Your child seems to behave in ways that resemble attention deficit hyperactivity disorder, but perhaps you’re hesitant to explore the matter. After all, you can’t help but think these may be age-appropriate behaviors or a perhaps a phase. So, maybe it’s best to hold off on getting a formal diagnosis.
Not so fast, cautions E. Mark Mahone, a child neuropsychologist, research scientist and the director of the department of neuropsychology at the Kennedy Krieger Institute in Baltimore.
[See: 10 Concerns Parents Have About Their Kids’ Health.]
Early Diagnosis, Better Outcomes
“Parents should not wait to seek out an assessment,” Mahone says. “As with any developmental condition, the outcome is going to be better with early, accurate identification followed by appropriate treatment and intervention.” Delaying this, he explains, may lead to social or cognitive issues that could have been prevented.
Mahone says that parents’ first stop should involve meeting with a pediatrician, who will “do medical screening to make sure that what may look like ADHD isn’t due to another medical condition.” He explains that other medical issues may mimic ADHD symptoms. “A fair number of children have hearing loss in their preschool years that may not be identified later,” he says. “Hearing problems may make children look inattentive, as though they’re not following directions.” He also says that a language disorder and autism may look like ADHD, and that anxiety and situational stress also play a role. A pediatrician will then recommend next steps based on findings, which may include working with developmental experts.
At the same time, Mahone emphasizes that “there’s a difference between having symptoms and having a disorder.” A person can have a lot of symptoms, but not necessarily have the disorder. A good rule of thumb is that something is typically labeled a disorder when it greatly interferes with the ability to function effectively in various environments, Mahone says. Still, seeking professional expertise can lead to a determination and subsequent next steps.
Melinda Kulish, a neuropsychologist and psychoanalyst with a private practice in Cambridge, Massachusetts, also encourages parents to be aware that many things can cause behaviors that may look like ADHD. In fact, she says that just about every emotional symptom can look similar to ADHD, such as a depressed child and inattention. “Think about a child’s history,” she says. “Ask yourself if anything is going on emotionally that can make a kid look like he or she has ADHD.”
She says that an early diagnosis provides the entire family with “a much clearer road map of what to do” and “heads off the ways in which children and adults can spin narratives about a kid that’s not correct.” She says that others may mislabel certain behaviors as lazy or spacing out when other issues are at hand — issues that can exacerbate the situation by causing anxiety and depression. “Children can end up feeling terrible about themselves,” Kulish says.
[See: 10 of the Biggest Health Threats Facing Your Kids This School Year.]
Why Parents Sometimes Wait
With so many reasons to address the issue sooner than later, why then might some parents wait to obtain a formal diagnosis?
“I think there’s a sort of misconception some parents have that a basic struggle will resolve in time,” says Caroline Maguire, an ADHD and social skills coach at New England Coaching Services in Concord, Massachusetts, and the author of “Why Will No One Play With Me?” “Sometimes the thought is that waiting will make a kid magically become ready,” she says, “So people become used to approaching things in terms of a ‘wait and see’ process.”
However, waiting may be appropriate in certain situations. Mahone says such an approach is fine if it’s really a developmental phenomenon children will grow out of — which again, can be clarified with an assessment. “But if you avoid an assessment and something else is wrong, the child may be vulnerable to having lots of problems that could have been managed through available interventions all along,” he says. “This can affect family relationships and learning in school.”
Kulish adds that there’s often a balance parents try to find of giving a kid a right diagnosis but also of keeping an eye on how things develop. Behaviors and abilities may shift as children age, she says, manifesting differently in time. A very young child of 4 or even 8 may seem hyperactive, but during the teen years that hyperactivity may be more controlled. A teen may not have the meltdown a 5-year-old might, she explains, and certainly adults with the disorder won’t have a tantrum at work. Waiting may be beneficial if there are concerns about a very young child who is 3 or 4 years old, she says. Social expectations, life experiences, treatment and a developing brain — particularly the frontal lobes — are all factors in some of the ways symptoms may change or look different through the years.
Address All Issues, Remain Educated
Kulish says that some parents might want to consider waiting in the event symptoms outside of ADHD exist. It’s always best to treat emotional problems first, she says, noting that it can be hard to test for ADHD when other things are going on. “Treat depression or anxiety first,” she says, because sometimes ADHD symptoms go away once other concerns are resolved.
Some hesitancy about getting an early diagnosis may also stem from lack of knowledge about ADHD. “Without education about ADHD, parents may not know that an early diagnosis is important,” Maguire says. She explains that some parents just aren’t sure what to do, often teetering on an “is she or isn’t she” fence. What they don’t understand, Maguire says, is that ADHD has a lot to do with brain wiring differences. Without proper treatment, each school year will likely become increasingly challenging for a child with ADHD. With a diagnosis, options may be available for children, including in-school accommodations and strategies to help these children thrive rather than struggle.
[See: 8 Things You Didn’t Know About Counseling.]
Other parents are hesitant because they’re afraid of the stigma that sometimes comes with a diagnosis, Maguire says, or they’re incorrectly influenced by other people. For example, another parent may make an observation and say, “Oh, that’s not ADHD.”
It’s best to get an assessment from a medical professional, Maguire says. Even if everything turns out to be fine, she reassures parents that a medical expert won’t be angry at you for coming in and demonstrating a caring, proactive attitude.
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Is an Early ADHD Diagnosis Best, or Should Parents Wait to Seek Answers? originally appeared on usnews.com
