- Some hyperactive-impulsive or inattentive symptoms must have been present before seven years of age.
- Some impairment from the symptoms must be present in at least two settings.
- There must be clear evidence of interference with developmentally appropriate social, academic or occupational functioning.
Thursday, May 24, 2012
ADHD or typical "tween distractibility and hormones?
According to the DSM IV(Diagnostic and Statistical Manual of Mental Disorders), there are several “essential features” that must be present for a diagnosis. Among them are:
‘Tweens don’t develop ADHD when they enter middle school. If they have already been diagnosed, symptoms may become exaggerated, but distractibility during this time is unlikely to be ADHD. More likely, it is a combination of hormones and the new, exciting adolescent world youth are experiencing. Most every child at this age will test some boundaries and the extent of his or her independence. What is much more effective than the pursuit of a diagnosis are parenting strategies. This is clearly the most difficult stage to parent! It is exhausting to maintain clear boundaries and consistently enforced consequences. Parents must remember that it’s normal for their child to be angry with them, yell the hateful things, etc. but that the boundaries are necessary for safety and success. Parents must continue to be in charge.
The “impairment” must be present in at least two settings means that if a child has ADHD, the symptoms will present themselves everywhere the child goes. If a child is distracted and non compliant at home, but does not display that at school, it is not ADHD and vice versa. ADHD is not a choice; therefore, the symptoms cannot be controlled depending on the environment. Where the concerning symptoms present the most is likely to be a place where there are not consistent consequences. For example, let’s say your middle schooler has zoned out of good homework habits and turning in schoolwork on time. If, after meeting with teachers, you are told that your middle schooler displays good behavior overall but is much more interested in social activity, believe it!!! More than likely, that is the truth! They have discovered the opposite sex, they are finding out that they have some choices; they are exercising some free will and are, in fact being typical ‘tweens. Of course this should not rule out some good research such as talking with your child, keeping up with his or her friends and activities, and parent/school communication, but it does not necessarily warrant an ADHD diagnosis. It does justify those consistent consequences even if that is only closer supervision to schoolwork. Consequences need not be severe or harsh, just consistent. Simple things like priority setting; i.e. no TV, computer or cell phone until school assignments are complete. The trick is to stick with it so the child knows what to expect and has the power to create success through his or her own choices.
The last criterion, particularly as it relates to school is that impairment is clearly interfering with functioning. A slight drop in grades, a little daydreaming, a few friend troubles are all part of growing up. The problem of concern must present significant, extreme difficulty for the child. True ADHD isn’t just a phase or a slight change in behavior; it is clearly out of the ordinary.
If you have concerns about your middle schooler, by all means meet with teachers and talk with your child, but resist the urge to immediately look for a diagnosis and treatment when it may just be simple adjustment and choices. In the long run, with or without ADHD, all of us have to learn coping strategies for our weaknesses. We are all held accountable for our personal choices. Also, keep in mind the treatments for ADHD which are usually behavior modification techniques, easily employed in the home and school, and/or medications. Medicating a child who is just a bit distracted over typical things is probably not a wise choice and doubtfully one most doctors or parents would agree with. Adolescence is a good time to correlate choices and personal responsibility with consequences. Help your child the most with strategies, support and love.
First published at Nashville Parenting Examiner
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