Understand the diagnosis, what to do and access resources
ADHD is often misdiagnosed. The term is often used to describe children who misbehave or are inattentive however there are very specific criteria for a child be to diagnosed with ADHD. Here are some things parents should know about ADHD and the diagnosis:
- ADHD should be diagnosed by a licensed medical or mental health professional.
- Be cautious of teachers or others with good intentions labeling a child with ADHD as it may be an incorrect diagnosis.
- There are no definitive tests for ADHD.
- There are no blood analysis, genetic testing or brain scans that can predict ADHD.
- Diagnosis is usually reached through observation of behavior over time.
- Parents should consider other options and therapies before resorting to medication due to side effects. This includes behavioral therapies.
- Children who are diagnosed with ADHD may outgrow it later in life.
How do I know if my child has ADHD
The following criteria is required in order to be diagnosed with ADHD according to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition).
- Inattention: Six or more symptoms of inattention for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level.
- Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-impulsivity for children up to age 16, or five or more for adolescents 17 and older and adults; symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level
In addition, the following conditions must be met:
- Several inattentive or hyperactive-impulsive symptoms were present before age 12.
- Several symptoms are present in two or more setting, (e.g., at home, school or work; with friends or relatives; in other activities).
- There is clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning.
- The symptoms do not happen only during the course of schizophrenia or another psychotic disorder. The symptoms are not better explained by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).
Based on the types of symptoms, three kinds (presentations) of ADHD can occur:
Combined Presentation: if enough symptoms of both criteria inattention and hyperactivity-impulsivity were present for the past 6 months
Predominantly Inattentive Presentation: if enough symptoms of inattention, but not hyperactivity-impulsivity, were present for the past six months
Predominantly Hyperactive-Impulsive Presentation: if enough symptoms of hyperactivity-impulsivity but not inattention were present for the past six months.
Because symptoms can change over time, the presentation may change over time as well.
Diagnosis confirmed. Now what?
Diagnosis can be a form of relief for parents. Interventions can begin. The most effective form of treatment include behavior modification techniques, therapy and sometimes medication. Parents should work closely with behavior specialists and medical professionals but parents are the first line of treatment. If parents make changes in the home environment, children will be able to adapt and correct behaviors more quickly. Treatment is often customized to the child. Not all ADHD interventions work the same with all children. Parents will be able to tell what is effective.
Children may outgrow ADHD.
Parents should research and understand their options in order to custom fit treatment to their child. Parents are the best advocates for their children as they have a better knowledge of how their child behaves in various situations. Parents who work with professionals enhance the effectiveness of treatment and shorten the amount of time necessary for a child to be successful.
Parents should consider the following when considering a treatment option for their child’s ADHD
- Behavior therapies should be tried first. Medication, because of side effects, should be a final option.
- Follow a routine. Use a timer, clocks, charts and calendars to help you and your child follow the routine.
- Be consistent with schedules, routines, rules and consequences.
- Simplify your child’s schedule if possible but keep them busy. Sometimes over-scheduled children with ADHD become more difficult because of the pressure or being overwhelmed. Evaluate their needs based on their abilities and plan accordingly. You can include lower stress activities or chores to keep them busy.
- Create a quite place. Create a space for your child that is their own where they can go to relax. DO NOT use a time-out space for this.
- Be aware that television, computer and video games may actually increase your child’s symptoms.
- Parent exhaustion is real. It can be physically, emotionally and psychologically exhausting. Take some time to recharge. Take care of yourself. Set aside a time and follow that routine and it can also serve as an example to your child of following a schedule.
Behavior modification therapy and medication
The most common ADHD treatment usually involves behavior management, psychological counseling and, if necessary, medication. Therapy often includes behavioral techniques like the parenting classes on Smarter Parenting. Using the skill of Preventive Teaching, Correcting Behaviors and Effective Rewards and Consequences will help shape your child’s behaviors. Remember to be consistent. More than a dozen medications can be used in the treatment of ADHD for children ages 6 and up, according to the Mayo Clinic. Stimulants are the most commonly prescribed medications. But there are side effects to consider, including insomnia, decreased appetite, weight loss, headache and increased blood pressure. Working with a physician and monitoring the effectiveness of the medication may take some time before the right combination works.
Common misconceptions about ADHD
Medication is NOT the only way to cure ADHD. Medication can be helpful but only as a last result. Side-effects can be far worse than having ADHD. Consult your physician. In reality, learning strategies and incorporating skills is the most helpful way to work through problems that arise through ADHD.
ADHD does NOT make me lazy. ADHD actually makes you the opposite. People with ADHD are often more acutely aware of what needs to be done but they lack the ability to remain on task.
ADHD does NOT make me dumb. The reality is that people with ADHD, as they grow older, find creative ways to adjust and become extremely productive. This ability to adapt and find ways to work through issues is often a complex process and requires a lot of problem solving, trial and error. ADHD just affects the way they do normal functions but most people figure out other ways to do them which makes them highly intelligent.
ADHD will result in me having problems for the rest of my life. It is true there is no cure for ADHD however, learning strategies help reduce the symptoms. Reducing the symptoms helps increase the abilities of the individual to improve and function with less problems.
Customizing Preventive Teaching for ADHD
Use this skill before doing any task or activity. By expressing that they will struggle at certain points and anticipating their feelings you can address what they need to do when those feelings arise.
Tips for parents on using this skill for ADHD:
- Be sure to describe what you want your child to do. Avoid saying what your child should NOT do. That is not helpful.
- Be specific in providing an alternative to the negative behavior.
- Initially practice the new behaviors using a time frame that you child can complete. Slowly increase the time frame to help them remain focused.
- Provide a reward to increase the likelihood of repeating the positive behavior.
- You can use a timer to help your child learn to shift focus during the practice. The timer gives them a visual cue of what they are doing and provides them with the ability to recognize that what they are doing will have an end.
Customizing Correcting Behaviors for ADHD
Use this skill when your child loses concentration for the task at hand. Watch the video for the steps and read the parenting tips below on how to implement it with a child with ADHD.
Tips for parents on using this skill for ADHD:
- Practice the behavior multiple times and show them specifically what you want them to do.
- Provide a consequence that is immediate. Children with ADHD are not motivated with consequences that are not immediate. Figure out what consequences would work before you practice.
- If your child is older and is able to complete the practice effectively, change it up and make it a little more difficult. This helps them adjust for differences and keeps things new and fresh.
- If they practice, be sure to praise them and to decrease the consequence. Remember, our focus is to teach, not to punish. By teaching, they will change the behavior long term and that is really the desired goal. If not, the same negative behavior will happen again.
For more tips and ways to implement both of these skills you can visit the specific pages on this site for each of these skills. It has games, activities and printable materials to help you and your child learn this skill in an effective way.
The following resources may be helpful
The National Institute of Mental Health provides further insight into ADHD with videos, testimonials, and free brochures.
The Center for Disease Control also has materials on ADHD that are based on specific age ranges. This website also provides some printable materials that are very helpful to parents including:
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