Identifying and Diagnosing ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that is discussed in may schools and in many classrooms. Many parents and teachers wonder if a child, who can't seem to sit still or pay attention in class, has ADHD. It's a delicate topic between parents and their children's teachers, especially at the primary age because normal behaviors for these young children can look like behaviors seen with children who have an ADHD diagnosis. Honestly, it can be hard to tell the difference between normal social-emotional development, delayed social-emotional development, and ADHD.
Today, I want to connect you to information that will help you understand ADHD and the behaviors of the children who have it. Because ADHD is such a complex disorder this blog entry will cover identifying ADHD and how it's diagnosed.

Statistics from the Center of Disease Control (CDC)

In 2016:

• Approximately 9.4% of children 2-17 years of age (6.1 million) had ever been diagnosed with ADHD, according to parent report in 2016. (In a classroom of 20, this means 1-2 kids has a diagnosis of ADHD, and it's possible more students may be undiagnosed.)

Among U.S. children ages 2-17 years in 2016:

• Nearly 2 of 3 children with current ADHD had at least one other mental, emotional, or behavioral disorder. (This means ADHD is comorbid with several other disorders.)
• About 1 out of 2 children with ADHD had a behavior or conduct problem.
• About 1 out of 3 children with ADHD had anxiety.
• Other conditions affecting children with ADHD: depression, autism spectrum disorder, and Tourette Syndrome.

Statistics source: CDC Data on ADHD

How is ADHD diagnosed?

For diagnosing mental health disorders, doctors and mental health professionals use the American Psychiatric Association's book the Diagnostic Statistic Manual (DSM), Volume 5, most commonly known as the DSM-5. The DSM-V lists three different types of ADHD: ADHD Inattentive Type, ADHD Hyperactive Type, ADHD combined type.
Here is a run-down of all three types and their dominant symptoms:

ADHD Inattentive Type: A Few Symptoms

• Has difficulty sustaining attention in tasks in play or work activities (i.e., gets distracted easily)
• Often daydreams and/or seems "spacey"
• Does not seem to listen when spoken to directly
• Forgetful in daily activities
• Avoids, dislikes, or is reluctant to engage in tasks that required sustained mental effort like some chores and homework (You might hear a child say, "It's too hard," "It's too boring," or "It takes too long," in response to being asked to do a task.)
• Does not follow through on instructions for schoolwork or chores

**According to the DSM-V, Attention Deficit Disorder (ADD) is not currently being diagnosed as ADD. What we once diagnosed as ADD is now being diagnosed as Attention Deficit Hyperactivity Disorder (ADHD) - Inattentive type, one of three types of ADHD.**

ADHD Hyperactive/Impulsive Type: A Few Symptoms

• Hyperactive symptoms:
• Fidgets with hands or squirms in seat
• Talks excessively
• Appears as if "driven by a motor" or "on the go"
• Leaves seat or runs around in inappropriate situations

• Impulsive symptoms:
• Blurts out at inappropriate times
• Has difficulty waiting turn
• Interrupts others' conversations or butts in "their business"

ADHD Combined Type: Some Symptoms from Inattentive Type and Combined Type

To receive a diagnosis, a child must show some or most of these symptoms for more than 6 months, and those symptoms must affect daily life or school negatively. Our littles (kids in primary schools, ranging in ages from 5-9) are all going to show some of the symptoms above and can still be considered neurologically typical (a more precise way of saying "normal" or non-ADHD). What kid doesn't blurt out now and then? The key is that the symptoms negatively affect daily life or school, or the child's behavior is significantly developmentally behind what is more common with their classmates. 

My source for helping me with these lists: ADHD Symptoms Checklist

A more complete list of symptoms and how ADHD is diagnosed can be found here: DSM5 Diagnostic Criteria

"My child's teacher and/or I have noticed some ADHD symptoms in my child's behavior. Now what?"

If you or your child's teacher have noticed a child exhibit some of these symptoms, one of the first steps is to talk to your child's pediatrician. Most pediatricians are well informed in ADHD, and they can guide you to next steps. 

Next steps might include

• A consultation/observation with you and the child in the doctor's office
• Paperwork -  The doctor might ask you to fill out a form yourself and give one to a teacher to fill out 
• A physical exam to rule out any physical causes like hearing or vision problems or even an allergy
• Asking about a child's social history -  Are there any big changes happening in the child's life?
• Asking about family medical history -  Does anyone in the family have a diagnosis of ADHD or other mental health disorders?
• Asking about symptom history - A doctor may ask questions such as "When did you first start noticing these symptoms? Do the symptoms happen in more than one setting?"

If one or more of these steps show that your student has ADHD, next steps include talking to professionals and doing research on different treatments and coping strategies. The professionals that you can seek out for help include your child's pediatrician, an agency counselor, your child's school counselor (which is me, Mrs. Heilman, if your child goes to CB Smith, Starke, or Willow Primary Schools), or your child's teacher. Because this blog entry is getting pretty long and full of info, I'll save treatments and coping strategies for ADHD for another day. In the meantime, feel free to write specific questions about ADHD in the comments.