How to Diagnose and Treat ADHD in Children

A parent's guide to ADHD in children: recognizing symptoms, finding a doctor, evaluating medications, and helping your child thrive.

How to Diagnose ADHD in Children ADDitude Magazine

Every positive step we have taken has been inspired by another family's recommendation.

Susan Skok, mother of an ADHD child

Imagine a child whose ADHD has been diagnosed and who is getting appropriate treatment. His symptoms are under control, and he's doing reasonably well, socially and academically. Let's call this "Point B." Now imagine the same child before receiving a diagnosis. He's having difficulty at home and at school. Let's call this "Point A."

How do you get from A to B? There's no definitive diagnostic test for ADHD in children -- no blood analysis, no brain scan, no genetic screen -- so it's not easy to tell whether a child has the disorder. And doctors vary in their abilities to diagnose and treat the disorder, so it's easy to go down blind alleys before getting the help your child needs.

Susan Skok knows all about blind alleys. The mother of two boys with ADHD, this Melbourne, Florida, resident spent thousands of dollars on mental-health professionals before she found a doctor who provided real help.

Jill Hogan, of Elgin, Illinois, tells a similar story. "My poor son, Sam, had to endure several psychologists and psychiatrists, some of whom actually got their techniques from radio or television talk shows," she says.

The good news is that, if you take matters step by step, as outlined below, you can avoid such pitfalls--and make it to Point B more smoothly than you might have imagined possible.

The "Aha" moment

The ADHD journey inevitably begins with the "Aha" moment, when it dawns on you that your child's problems may be caused by ADHD or another biologically-based disorder.

For some parents, this moment comes when a teacher calls to say that the child is disruptive in class or falling behind academically. For others, it comes after they read an article about ADHD or see something about it on TV—or hear that another child at school has been diagnosed with the disorder.

Whatever triggers your "Aha" moment, seek help at once. Without a prompt diagnosis, an ADHD child is apt to be branded "slow" or "lazy" (or worse). Such labels undermine self-esteem and can lead to years of underachievement and family turmoil.

Perhaps most important, don't panic. With appropriate treatment, ADHD children do well. And if your child does have the disorder, you can take solace in the fact that it is about biology and is in no way your fault.

Jennifer Haus, of Clinton, Mississippi, knew that her young son's shoe-tossing, bookcase-toppling meltdowns weren't normal. But friends and family members repeatedly told her that Mitchell's tantrums resulted from poor discipline. She tried time-outs, reward charts, withdrawal of privileges--nothing worked. Then, one day Mitchell came home from school crying. He said that he felt "different" from his classmates. "That," Haus recalls, "is when I called his pediatrician."

Consulting the doctor

After your "Aha" moment, your first impulse will probably be to consult a pediatrician. That makes sense. "Most pediatricians are comfortable diagnosing and treating ADHD," says Larry Silver, M.D., clinical professor of psychiatry at Georgetown University Medical School in Washington, D.C. "Usually, that's the only medical professional you need."

Still, just because your pediatrician feels comfortable doesn't mean you should. Before agreeing to have your child treated, "ask how many other cases of ADHD the doctor has treated, and what the plans and outcomes were," says Russell Barkley, Ph.D., research professor of psychiatry at SUNY Upstate Medical University in Syracuse, New York. If the doctor has handled only a few cases, you might be better off going to a developmental pediatrician, child psychiatrist, or another specialist who has significant experience with ADHD.

"Regardless of how experienced your pediatrician is," says Barkley, "you should strongly consider a medical specialist if your child's ADHD is accompanied by another diagnosed disorder, such as oppositional behavior, depression, anxiety, bipolar disorder, emotional problems, or learning disabilities, or if there are urgent issues involved, such as your child's hurting himself or getting kicked out of school."

Your pediatrician or health insurer can probably steer you to a qualified specialist. If not, contact your local chapter of Children and Adults with Attention-Deficit Hyperactivity Disorder (CHADD). Ask family and friends for their recommendations. "Every positive step we have taken has been inspired by another family's recommendation," says Susan Skok.

This article appears in the Winter issue of ADDitude.
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