Understanding ADHD symptoms and diagnosis in children

ADHD

In order to understand what parents are dealing with who have children with ADHD, we'll look at what the disorder is and how it manifests itself.

ADHD can present itself in three categories: children who are predominantly hyperactive-impulsive, children who are predominantly inattentive, and those who are combined hyperactive-impulsive and inattentive. Most children have the latter -- combined ADHD (NIMH, 2009).

There is no cure for the disorder, but treatments can relieve many of ADHD's symptoms and allow a child to attend school and lead a fairly normal life. ADHD can strike not only children but also teens and even adults.

The first thing a parent has to deal with is to have the disease recognized and diagnosed -- not as easy as it sounds. Some impairment symptoms don't always manifest themselves. In other words, a child can be impaired at home and at school, but not while he is out playing, etc. The symptoms must interfere with the child's functioning at a normal level at home and in school. Finally, some of the symptoms must be present before the child is seven years old for it to be diagnosed as ADHD (Web MD, n.d.).

Symptoms

There are actually three main characteristics of this disorder that parents need to learn to deal with. They are inattention, impulsivity, and hyperactivity. But there are many sub-symptoms in each of these categories:

Inattention may not be obvious to a parent until the child is in a controlled or structured environment like school A few of the symptoms are: (Web MD, n.d.).

difficulty paying attention to details and tendency to make careless mistakes in school or other activities; producing work that is often messy and careless easily distracted by irrelevant stimuli and frequently interrupting ongoing tasks to attend to trivia or events that are usually ignored by others students difficulty finishing schoolwork or paperwork or performing tasks that require concentration work habits disorganized frequent shifts in conversation, not listening to others, not keeping one's mind on conversations, and not following details or rules of activities in social situations

...and more

Hyperactivity symptoms can be quite obvious in younger children (Web MD, n.d.):

fidgeting and squirming when seated

talking non-stop

being always on the go

Toddlers and pre-schoolers can be very active anyway, and often it is difficult to separate normal activity from ADHD. But those children with the disorder are constantly in motion, jumping up and down on furniture, and usually cannot sit still to have a story read to them.

Impulsivity can lead to accidents like knocking things over and running into people. Symptoms include (Web MD, n.d.):

impatience blurting out answers before questions have been completed

frequently interrupting others or intruding on their space often enough to cause problems and create a disturbance

Impulsivity can be dangerous when children climb on unstable perches or to heights they are not used to. Of course, many of these activities occur with normal children as well. But with ADHD kids, it happens often and in inappropriate places such as friends' homes, stores, etc.

(Web MD, n.d.)

ADHD in Teens

What do parents have to recognize in their teens to know if they have ADHD? The symptoms from childhood can change when the adolescent and teen years begin. And the problem is they might become less noticeable to the point that some parents may deduce that the child is better and is "getting over" the disorder.

However, academic work becomes much harder to deal with for an ADHD teen. It is getting more difficult, teachers are more demanding and homework is heavy-duty. Also, relationship problems may appear as the child obtains more "serious" friends and those friendships become more important (Medem, 2007).

Driving

Driving becomes a serious concern for teens with ADHD. Teens without ADHD are a hazard on the roads. Teens with the disorder are more likely to not pay attention, more apt to forget to wear their seatbelt, and will probably drive faster and more recklessly.

There are numerous measures a parent needs to take with a teen who drives. They include:

Severely limit or prohibit, if possible, nighttime driving.

Ensure your ADHD teen is buckling up his seatbelt. This could mean the difference between life and death, so enforce it -- rigorously.

Try to time your teen's medication so that it corresponds to the times he may be driving.

Do not let your teen drive with too many other passengers. The more in the car, the worse his or her attention on driving will be.

Talk to the teen on the dangers of drinking or using drugs and driving. Make sure this is one rule that is never violated. Withdraw car privileges if you find out that it has been (Medem, 2007).

Substance Abuse

ADHD teens are even more susceptible to alcohol, drug abuse and smoking than other teens.

Because of the impetuosity trait of ADHD children, they are less likely to think or remember the consequences before they try these substances, and they are apt to experiment at a younger age.

How can parents handle this? By treating and managing the ADHD meticulously and constantly. Researchers have found that youth and teens who are treated correctly are much less likely to grow up with a drug or alcohol habit. Talk openly and honestly with your teen and make sure they know what your expectations are in this area. Set house rules, and remember when it comes time to enforce them that tough love is best. No exceptions. Discuss this subject frequently and keep it on the front burner. Stay involved in your son's or daughter's life. Know their friends, where they go, and don't think that a casual search of their room is an invasion of their privacy. You could be saving his or her life.

One thing not to do, perhaps surprisingly, is a drug test. Other measures can take its place. It is a statement that you don't trust your teen -- a kind of slap in the face -- when it is far more important to be able to have open and honest discussions with the child (Medem, 2007).

Relationships

Parents of ADHD teens worry most about their son or daughter establishing good relationships with their peers, if only because these teen-to-teen friendships are the most important ones for any teen during those trying years. And the number one concern is what they can do if their teen develops a relationship with a "bad" friend.

When researchers ask ADHD teens what gets them into trouble the most, the answer is usually those bad friends. But why is this such a major problem for parents? Because there is almost nothing the parent can do. The teen's relationship with that "bad" friend is stronger than any other relationship he or she has during those years (Kane, 2009).

So, what is the parent to do? First, do not attack your child's friends. This is a losing proposition from the start and will alienate your teen immediately. Not only will it alienate your teen, it will encourage the friend to gain an even stronger hold on your child. But, it is okay to comment and discuss "bad" or dangerous actions that the friend is encouraging your teen to participate in. This is not personal, it is smart.

Next, a parent might attempt to find an adult or older teen to help influence their teen in the "right" direction. This is risky. But if it works, at least your teen is now talking with someone you trust and that person can offset any negative influence from the "bad" friend. The risk is that your teen discovers your "behind the back" actions to "force-feed" someone onto him or her. If this is to succeed, it must be accomplished delicately, diplomatically, and the relationship between your trusted confidante and your teen must be developed slowly and carefully.

Finally, make sure you know your child's friends. So many parents don't. Don't just know of them, know them personally. For one thing you may find out that the friend you considered "bad" may not be. And even if they are, you may have a chance to positively influence them, but only if they trust you and know you are friend, not foe. You may also be adding to the circle of people around your ADHD teen who can help in time of need and can come to understand his or her special needs and assist with them. And consider the message a parent like that gives to his own son or daughter. You are telling them that their friends are important to you and that you care (Kane, 2009).

Homework

Why is this so important that we make a separate heading for it? Because homework for any child is a difficult time for parent and child even under normal circumstances. And, in today's schools, as assignments are more difficult, the child or teen's focus is on other things and the homework must be almost forced upon them. With an ADHD child, the situation becomes a critical mass that must be resolved in an orderly way that the child will understand and be organized enough to accomplish the homework satisfactorily.

With the ADHD teen's short attention span and restlessness, this problem becomes crucial to solve. But how? The answer may lie in a framework and structure that allows the ADHD child to accomplish the homework throughout his or her school years (Robin, n.d.).

First, the parent and child must work together to investigate the points at which they are having the problem with homework. Are they writing down the assignment properly? Do they understand the assignment? Do they bring home the appropriate schoolbooks, etc. with which to accomplish the assignment? Do they have a quiet, well-lit workspace at home? Are they adhering to the promised schedule for doing the homework? Do they have a problem focusing once they sit down to do it? Are his or her medications planned so that they can take advantage of it during those hours and have optimum concentration?

Second, work out a written agreement with your ADHD child -- a simple, structured document that they can understand and adhere to. Address specifically those homework areas that you have both identified as needing improvement with solutions that you have both agreed to. Try it out for a few weeks, and adjust it as necessary. And don't forget incentives for sticking with the agreement, and make them part of that document as well. The incentive could be more TV time, more time on the internet, a slightly later curfew on the weekend, or anything else that would truly motivate your teen (Robin, n.d.).

Parents and the Big Picture

Most often a feeling of "What do I do now?" pervades a parent's mind when their child is first diagnosed with some form of ADHD. You need information, and if you have access to the internet, it is a very good source for all the data you might need. Whether the internet, the library, a friend with an ADHD child, or a professional, arm yourself with all the helpful information you can get.

What you will find is that, though frustrating at times, raising an ADHD child can give you a sense of fulfillment and satisfaction if you know how to deal with it. Most ADHD children live successful, nearly normal lives with the medications available today.

But the important word is "you." The parent can create a home environment that is useful, constructive and positive in which the ADHD child can thrive if they start immediately when the child is young (Natural Resource Center on AD/HD, 2004).

"If you have a child with ADHD, you know how frustrating it can be when your kid doesn't listen, do what you asked, or finish what was started. With the constant monitoring your child requires, it may feel as if he or she is the one running the home. This added stress can breed resentment, causing you to focus on your child's deficits while overlooking successes and positive traits. On top of that, you may also feel guilt over your frustration" (Jaffe-Gill, Dumke, Segal, de Benedictis, Smith, & Segal, 2007, para. 2).

But remember that your child doesn't want to be the way he or she is. ADHD can be like depression. Forgotten is the fact that the person has a disorder -- a disease. What is seen is the behavior without any visible signs of a sickness -- just an overactive, aggressive child who can't stop talking, or running, or bumping into things.

Follow the right steps with patience, love, and compassion and your home life can be almost normal.

Managing Your Child's ADHD

"Children with ADD/ADHD generally have deficits in executive function: the ability to think and plan ahead, organize, control impulses, follow through, and complete tasks. That means you need to take over as the executive, providing extra guidance while your child slowly acquires executive skills of his or her own" (Jaffe-Gill, et al., 2007, para. 10).

Become an outstanding record-keeper. Keep records and files of everything having anything to do with your ADHD child. Symptoms, doctor's opinions and assessments, significant problems, treatments, progress, school report cards -- everything. They could be helpful if you move to a new location or change doctors, or something changes drastically with the disorder.

Keep a routine. The more regular an ADHD child's schedule can be, the better. This applies to school, chores, homework, play time, eating, and sleeping.

Form a team of support advisors. Your spouse, the child's teacher, his doctor, his counselor, your church pastor or Sunday school teacher, another parent whom your child may be close to, etc. Have a regular monthly meeting with all of them together if possible. Compare notes and opinions on how your child is doing. Be candid with them. Share your frustrations and praises. Listen to their pertinent "3rd party objective" opinions.

Talk, negotiate, and consult with your ADHD child. Have dialogues with your child. Listen more than you talk. Communicate clearly and precisely what you want him or her to do. Make your instructions positive in the sense that you tell the child what to do, and not what not to do.

Give instructions one simple step at a time. Don't just listen to the child, take into account what they say just as you would your own advice.

Parent Training. Many organizations offer training for parents of ADHD children. Take advantage of them. Techniques, tips, advice, counsel, support and companionship can all help your ADHD experience be more successful. It will also benefit your child in that you will feel more confident in dealing with his disorder.

Prognosis for ADHD

"ADHD is a long-term, chronic condition. About half of the children with ADHD will continue to have troublesome symptoms of inattention or impulsivity as adults. However, adults are often more capable of controlling behavior and masking difficulties" (Kane, 2009, para. 1).

It is estimated that somewhere between 5-10% of school-age children are diagnosed with ADHD, and that boys are ten times more likely to be diagnosed with the disorder than girls.

About 75% of children diagnosed with ADHD can be treated with stimulant medication, like Ritalin, Concerta, or Methylin, and receive relief from the symptoms. Approximately half of ADHD children do outgrow the disorder in their late teens or early adulthood. The other 50% will probably retain some or all of their symptoms into adulthood.

ADHD can be inherited.

Conclusion

Parenting of an ADHD child is exhausting and frustrating. An ADHD child is a huge bundle of energy, motion, danger, and unpredictable behavior waiting for an opportunity to explode. And the parent is usually the one in the path of the explosion.

The ADHD child's mood swings, inability to complete chores, and hot temper have brought many an ADHD parent to tears over what to do.

It is too important not to emphasize that early intervention and treatment are the keys to a semi-normal life for both child and adult. Consistent, competent, treatment is necessary to "beat" this disorder. When symptoms first appear, possibly around age four, the child should be evaluated for ADHD.

It will be a long, enduring struggle, but with planning, patience, and persistence, a family can live a somewhat normal existence with a treated, stable ADHD child.