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Bright Futures

Articles and Updates from Phoenix Children's

December 08, 2021, Susan Chung, MD
What families need to know about ADHD
What families need to know about ADHD

As the academic school year is well underway, many families and students may be focused on exams, report cards and learning goals this time of year. Like many parents, you may have wondered at some point if your child may have attention-deficit/hyperactivity disorder (ADHD). Below, we cover what concerned families need to know about ADHD.

What is ADHD?

ADHD is one of the most common disorders of childhood affecting roughly 1 in 10 children in the U.S. The hallmark of ADHD is decreased executive brain function categorized into three main types: Inattentive, hyperactive or a combination of both.

A decrease in dopamine and/or norepinephrine neurotransmitters in the prefrontal cortex are thought to be the cause of these symptoms and are also the target of pharmacological ADHD treatments. While primarily affecting school-aged children, ADHD can persist into adulthood with symptoms potentially improving or diminishing with age.

What are common signs of ADHD in children?

Signs of ADHD are also categorized into the three main types of this neurodevelopment disorder: Inattentive, hyperactive or a combination of both.

Inattentive type commonly presents in numerous ways:

  • Inability to pay attention to details
  • Careless mistakes in school or work
  • Difficulty listening and/or staying focused on tasks and activities
  • Easily distracted or forgetful
  • Unable to follow instructions or complete tasks
  • Difficulty organizing tasks
  • Frequently losing items needed for daily life

Hyperactive type commonly presents in the following ways:

  • Inability to stay seated, fidgets or squirms in seat
  • Tendency to run or climb on things when and where inappropriate
  • Inability to appropriately partake in quiet activities
  • Talking a lot, or too much
  • Showing signs of impatience (interrupts people who are speaking, can’t wait his/her own turn, etc.)

For children who have both the inattentive and hyperactive type of ADHD, they can exhibit any of the abovementioned symptoms.

Usually, ADHD behaviors are prevalent and seen in children at a young age (7 years of age and younger). Children with the hyperactive or combined type of ADHD may show signs at an earlier age when behaviors like interrupting, fidgeting, talking out of turn or having trouble staying seated in a classroom are more noticeable. On the other hand, it may take more time to recognize the signs of the inattentive type of ADHD in children, as it is commonly expected for younger children to have shorter attention spans and to be easily distracted.

For parents, it’s often difficult to determine at what point a child’s behavior becomes a cause for concern.

When should parents speak with a healthcare provider?

Generally, parents should consult with a pediatric provider about their child’s inattentiveness and/or hyperactive behavior when they can answer “yes” to all of the following questions:

  1. Is the child between 6 and 12 years of age?
  2. Has the child shown a consistent pattern of inattentiveness and/or hyperactivity since the age of 4 years old?
  3. Is the child’s behavior causing them to struggle in their home or school environments?
  4. Are the child’s behaviors witnessed by both mom and dad, and a third-party adult, like a teacher?

How is ADHD officially diagnosed?

During a child’s medical evaluation, a pediatric provider will screen for underlying conditions that mimic ADHD and rule out other contributing factors that may be interfering with a child’s behavioral development — such as sleep deprivation, obstructive sleep apnea, vision/hearing problems, learning disabilities, developmental delays, as well as emotional factors due to bullying, family stressors or other factors.

The provider may use a standardized behavioral screening tool that requires input from both a parent and a third-party adult, such as a teacher, to assess a child’s overall behavioral tendencies at home and in the classroom. Two commonly used assessment tools include the NICHQ Vanderbilt Assessment Scale and Conners ADHD Rating Scale.

If initial results are unclear or confounded by other complicating factors, a pediatrician may recommend a referral to a psychiatry specialist, who can apply advanced testing tools.

What are common treatment methods for ADHD?

Often, a pediatrician is the first point of contact in assessing ADHD symptoms and helping families decide which treatments are optimal for their child.

For younger children, a pediatrician may recommend working with counselors to implement behavior therapy. Counselors can assess for learning disabilities, developmental issues and vision/hearing concerns.

For children with underlying areas of concern, parents may be encouraged to speak with the child’s school to set up a 504 plan or individualized education plan. These plans enable a school to provide a special education environment conducive to a child’s unique learning style and aptitudes.

For some children who have ADHD, behavior therapy and school accommodations may not be enough. Parents may want to speak with their child’s pediatric provider about viable medication options, that can help manage ADHD symptoms, or obtain a referral to a psychiatry specialist for a more in-depth evaluation.

If you’re concerned that your child may have ADHD, our pediatric team at Phoenix Children's Pediatrics can help. Visit https://phoenixchildrenspediatrics.org to find a pediatric provider near you.

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