Symptoms of ADHD
The following symptoms occurring in more than one setting, for example at home and at school:
Difficulty paying close attention
Makes careless mistakes in school, at work, during other activities, overlooks details
Difficulty sustaining attention in tasks, play, or reading
Often does not seem to listen when spoken to directly, absentminded
Often does not follow through on instructions
Difficulty organizing tasks and activities, planning ahead, keeping belongings in order
Avoids dislikes or doesn’t want to engage in tasks that require sustained mental effort
Often loses items necessary for tasks (keys, wallet, books, pencils, glasses)
Is often distracted by extraneous stimuli, forgetful in daily activities like doing chores
Often fidgets, taps hands or feet, squirms and wiggles in seat
leaves seat in situations when remaining seated is expected (like in class, at dinner table), runs, climbs in situations where it’s inappropriate
Unable to play quietly
often “on the go” or “as if driven by a motor”
Often talks excessively
Often blurts out an answer before a question has been completed, has difficulty waiting turn, often interrupts or intrudes on others
**Please note that the American Academy of Pediatrics states that ADHD must be diagnosed by a medical professional such as a physician, psychiatrist, or pediatrician. It is important to consider whether the following symptoms are occurring in most settings, and to ask other parents, teachers, and caregivers their impressions of the child as well. Since ADHD is a neurodevelopmental disorder, it is not to be taken lightly as a diagnosis.
Types of Treatment for ADHD
The American Academy of Pediatrics (2011) acknowledges that inappropriate diagnosis of ADHD may cause children to receive treatments they do not need, or may cause another condition to be missed. Best practice for diagnosis include an evaluation for all children ages 4-18 who present with inattention, hyperactivity, or impulsivity and adherence to DSM-V criteria, consideration of the DSM-PC. Providers should administer a rating scale such as the Connors Comprehensive Behavior Rating Scales and the ADHD Rating Scale IV, and obtain behavior reports from parents, teachers, or adolescent child (2011, p. 7). It is important to note that mood and neurological disorders often co-occur with this diagnosis and that the primary care provider should be trained to recognize this and make appropriate referrals. For treatment of children 4-18 years of age the AAP recommends “evidence-based behavior therapy” administered by a parent or teacher and to administer methylphenidate “if the behavior interventions do not provide significant improvement” (p. 2). Typically, preschool-age children who meet criteria are referred to programs such as Head Start or Early Childhood Special Education services in the community, while some physicians will recommend parent training programs. The AAP does advise the PCP or clinician to weigh the risks of prescribing medication at preschool age. For all ages, the organization also recommends medication management to achieve maximum benefits (p.4).
The AAP admits that there is a limitation of mental health resources for children with ADHD.
One of my hopes as a counselor is to use my experience to fill the gap through working to assist children in understanding brain and body, individual differences that come along with ADHD, address self-esteem, peer relationships, and symptom reduction through relationship-based mental health treatment that builds and rewires the brain from the bottom up!
If you have tried behavioral therapy and medication, and are feeling like something is missing, seeking support for your child through a neuro-relational counseling framework could be what you’re looking for!
What we know about Children and ADHD
ADHD is one of the most commonly diagnosed neurodevelopmental disorders among children and adolescents. Limberg, et. al (2018) cite the National Survey of Children’s Health, stating that one in eleven school-age children in the United States had an ADHD diagnosis in 2011. Prevalence rates of ADHD are 5% internationally according to Tatlow-Golden, et al. (2016) and to the Diagnostic and Statistical Manual, Fifth Edition (2013). Tatlow-Golden’s study on practitioner knowledge also shows a gap in training and a need for increased collaboration between providers and family members.
ADHD is associated with increased teacher stress and classroom disruption. Children with ADHD often experience peer rejection, academic struggles, and some experience anxiety and depression as well as an association with a “greater initial exposure at a young age to substance useand slightly faster progression” (Molina, et. al, 2018). Neurological anomalies are also present in children with this diagnosis.