When Is It ADHD In A Child?

I talked with Erin Schoenfelder, PhD,a specialist in ADHD and Director of Behavioral Treatment at the PEARL Clinic (Program to Enhance Attention, Regulation & Learning) here at Seattle Children’s Hospital, about ways to recognize ADHD in children and teens. The previous post we shared included the acknowledgment that it may be harder to parent a child with ADHD and provided reasons for it along with 5 tips to help parents and families. In the podcast above, Dr. Schoenfelder helps parents, teachers, and pediatricians understand what ADHD is and identifies ways to support, diagnose, and evaluate children with whom parents and teacher hold concern. First and foremost make sure you understand how a child sleeps before doing any further work-ups! Sleep challenges can be a big mimicker of ADHD as deprivation causes inattention and distractibility.

What is ADHD?

Developmentally atypical symptoms of inattention and/or hyperactivity/impulsivity.
Developmental disorder that persists over time and years and is consistent across settings (i.e. children have challenges at school, at home, during sports activities, at a synagogue or church).

Signs, Symptoms, Red Flags

Problems in multiple settings completing work, getting along with others, following directions, and succeeding
Teacher noticing the child is standing out from others
Child an outlier in a group – soccer practice, birthday parties, home
Risky behavior, getting injured due to impulsivity
Falling behind in learning due to off-task behavior

When to Seek Evaluation

Now, if you’re worried!
Behaviors, focus, or distractibility is causing substantial problems from day to day that worries a parent and/or a child. There is NO reason not to talk about this with a school teacher, counselor and your pediatrician, family doc or nurse practitioner.

When is it NOT ADHD?

Transition problems/environmental — when children are adjusting to new stresses or events/conditions in their home and school it may not be a problem with the child but with their situation!
Anxiety, trauma, mood — children can have anxiety that will distract them
Learning problems — Sometimes children struggle both at home and at school because of learning challenges. If you are concerned about delays in literacy, struggle with school work outside of what you expect, talk with both your teacher and/or counselor at school.
Sleep problems — chronic sleep challenges is a huge reason children are inattentive and distractible at times
Medical mimics — make sure if concerns about other symptoms (sleep challenges, fatigue, eating) that you discuss things that could be going with a child’s thyroid or other health system. Sometimes children will get blood work for part of an evaluation although I would suggest that is NOT the norm.

How Can Evaluation Help?

Understand why behavior is occurring for a child and target reasons for it.
Points to evidence-based treatment recommendations (sleep changes, medications, diet changes and behavioral strategies that are more effective for children with ADHD).
Opens door to accommodations in school and at home (more time for testing, different seating in school, re-prioritizing sleep, etc).