children s health issues
Attention Deficit Hyperactivity Disorder (ADHD)
Diagnosis of ADHD
A doctor's evaluation group to diagnose the combined type of ADHD; see Signs of ADHD ). Signs must be present in at least two separate environments (typically, home and school) so that a child's reaction to specific problems in one situation is not mistaken for ADHD. Occurrence of signs just at home or just at school and nowhere else does not qualify as ADHD because such signs may be caused by the specific situation. Signs must also be more pronounced than would be expected for the child’s developmental level and must be present for 6 months or more. Often, diagnosis is difficult because it depends on the judgment of the observer. Also, children who are primarily inattentive may escape notice until their academic performance becomes adversely affected. There is no laboratory test for ADHD. Questionnaires about various aspects of behavior and development can help doctors and psychologists make the diagnosis. Because learning disorders are common, many children receive psychologic testing both to help determine whether ADHD exists and to detect the presence of a specific learning disorder, either as a cause for inattention or as a coexisting problem. A physical examination and sometimes various blood and other tests to rule out other disorders are also done. An increasing number of children are diagnosed with attention-deficit/hyperactivity disorder (ADHD). However, there is concern among doctors and parents that many children are misdiagnosed. A high activity level may be completely normal and simply an exaggeration of normal childhood temperament. Alternatively, it may have a variety of causes, including emotional disorders or abnormalities of brain function, such as ADHD. Generally, 2-year-olds are active and seldom stay still. A high activity and noise level is common up until age 4. In these age groups, and in children functioning developmentally in this age range, such behavior is normal. Active behavior can cause conflicts between parents and child and may worry parents. It also can create problems for others who supervise such children, including teachers. Determining whether a child’s activity level is abnormally high should not simply depend on how tolerant the annoyed person is. However, some children are clearly more active than average. If the high activity level is combined with short attention span and impulsivity, it may be defined as hyperactivity and considered part of ADHD. Scolding and punishing children for a high activity level usually backfires, increasing the child’s activity level. Avoiding situations in which the child has to sit still for a long time or finding a teacher skilled in coping with such children may help. If simple measures do not help, a medical or psychologic evaluation may be useful to rule out an underlying disorder such as ADHD. 