By Guest Blogger Jim Anderson, MD, Pediatrician, Wake Forest Health Network – Pediatrics at Premier
It’s that time of the school year when progress reports are sent out and parent-teacher conferences occur. For some parents, this can mean an often-worrisome subject is brought up: their child may have ADHD (Attention Deficit Hyperactivity Disorder).
If you’ve gotten this news, you may feel confused and even emotional. Your mind might immediately go to fears or concerns about medication. These are normal reactions. My advice, however, is that you respond clearly to a teacher’s or administrator’s concerns. Ask specific questions, like: “What is my child doing that brings this into question?” It will be helpful to you if you’re given specific observations.
Some schools may also conduct what is known as Conner’s Assessment, a methodology for screening and diagnosing ADHD. These assessments are performed by a school guidance counselor or psychologist.
After discussing the matter with your child’s school, your next step should be to make an appointment with your pediatrician, or a physician like me who’s a specialist in ADHD. This doctor will help you further evaluate whether your child does—or does not—have ADHD, by discussing your child’s behavior and performing a diagnostic assessment.
While physician offices may do things somewhat differently, the American Academy of Pediatrics has a clinical pathway by which patients can be evaluated for ADHD. An important part of the assessment is the Vanderbilt Assessment Scale, which applies diagnostic criteria to real-life situations. We use the Vanderbilt scores to determine the type of ADHD that your child may have and if there are any coexisting conditions such as anxiety, oppositional defiant disorder, or conduct disorder.
Another option for having ADHD diagnosed is for the child to undergo a full battery of psychoeducational testing through a psychologist. Typically, this step isn’t necessary unless the child is potentially dealing with other psychological conditions, academic concerns, and/or the existing ADHD medications isn’t working.
The Question of Medication
Some parents are reluctant to allow their child to take medication for ADHD, and this can delay treatment of the disorder. It’s understandable that parents may feel this way. After all, ADHD is a genetic condition with about 80% of the time one or both parents have it. Because many parents of these children also have the disorder, they remember what the medications were like when they were younger.
Fortunately, ADHD medications have improved substantially over the past couple of decades. The medication distribution methodology has significantly improved like that is seen with a micro-particle distribution system, and the medicine side effects have considerably decreased. Overall, the medications are more efficacious and better tolerated now than ever before. There are also DNA tests that can be done to see what specific medications would be best for your child.
If you have concerns about medication, it’s best to discuss them with your pediatrician or family doctor. My philosophy, and that of most physicians today, is to start low and go slow, aiming for the best dosage and medication for an individual patient, based on his or her age, presentation, size and family history. We want to find a dose that works, but we don’t need to get there on the first day. And if a parent isn’t happy with their child’s experience on a medication, we will change it right away. There are myriad ADHD medications out there to choose from, and it is important to have a physician who understands the different medications.
Be encouraged that medication can be a safe, effective way to improve your child’s focus in school. However, it’s not a magic bullet. I like to think of these medications like I think of my glasses—they enhance my God-given ability to see, but they don’t see for me. If I were to take a driver’s test with my eyes closed, my glasses wouldn’t help me—but if I do have my eyes open, they help me to see all the better. With my glasses on, my success is due to my hard work and not the glasses alone. This same principle can be applied to children in their studies. No medication is going to help your child do better in school if he or she isn’t doing the work. However, when he or she is diligent about schoolwork, the medication allows the child to use their God-given intellect to the best of their ability. Your ADHD child will develop confidence in his/her abilities and be successful in all areas of life.
For an ADHD evaluation at Dr. Anderson’s office, call (336) 802-2200.
For over thirty years, Brenner has been dedicated to meeting the unique and individual needs of the families of Northwest North Carolina. Their network of locations, pediatric expertise, and top ranked physicians and nurses ensure that you and your child are well taken care of. Because while they are constantly innovating, they will never stop caring. This is a community connected by care.
Visit brennerchildrens.org for more information.
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