|Kid's Health (Archive)
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Is it ADHD - Or Something Else?
Johnny is fidgety, disruptive and doesn't pay attention in school. What might the problem be? If you answered "G," go to the head of the class.
"What looks like ADHD may not be ADHD at all. At least a third of the children who are referred here for evaluation of possible ADHD do not have ADHD," says developmental-behavioral pediatrician Geeta Grover, M.D., director of CHOC Developmental-Behavioral Pediatrics. Developmental-behavioral pediatricians are fully trained, board-certified pediatricians who specialize in the developmental, behavioral and educational issues of childhood.
Determining the specific cause of a child's difficulties in school requires a comprehensive assessment. At CHOC Developmental-Behavioral Pediatrics, this assessment includes a detailed medical history and physical examination, including a neurological exam. The child's developmental milestones and school history, including report cards and standardized test scores, are reviewed, providing a complete picture of the child's behavioral, educational and developmental concerns and challenges.
"We spend at least an hour and a half with each new patient because it takes that long to adequately assess the possibilities," Dr. Grover says. She works in conjunction with a pediatric nurse practitioner/case manager who helps coordinate care, acts as a liaison with the child's school, and serves as a family resource. Additional team members may be consulted, including a psychologist, geneticist, neurologist, social workers and psychiatrist. Speech and language evaluations may also be recommended.
Early Intervention Dramatically Improves School Performance
"Language and reading disabilities are two very common learning disorders that can sometimes mimic or coexist with ADHD. If a reading disability is not diagnosed and treated by the third or fourth grade, the chances of a child achieving adequate adult reading skills are only about 30 percent," Dr. Grover says. "But if we can intervene before third grade, we can dramatically improve those outcomes,"
Dr. Grover urges parents not to wait if their child is struggling with school, either academically or behaviorally. Early intervention can dramatically improve outcomes.
"Grade retention is another red flag to watch for. If the school recommends that your child be held back, find out why. Follow up with your child?s school and your pediatrician so that learning, language and attentiveness issues may be fully assessed," recommends Dr. Grover, who adds that grade retention is generally not the best solution. "Don't think it is just because the child is not trying hard enough or you are not doing a good enough job as a parent. There may be some real underlying issues or disorders that just have not been diagnosed yet."
If you are concerned about your child's attentiveness, behavior or progress in school, please consult with your pediatrician. Additional resources are available through the CHOC Developmental Behavioral Pediatrics program. For more information, please call (714) 532-7578.
ADHD and other developmental-behavioral conditions are not caused by poor parenting skills, too much sugar, preservatives or food additives. Instead, these conditions are caused by biological factors that usually respond well to treatment, which may include behavioral management, educational intervention/accommodation, and medication.
Johnny is fidgety, disruptive and doesn't pay attention in school. What might the problem be?
If you answered "G," go to the head of the class.