ADHD
We have noticed an explosion in ADHD diagnosis in the last several decades. Perhaps the first thing that is important to note is that the diagnosis of ADHD is best made between the ages of 4 and 18, during which the peak of symptoms is usually around the ages of seven to eight. Diagnosing adults is much more difficult because there is a much greater frequency of conditions such as anxiety and depression which complicate the picture. Most primary care physicians feel comfortable diagnosing ADHD in children but feel less comfortable with adults. Secondly, it's important to note that the diagnosis of ADHD requires that the individual's function must be impaired in academic, social, or occupational activities. This means that if you think of yourself as a person with "high functioning ADHD" because you experience no change in your ability to function, then you probably don't truly have the diagnosis of ADHD. You may have difficulty with attention, which can be super annoying, but it's just not diagnosable as true ADHD until it keeps you from functioning well. Full diagnostic criteria include symptoms of hyperactivity/impulsivity or inattention that: Occur often, are present in more than one setting (like school and at home), persist for at least six months, are present before the age of 12 years old, impair function in academic, social, or occupational activities, and are excessive for the developmental level of the child.
Once diagnosed (often with symptoms score sheets sent to home and school), treatment can include both medications and non-medication options. In addition to working with a trained counselor, there is a non-medication options called Parent Training in Behavior Management (PTBM), which includes: maintaining a daily schedule; keeping distractions to a minimum; providing specific and logical places for the child to keep their schoolwork, toys, and clothes; setting small, reachable goals; rewarding good behavior, using charts and checklists to help the child stay "on task;" limiting choices; and finding activities in which the child can be successful (hobbies, sports, etc.). Finally, it is important to note that up to a third of children with ADHD have a concurrent disorder such as anxiety, sleep difficulty, or a learning disorder such as dyslexia. Their symptoms of ADHD may be significantly improved by treating this alternative or additional diagnosis as well.
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Information provided by
Stewart Decker, MD, MPH, FAAFP, FWMS
Jeanette Rutherford, MA, LPC
Jennifer Newton, RD, LD, CDCES, MPH
