Getting Help for Children with ADD / ADHD (page 3)
If you think your child may have ADD / ADHD, it's important to have clinical personnel evaluate your child's condition, because other neurological and psychological conditions can look like ADD / ADHD or exist along with ADD / ADHD. Once your child is diagnosed, you can connect with professionals who provide therapy, support, and practical assistance, working with children to help them understand their feelings and cope with the realities of having ADD / ADHD.
Diagnosing ADD / ADHD in children
If you suspect that your child has ADD / ADHD, schedule an appointment with your doctor for a diagnostic assessment. At present, no laboratory or imaging test exists to determine if your child has ADD / ADHD. Clinicians base their diagnosis on the behavioral symptoms they observe and by and ruling out other disorders.
The American Academy of Pediatrics recommends that an evaluation for childhood ADD / ADHD include:
- A thorough medical and family history.
- A general physical and neurological exam.
- A comprehensive interview with the parents, the child, and the child's teacher(s).
- Standardized screening tools for ADD / ADHD.
- Observation of the child.
- A variety of psychological tests to measure IQ and social and emotional adjustment.
What is required for a diagnosis of ADD / ADHD?
To be diagnosed with ADD / ADHD, your child must exhibit multiple symptoms of hyperactivity, impulsivity, and inattention. In addition, the symptoms of ADD / ADHD must:
- Severity – The symptoms must be more frequent or severe than in other children the same age.
- Early onset – Some of the symptoms must have been present before age 7.
- Duration – The symptoms must have been present for at least 6 months.
- Impact – The symptoms must have a negative impact on the individual's school, family and/or social life.
- Settings – The symptoms must be present in multiple settings, such as home, social settings, and school.
Choosing a specialist to evaluate your child
When choosing a specialist, it's a good idea to get recommendations from other doctors, therapists, and parents. Talk to former patients and clients, if possible, and find out what their experience was. It's also important to find out what's covered by insurance. Will your health insurance cover part or all of your child's ADD / ADHD evaluation?
- the professional certification and academic degrees of the specialist,
- the procedural code (CPT code) and diagnostic code (ICD code) that the specialist will use to bill for the evaluation,
- how comprehensive the evaluation is, and
- how much the specialist will charge.
Then talk with your health insurance provider about what your plan covers for evaluation for ADHD. Some insurance policies cover evaluation for ADHD from one kind of specialist, but not from another.
Co-existing conditions and ADD / ADHD
Major stressful life events can result in temporary symptoms that look like ADD / ADHD. These events include parental divorce, child abuse, death of a loved one, a move, or a sudden traumatic experience. Under these circumstances, ADD / ADHD-like symptoms may arise suddenly and, therefore, would have no long-term history. Remember, ADD / ADHD symptoms must exist for at least six months and cause some difficulty before the age of seven. Of course, a child can have ADD / ADHD and experience a stressful event, so such events do not automatically rule out the existence of ADD / ADHD.
Other mental health conditions such as those listed in the box below can be the result of ADD / ADHD, in addition to ADD / ADHD, or mistaken for ADD / ADHD. That is why evaluations need to be conducted by a professional who is trained in a wide variety of child and adolescent disorders.
Disorders That Commonly Co-Occur With ADD / ADHD
Oppositional Defiant Disorder
A pattern of negative, hostile, and defiant behavior. Symptoms include frequent loss of temper, arguing (especially with adults), refusal to obey rules, intentionally annoying others, blaming others. The person is angry, resentful, possibly spiteful, and touchy.
A pattern of behavior that persistently violates the basic rights of others or society's rules. Behaviors may include aggression toward people and animals, destruction of property, deceitfulness or theft, or serious rule violations.
Excessive worry that occurs frequently and is difficult to control. Symptoms include feeling restless or on edge, easily fatigued, difficulty concentrating, irritability, muscle tension, and sleep disturbances.
A condition marked by trouble concentrating, sleeping, and feelings of dejection and guilt. There are many types of depression. With ADD / ADHD you might commonly see dysthymia, which consists of a depressed mood for many days, over or under eating, sleeping too much or too little, low energy, low self-esteem, poor concentration, and feeling hopeless. Other forms of depression may also be present.
Problems with reading, writing, or mathematics. When given standardized tests, the student's ability or intelligence is substantially higher than his or her achievement. While children with ADD / ADHD frequently have problems with reading fluency and math, these problems have to do with attention and memory, rather than a learning disability.
Finding professional help for childhood ADD / ADHD
Although there are many ways parents can help a child with ADD / ADHD at home and many strategies teachers can use in dealing with ADD / ADHD in the classroom, sometimes a physician or therapist who specializes in ADD can help you decide how to proceed in treating your child with ADD / ADHD and can provide appropriate interventions.
Your family doctor or pediatrician is a good place to start. He or she can provide an initial assessment and refer you to ADD / ADHD specialists for further evaluation and treatment.
Child and adolescent psychiatrists can:
- diagnose ADD / ADHD
- prescribe medications
- provide talk therapy
Psychologists and psychotherapists can:
- diagnose ADD / ADHD
- provide talk therapy
- help children and families dealing with ADD explore their feelings.
Cognitive-behavioral therapists can:
- set up behavior modification programs for children at school and at home, including rewards and consequences
- help establish concrete goals for behavior and achievement
- help families and teachers maintain goals, expectations, rewards and consequences consistently
Support groups can:
- give kids with ADD / ADHD a place to share helpful strategies
- provide a safe place to vent feelings to other kids who understand
- show children with ADD / ADHD that they aren't the only kids with these problems
- teach children with ADD / ADHD how to understand social cues and transfer their new knowledge to the larger world
Educational specialists can:
- teach techniques for succeeding in school
- help kids learn how to manage their time, organize assignments, take notes, and keep track of materials
- help families of children with ADD obtain accommodations from schools
- advise families about assistive technology
Some other types of professional help are more suitable for adults and teenagers than for children. Much depends upon the maturity of your child and your child's desire to change the behaviors of ADHD. See Professional Help for Adult ADD for information about ADD coaches and professional organizers.
During the course of treatment, most professionals who specialize in ADD / ADHD will educate you and your child about the condition so that you can better understand ADD behaviors.
Reprinted with the permission of Helpguide. © 2001-2008. All rights reserved.
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