AD/HD: What Every Parent Needs to Know

from Shine Newsletter, Fall 2006

Attention-Deficit/Hyperactivity Disorder (AD/HD), a common behavioral disorder, can be perplexing. Here’s what you need to know.

For most kids, squirming, inattention and hyperactivity are just normal parts of childhood that don’t hinder their lives — and are gradually outgrown. However, for some children, these problems can be the result of a more serious condition: Attention- Deficit/Hyperactivity Disorder (AD/HD).   AD/HD — formerly known as Attention Deficit Disorder (ADD) —is recognized by both the American Academy of Pediatrics and the American Psychological Association. If your child is diagnosed with AD/HD, keep in mind that the disorder isn’t caused by bad parenting, school situations or too much sugar. Rather, it is believed to have biological origins, which researchers continue to investigate to better understand the possible genetic and environmental links. When uncontrolled, AD/HD can lead to behavioral or concentration problems that interfere with a child’s social life and schoolwork.

To bring you expert insight into this somewhat perplexing disorder, Shine spoke with Bert Dech, MD, psychiatrist at The Children’s Hospital. Dr. Dech has worked with many AD/HD children since joining the hospital’s staff in 1990.

Shine: How can I tell if my child has AD/HD?

Dr. Dech: AD/HD is an actual medical condition. When a child has AD/HD, his or her impulsiveness and hyperactivity can create organizational or time-management problems, either of which can cause difficulties at school.

Shine: How is AD/HD diagnosed?

Dr. Dech: There is no test to determine if AD/HD is present. As a result, physicians must perform thorough evaluations of the child’s physical and mental health, health history and behavior.

To do this, a physician should perform a physical exam to explore your child’s health history, family health history, medications and allergies. The doctor also should test your child’s hearing and vision to rule out other medical conditions. Parents will fill out a questionnaire that will be used to rule out possible emotional causes, such as depression or anxiety.

Shine: Are children overdiagnosed with AD/HD?

Dr. Dech: I think they are both over and underdiagnosed, depending on who is doing the evaluation.  There are people who don’t do the diagnosis correctly, and some who don’t believe the disorder exists.

Shine: In the long-term, what will a diagnosis of AD/HD mean for my child?

Dr. Dech: The biggest long-term problem is not treating AD/HD effectively. Most children with AD/HD will need a combination of behavioral and medical therapy to keep their symptoms under control.   The worst thing you can do is ignore the condition and hope it goes away, because kids with AD/HD have higher rates of drug use and legal problems.

Shine: What do I need to know about medications for AD/HD?

Dr. Dech: Think of AD/HD medications like you would eyeglasses: Each has to be individualized for the patient to get the right effect, so don’t be concerned if the doctor changes your child’s dosage. If you give the child too little, it won’t be effective.   If you give too strong a medication, the child could become nonreactive.   You’re not trying to change the personality of the child with the medications, but you want to stop disruptive behavior.  The most effective AD/HD treatment is a combination of behavior modification and medication. Common forms of behavioral therapy include creating a routine schedule for the child to follow, reorganizing the school and home environments, limiting the child’s choices, reducing potential distractions and helping the child discover a talent.

Shine: If my child is affected by AD/HD, how can I help with schoolwork?

Dr. Dech: Make sure the teacher is aware of the condition and that he or she is careful not to continuously reprimand the child for not always following through with directions. Your child may listen and understand but may not be able to completely control his or her actions. At home, provide a lot of structure and routine, and make sure your child takes his or her medication.