When are ADHD Children Identified

by Joseph M. Carver, Ph.D.

(Page 4 of 6)

ADHD Children are often diagnosed as being "hyperactive type" or "inattentive type" - or the combined version. There is difference in identification with these two types. The obviously hyperactive child is often identified within the first week of kindergarten or first grade. Parents arrive at a professional office with a note from the school principal, often demanding that the child be seen by a psychologist or pediatrician. These hyperactive children have been running around the room for three days at that point.

The inattentive type of Attention-Deficit Hyperactivity Disorder (ADHD) is more difficult to detect. The inattentive child is often labeled a "dreamer", "immature", "in a world of his/her own", or parents are told the child should be held back. As all six year old children are somewhat flighty at times, the inattentive child is typically advanced in school with the understanding that they will probably mature as they age. For this reason, inattentive ADHD Children often aren't identified until they are discovered to be one or two grades behind (see Academic Problems).

Academic Problems
ADHD Children typically have many academic problems. Despite being intelligent, academic performance is often below grade level. The best way to visualize the difficulty is to image an automobile with a Rolls Royce engine (the IQ/ability) and a go-cart transmission (attention/concentration system). The power of the engine is not getting to the wheels due to a difference in the transmission capability. Engine performance is only as powerful and efficient as the transmission system. If a child's intellectual ability (IQ) is measured at 115 and his/her concentration "IQ" is 75 - academic performance will most likely be at the "75" level - with hyperfocus bursts of sheer genius at times. In this situation we find very bright children often performing one or two grades behind despite amazing abilities to reprogram the school computers.

Without treatment, ADHD Children rapidly lose ground in school. Imagine an ADHD Child with only 75% concentration. For each grade completed, he/she retains 75% despite the IQ level. After four grades in school, the ADHD Child has retained only three grades and is now one grade behind. At this point, the child begins failing and lacks the foundation to understand some more complex math concepts.

Attitude Problems
Parents often asked about the risks involved in both medication treatment and not treating Attention-Deficit Hyperactivity Disorder (ADHD). Untreated ADHD Children can experience academic failure and behavior problems but more importantly, they often sustain damage to their self-confidence and self-esteem. Years of untreated ADHD gradually wear down the self-esteem of the child, creating a commonly found "ADHD attitude".

The "ADHD attitude" forms as a direct result of lots of adult attention. ADHD Children receives lots of attention but when we monitor that attention with a camcorder, we find that the attention received is about 90% negative. Adults are constantly attending to the ADHD Child with comments like "don't touch that", "sit still please", "stop that singing/drumming/moving", or "leave your sister alone". The ADHD Child finds the same type of attention at school, the teacher commenting "sit down", "please pay attention", "your work is too sloppy", and "leave your neighbor alone". As time passes, the student develops a negative view of himself or herself. Comments we often hear from hyperactive youngsters are "I can't do anything right", "they're always on my case", "they never say anything to my sister", or "no matter what I do I get into trouble." ADHD Children often describe themselves as "stupid" or a troublemaker. Personality development can be permanently altered or damaged by the presence of an ADHD attitude. With proper treatment of the hyperactivity, this self-view can gradually change to a more positive self-image. If the change does not appear in time, counseling in this area might be needed. One child recently treated at the office, when asked how his school situation had changed since medication treatment, replied "Now I got three friends!" It's important to remember that untreated ADHD often prevents the ADHD Children from obtaining and keeping friends. Like an octopus, the hyperactive student is constantly touching, hitting, poking, slapping, and irritating anyone who enters their body zone/range. For that reason, other students keep their physical distance from the hyperactive octopus.

Parents of ADHD Children: Issues
Parents of ADHD Children often develop difficulties of their own due to the constant supervision and effort required by the ADHD son or daughter. Commonly encountered parental issues:

"I can't take it anymore!" Many parents arrive exhausted and overwhelmed by the constant stress involved in rearing ADHD Children. Single parents are particularly vulnerable to being gradually overwhelmed by the night and day coping required with ADHD Children. At times, parents may require treatment for stress, anxiety, or depressive reactions.

"They say he's all boy." As the infant grows and the symptoms of ADHD surface, parents begin to question the activity level of their child. As they compare their child with other children, they ask the opinions of relatives, friends, and others. Initially, parents are often told "He's just all boy". While many later stick to their original assessment as "all boy", you'll notice that nobody volunteers to baby-sit that "all boy" child.

"We're both crying by the time homework is over!" Homework time, labeled "homework hell" by some parents of ADHD children, is often so stressful that both child and parent are traumatized by the experience. If the child is receiving medication treatment, it is not unusual for the child to experience a period of "emotional instability" after school, as the school-time medication loses effectiveness. Homework during that time would involving crying, yelling, temper tantrums, frustration, etc.

"I must be a bad parent!" With ADHD Children, normal parental discipline and educational techniques don't work. Your neighbor offers "I did this (technique) and Billy hasn't repeated it since!" If your child has ADHD, use of that technique will have little or no effect. After trying various recommendations and reading parenting books, and still nothing works, parents become demoralized and feel they are at fault. In reality, a completely different approach is often needed for ADHD Children.

"Dealing with this is ruining our marriage!" Selecting a coping style to deal with ADHD Children often places parents at odds. One parent may come from the "All he needs is a good spanking" school of discipline (totally ineffective by the way) and the other desires to protect and understand the condition. Parents also argue over issues of medication, who does homework, and who deals with the school. Parents of ADHD Children often receive daily notes from teachers/principals - the record at my office being 37 discipline slips in a two week period. When the marriage is troubled in this manner, marital counseling and support is often needed.

About the Author

www.drjoecarver.com
This handout was written by Joseph M. Carver, Ph.D., a Clinical Psychologist. Dr. Carver is in private practice in Southern Ohio.