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What you should do if you suspect your child has ADHD

What you should do if you suspect your child has ADHD

Attention-Deficit/Hyperactivity Disorder (ADHD) is a psychiatric disorder characterized by symptoms of inattention, impulsivity and/or hyperactivity. ADHD is one of the most common childhood disorders and frequently continues into adolescence and adulthood. Although so many individuals with ADHD are bright, creative, and dynamic and have tremendous gifts, ADHD can greatly interfere with educational, occupational, economic and social functioning. Fortunately, there are many effective approaches to managing, facing and embracing ADHD and helping individuals achieve greater balance in their lives. If you suspect that your child has ADHD there are several simple and straightforward steps to take to get things started.


Do

Do get informed

It is important to reach out to reliable sources so that you can learn about ADHD. In fact, pediatricians can be great sources of information about normal vs abnormal behavior in kids, and many are very comfortable diagnosing and treating ADHD. There are also specialists in pediatric mental health, child/adolescent psychiatrists and psychologists, who can provide information about ADHD - most pediatricians will have the name of a child psychiatrist or psychologist with whom they work.

The internet can be a very helpful source of information about ADHD; it can also be a source of misinformation and confusion. There are reliable websites from several expert organizations, including the Hallowell Center, the American Academy of Child and Adolescent Psychiatry (AACAP), the National Institute of Mental Health (NIMH), the American Psychiatric Association (APA), the American Academy of Pediatrics (AAP), Children and Adults with Attention Deficit Disorders (CHADD) and ADDitude Magazine. These websites can provide reliable and cutting edge information and education about ADHD.

Do find a provider with whom you and your child connect

In order to get the most out of your treatment, it is helpful for you and your child to feel like you can trust and can be open with your treatment provider. This will make you feel better and will also let your provider take better care of you. For example, it may take some time for parents to finally reveal that their child is regularly eating a very sugary cereal for breakfast every morning, for example. Perhaps you are embarrassed that you would be judged for this in light of your therapist’s recommendations to limit simple carbs and boost protein content in breakfast. While sugary cereals do not cause ADHD, the amount and types of foods that kids eat can impact upon their levels of energy, focus and mood.

Once you realize that you are not in trouble with your child’s therapist and that they are more of a supportive coach, they will be able to work together on a healthier, kid-friendly diet for your child.

Do consider all treatment options

I frequently describe treatments for ADHD as "tools in a toolbox." For example, building a table requires a few different tools - a hammer, saw, screwdriver, tape measure, pencil, etc. All of these tools are important and together they help to get the job done. Knowing when to choose the appropriate tool is also part of getting the job done. Similarly, treatment for ADHD often involves a combination of “tools” including the following: good sleep hygiene, exercise, nutrition, social connection, therapy/coaching and medications. Since there is not a single treatment that works for everyone, becoming an "informed consumer" will also be useful.

Children are constantly growing and changing and may respond to different "tools" at different times and stages. You know your child best and learning about all of the treatments and "tools" will help you and your provider to decide where to start and what might be the best fit for your child. Establishing a relationship with a provider who will listen, provide education and flexibility can make for a positive treatment experience. Different providers may have different treatment approaches so finding the right fit for you and your child can take time.

Do find the right treatment for your child

Once you have read about ADHD and various treatment approaches it will be time to move forward with treatment decisions. Although you are more informed and there is less mystery about this condition, the decision to try different treatments can be quite anxiety-provoking. Parents are often especially concerned about medications. Similar to the first time you put your child on antibiotics, you may have substantial anxiety about how your child will respond, despite the reassurance of the pediatrician that the antibiotics are well-known, characterized and studied and can be quite safe.

Researchers have found through numerous well designed studies sponsored by NIH and not by pharmaceutical companies, that medications for ADHD can be quite effective in enhancing focus/attention and helping kids “put the brakes on” both in and out of school. There is no evidence that they cause drug addiction and, while they have side effects like all medications, these side effects are reversible and can be managed if the medication turns out to be helpful.

Medication is just one of the “tools in the toolbox”. Medications can be quite helpful but there needs to be healthy sleep hygiene, exercise, nutrition, social connections, parental support, structure and guidance throughout treatment for the medications to work most effectively. In some cases, medications are not the right fit - they may lead to uncomfortable side effects that interfere with treatment. Sometimes it makes sense to start with parent coaching/guidance and work with parents and schools to provide more structure and support for your child. In other cases, it may make more sense to increase exercise, improve sleep hygiene, and/or work on enhancing/improving your child’s nutrition.

Be open to treatment approaches that may have less evidence behind them. If your child is struggling with “evidence-based” approaches to treatment then discuss other options with your provider, such as more complex nutritional approaches, meditation, neurofeedback, etc. There is no “one size fits all” for treatment. It is important to find a provider who will tailor the treatment to fit your child’s strengths and needs and to be open to trying certain tools at certain times.

Do be optimistic

Optimism is a powerful force and is a key component of resilience. Studies show that ADHD is quite responsive to numerous interventions. So many children develop improved coping skills and make substantial progress while discovering their tremendous gifts and strengths. The fact that you are reaching out for help and information is a sign of strong parenting and will go a long way towards helping your child.


Don't

Do not panic

Stay calm in the midst of uncertainty. Heightened anxiety can interfere with staying focused and making responsible and informed decisions. While it is normal to feel anxious in response to uncertainty, anxiety can be both motivating and interfering. Use your anxiety to motivate you to become informed about this condition. Education will reduce your anxiety, especially as you learn that ADHD is a common childhood disorder and there are many effective treatments. Furthermore, so many individuals with ADHD have tremendous gifts and strengths that will take them far in life.

Try to find a treatment provider who endorses a strength-based approach to ADHD and certainly find someone with whom you and your child are comfortable. A strength based approach means that the provider is not focusing on the “deficits” but, rather, upon all of your child’s wonderful gifts. Strength-based treatment is comprehensive treatment that involves building new skill sets while recognizing and enhancing your child’s strengths.

Do not feel stuck with the first provider you meet

Although you are feeling vulnerable and looking for answers and support, it is very important to feel connected with your provider. Parents can feel great urgency to move forward with care/treatment and may feel internal pressure to stick with the first person they meet. Know that there are many options and find the right fit.

Do not immediately rule out treatment options

Keep an open mind regarding all potential treatments for your child. You will likely seek out and receive a lot of advice from friends, family, providers, internet, etc. Most folks will be trying to help and have good intentions but most of them are not experts and/or are not familiar with interpreting research about this condition. Find a trustworthy and nonjudgmental provider who can provide education as well as a cutting edge understanding of and approach to ADHD.

Do not believe that one size fits all

There are many effective treatment approaches to ADHD and there is no evidence that everyone responds similarly to the same intervention. While many well designed studies have found that medications can be quite effective at reducing the severity of ADHD symptoms, they are not necessarily the right treatment choice for your child. You need to work with a provider who will consider your child’s individual strengths and needs.

Do not give up

Remain persistent and optimistic and never give up! You will likely encounter numerous bumps as you navigate the healthcare system. Try to find the right provider and treatment approaches for your child. Try to think of this as a journey with lessons and teachable moments. There is no perfect or right way to do this - by reaching out for help you have made the first step and you are clearly a parent who is interested in caring for your child. Use your supports, surround yourself with those who are patient and loving and be confident that you are doing the right thing by seeking treatment.


Summary
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ADHD is one of the most common childhood disorders and is often a misunderstood and treatable condition. Although ADHD can present challenges, children with ADHD have so many gifts and strengths. If you think that your child may have ADHD reach out for education and guidance from reliable experts and choose providers and treatments that fit the specific needs of your child. Patience, open-mindedness and optimism will help foster resilience and will serve to support you through this journey.


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Andrew R. Gilbert, M.D.Medical Director

Andrew R. Gilbert, M.D. is a board certified child, adolescent and adult psychiatrist and Medical Director of the Hallowell Center in New York City. Dr. Gilbert practices both psychopharmacology and psychotherapy and each approach is individuall...

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