Behavior & Development • Sep 19, 2017

ADHD?  Not my kid!

I was that parent and I still struggle with my son’s diagnosis. As a pediatrician, I knew there were signs early on, but I brushed them off as “typical boy.” After all, I had the kid who was gifted, reading well above his grade level, was accelerated in math and could play Risk for hours on end. How could he possibly have ADHD?

True, he couldn’t keep his hands to himself in soccer practice and would kick the dirt around in baseball games, but he was excelling at school. Teachers loved his mind. But over time, the reports home about him not paying attention or following directions and not thinking before acting increased. His impulsive behavior turned off other kids.  This upset him. Behaviors that passed as “ok” at 5-years-old were no longer socially acceptable at 8-years-old. We tried talking to him. We tried the school counselor, who offered “mindfulness” techniques. All this helped, but it wasn’t enough. Finally we accepted there was a problem and we talked to his pediatrician.

I see parents in my practice who quickly make the leap to ADHD for their preschooler, who just doesn’t sit still, and other parents who can’t accept that ADHD is the reason their 10-year-old cannot retain what he reads despite reading the same page over and over again.

The range of responses to ADHD from parents, teachers and medical providers is as broad as ADHD itself. The important thing to remember is that kids with ADHD are not “bad kids.” They want to do well and they want to please you. They wish they could pay attention and sit still like their peers, but they just can’t. There are several types of ADHD.

ADHD “combined” type might be the child who cannot sit in circle time in Kindergarten for more than 5 minutes, cannot stop talking to his neighbor in the classroom even after the teacher has told him a hundred times, and has no idea what direction he was given by the teacher one minute before.

ADHD “hyperactive” type is the child everyone can easily recognize from the moment they meet him. He is bouncing off the walls and cannot stop moving his body and he interrupts you constantly.

ADHD “inattentive” type can be like my child. He’s just a little unorganized. He forgets his homework, he forgets his library books.  He never gets dressed when you ask him the first 10 times. In school, he is excelling, because the work is easy.  If you ask him if he has trouble paying attention in class, he tells you he often stares at the tiles on the floor and misses what the teacher has told the class to do. Then he is frustrated because he missed the directions and doesn’t know what to do. But give my kid an 800 page Harry Potter book and he won’t put it down for days. So you may not realize how this bright, sweet child of yours is struggling until the work gets too hard and he can’t “get by” anymore.

So what do you do if you are getting reports home from teachers about little Joey constantly interrupting, not sitting in his seat, not turning in homework and not paying attention? You talk to your pediatrician. Set up a meeting with your pediatrician and bring as much info from your child’s school as you can. The more we know, the easier it is to sort out the problem. You pediatrician will talk to you and your child a lot because we need to make sure there isn’t depression, anxiety, sleep deprivation, a problem at home or any host of other issues that can look like ADHD. Your pediatrician will ask you to complete some questionnaires and ask your child’s teachers to do the same. The evaluation is a long process and may involve your family meeting with a psychologist if the diagnosis or management isn’t clear to your pediatrician at the time. This is all done with the best interest of your child in mind.

Managing ADHD is multifaceted. The most effective management is with medication and there are many options out there. You should also talk to your school about a 504 plan to help your child succeed with his ADHD. You may also need to make some changes at home to help your child stay on task and keep organized. The goal of our management of ADHD is to maximize your child’s potential and allow him to be successful in all aspects of his life.