Attention deficit hyperactivity disorder is a neurologic disorder in which one has an inability to focus consistently that is disruptive to their daily life. This can occur with or without symptoms of hyperactivity and/or impulsivity. Symptoms occur in multiple settings (at home and at play) not only in the classroom. This disorder has a genetic basis, meaning it tends to run in families. It is not the result of poor parenting, eating too much sugar, or the child being lazy or stupid. ADD is both overdiagnosed and underdiagnosed. Not every child with attention difficulties has ADD. As many other factors, such as illness, learning problems, stress at home, illicit drug use, poor vision, depression, or other psychiatric disorders may resemble this condition. On the other hand, many “daydreamers” who have poor academic achievement due to inability to focus, or children who do well in elementary school but have problems in middle school or high school may be overlooked if they are not disruptive in the classroom.
How is ADD/ADHD Evaluated at WE CARE PEDIATRICS?
The evaluation of ADD/ADHD is a time consuming process and is not one that can be done on an “emergency” basis. If a parent expresses concern that a child may have difficulty focusing, we initiate an evaluation using Connor’s forms, a standardized evaluation system. Several teachers, and each parent or other adults who are very familiar with the patient, and the patient him/herself (if over the age of 12 years) complete forms and then we review them. If the results are suspicious for ADD/ADHD, we bring in the parents for a one hour consult to further discuss the diagnosis and treatment. If further evaluation is indicated, or if either parent in uncomfortable with the diagnosis, referrals are made to psychiatrist or a Developmental/Behavioral specialist.
How is ADD/ADHD Treated?
Not every child with a diagnosis of ADD requires medication. Practical measures, such as, ensuring that the child is getting sufficient sleep, a proper diet with protein at each meal, and limiting artificial coloring and preservatives in food, may ne beneficial. In addition, many children benefit from a complete psycho educational evaluation through the school system. This can identify other educational problems that will respond to classroom accommodations. Public schools will create an individual educational plan (IEP) or a 504 plan for children who qualify. When measures are not sufficient, we do recommend medical treatment. It is important to remember that there are a number of different medications available to treat ADD/ADHD, and what works for one person may not work for another. We usually start patients at low dose and gradually increase it until a dose is achieved that adequately treats the symptoms without significant side effects, such as moodiness, social withdrawal, or development of a tic occur, the medication is discontinued and another is started, if desired. Because of the complex nature of ADD/ADHD treatment, we see patients for 30 minute appointments every few months to monitor their response to medications. These appointments are essential for continued treatment, and frequently do need to take place during the day.
Where can I find additional information on ADD/ADHD?