SalemNews.com, Salem, MA

March 1, 2013

Does my child have ADHD?

Dr. Kate's Parent Rap
Dr. Kate Roberts

---- — Q: My 5-year-old son’s teacher told me that my son has ADHD. Can they even determine this, and what should I do?

A: Many parents that visit my office report that they have been asked by teachers, friends, extended family and neighbors about whether their child has ADHD. You are correct to question, “Who really can give this label to my child?” Attention deficit hyperactivity disorder is only formally diagnosed by medical or health professionals. That being said, let’s assume your child’s teacher is raising concerns with your son’s best interests in mind. What is most important is that you realize two things. First, you know your child better than anyone, and second, children develop at different rates. For example, many children under the age of 8 with or without ADHD cannot focus and sit still in a classroom for six hours at a time.

With that perspective, go ahead and schedule a conference with your child’s teacher and the guidance counselor or school psychologist to hear what they have to say. The conference should have two main objectives. First, you want clarification regarding the specific behaviors that are concerning the teacher: “What exactly is your son doing?” Second, you want to find out, “How is the teacher managing those behaviors in the classroom?”

The behaviors that (may) reflect ADHD include difficulty with the following behaviors: attending to details, sustaining attention, listening and following directions, keeping track of items, following daily routines, and transitioning from one task to the next. In addition, some children with inattention also display hyperactivity such as being overly active, restlessness, fidgety and impulsive, with frequent blurting-out behavior.

Be aware that although ADHD behaviors can mimic behaviors that are often described with terms like disruptive, acting out and noncompliant, ADHD-like behaviors are a result of either normal development for younger children or, if ADHD is truly present, the ADHD condition and not a conscious attempt to disrupt.

In the classroom, there are two levels of behavior management. First, there is overall classroom management, i.e., “How structured is the classroom?” For ADHD children (and most 5-year-olds in kindergarten today who are asked to sit and listen for long periods and learn reading and writing), highly structured classrooms are the most successful for academics. Examples of highly structured classrooms include a strict daily routine that can be internalized by students, allowing them to have a sense of control over their world. In addition to the overall classroom management, children with ADHD-like behaviors benefit from a positive behavior plan. Examples include ignoring negative behaviors, and addressing one problematic behavior at a time through positive rewards (a sticker for every time he raises his hand instead of blurting out). At home, you can implement similar programs.

Plan a conference at the school in four to six weeks to follow up on what is working and what is not. You can always make an appointment with the pediatrician to discuss the behaviors that are interfering with your child’s success at school.

Parenting tip: A strong adult-child rapport is essential when motivating children with ADHD or ADHD-like behavior to learn to control their behavior. The most important thing for children who struggle with ADHD is how it impacts the development of their self-esteem, not their performance. If your child feels capable, that will reflect in their performance over time.

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Dr. Kate Roberts is a psychologist and parenting strategist with offices on the North Shore. Stay tuned for future columns that will address overnight camp and MCAS stress. Your questions can be answered at kate@katerobertsandassociates.com. Visit drkateroberts.com to learn about New Reality Parenting.