Our popular culture has taught us well: If a child is acting out, having problems paying attention and can’t focus in school, most of us would nod, knowingly, “Ah, he (or she) must have ADHD.”
Attention deficit hyperactivity disorder falls in a unique category, because it’s as often underdiagnosed as it is overdiagnosed. Even though diagnoses of ADHD have increased by 41 percent over the last decade (according to a recent New York Times article), there are still children who are struggling with this disorder, undiagnosed--and there are still others who are being medically treated for ADHD when they may have an entirely different disorder.
While ADHD medications can do wonders in helping a child focus when he or she has ADHD, they don’t do much when there’s another underlying disorder. That’s where an early psychological assessment can help figure out if it’s really ADHD or something else that’s mimicking those symptoms. An assessment screens for any language or learning problems, social or emotional difficulties and any developmental concerns.
In my own practice, it may sound surprising, but only about one-third of children who come in with symptoms of hyperactivity and difficulty paying attention are actually diagnosed with ADHD.
What else can cause these symptoms? Children can sometimes have a language processing disorder: This means that they have a hard time grasping the verbal instructions that we hear and understand; they’re easily overwhelmed by language and noise around them, so instead they tune it out. This disorder can sometimes, but not always, present with speech delays.
Young children don’t typically suffer from depression, but anxiety—separation anxiety or social anxiety—can also make children distracted. Children with learning disorders, such as reading or math disorders, can also act out or not pay attention in class.
Like ADHD, it’s possible (and probable) that children will grow out of these disorders. But in the meantime, it’s important that they get the right combination of medication and/or behavioral therapy so they can succeed in school from the start.
Research has shown that combination therapy is the most effective in helping kids succeed when they have an attention or learning disorder. Medication alone can’t teach a child how to organize, how to listen or how to study. Behavioral therapy can teach children (and parents) specific tactics, counsel kids if they are anxious and provide parent training.
Tactics can include establishing a visual chart so kids can remember the morning routine; teaching kids to make a checklist so they can organize and complete homework; even teaching kids valuable social skills such as when to listen and how to be a good friend.
ADHD may get all the attention, but if a child has difficulty paying attention or focusing in school, it’s not always the problem. It’s important that pediatricians, parents, teachers and psychologists all work closely together to ensure that kids are correctly diagnosed from the start and get the right resources to make their school experience an excellent one.
(Dr. Northington is a pediatric psychologist with NeuroBehavioral Associates. She specializes in learning and attention disorders as well as academic giftedness.)