Dr. Courtney Tolinski, Ph.D., LP, NCSP
I have many families that come into the office wondering if their child may have Attention-Deficit/Hyperactivity Disorder, also known as ADHD. Sometimes, it’s because a teacher has asked them about it. Other times, it’s because they’ve noticed that their child seems “different” than their brother or sister. Parents will often comment that their child is very active and likes to stay busy. While they get easily distracted in class or when they’re doing homework, they can spend hours doing activities they like, such as playing with legos or creating an art project. Families frequently say that their child has a hard time dealing with their feelings and seems immature at times. However, they also comment on how creative, smart, curious and funny their child can be. As a clinician, hearing this pattern of strengths and challenges signals to me that their child may, in fact, have ADHD. When I ask about the family’s history of attention challenges, I often learn that someone in the family (usually mom or dad) also struggled with paying attention in school. In fact, parents are usually surprised when I tell them that ADHD is highly heritable with rates around 50%.
In order to assess for ADHD, I collect information from the child’s teachers and parents, including asking them to fill out rating scales on the child’s behavior and how often they are seeing inattention or hyperactivity. Like most disorders, attention and hyperactivity can look different in children, appearing anywhere from mild to severe in presentation. However, to meet the Diagnostic and Statistical Manual’s (DSM-5) criteria for a diagnosis of ADHD, the child has to show six of the following nine criteria on a fairly regular basis:
- They make careless mistakes in their work or don’t pay attention to details.
- Have poor sustained attention during lengthy conversations, lectures, etc.
- Their mind seems distracted when you’re talking to them.
- They often start tasks but lose focus/are easily sidetracked.
- Have difficulty keeping their things tidy and are disorganized.
- It’s hard for them to get started on “boring” or challenging work, such as homework.
- They frequently lose things such as pencils, books, their glasses, etc.
- They’re easily distracted by noises, people or their environment.
- It’s easy for them to forget various tasks/activities that are part of their daily life.
- It’s hard for them to sit still – they’re fidgety or squirmy.
- They often get out of their seat in class.
- Younger kids may run or climb when they’re not supposed to, while older kids have a feeling of restlessness.
- They play or do activities loudly.
- They are frequently on the go and are difficult for others to keep up with.
- They are extremely chatty.
- It’s hard for them to not interrupt or blurt out in conversations before someone else finishes their thought.
- Waiting for their turn in line feels impossible for them.
- They often interrupt or intrude on others’ activities.
When a child is diagnosed with ADHD, they can either be described as predominantly inattentive (which was formerly known as just Attention-Deficit Disorder or “ADD”), hyperactive/impulsive or combined presentation, meaning they have features of both. I make sure that the child has a history of inattention or hyperactivity going back to preschool and that we’re looking at other factors that can mimic ADHD, such as anxiety or an auditory processing disorder. In addition, I perform various assessments to look at their executive functioning, attention, memory, language and academic abilities. This is important because many children with ADHD also have a learning disability, such as dyslexia, or a mood disorder like anxiety or depression.
If your child is determined to have ADHD, they will most likely need support at home and at school to help them achieve their best potential. With an evaluation, we can also offer specific recommendations as part of a school 504 plan or Individual Education Plan (IEP).
Click here to learn about the the Zarlengo Foundation Learning Evaluation Center at Havern School.