ADHD . . . Truth Or Trend?

I have decided to focus our first blog on this topic because of the numerous referrals we have received over the past several years for children who have been labeled ADHD by one person or another, but who do not meet the criteria for this diagnosis. As a result, parents are left frustrated, angry, and feeling helpless; and children’s self-esteem quickly plummets as they also become frustrated and baffled in trying to understand how to manage and understand what is going on, on the inside and out. Many of these children have been started on stimulant medication as a first course of action . . . a topic for a later blog.

Many of the behaviors that parents, teachers, and others complain about may, indeed, sound like ADHD to some. Some of these behaviors include constantly moving, easily distracted, difficulty completing one task from beginning to end, “spacing out”, being over talkative, not paying attention and many others. For teachers, this becomes a classroom management issue. For parents, tasks like homework can become time of battle. The feelings of frustration and desire to help leave the adults searching for an answer. My frustration is that during this vulnerable time, when a family is searching for answers, the first answer that comes along is often ADHD. Parents and others accept this answer because it makes sense based on the information they have and it feels good to have an answer, even though that answer is often inaccurate. As a parent, searching for answers when my children have been sick from time to time, I know the feeling well. However, when they fail to get better, that “good feeling” quickly turns to feelings of helplessness and dismay.

Often times, there are MANY other explanations for the child’s behavior. Sometimes the explanation is a different diagnosis (other than ADHD) and sometimes it may be other internal struggles the child may coping with. We cover these in great detail in many of our seminars and workshops.

Lastly, for those reading this blog who may not be mental health professionals, I’d like to include the criteria that we use to diagnosis ADHD. There are fifteen criteria that a child must meet in order to be accurately diagnosed with ADHD. They must meet all fifteen criteria!! Diagnosing is not rocket science. We must use the criteria listed below. If you choose to review the criteria, please pay particular attention to the age and other rule out diagnoses. Symptoms have to be present before age 7 in order for a child to meet the criteria for ADHD!


Diagnostic criteria for Attention-Deficit/Hyperactivity Disorder

A.Either (1) or (2): (1) inattention: six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level: (a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities (b) often has difficulty sustaining attention in tasks or play activities (c) often does not seem to listen when spoken to directly (d) often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions) (e) often has difficulty organizing tasks and activities (f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework) (g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools) (h) is often easily distracted by extraneous stimuli (i) is often forgetful in daily activities

(2) hyperactivity-impulsivity: six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

Hyperactivity (a) often fidgets with hands or feet or squirms in seat (b) often leaves seat in classroom or in other situations in which remaining seated is expected (c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness) (d) often has difficulty playing or engaging in leisure activities quietly (e) is often "on the go" or often acts as if "driven by a motor" (f) often talks excessively

Impulsivity (g) often blurts out answers before questions have been completed (h) often has difficulty awaiting turn (i) often interrupts or intrudes on others (e.g., butts into conversations or games)

B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.

C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).

D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.

E. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorders, or a Personality Disorder).

In conclusion, my recommendation if you believe a child is truly suffering with ADHD is to have them evaluated by a mental health professional who is trained in interviewing children. Whenever I seek treatment for my own children for anything my first question to a professional is, “What percentage of your work is dealing with children of my child’s age and with my child’s issues?”. If the answer is not at least ninety percent, I am searching elsewhere for assistance.

Debbie Mann, LCSW

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