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Many times, parents see signs of an attention deficit in toddlers long before the child enters school. At a young age, a child may already display some signs of hyperactivity. The child may seem to lose interest and dart off even during his favorite TV shows or while playing games. In one case, during a game of "catch," a child left the game before the ball even reached him!

In many cases, the teacher is the first to recognize that a child is hyperactive or inattentive and may consult with the school psychologist. Because teachers work with many children, they come to know how "average" children behave in learning situations that require attention and self control. However, teachers sometimes fail to notice the needs of children who are quiet and cooperative.

A child may be unable to focus long enough to play a simple game. Or, the child may be tearing around out of control. But because children mature at different rates, and are very different in personality, temperament, and energy level, it's useful to get an expert's opinion of whether the behaviors are appropriate for the child's age. Parents can ask their pediatrician, or a child psychologist or psychiatrist to assess whether their toddler has an attention disorder or is just immature, has hyperactivity or is just exuberant.

Everyone can get restless or distracted at times, get disorganized, act impulsively, etc. The difference is that for most people these behaviors are relatively infrequent and relatively mild. For people who have ADHD these behaviors are severe and consistent, so much so that it causes a significant degree of impairment in the person's ability to function. This can cause very real and serious problems at school, at home, on the job, in relationships, etc. If the behaviors or symptoms are not severe enough, then by definition it's *not* ADHD. Here's what parents should watch for.

  • Having a LOT of difficulty sustaining attention.
  • Making careless mistakes, not paying attention to detail.
  • The child or adult with ADD often "doesn't seem to listen", seems tuned out.
  • Children fail to follow instructions, don't get schoolwork or chores done.
  • Lots and lots of difficulty with organization, keeping track of things.
  • Losing things often -- particularly things like supplies, homework, papers, etc.
  • Getting easily distracted by outside stimuli, like people talking or things going on outside the window
  • Forgetting to do things -- very frequently, which means things don't get done
  • Physical restlessness for some people, fidgeting, can't sit still, etc.
  • For many children, a lot of difficulty remaining seated, waiting in line, etc.
  • Being physically "on the go" for some people, overactive in their behavior
  • For children, having difficulty playing quietly or co-operating within a group
  • Reacting impulsively, without thinking first -- with ADHD it is often a matter of "act before you think," instead of "think before you act"!!

HOW IMPORTANT IS A THOROUGH EVALUATION?
Very. In order for someone to be diagnosed with ADD, comprehensive evaluations must be administered that include a complete individual and family history, ability tests, achievement tests, and the collection of observations from people who are close to the person who is being assessed.

It is also extremely important to have an assessment that is individualized and designed to uncover co-existing conditions, such as learning disabilities and behavior, mood or anxiety disorders (depression, generalized anxiety, obsessive-compulsive disorder, oppositional defiant disorder, etc.), or any other problem that could be causing symptoms that look similar to the symptoms of ADD.

WHAT DOES A THOROUGH EVALUATION INCLUDE?
A thorough evaluation includes gathering information from a variety of sources. A thorough review of the person's medical, academic and family history is essential. In the case of a child this is done through a detailed, structured interview with the parents. Behavior rating scales should be filled out by parents and teachers to provide information on types and severity of ADD symptoms at home and at school, as well as types and severity of other emotional or behavior problems. Depression, anxiety and other emotional disorders are tested through a comprehensive psychological screening. Intellectual and achievement testing is used to help screen for and then assess learning problems, and areas of strength and greatest struggle.



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Date of Last Update: 07/27/12