Everyone who works with children or adults in a private practice setting will have their own opinion on how attention deficit hyperactivity disorder (ADD or ADHD) should be diagnosed. Some clinics take the “more is good” perspective and will recommend a large number of tests, often costing many thousands of dollars. Other clinics, usually with rushed doctors, will simply give parents a brief rating scale and then make a quick diagnosis and prescribe treatment, usually medication. Unfortunately, neither of these extremes is in the best interest of the patient. If you are the parent of a child or teen who is struggling in school, and perhaps in life in general, you should be familiar with what this disorder we call Attention Deficit Hyperactivity Disorder does. First of all, the symptom of inattention. The person has trouble concentrating on the right thing long enough to do it. Many people, including her parents, complain that she just doesn’t seem to listen when spoken to. By not maintaining attention, or by acting like a “space cadet”, he does not finish his chores or duties. You can’t concentrate on what you’re doing for a long time unless it’s very exciting or very entertaining, and you don’t pay much attention to what you’re doing, so you make a lot of careless mistakes. Video games are an exception because they give immediate feedback, are exciting and fun. Chores and homework are not. Inattention is seen more with homework, chores, and other boring things you want him to do. It’s really disorganized. Most commonly, this is seen in spending three hours to finally finish his homework, then losing it at school (it’s in his backpack) or forgetting to turn it in. He really tries to avoid doing homework or chores. You are easily distracted or pay attention to the wrong thing at the wrong time. He is often forgetful and needs to be reminded to do things frequently. The vast majority of people diagnosed with ADHD have inattention problems. The next classic symptom is poor impulse control, or a lack of self-control. Not all people with ADHD have this problem, but many do. He often blurts out answers in class.
You can’t wait your turn when you’re playing or at school, and you move on up the ranks. He interrupts others a lot, he just doesn’t wait well. You tend to do things without thinking about them first and say things you don’t think about first. He does not consider the consequences of his actions. Approximately half of people diagnosed with ADHD are hyperactive. Since the word “hyperactive” is in the name itself, you might think that everyone with the disorder must be hyperactive, but that’s not the case. There are probably five or six types of ADHD, each different from the other in terms of brain function. You can learn more about the different types of ADHD in the ADHD Information Library. How do you know if your child or adolescent is hyperactive? He has happy hands and feet that wiggle and wriggle a lot. You just can’t stay in your seat for long when you’re supposed to at school or at the dinner table. You may run too much or climb on things you’re not supposed to do. It is often too loud. It is “on the fly” as if it were “powered by a motor”. He speaks too much. Leave footprints on the ceiling. It is important to note that at least some of these symptoms must have been seen before the age of seven. Also, that at least some of the symptoms are seen both at home and at school. Also, that these behaviors are really a problem. Not just a little, but a lot. Keep in mind that there are several reasons why a child may have these symptoms in addition to attention deficit hyperactivity disorder. For example, thyroid problems, depression, anxiety disorders, hearing problems, etc. Please do not try to “diagnose” your child. Consult your doctor or see a qualified mental health professional. This website is not a substitute for talking to an expert. Keep in mind that overdiagnosis of attention deficit hyperactivity disorder is a big problem. There are some kids who are diagnosed with ADHD who don’t have it. It is not uncommon for someone with depression or anxiety, specific learning disabilities, early-onset bipolar disorder, or Tourette syndrome to be diagnosed with attention deficit hyperactivity disorder. Often this is the result of a diagnostic “screening” that is too brief and does not take into account the many reasons why a child may be inattentive, impulsive or hyperactive. But the overdiagnosis of Attention Deficit Hyperactivity Disorder is not the only problem. Underdiagnosis of attention deficit hyperactivity disorder is also a problem. This happens most often in the school setting where the school psychologist writes his report perfectly describing a person with ADHD, and then refuses to use the label “Attention Deficit Hyperactivity Disorder” on his report anywhere.
It also often occurs in therapists’ offices, where the therapist is unfamiliar with the neurological aspects of ADHD and only sees the characteristic behaviors as “exaggerated behaviors” due to family issues, rebelliousness, etc. Therapists who operate entirely from a “Family Systems” orientation are especially at risk of making this mistake, as I admit I did during my first two years in practice. Some studies suggest that only one in three people with attention deficit hyperactivity disorder will ever receive help. Two out of three people who have ADHD will never receive a diagnosis or treatment. They will never really know what it is that has bothered them throughout their lives. So we have two problems. One is overdiagnosis and the other is underdiagnosis of Attention Deficit Disorder.
