Instead of eating, your child races around the dinner table. Moments earlier, the youngster abruptly stops playing with a favorite toy in favor of watching the birds gather around the backyard feeder. While these behaviors may seem normal for an active, curious child, could it possibly suggest he or she has the neurodevelopmental disorder ADHD?
According to the American Psychiatric Association, attention deficit hyperactivity disorder, or ADHD, is one of most common mental disorders among children. Approximately 5 percent of children have this disorder, which often leads to disruptions at home, school and in social settings.
“The essential feature of ADHD is a persistent pattern of inattention or hyperactivity-impulsivity — or both — that interferes with functioning or development,” says Dr. Julia Breur, a licensed clinical psychotherapist in Boca Raton, Florida.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
Recognizing Dominant Behaviors
She notes that inattention is one of the three possible behaviors associated with ADHD, as defined by the APA’s classification and diagnosis standard, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or DSM-5. In this case, Breur says a child will wander off task, have difficulty maintaining focus and often be disorganized.
Hyperactivity-impulsivity involves another set of behaviors a child with ADHD may display.
Hyperactivity includes excessive motor activity in which a child may run around uncontrollably, talk excessively or fidget — or engage in all of these. The other arm of this behavior, impulsivity, involves acting in haste, usually without first considering potentially harmful consequences. An example: running into the street without first looking for cars. Other aspects of the behavior, Breur says, include seeking immediate rewards, an inability to delay gratification and frequently interrupting others.
The third set of behaviors is referred to as “combination,” and occurs when elements of both inattentive and hyperactive-impulsive behaviors are displayed.
These behavioral breakdowns mean your child demonstrates a predominant set of ADHD signs: inattention, hyperactivity-impulsivity or combination. Upon your child’s ADHD diagnosis, you’ll likely be told what specific type, or common set of ADHD behaviors, he or she primarily exhibits.
Behavior in Multiple Settings
Aniesa Schneberger, a licensed mental health counselor at Tampa Life Change, says it’s necessary to observe whether or not a child is routinely acting inattentive or hyperactive — or both — while in a variety of settings. ADHD symptoms, she says, should be prevalent in at least two environments, which is another DSM-5 criterion.
For example, if a child is acting out at school but not at home, then this could indicate an ability to control their behavior. If this is the case, it may not be a sign of ADHD after all.
[See: Hoarding, ADHD, Narcissism: Inside the Minds of History’s Great Personalities.]
“This is an important one,” she says, adding that a child with ADHD can’t switch their symptoms on and off depending on the environment. Behavioral consistency across a host of settings is a telltale indication that a child may have this disorder. It’s also the reason why obtaining a diagnosis when a child is under the age of 5 — the traditional age of entering school or a structured learning environment — can be challenging. Without exposure to various environments to serve as a basis for comparison, it’s difficult to accurately assess if a child has ADHD. “Because of this, children are typically diagnosed around the age of 5 or 6, after being involved in these types of environments for a couple of years,” Schneberger says.
Another reason it’s important to observe your child in a variety of settings is to take note of their interaction with others. In particular, look for behaviors that are inconsistent with children their age. “It’s important to take note of how your child is interacting with other children,” Schneberger says. “Often times children diagnosed with ADHD can be intrusive during activities and conversations, don’t respect the space of other children and can’t seem to wind down when playtime is over while other children are resting.”
Parents Share Their Stories
These experts’ words ring true for Massachusetts resident Erica Torres, the mother of Isabella, 10.
“I began noticing her ADHD behaviors when she started school around age 6,” says Torres, who has ADHD herself. She explains that still today her daughter has inattentive and impulsive behaviors, which include coloring neatly, then stopping suddenly only to finish in a hurried, messy fashion. “She never finishes a project,” Torres says.
Torres finds conversations with her daughter are usually challenging. Isabella is easily distracted, she says, often starting her conversations over from the beginning. “Most of the time I have to remind her to focus so she can finish.”
She adds that this is the first year a teacher mentioned her daughter’s behaviors. This feedback meshes with her own observations, and she’s decided to have Isabella tested in the near future.
“Having clear and constant communication with your child’s teacher can help gain perspective on the severity and frequency of symptoms,” Schneberger says.
Dona Yasser, a marketing and education coordinator at a New Jersey periodontal office who was diagnosed with ADHD as an adult, says her two boys have the disorder. However, only one — who had autism first — has been officially diagnosed. This son, she says, has difficulty focusing, demonstrates impulsivity issues and exhibits an inability to properly filter his thoughts before speaking. However, she says “it’s a toss-up which is autism and which is ADHD,” a point other parents may want to take into consideration in the event other known disorders create behavioral overlaps.
Yasser’s other son, now a dean’s list college student who is planning for grad school, has not been formally diagnosed. Still, she explains that it’s obvious to her and her husband that he “has all the hallmarks of inattention,” which they started noticing when he was approximately 3 years old. In his younger years and still today, he has to be near people and remain physically busy, constantly seeking a stimulus. “He has never had a focus issue, though,” Yasser says.
Getting a Reliable Diagnosis
While other people’s observations about your child may be congruent with your own, it’s critical not to let their words serve as a final, informal diagnosis. In fact, the APA notes that while teachers and school staff can play a role in the ADHD evaluation process, they cannot diagnose the disorder. According to the APA, “only parents and guardians can make those decisions with the child’s physician.”
[See: Kids on a Plane: How to Entertain Children Without Losing Your Sanity.]
When it comes to obtaining a formal diagnosis, Breur explains that no single test exists. Symptoms, she says, should be experienced regularly for a six-month period. Additionally, medical exams, which involve vision and hearing screenings, are also part of this assessment, as is involvement of pediatricians, psychiatrists, psychologists and psychotherapists. “The diagnosis will involve information from various sources,” she says.
It’s also important to get your child a second, or even a third, opinion, Schneberger says. “Often times due to their age, children can be misdiagnosed. Getting other opinions can decrease this probability.”
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I’m Worried My Child Has ADHD. What Can You Tell Me About the Disorder? originally appeared on usnews.com
