from his teachers increased, and his grades began to suffer. His impulsiveness even caused problems with his friends. At this point, you bring him to his pediatrician and he’s diagnosed with ADHD. He will begin therapy and a stimulant to help control his behavior so that he can think clearly.  
 
The path to being diagnosed with ADHD can be lengthy and frustrating because most children will be overlooked based on what is normal energy and impulsiveness for their age. Once school starts, the child’s academic and social performance are taken into account. This is where it takes a village to raise the child. A sound support system at school, his home, having a good therapist, and the correct medication will ensure your child develops at the correct pace.  
 
Let’s look at the diagnostic criteria for ADHD according to Diagnostic Statistical Manual, Fifth Edition (DSM-V, 2013). Keep in mind that roughly 2.5 percent of adults and about 5 percent of children are diagnosed with ADHD. 

1. You first have to have a pattern of inattention and/or impulsivity that causes problems in one or more areas of your life.  
   1. Inattention: (6 or more of the following symptoms) 
      1. Fails to give close attention to details or makes careless mistakes 
      2. Difficulty sustaining attention in tasks or play activities 
      3. Often does not seem to listen when spoken to directly 
      4. Often does not follow through on instructions 
      5. Often has difficulty organizing tasks  
      6. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort 
      7. Often loses things necessary for tasks or activities 
      8. Easily distracted 
      9. Forgetful 
   2. Hyperactivity/Impulsivity 
      1. Fidgets with or taps hands or feet or squirms in seat 
      2. Leaves seat in situations when remaining seated is expected 
      3. Often runs about or climbs in situations where it is inappropriate 
      4. Unable to play or engage in leisure activities quietly 
      5. Of “on the go” acting as if “driven by a motor” 
      6. Talks excessively 
      7. Blurts out an answer before a question has been completed 
      8. Often has difficulty waiting for his or her turn 
      9. Interrupts or intrudes on others 
   3. Several symptoms presented prior to age 12 years 
   4. Several symptoms are present in two or more settings  
   5. There is clear evidence that the symptoms interfere with their life 
   6. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder  

If you feel that you are AD/HD, reach out to your primary care physician. They can give you a referral to a mental health professional where you will be screened. The treatment for ADHD is cognitive behavioral therapy (CBT) where you will learn time management skills, impulse control, and on-task behavioral skills. There is no shame in asking for help, especially when you will become better than you were.