“Does my kid have ADHD?” This is a really common concern that I get. Maybe the kid is zooming around the room. Maybe the kid is struggling to finish school work. Maybe the kid’s room looks like it was hit by a tornado.
Maybe the kid is just a kid. With a different personality than their parents. With a different personality than their siblings or cousins. Maybe the kid is younger than their classmates. Maybe the kid doesn’t have ADHD. Maybe the kid has ADHD and doesn’t need any additional support. Here’s are the broad categories I tell parents to look out for in determining if a kid needs further evaluation for ADHD – presenting the 4 Ss:
- Safety – Is the kid safe, or are they running in the the streets, escaping from the house, jumping off of really high places, making poor choices? Are they getting hurt or hurting others?
- School – Is the kid learning in school, or are they not keeping up with basic concepts?
- Self esteem – Does the kid think this is not a problem, or do related struggles make the kid feel less confident? Are they feeling down about their struggles?
- Social – Is the kid making friends, or are they having a hard time making friends or often getting into conflicts with other kids or adults?
If the kid is safe, learning, has good self-esteem, and is making good connections with peers, then I continue monitoring the kid. I might follow up in 4-6 months, or just each year at the well visits. However, if they are struggling in any of these areas, then I will dive deeper with an evaluation. I give the parents and teachers surveys (the Vanderbilt forms) to fill out.
Sometimes, they point me towards a slam dunk diagnosis of ADHD. Sometimes, they offer a piece of the diagnostic puzzle, and I use other clues to figure out the diagnosis. Sometimes, I don’t make the diagnosis until I build up years of clues and data and the kid’s own account of what’s going on in their brain. Sometimes, I ask for help from a psychiatrist, therapist, or behavioral pediatrician. And always, the families and kids are part of this discussion.
Once I make a diagnosis, or working diagnosis of ADHD, these are some next steps I take to offer my patients and their families additional support:
- Recommend accommodations in their learning environment through a 504 plan
- Instruct the parents on how to request an IEP (individualized education program) evaluation at school for their child
- Refer to a therapist or psychologist
- Refer to occupational therapy
- Refer parents to the additudemag.com website for parenting strategies
- Refer kids to the same website for learning strategies
- Recommend lifestyle changes (more routine, more reminders, shorter instructions, simpler instructions, wholesome nutrition, adequate sleep, less screen time, and LOTS of exercise)
- Recommend supplements such as fish oil and vitamin D (always talk to your child’s pediatrician prior to starting any over the counter supplements and medications)
- Prescribe medication
- Improve the kid’s functioning in school and life while keeping their personality and building on their strengths
Sure, parenting a child with ADHD or ADHD-like behaviors can be challenging. It’s hard to keep up with all that energy. It’s hard to constantly remind and redirect and negotiate. It’s hard to tolerate chaos when the parent’s style is order and neatness. But it’s also an opportunity for empathy, creative problem-solving, and growing together. It’s awesome to watch a kid blossom in their own unique way. So when parents ask me if their kids have ADHD, the deeper question I try to answer, is either way, how can I help their kid thrive.
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