“Living With ADHD”

“Organizing Life One Minute at A time”

An UncommonSense Health Newsletter

from drhuggiebear.com and Frank Barnhill, M.D.

Issue 4 Volume 1 April 2005

The UncommonSense Health Newsletter is dedicated to being your source for easy to read, up to date information on current and important medical issues for your growing family.

Dr. Frank’s behavioral rule #1:

“ADHD is first a diagnosis of exclusion, then a diagnosis of inclusion!”

You must first exclude all the illnesses that mimic ADHD and then be sure the diagnosis fits ADHD traits.

Sorry this issue is a little late, but Dr. Frank had surgery and was not quite up to par for a couple of weeks. Nothing serious and now he’s back at the keyboard!

This Month’s issue:

ADHD diagnosis

How do you know when to have your child checked for ADHD?

Frank Barnhill, M.D.

This question seems to pop up more frequently as parents and teachers struggle with whether or not to “label” a child as ADHD. Unfortunately, that’s exactly what happens once someone gives your child the diagnosis of ADHD. Once the label is applied, it’s very hard for a child to lose it. It will affect him or her literally throughout school and young adult years and possibly beyond.

So, it is very important to seek professional help in making sure the diagnosis of ADHD is correct. Unfortunately, a lot of doctors and counselors aren’t adequately trained to make diagnoses in subtle (soft) or difficult cases. It’s easy to make an ADHD diagnosis when a child shows nearly all the signs and symptoms, but research indicates that the best success in treating ADHD occurs when your child’s disorder is discovered at a very early stage. The younger an ADHD child is properly diagnosed and treated, the more successful the child becomes in school, family and social interactions.

The real dilemma seems to be in the question; exactly when is a child ADHD or just being a child? Current trends in treating ADHD lean toward using the least amount of intervention or tinkering with a child’s behavior and learning styles needed to help the child develop learning and coping skills needed to become successful in all aspects of life. In order to make an accurate diagnosis and start the right therapy, we must look at a few facts about ADHD:

Probably, schoolteachers talking to parents generate 75% of all referrals for ADHD evaluation. That means it is very important that parents and teachers communicate regularly with each other. Parents must not rely on the teacher to initiate these meetings. The parent has an equal responsibility to teach and be their child’s learning advocate.
Another 75% of all parents of ADHD children will actively deny their child could possibly be ADHD. This fact alone will tend to delay proper diagnosis by as much as a year or even more.
In my experience, at least 75% of all children who are eventually properly diagnosed ADHD, had “soft” signs and symptoms that were missed or ignored.
About 75% of all children treated for ADHD will respond to therapy within one year. That means you can’t expect a miracle overnight cure and whatever treatment the parents elect to use must be consistent and persistent.
About 75% (or some sources quote 90%) of kids treated by only behavioral therapy will fail to meet successful goal points and will experience worsening ADHD signs.

Now that we have that out of the way, let’s take a look at the early or soft signs of ADHD. These are derived from medical literature and years of interviewing ADHD kids and parents. Where there are clear differences between ADHD boys and girls, I’ll drop hints.

Soft signs of ADHD include:

An infant being very fussy and needing to be held a lot more than usual
Children who tend to crawl, walk, potty train, and talk later than normal
Toddlers who are excessively prone to injury because of “hyper behavior” (more often boys)
Kids that seem wound up all the time or can’t sit still and seem to be into everything
Children who are difficult to get to bed or once there can’t go to sleep easily or are restless sleepers even though they have played hard all day
Boys and girls who try to cut their own hair or cut the labels out of clothing because they are bothered by them (More often boys)
Kids who don’t play well with other children or play too rough
Children who demand a lot of attention and throw excessive and increasingly worse temper tantrums to get attention
Boys more so than girls who will not behave even after appropriate training
Those who argue excessively and seem to be driven to get the last word in a conversation
School age kids who seem to complete homework too easily or rapidly. This sometimes means the child really didn’t understand the assignment and just buzzed through it.
When your child reads to you, he or she skips words or entire paragraphs and possibly gets frustrated too easily and gives up
A child who makes excuses about doing chores and just never does them, no matter how many times reminded

There are many more hard signs and symptoms of ADHD, but those are not appropriate for an article on early intervention. Hard signs are readily identifiable by parents, siblings, teachers and friends, so they are more easily noticed. I’ve often suspected some of the above symptoms can be translated and applied to adults who are probably ADHD, and have persistent signs, but no longer meet all of the criterion for the diagnosis. This situation would be called partial or sub-threshold ADHD.

Hopefully, with the above hints and soft signs of early ADHD, you’ll be able to spot a child who has the disorder and seek evaluation as early as possible. I’d like to caution you now: Almost every child will sooner or later show some or all of the above listed symptoms of ADHD. The key in making an early, accurate diagnosis lies in observing the presence of these signs more than once. In fact, ADHD kids will display these listed traits many times, in many different situations and in different surroundings such as at church, home, while visiting friends, on a grocery store trip, on vacation, with the baby sitter or at school.

Remember: Our goal in treating ADHD must be to use the most appropriate therapy to help your child develop the social and learning skills necessary to reach their fullest potential as a happy child and eventually an independent adult.

Dr. Frank’s Golden Rule:

“ADHD is first a diagnosis of exclusion, then a diagnosis of inclusion”.

Frank Barnhill, M.D.

No portion of this information is intended to be offered as medical advice for the individual. Your family doctor is still the best source of advice for you and your family and you should consult him or her if you have any medical concerns. If you wish to use this article as a parent handout or in your newsletter, please see http://www.drhuggiebear.com/ for our reprint policy . mailto:drfrank@drhuggiebear.com

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Frank Barnhill, M.D.

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