Solutions for parents worried their child may have ADHD

Since the children have been back in school for a few weeks, parents have probably started receiving feedback from teachers about their child’s performance and behavior in class. If you hear your child has trouble paying attention, sitting still, or controlling their emotions, you may be wondering if they have Attention Deficit Hyperactivity Disorder (ADHD). dr Jennifer Crosbie, a clinical psychologist at the Hospital for Sick Children, says that the hallmarks of ADHD are difficulties with attention, concentration, hyperactivity, and impulsivity. She has answers for parents with questions about this common neurodevelopmental disorder.

At what age is ADHD typically recognized?

ADHD-related problems are most commonly identified in the early school years—on average, around 1st or 2nd grade. Then the symptoms or characteristics typically begin to cause impairment, particularly at school. Children struggle with things like sitting in class, following a routine, or playing recreational activities and sports.

Why do some children develop this disorder and others not?

There are other factors, but we know that genetics is a significant part of what underlies ADHD. We also know that it is the most common childhood mental disorder, occurring in about six percent of children.

ADHD is diagnosed more frequently in boys than girls at a rate of about four to one. Girls can be a little harder to identify. Girls can have a slightly different appearance than boys – less on the side of hyperactivity and impulsivity. But even taking that into account, it’s more common in boys.

What should parents be aware of if they suspect their child has ADHD?

When you look at the symptoms or characteristics associated with ADHD, it’s easy to feel like these are things you can see in everyone. And some of them sound a lot like normal childhood behaviors. But what is different for children with ADHD is that there are more of these traits; several of them come together in one child.

These behaviors occur in multiple situations and are often inappropriate. In other words, it’s starting to cause trouble for them. We’re not talking about occasional impulsiveness or hyperactivity—this behavior happens at home, at school, and with friends. Children with ADHD behave this way more often than their peers.

Can you give some examples?

A child with ADHD tends to be inattentive in class and often misses what is being said to them. Often it’s because they’re distracted or paying attention to something else, and when they sit down to get work done, they don’t know what to do. It’s not that they can’t do the job, they just missed the instructions. So you constantly switch from one task to the next and are easily distracted. And not just a little, but a lot.

This level of distractibility and inattention makes it difficult to complete schoolwork or even daily activities at home, things that other children their age can do with relatively little effort. It can also affect peer relationships. You try to play a game with friends but keep forgetting the rules or not paying attention. Or maybe they have a hard time waiting, so they keep jumping in line. This behavior can cause difficulties in their social relationships.

When it comes to impulsiveness and hyperactivity, they may be constantly climbing, running, and jumping, talking more than their friends, and talking about their friends. You might jump off things that are too high or jump in front of things without looking.

And there’s a real intensity around these behaviors. It’s not just every now and then, like at a birthday party when they’re excited, or at the park when they’re having a great time with friends. These behaviors are pervasive in several situations and cause difficulties.

How is ADHD diagnosed?

A diagnosis is based on a behavioral description. We typically interview parents and often gather information from teachers as well. We look at a range of behaviors in comparison to other children their age and determine if it interferes with the child’s everyday life enough to be diagnosed as a disorder.

As with most medical conditions, the ideal is to diagnose it as soon as it causes trouble. A diagnosis allows us to create a treatment plan and develop strategies to help that child. You want to avoid your child becoming frustrated with school.

What does a treatment look like?

There are two main classes of interventions for ADHD. Behavioral interventions are when you adjust the child’s environment. This may include giving them more feedback, strategizing to make sure you have their attention when you ask them something, giving them reminders, building in extra structure, and maybe shortening tasks so they’re not as detailed . For some kids, being very busy can mean getting up and moving around.

The other main intervention is medication. Families can decide what is best for them by talking to their primary caregiver. Evidence suggests that a combination of behavior modification and medication is often optimal.

How can parents help make things easier at home?

In general, you can replicate at home the recommendations we give regarding the environment at school. This includes breaking things down, avoiding overly complicated instructions, and making sure you have their attention. Also, it helps to provide reminders and clear feedback on what’s expected and what’s wrong.

Try to be organized and build in structure and routines – do the same things in the same order every day with clear reminders.

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