Thursday, February 21, 2019

Dr. Tang discusses ADHD

Julian Tang, MD
Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed mental health challenges in the United States. Approximately 8% of children between the ages of 6 to 17 yrs. old have been diagnosed with ADHD with boys being twice as likely as girls to have ADHD.

Does my kid have ADHD?

This is one of the most common questions we get from parents and caregivers and the answer is not that straightforward. Children already have a wide presentation of temperaments, levels of physical activity, and focus levels. The brain also continuously develops and matures over time which affects a child’s ability to stay on task and focus. My usual expectation that is a child’s focus and impulsivity should start to show some improvement around 4 to 5 years of life.

The main aspect I look for regarding ADHD is if a child’s focus and hyperactivity negatively impacts their quality of life in both social interactions and academic activities. If I have a patient that might have focus issues but is thriving with peer relationships and has self confidence in their academic abilities, then I tend monitor how those patients do over time. If a child only has behavioral challenges at home or only in school, then I tend to look at that setting. If it is only at home, then I would delve into family dynamics and see if there are household stressors. Children when under stress will often react with inattention and overactivity. If it’s only at school and only with certain subjects, then I would be more suspicious of a possible learning disability or teacher interaction. Bullying would also be a possibility.

The other huge factor that affects a child’s attention, focus, and behavior is their sleep habits. Children 3-5 years old should get 10-13 hours, 6 to 12 years old 9-12 hours, and 13 to 18 years old 8 to 10 hours. In some cases, correcting bad sleep hygiene can “cure” ADHD. Ensuring a good sleep routine will help maximize your child’s sleep quality. If your child still has difficulty staying asleep or poor sleep quality please let one of our providers know at your next visit.

Diagnostic tests

There is no singular test that diagnoses ADHD. It is mainly a combination of history based from caregivers & teachers which can be reinforced with ADHD rating scales such the Vanderbilt or Connors.

Typically at PHA we use the Vanderbilt ADHD rating scale which can be found online here:

Treating ADHD

Helping a child with ADHD is a multifactorial approach. In certain cases the school will adjust a child’s education plan such as modifying homework assignments, taking tests in less distracting environments, or allowing more time to complete tests. Behavioral modification therapy techniques, individual and family counseling are also a common. Caregivers can help empower the child by setting specific doable goals and staying consistent with rewards and consequences with clear concise actions and tasks. Medications are also another way to help children with ADHD through our providers here. Please contact our office if you have any questions or would like further information.

The following links will have additional information and resources regarding ADHD

National Resource Center on AD/HD

Children and Adults with ADHD (CHADD)

Attention Deficit Disorder Association

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