Attention-deficit/hyperactivity disorder, more commonly known as ADHD, is a disorder in which children are more apt to have trouble learning because they have difficulty maintaining attention, are hyperactive or impulsive, and may have trouble with organization and planning.
Symptoms of ADHD include inattention, difficulty focusing and concentrating, and sometimes hyperactivity and/or impulsivity. These symptoms have to significantly impact daily functioning in some way, at home, at school, or at a job, for example.
Children who are diagnosed with ADHD must have a certain number of symptoms in two or more environments. On this week’s On Call for All Kids, Jennifer Katzenstein, Ph.D., ABPP-CN, co-director for the Center for Behavioral Health at Johns Hopkins All Children’s Hospital, provides some effective tips to help parents better understand ADHD.
What is ADD?
Interestingly, with the newest edition of the DSM-5, our diagnostic manual, ADD was removed, and ADD became “ADHD, Predominantly Inattentive Presentation.” There is also “ADHD, Combined Presentation,” “ADHD, Predominantly Hyperactive/Impulsive Presentation,” and then two other diagnosis, “Unspecified ADHD” and “Other Specified ADHD,” for unique situations.
What should I do if I have concerns? How do we move forward with a diagnosis?
If you have concerns, it is great to start with your child’s teacher or teachers, to see if they have concerns. Then, check in with your pediatrician, who is able to do measures for both you and the teacher to complete to determine if a diagnosis is appropriate. If there are more factors influencing symptoms, or if the pediatrician wants more information, then a psychologist or neuropsychologist might get involved.
What treatments exist for ADHD? Is it always medication?
There are three main components that are part of any treatment plan for ADHD: 1) home interventions, 2) school accommodations and supports, and 3) the potential for medication management. Medication is always a family decision, but we know we have great home interventions that can assist with management of symptoms, as well as school supports.
How can I advocate for services at school?
Definitely start with your teacher. Find out what the teacher is seeing, and how to best navigate the school system, which can vary by school district. Then, with a diagnosis of ADHD, you can request a Section 504 Plan or Individual Education Plan by the process set out by the school. A great way to do this is to provide a letter to school personnel in writing, requesting a meeting to determine if your child is eligible.
What are the best things to do to support ADHD at home?
At home, a few great tips include starting a behavior chart or technique such as a button/stone jar for “catching good behavior,” and using frequent breaks during homework time, with lots of opportunity for physical/outside play. In addition, keep expectations consistent and give lots of positive reinforcement and praise.
What else should I be watching for?
Monitor anxiety and depression, because frustration and difficulties with school can definitely impact anxiety and mood. In addition, make sure to be monitoring executive functioning skills, such as planning and organization, time management and multi-tasking, as children with ADHD can have concerns in these areas and need additional supports too!
What does the future look like for my child?
The future is bright! We know there are great treatments for ADHD, and amazing personality characteristics, creativity and social skills that accompany ADHD as well. We want to make sure all kids get everything they need to be successful.
On Call for All Kids is a weekly series featuring Johns Hopkins All Children’s Hospital experts. Visit HopkinsAllChildrens.org/Stories each Monday for the latest report. You also can explore more advice from Jennifer Katzenstein, Ph.D.