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ADHD


Schedule an appointment for an ADHD Assessment


What is ADHD?
Attention deficit hyperactive disorder (ADHD) is a neurodevelopmental disorder.  It is NOT a mood or behavioral disorder.  There are certain neurotransmitters in the part of the brain linked to attention, memory, sleep and learning that work differently in children with ADHD.  While some would argue that ADHD is overdiagnosed, it is one of the most common childhood brain disorder affecting 5-10% of children today.   It is really difficult to diagnose ADHD before the age of 4 due to variable normative behaviors, and is most commonly identified during early elementary years once adherence to social norms becomes crucial to learning and making friends.  

Often times, once a child has started school, the teacher will gently bring up ADHD and suggest your child get evaluated.  In comparison to your child's peers in a social setting, the teacher can be a good gauge of your child's ability to focus and stay on task.  The symptoms of ADHD must be present in more than one setting of a child's life, so it's important to know what is going on in your child's classroom.  

Inattention, hyperactivity, and impulsivity are the hallmark problematic behaviors in children with ADHD.  Your child may need an evaluation for ADHD when the symptoms are inconsistent with normal developmental levels, symptoms interefere with child's ability to function at home or school, and symptoms are present before the age of 12. 

 
There are 3 subtypes of ADHD: 

Predominantly Inattentive Type 
6 or more symptoms must be present
Predominantly Hyperactive and Impulsive
6 or more symptoms must be present
Combined Type, Hyperactive-Impulsive and Inattentive

  • Fails to give close attention to details, makes careless mistakes
  • Difficulty sustaining attention in tasks or play
  • Often doesn't listen when spoken to directly, fails to finish school work or chores
  • Difficulty with organization
  • Poor time management
  • Avoids tasks with sustained mental effort such as school work
  • Often loses things
  • Easily distracted by external stimuli
  • Often forgetful in daily activities
  • Often fidgets or squirms in seat
  • Often gets up from seat without permission
  • Often runs or climbs about where it is inappropriate
  • Often unable to play quietly
  • Is often "on the go", trouble sitting still for extended period of time
  • Often talks excessively
  • Often blurts out an answer before question completed
  • Often has difficulty waiting turn
  • Often interrupts others
  • 6 or more symptoms are met from both categories (12 total)


What causes ADHD?
Scientists are not sure what causes ADHD, although many researchers have studied this and have determined several probable causes.  Studies have shown that genese play a large role.  Like many other illnesses, ADHD probably results from a combination of factors.  In addition to genetics, researchers have linked possible environmental factors, brain injuries in childhood, and the social environment as contributors to ADHD.  Furthermore, studies show that the number of children being diagnosed is increasing, but it is unclear why.  

Genes
Studies have shown that ADHD does in fact run in families.  There are genetic characteristics that seem to be passed down.  If a parent has ADHD, their child has more than a 50% chance of having it.  If an older sibling has ADHD, the sibling has a 30% chance of having it.
 
Environmental Factors
Children born pre-mature or at a low birth weight have a higher risk of developing ADHD.  Children who have had head injuries to the frontal lobe, the area that controls impulses, may develop hyperactivity as well.  Brain injuries as a result of having a fever above 104 degrees in infancy may also contribute to brain damage resulting in symptoms of hyperactivity and poor impulse control.  Studies show that pregnant women who smoke or drink alcohol may have a higher risk of having a child with ADHD.  Exposre to lead, PCBs or pesticides may also have a role.  Although much debate has occurred, there has not been a link to watching too much TV and ADHD as of yet.  

Nutrition
Although sugar and certain food additives is a popular suspect in causing ADHD, there is no reliable research to support these claims.  However, if your child does already have ADHD, it is important to evaluate nutrition to make sure it isn't exacerbating symptoms.  

Neurobiology
Certain brain messengers, called neurotrasmitters, have been proven to work differently in children with ADHD.  Certain regions of the prefrontal cortex, which controls behavior, judgement, impulses, and attention, may not function properly in people with ADHD.  



What is the typical approach to treatment for ADHD?

With a thorough assessment and accurate diagnosis, ongoing treatment can help individuals with ADHD to be successful in school and lead extremely productive lives. Treatments can relieve many symptoms of ADHD, but there is currently no cure for the disorder.  We conduct an extremely thorough assessment for ADHD, often taking up to 4 sessions, communicating with teachers, and conducting a school visit.

Additional recommendations may occur prior to completing a diagnostic evaluation to rule out other contributing factors to a child's symptoms.  These may include a formal speech and language assessment, formal cognitive testing, and/or a vision and hearing screening.

Treatment for ADHD is crucial because living with ADHD and not knowing how to recognize and control the symptoms can make life extremely difficult for a child or teen. Children with ADHD:
  • Often struggle in the classroom, which can lead to academic failure and judgment by other children and adults
  • Tend to have more accidents and injuries of all kinds than children who don't have the disorder
  • Have poor self-esteem
  • Are more likely to have trouble interacting with and being accepted by peers and adults
  • Are at increased risk of alcohol and drug abuse and other delinquent behavior

Together we will proceed with a treatment approach, and it may include some or all of the following.
  • Parent skills training to help parents learn tools to successfully manage the child's challenging behaviors, and to learn how to structure routines in a way that allows a child's self-esteem to flourish. 
  • Individual therapy with the child, which may include play, sandtray, talk therapy, or bibliotherapy to boost self-esteem and normalize symptoms of ADHD
  • Family therapy to help a family learn how to manage the dynamics involved in living with a person with ADHD
  • Theraplay® to help parent learn attunement to child's subtle cues of dysregulation
  • Group therapy to teach children with ADHD social skills
  • Behavior therapy to help with executive functioning skills such as organization, study skills and self-monitoring
  • Dialectical behavior therapy to teach self-regulation skills and learn how to modulate arousal 
  • Cognitive rehabilitation (brain training) to practice tasks designed to improve attention, concentration and memory with repetitive practice

When you bring your child to us for an intake assessment due to attention concerns, we use evidence-based methods to gain perspective on the nature and intensity of your child's symptoms before making a diagnosis.

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