Published: Oct. 17, 2006
Updated: Oct. 28, 2010
As soon as he became mobile, little Jeremy also became a handful. “He was like a Mexican jumping bean, darting around, turning flips on the sofa,” recalls his mother, Diana. As he grew, so did the challenges. “He wouldn’t listen, and couldn’t follow directions or finish a task,” Diana says. “We used to get calls from his school every day. Sometimes they wouldn’t let him go on activities. Sometimes they locked him in the office.”
These days, the behaviors associated with ADHD -- Attention Deficit/Hyperactivity Disorder -- are widely acknowledged, and a wealth of information and support resources is available. But -- though awareness of ADHD has improved greatly in the decade since Jeremy was a toddler -- diagnosis can still be tricky, as precise symptoms vary from child to child.
“Almost everyone has some of the symptoms of ADHD, and other disorders can have similar symptoms,” says Scott H. Kollins, PhD, director of the Duke ADHD Program. “To make a proper diagnosis, a thorough assessment is required by a qualified clinician. Overreliance on just the symptoms can often lead to a misdiagnosis. Many children who truly do meet the criteria for ADHD can be missed, and many children who do not have the disorder can be mistakenly diagnosed."
A detailed professional evaluation is essential before medicine is prescribed, Kollins says. It’s not enough, for example, that a child simply be branded a troublemaker in school. Educational and behavioral interventions should nearly always be tried first, particularly for milder cases. Medications such as methylphenidate (the stimulant used in prescription drugs such as Ritalin and Concerta), as well as certain amphetamines, can be a boon to many children, but may affect growth and development and must be carefully monitored.
Whether or not medication is used to help manage symptoms, parenting an ADHD child remains a complicated job -- one that demands enormous reserves of patience and persistence. How best to sort through all the available tips and tactics? “Experience is the best teacher,” says Barbara Donadio, RN, BSN, a nurse clinician with Duke General Pediatrics and herself the mother of an ADHD child. “Parents need to try things very methodically, and see if they work for their child, their family. And be scientific about it: when one thing doesn’t work, do something else.”
Perhaps the most important advice of all, says Donadio, is to “avoid negative thinking. Maintain hope and faith. Acknowledge the positive traits of children with ADHD -- they’re often extremely intelligent, independent, and creative. We parents of ADHD children are often so busy problem-solving that we don’t take time to acknowledge the successes.”
As for Jeremy, now 11, a regimen of timed-release Dexedrine, combined with his parents’ consistent encouragement and compassionate discipline, has made a world of difference. “ADHD is a lifetime thing,” Diana says. “You don’t grow out of it -- you adjust to it."
In fact, research has shown that about 50 percent of people diagnosed with ADHD as children will continue to have difficulties into adulthood, Kollins says. "Periodic assessment is important to best modify treatment plans. We recommend a thorough re-evaluation every two to three years."
This is not a complete list of accepted ADHD criteria. For more information, talk with your health care provider or contact the Exceptional Children’s Assistance Center at 1-800-962-6817.
Duke offers an ongoing series of free seminars at Teer House to help parents better understand ADHD and learn to cope with it. For more information, call 919-477-2644.
In addition to those offered at Teer House, the Duke ADHD Program hosts a free "Parents as Partners" seminar series. Visit the Duke ADHD Program Web site for details.