How to tell if your Child has ADHD

There are varying degrees of ADHD. This can make it difficult to diagnose if your child has a mild case of ADHD. Often, though, their will be a specific cluster of disorders that tend to be associated with ADHD, and you will have been aware of them since early childhood, perhaps your pediatrician will have noticed them and has been giving you advice or special therapies.

I am the mother of 16 year old daughter with an extreme case of ADHD, and a professional at the MA level, having worked in an acute psychiatric hospital and have observed various forms of ADHD in children and teens. If your child has a medium to severe case of ADHD you are probably very aware that your child is different and that you are very frustrated. So I pull out the DSM IV and will use their guidelines with more specific and perhaps bizarre behavior that you might be seeing in your ADHD child.

“Failing to give close attention to detail” can be observed in their school work. Perhaps the child fails to complete assignments or like my daughter she used to subtract backwards. I thought she had a math learning disability, but it was nailed down to attention. Many ADHD children do not pay attention to their hygiene. They don’t brush their teeth well and if you do not step in, will walk out the door with uncombed hair and shoes untied and dragging the ground. I found Velcro shoes a positive choice!

“Often has difficulty sustaining attention in tasks or play activities.” ADHD children often move quickly from one thing to the other and fail to complete things because they get bored quickly. On the other hand, with a very high IQ child, like my daughter, she was frequently reading 5-6 books at the same time and would alternate from one to the other and be able to tell you about each one. So their can be the upside that an ADHD child may appear to be remarkable at multi-tasking on things they enjoy doing!

“Does not seem to listen when spoken to directly.” Many children are like this, and they really have tuned you out. Especially when you have asked them several times to do a task they do not want to do. This is true of the ADHD child; however, the ADHD child is hearing you and then they forget to follow through with what you have asked them to do. They can frequently repeat what you said word for word and when you ask them why they didn’t do it, they say,”I don’t know!”

“Often does not follow through on instructions and fails to finish school work and chores.” The ADHD child is not organized and they move from one thing to the next. They do not always have the ability to remember how to do something as simple as the dishes unless you post the order they must follow over the sink! Because they move from project to project so quickly, it is common that most of their projects will not be completed unless you are right on top of them. When they do finish a task it is imperative that you go way overboard to praise and reward them to reinforce this behavior in a positive way.

“Often has difficulty organizing tasks and activities.” This really seems simple to fix: Make a list, get a planner, folders, compartments, and every other item to help your child stay organized. This is a fatal mistake, so to say. My daughter loves nothing more than to have all sorts of organizational things to play with. She can change her mode of organization every day and spend wasted hours doing so. She feels like she is creating the best plan every day, but this eats up a great amount of time she could have spent on more important tasks, like the homework she isn’t doing as she works on her next idea on how to organize completed homework! Then she gets mixed up and forgets how her new system works, not to mention she never did get to the homework itself.

“Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.” The ADHD brain is designed to seek out exciting stimulation. Your child, if like mine, will test high on national testing scores and then get A’s on her favorite subjects and F’s on the things she does not find exciting. There are ways to change this. There are many educational computer software programs and other electronic devices designed to make learning fun and exciting. Don’t force your child to sit and be bored on the task they don’t find exciting. Give them the unexciting tasks in small increments, intermixed with the things they need to accomplish with what is exciting to them.

“Often loses things necessary for tasks or activities.” The ADHD child often sets things down and cannot remember where they put it. You can exhaust hours trying to find the science paper that you saw completed that took all week for them to do, and amazingly it is not saved to the hard drive-this is the really fun part of ADHD. And when you ask them if they backed it up, they say,” I think so!” But it’s not there. In-fact it has simply vanished into thin air, even though you personally set the save function to every 2 minutes. Now my child’s room is very messy and it is not so amazing that anything and everything can get lost in in. When I worked in the school district in Special Ed, I noticed my ADHD kids had lockers that were crammed full of papers and often times we did find the assignment all wadded up and wrinkled.

“Is often easily distracted by extraneous stimuli.” After my child’s first dose of a stimulant, she commented to me, “Mommy, now I don’t have to watch the cars go by when I am reading.” I can’t relate to that, but ADHD children seem to see everything and anything in their vision range. Also video games and cell phones are not advisable. They bring too much excitement to the ADHD brain and distract the ADHD child from doing the more boring tasks that the need to do.

“Is often forgetful in Daily activities.” The ADHD child needs a planner and lists to stay on task. And ADHD child frequently forgets where they put these planners and lists and will space out what they should be doing when. You might have a daily meeting place to pick them up after school, but they forget and go to the other side of the school. “I forgot,” is a popular phrase for the child with ADHD.

These have been a few of the examples that you might notice for Attention issues and not all children are ADHD, some are ADD, and the above would be what you are looking for. Sometimes it is really hard to spot and your child might never be noticed by the teacher and labeled as just not smart and not getting the subject matter. If you know your child is smart and see it in what they do at home or on national test scores, please go have them tested. They are very distracted and frustrated on what they are missing out on.

I’m now going to move on to the full blown ADHD child. And I am assuming that my readers do teach their children manners and appropriate behaviors, correcting them when they are out of line. If this is so, you will easily spot your little ADHD ball of energy!

“Often fidgets with hands or feet and squirms in seat.” We are not talking about a child that has to sit through a long church service. Your ADHD child is always moving. They may be looking for things to play with, counting their fingers over and over again, or like mine and many ADHD children one of the sure fire things to look at is they bite their nails. They don’t bite them a little bit, they bite them down as far and farther than they can. They also might have what is called picking. My daughter always had a picking area. It did not come from having an injury, she would just choose a place, like the middle of her forehead and pick. I would comment on it and she might be able to let it heal and I would be so excited, only to see as I combed her hair she had picked a small bald spot on the top of her head. Not all ADHD children are pickers, but a large majority are nail biters. In Fact, when I have a client and I notice their stubs of fingers I just ask,”Are you ADHD?” I have never had one answer back with a no.

“Often leaves the seat in classroom or other situations in which remaining seated is expected.” Working in the school district I saw this all the time from 6 year old all the way through middle school. They get up and sharpen their pencil over and over, even though told not to. They will get up and wander the classroom looking at things or trying to distract the other kids, if they have earned the label “class clown.” If you have this child, I am certain you have been called to discuss his behavior pretty early on. And have already heard the phrase ADHD and are maybe not wanting to believe it, as you are not seeing your child jump up from video and computer games or TV at home. The teacher is calling you not to pick on your child, but she is noticing that your child’s behavior is 100 times more noticeable than the average student.

“Often runs about or climbs excessively in situations in which it is inappropriate.” In the acute hospital setting, I see the very extreme of this. These children seem to jump from seat to seat, climb on the table and leap, almost flying through the air. They do not respond to being reprimanded. If they are placed in a time out, they will simply continue to perhaps start leaping like a frog off the ground. ADHD children have an abundance of energy that you and I do not have. They might try to sit still in a group setting, but each has their own limit to sit still and will leave and you might find them in their room with their mattress on the floor and they are diving off the dresser onto the mattress, making it slide a few feet. Most of the children that I have seen have behavior like this at home that mom and dad are at whits end and bring them to the psychiatric hospital for help.

“Often has difficulty playing or engaging in leisure activities quietly.” This often goes hand in hand with the symptom directly above. These children are very noisy and loud. And if they don’t win at a game are obnoxiously loud and might say the other person cheated. They frequently don’t seem to fit in with their peer group, because their behavior annoys their peers. They have poor social skills.

“Is often ‘on the go; or often acts as if ‘driven by a motor.’ You will have already noticed this in the examples above, but for instance in my daughter, she always has to be doing something. She rarely sits down and just does nothing. She is on the phone, on the computer, looking at everything she owns and making a mess in her room, she is taking a bath, painting her nails several times a day, changing her clothes for no reason, drawing, making bracelets out of beads, just always seeking something else to do, but doesn’t do what she needs to do. She moves from thing to thing in very short time spurts.

“Often talks excessively.” My daughter never shuts up. If she isn’t talking to someone, she is singing. This is the child that manipulates the conversation and you can’t get a word in edge wise. If they are very intelligent, they are telling you about what they have learned. If they are a teenage girl you know about every single crush they have from day to day. They talk to the point that you are annoyed.

The next ADHD symptom we are going to address are the different forms of impulsitvity. I think the DSM IV puts them just a bit too mild. I am going to give you some examples that I have experience with at home and in the acute setting. You must remember that an impulsive ADHD child when they get angered really can lose it.

“Often blurts out answers before questions have been completed.” I think that one stands on its own and if your teacher is telling you this, you must realize it was not a one time thing, she is telling you it happens all of the time and is disruptive to the classroom.

“Often has difficulty awaiting turn.” They fidget or act out, because they don’t have the ability and their energy is so high to sit quietly and wait. They may be waiting in line to use the bathroom and start poking other kids resulting in the two children hitting each other.

“Often interrupts or intrudes on others.” I’m going to use my daughter for an example. Usually when I am at work, she has been with her sister. Keeping in mind I chose to work three 12 hour shifts so that I would be at home with her most of the week and she could enjoy her sister that is an adult on the weekends. My daughter enjoys calling me at work. Remember I am working on a unit with teens that have anger management problems, have had suicide attempts, cut on themselves, or might have a handful of very active ADHD little boys in the mix, and I might also have a sex offender or two. My job is to keep them all in sight and run groups. My daughter has the ability and will call my cell phone every 3-4 minutes. When I take a break and call her back, she says she just wanted to talk to me. If I don’t call her back, she will start calling the nurses station over and over again. They know what they are dealing with and are very stern and forbid her to call. When I have spent all day with her and a friend of mine wants to go for coffee, my daughter has flung her body on the hood of the car so that I could not go without her. When I learned how to sneak out and not say anything (we are talking about a 14 year old that tests at college level in scholastics) she will run as fast as she can down the middle of the street trying to catch me. Now at work I see this intrusiveness in some ADHD patients and if you don’t meet their need, they might get angry and throw a chair at you. Or, they may have a long string of profanity that they call you. They might start hitting the walls, or head banging.

Now the DSM IV goes on to address how we decide if it is ADHD/ADD. AS a parent let me advise you that the school is not an expert. Do not just take a questionnaire and take the school’s diagnosis. Your Special Education teacher is not the expert on diagnosis. He or she is an expert on trying to figure out how to help your child learn using different methods that are not used in the regular classroom. There are many disorders that could mimic some of these behaviors and not be attention deficit at all. It is very important that you take this child into a Neuro Psychologist and undergo extensive testing. This might cost a grand, and insurance might not pay for it, but this is your child. Once the diagnosis is made, no matter what it might be, you need to follow their directions. This will usually include therapy and a medication consultation. Go out of your way to find a good child psychiatrist and take him all of the testing documentation you have received. It might take a few months to get your child on the right medication regimen. And remember as they grow, their medication needs change.

A key factor in dealing with ADHD is behavior modification. Find a good therapist that works specially with ADHD children. Make sure your child likes this therapist. Then comes the really tough work. The behavior modification and administering the medication is on you. You have to stay consistent or it won’t work. Don’t be surprised if you need to place your child in an inpatient setting for a week or so to get the medication right. Don’t be embarrassed, this is not only you. I have seen hundreds. Don’t fall into denial. You need to get a grip on this as early as possible. It is difficult to break a behavior. I like to encourage parents to go on-line to “Love and Logic” by Jim Fay and listen to his Cd’s and follow his behavior method. There are age appropriate courses and also some that deal with ADHD and homework. But you the parent is the key factor. You must stay consistent. You need to work hand in had with teachers and daycare providers. This is difficult, but you can conquer!

(referencing the DSM IV)