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Is My Child Hyperactive?

by Joan M. Reid    

Ask any parents if they think their child is hyperactive and they'll probably respond with a resounding "Yes!" Children are supposed to be active, but that doesn't mean they are "hyperactive." However, more and more children are being diagnosed as having Attention Deficit Hyperactivity Disorder (ADHD). It is estimated that three to five percent of the population has ADHD.

ADHD involves a persistent pattern of inattention and/or hyperactivity and impulsivity. Usually children with ADHD are of school age before their parents seriously suspect that they may have a problem and have an evaluation done. However, children aged four years and older can be successfully tested and diagnosed for ADHD. If you observe the following behaviors in your school-age child over a six-month period you may wish to begin the evaluation process:

Impulsivity (At least three of the following):

• Often acts before thinking
• Shifts excessively from one activity to another
• Has difficulty organizing work
• Needs a lot of supervision
• Frequently calls out in class
• Has difficulty awaiting turn in games or group situations

Inattention (At least three of the following):

• Often fails to finish things he or she starts
• Often doesn't seem to listen
• Is easily distracted
• Has difficulty concentrating on schoolwork or other tasks
• Has difficulty sticking to a play activity

Hyperactivity (at least two of the following):

• Runs about or climbs on things excessively
• Has difficulty sitting still or fidgets excessively
• Has difficulty staying seated
• Moves about excessively during sleep
• Is always 'on the go' or acts as if 'driven by a motor'

Only qualified, experienced professionals should conduct an evaluation. Behavior problems in children can also be caused by other things such as stressful life situations and learning disabilities. Inexperienced or unqualified "experts" can misdiagnose the problem. A questionnaire filled out by parents and teachers is not enough for an ADHD diagnosis--careful observations and assessments of the child must also be conducted.

How do you locate qualified professionals for evaluation? Start with your own local doctor. The local pediatrician will do some preliminary screening to rule out physical problems that can cause attention problems. Standard vision and hearing tests are in order and referrals to specialists may be needed. If no physical causes are found, the pediatrician may refer you to a more specialized physician, such as a developmental pediatrician (a pediatrician specializing in how children develop mentally and physically), a child psychiatrist, a pediatric neurologist, or a behavioral pediatrician (a pediatrician specializing in childhood behavior).

If your pediatrician diagnoses your child as ADHD and recommends medication without going through the above referral process, you will want to insist that further testing and consultation be done before accepting that diagnosis.

You will want to assemble a team to assess your child's difficulty and needs. Who should be on the team? Your child's team may consist of from two to five or six professionals. Depending on your child's needs, the team may include:

• Developmental pediatrician
• Child psychologist
• Learning disabilities specialist
• Neurologist
• Physical therapist
• Speech therapist
• Social workers
• Behavioral pediatrician
• Classroom teacher

What Causes ADHD?

There is no single cause of ADHD. It is defined by symptoms, not by its cause. There are a large number of biological or neurological events that singly or in combination can cause a person to be unable to pay attention and to be overactive. ADHD is not caused by poor parenting skills. While children will often have a reaction to certain foods consumed, this intolerance does not cause ADHD and following a specific diet, such as the Feingold Diet, has not proven to alter ADHD symptoms. Research also shows that sugar does not cause hyperactivity.

Many factors can cause children to have problems paying attention besides an attention deficit disorder. Family problems, stress, discouragement, drugs, physical illness and learning difficulties can all cause problems that look like ADHD, but really aren't.

Regardless of the cause, ADHD is thought to be associated with a disturbance in functioning of neurotransmitters in the brain. Neurotransmitters are natural body chemicals that transfer information from one brain cell to another.

Do Children Outgrow ADHD?

Professionals now think that thirty to forty percent of children with ADHD outgrow it as adults, and they are usually the mild cases. Overactivity may decline, but problems with inattention and impulsivity remain. As maturity increases, these children may experience only slightly more than normal difficulty in this area. For many children, however, ADHD will remain a lifelong problem requiring extra techniques for coping successfully with life.

References

Kennedy, Patricia, Terdal, Leif, and Fusetti, Lydia. (1993). The Hyperactive Child Book. New York: St. Martin's.

Children with Attention Deficit Disorders (CH.A.D.D.), American Academy of Child and Adolescent Psychiatry (AACAP). (1991, Fall/Winter). Medical Management of Children with Attention Deficit Disorders: Commonly Asked Questions. CHADDER, pp. 17-18.

Weiss, Gabrielle, and Hechtman, Lily Trokenberg. (1993). Hyperactive Children Grown Up. New York: Guilford.