The National Institute of Mental Health estimates that between three and five percent of preschool and school age children have Attention Deficit Hyperactivity Disorder. That’s about two million American children.
Although more and more kids are being diagnosed every year, Scott & White pediatrician Laura Ferguson, MD said that there’s a difference between a fidgety youngster and a child who needs to be on medication.
“ADHD is over diagnosed in little boys who are less than six or seven because little boys move around a lot,” she said. “And it’s probably under diagnosed in older children who don’t move around as much. And in girls because it just seems like they’re daydreaming.”
Some parents believe that just because their child’s teacher says they need medication for disruptive behavior, the problem is not always ADHD.
“There is diagnostic criterion that is used to diagnose,” Dr. Ferguson said. “There are questionnaires for parents and teachers to fill out to determine if that child has ADHD.”
One of the most common questionnaires is the Vanderbilt ADHD Diagnostic Teacher Rating Scale which measures how often a child engages in disruptive behavior, can’t pay attention or makes impulsive decisions.
Because many parents don’t realize that there is criteria for diagnosing a child with ADHD, there are many misconceptions about the disorder.
“A common misconception is that diet really influences children,” Dr. Ferguson said. “A lot of parents think that sugar or certain food additives can contribute to ADHD, but that’s really been disproven scientifically in research studies.”
Another worry for parents whose child has already been diagnosed is that their child will somehow become addicted to the prescribed medication.
“First line drugs for ADHD are all stimulants, but the kinds of medication that we use are not addictive,” she said. “Most of the drugs that we use for ADHD are really meant primarily to help the child pay attention in school.”
It may seem strange that a physician would prescribe a stimulant for a child who has trouble controlling their mind and body, but Dr. Ferguson said the medication only affects a certain part of the brain.
“We’re actually trying to wake up or stimulate that part of the brain that’s responsible for paying attention.”
Signs that your child may have ADHD might include talking out of turn, getting out of their desk, fidgeting and forgetting to do or turn in homework.
Dr. Ferguson said if you suspect that your child has ADHD, you should see your pediatrician. The doctor should not only interview the child, parents and teachers about their behavior, but they should also conduct a physical exam to make sure there’s not something else going on that looks like ADHD.
“Other conditions that can look like ADHD are learning disabilities, cognitive impairment or childhood depression,” she said. “When adults are depressed they tend to want to sleep a lot and cry, but when kids are depressed, a lot of times they’ll act out and not pay attention.”
If your Scott & White pediatrician or family doctor discovers that your child does not have ADHD, but another problem, there’s a team of developmental pediatricians to guide you and your child through whatever issues you are facing.
“If there are complications like a learning disability, we can refer to the developmental pediatricians and they can find testing,” she said. “And if they suspect depression they can refer the child to psychiatry.”
But if your child is one of the two million who have been diagnosed with ADHD, there is help.
Stimulant medications like Ritalin are usually the first line of defense against the disorder, but Dr. Ferguson said the child needs more than medication.
“It’s important for parents to know how to work with their child’s school,” she said. “There’s actually an ADHD tool kit published by the American Academy of Pediatrics. And in the tool kit there are things that help parents and teachers understand how to manage behaviors.”
Here’s a sample of the assessment statements on the Vanderbilt ADHD Diagnostic Teacher Rating Scale (pdf).
- Fails to give attention to details or makes careless mistakes in schoolwork.
- Has difficulty sustaining attention to tasks or activities.
- Does not seem to listen when spoken to directly.
- Does not follow through on instruction and fails to finish schoolwork.
- Has difficulty organizing tasks and activities.