Dr. Jacqueline Gerhart: How can a parent know if a child has ADHD?
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart:
I have a 5-year-old son who started kindergarten this year. Since starting school, he is constantly acting out at home. He doesn't follow directions and can't sit still. How do I know if he has ADHD?
ADHD stands for Attention-Deficit Hyperactivity Disorder. It used to be called ADD, but was changed to ADHD in 1994 by the American Psychiatric Association. It is the most common psychiatric diagnosis in school-aged children — about 2 percent to 16 percent of kids have symptoms of ADHD. It is more common in boys than girls. Some symptoms include: not listening when spoken to, getting distracted easily, jumping from one task to another, interrupting others, not waiting his/her turn, fidgeting with hands, running or climbing when not appropriate, or trouble sitting still or playing quietly.
To be diagnosed with ADHD, a child should have symptoms that last for 6 months or more, that are observed in two different settings (such as both at home and at school), and that are disruptive or inappropriate compared to most other kids that age. Also, the symptoms usually affect the daily life of the family and child.
Determining if your child has ADHD requires a team approach. It involves your family, your physician, your child's school, and possibly other resources such as a social worker, or counselor.
The first step is to have your child see a primary care physician or a child psychiatrist to discuss his symptoms. Often the physician will ask the child and the parent questions about what life is like at home.
The Conners' Continuous Performance Test (CPT) and the Vanderbilt ADHD Diagnostic Rating Scale are two tools clinicians use to help assess ADHD symptoms in kids. Usually the family and the teacher complete separate surveys and give them to the physician for review. The answers to these surveys help guide us, but do not always determine whether your child has ADHD. All of the information you and your school share with us (survey and non-survey) is considered in determining the best plan for your child.
Many parents come to me requesting medications. My first goal is to determine if the child might have something other than ADHD. Many symptoms of ADHD will occur from time to time in everyone. So, it is possible your child is exhibiting normal behavior. Your child also may be nervous or anxious about starting kindergarten, or may be exhibiting a stress response to being away from home. He also could have a mood disorder such as depression or anxiety, or a metabolic problem such as low or high thyroid hormone.
The good news is that often as kids get older, they are able to adjust to their symptoms, and can channel their energy toward specific tasks. Between 50 percent and 70 percent of kids with ADHD will no longer have symptoms into adulthood. Some of my adult patients who still have ADHD symptoms reference a time (often during high school, college, or their first job) where they found a "niche" and could function very highly.
For more information, check out the UW Health website health information article titled "ADHD: Should my Child Take Medicine for ADHD." Go to uwhealth.org and search for ADHD to find the article.
I hope your son enjoys kindergarten!
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 12/13/2011