IS IT ADHD?

Presented by: Dr. Kenneth H. Seely

One of the most common questions by parents seeking treatment for their child is, “Does my child have ADHD? Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most commonly misdiagnosed disorders of mental health. Teachers often refer to a disruptive child as having ADHD, and people will self-diagnose their children or the children of their neighbors, friends, or family. It was mentioned by one teacher, working with 3rd graders, that she would like to give them all Ritalin. ADHD is one of the most common neurobiological disorders of childhood. In 2003, the Centers for Disease Control and Prevention suggested a prevalence rate of 8 percent of children and adolescents between the ages of 4 and 17. This suggests that 4.5 million children were given the diagnosis, but the Diagnostic and Statistical Manual indicates a prevalence rate of 3-5 percent. This suggests that at conservative estimates there is a 3 percent rate of misdiagnosis, or about 1.7 million children are misdiagnosed with ADHD. Other conditions such as depression, anxiety, learning disabilities, behavioral difficulties, and other diagnoses can mimic several of the symptoms of ADHD. Many of these misdiagnoses are a result of multiple professions that assign the diagnosis of ADHD without a comprehensive understanding of the child, and a proper diagnosis of ADHD requires several steps and a comprehensive evaluation by a licensed Psychologist.

With so many questions about ADHD and so many ready to give their own diagnosis, how can a parent tell the difference between hyperactivity that is normal in a child, another disorder, or ADHD. Knowing all of the diagnostic criteria would help, but we need to understand several different things before it would be suggested that you take your child in for a comprehensive evaluation.

First, consider the developmental appropriateness of the behavior - that is, how similar is your child's behavior compared with what would be expected at his or her age? Until the ages of 5 or 6, many kids have an abundance of energy. In fact, in the typical kindergarten classroom, teachers incorporate many activities to keep kids moving and changing tasks. In general, it is normal for children, at one time or another, to have trouble focusing and behaving. However, by age 8, overactive behavior - such things as excessive fidgeting, difficulty remaining seated and taking turns, excessive talking and interrupting others - is likely to be developmentally inappropriate.

Second, examine where the behavioral problems occur. Is the child overactive at home, but well-behaved at school, church, and in other social settings? Does he or she get into trouble at school, without being disruptive at home? This is an important diagnostic consideration because ADHD is a disorder that affects a child's behavior in various settings. If a child's problem behavior is limited to one environment, it is likely an issue with the behavioral management strategies used in that setting rather than a disorder.

Finally, evaluate whether the behavior interferes with the child's ability to function in everyday life. If a child is overactive, it doesn't mean there's a problem. In children with ADHD, this overactive behavior prevents the child from meeting the expectations of their home, school and other environments. For example, while they can attend to video games and TV for hours on end, kids with ADHD often resist or procrastinate when given chores or tasks that require concentration and focus, such as homework.

A diagnosis of ADHD is a several-step process, requiring more comprehensive evaluation than just these three variables. Remember, many other difficulties and disorders can mimic these symptoms and if an overactive child meets these three criteria, I would encourage parents to take the child for a comprehensive evaluation. Although a school psychologist may be able to do intellectual and achievement testing but cannot give a definitive diagnosis of ADHD. A complete evaluation that includes clinically objective and subjective measures is necessary to rule-out other disorders and establish the diagnosis of ADHD. This will not only help you understand the challenges of your child, but also will help you to understand the most appropriate treatment for your child’s difficulties.

If you should have further questions you can contact me at 435-531-0527.

Sincerely;

Kenneth Seely, Ph.D.

Licensed Psychologist, Clinical

Kenneth Seely, PhD., Licensed Psychologist, Clinical, is the owner of Psychological Assessment and Treatment Services and is a licensed Psychologist in the State of Utah.  Dr. Seely received his PhD in Clinical Psychology and his Bachelors Degree in Psychology from BYU, and has practiced professionally in Southern Utah for the past 12 years.  Dr. Seely can be contacted at (Clinical) 2045 N. Main #2, Cedar City, Utah 84721 (435) 531-0527 Mailing Address:  P.O. Box 285, LaVerkin, Utah 84745