Does My Child Have ADHD? – Diagnosis, Assessment and Treatment for Your Child

Of all the learning difficulties, ADHD or Attention Deficit / Hyperactivity Disorder is perhaps one of the most difficult for teachers to manage in the classroom and for parents to manage at home. Find out more about diagnosis and intervention options available if your child has ADHD.

Children with the symptoms of ADHD live daily under huge amounts of stress, as do the parents and siblings who live with and love these children on a daily basis. Their learning and their social functioning are both undermined by their excessive need to move, to act without thinking and to quickly lose attention for the tasks at hand.

For teachers in the classroom situation, the behaviour of the ADHD child can be very disruptive for the other children and needs to be carefully and effectively managed to maintain a calm learning environment for all of the children.

Signs and Symptoms – How Do I Know if My Child Has ADHD?

The child with ADHD looks like every other child in the classroom. However they shows a preponderance of three categories of behaviour and will stand out because of these: inattention, hyperactivity and impulsivity.

The truly ADHD child will display many symptoms very early in life, before the age of 6.

For reasons unknown, ADHD is about twice as common in boys as it is in girls. It effects around 5% of all children.

The ADHD Child is Extremely Active

As a baby they may have been a very poor sleeper. They may have learned to walk very early, been a climber and run their parents ragged trying to keep him safe. They will have been very active as a toddler but will have been slower than others to learn to share and take turns. As a school age child, they may still not appear to need as much sleep as other children their age, and will often wake early and/or have difficulty going to sleep at night.

The most evident symptom in the ADHD child at school is difficulty sitting still for any length of time. They are restless, and constantly on the move. They will frequently get up out of their chair and move about the room. If they are able to stay in their chair, they will be restless and fidgety, moving most of the time, swinging their legs, kicking against the chair legs or the seat in front or them, or twisting around on their chair with their back to the teacher. This is aptly described as the “ants in the pants” phenomena! They will often run when they’re supposed to be walking, such as inside the classroom.

At home they may have difficulty sitting at the table for an entire meal, constantly moving, chattering, interrupting others, and maybe knocking things over in their haste to be finished with the torture of having to sit for so long! They may have difficulty settling at any game or activity for long, loosing interest quickly and moving on to the next thing.

The ADHD Child is Inattentive and Very Easily Distracted

They may have a very short attention span and be very easily distracted. Your child will quickly forget instructions even though they understood them when listening the first time. They may make careless mistakes in their work, such as adding up too quickly and getting the wrong answer, or leaving the ending off a word when writing (and most likely be able to correct the work easily when asked to take another look). They will seldom finish what was started without extra reminders and extra help.

The ADHD Child is Very Impulsive

Your child may be impulsive and often act without thinking first. For instance, they may call out in class, answer questions before they are completed, or talk excessively. They will often make noises (evidenced especially in boys) which may disrupt the concentration of others in the class.

They may sometimes lash out in frustration, especially at siblings, but then feel full of remorse afterwards when they’ve had time to think about what they’ve done. Socially they will blurt out comments, interrupt other peoples’ conversations, charge into games already started, and always try to be first in line. They may have trouble taking turns in games, and waiting for their turn with the teacher to check work. They will run outside at playtime without remembering to put things away, or other linear class instructions.

As the child moves through the day school their hyperactivity, impulsivity and inattention may result in difficulties starting tasks, as well as with finishing them. They may struggle to organise themselves, keep track of belongings, and remember to bring sports gear on the right day. They may have difficulty learning and remembering new concepts. Parents and teachers may well get frustrated too, as the child appears bright, but is constantly under achieving.

Often they are trying their very best, but not getting the same results of other kids. This may make them frustrated and possibly angry or aggressive. Without intervention, they inevitably begin to fall further and further behind academically.

An Undiagnosed ADHD Child Will Not Reach Their Full Potential

One thing is certain from the research into ADHD. Without a diagnose and some form of intervention, or individual work plan, you ADHD child will not be learning to their full potential.

This typically results in them falling further and further behind as they get older. High School will be particularly difficult. Some of these children may resort to attention seeking behaviours such as playing up, acting up, or aggressive behaviours.

The untreated ADHD adolescent will have high frustration levels, and possibly very low self esteem. They may feel like they are a failure in class, and will feel like they’re constantly getting into trouble at home and at school.

This can result in engaging in more negative, oppositional, or risky behaviours. And possibly, because of their impulsivity, some young people with ADHD end up on the wrong side of the law.

Categories of Behaviour in ADHD

There are three distinct categories of behaviour – inattention, hyperactivity and impulsivity – and all of these must be present, at least most of the time, for a diagnosis of ADHD to be made.

Behaviours within these categories must occur often, in many different environments, and well over and above the ‘normal range’ in frequency and intensity usually seen in children the same age. The MSD Manual describes these behaviours as:

• Inattention tends to appear when a child is involved in tasks that require vigilance, rapid reaction time, visual and perceptual search, and systematic and sustained listening.
• Impulsivity refers to hasty actions that have the potential for a negative outcome (eg, in children, running across a street without looking; in adolescents and adults, suddenly quitting school or a job without thought for the consequences).
• Hyperactivity involves excessive motor activity. Children, particularly younger ones, may have trouble sitting quietly when expected to (eg, in school or church). Older patients may simply be fidgety, restless, or talkative—sometimes to the extent that others feel worn out watching them.

Getting a Diagnosis for Your ADHD Child

The ADHD child is one who often cannot be ignored in the school setting. Parents are usually informed of their child’s behavioural difficulties quite early on. But an actual diagnosis for ADHD isn’t always obvious.

Many parents do not want to label their child for fear that a label will negatively affect how their child is treated in the education system.

But many others do want to know, and find it very helpful to name their child’s learning difficulty. It’s also very helpful for the child’s teacher if they know this child has a disability underlying their learning and behaviour issues. And it’s the first step in getting further help for your child.

One of the most compelling reasons for getting a full diagnosis is access to funding for support through the educational system. Also your family may be eligible for the Child Disability Allowance, an allowance for children who need substantially more care than others their age, and/or the Disability Allowance. Both can be applied for directly through Work and Income, with a diagnosis from a specialist and an application form filled out and signed by your doctor.

Getting an Assessment for Your Child with ADHD

Once a diagnosis has been made, parents can organise an assessment themselves by making an appointment with your family doctor. They will organise a referral to a paediatrician through the hospital, or a specialist assessor.

Your teacher, or your school’s RTLB resource, may also refer your child directly to a paediatrician or to an educational psychologist. They’ll discuss this with you first.

ADHD Assessment Using the Connor’s Scale

In many countries the Connors Scale assessment is usually used to determine if a child or young person has ADHD. This assessment is based on a developmental picture of the range of behaviours in each area which are expected at each age.

The child’s behaviours are rated via a questionnaire and then compared with age related norms.

The questionnaires are filled out by the child’s parents, their teacher, and sometimes also another adult who knows the child well and sees them functioning outside the home.

A self-report questionnaire is also used with children who are old enough, where the child is asked to respond verbally to questions about their own behaviour.

Getting Help at School for Your Child with ADHD

Because your child may be so visible (and audible) in the classroom and their behaviour may be disruptive to others, it’s likely your child will get additional classroom support.

After applying all of the strategies they know, your child’s teacher will most likely refer them to the SENCO (Special Needs Coordinator) who may then prioritise them for further assistance. Depending on the school’s own resources, they may be able to supply a teacher aide for a few hours a week. The teacher aide will shadow your child in the classroom, patiently reinforcing correct behaviours and helping to keep them on task, and on track.

Your school may also call in the services of an RTLB teacher (Resource Teachers for Learning and Behaviour), who may be called in by the school SENCO to observe and assess them. The RTLB teacher can offer further suggestions and strategies to the classroom teacher, and tools for managing your child’s behaviour.

Further funding for a teacher aide may also be made available through this service, but this is usually temporary and is usually withdrawn after a number of months.

If these strategies do not work and your child’s ADHD symptoms cannot be managed easily in class, further referrals will be made to access help through Group Special Education (GSE).

What Should Parents do if their Child is Diagnosed with ADHD

Because there are a number of other childhood illnesses and disorders that mimic the symptoms of ADHD, an assessment for ADHD is involved and should involve a psychologist interviewing the parents, the child (depending on the age), teachers and conducting a behavioural observation of the child in their natural environment such as at school.

After this is completed the child should be seen by a paediatrician who specialises in ADHD who will give the child a complete medical check-up just to make sure there is nothing else going on.

Depending on how severe the ADHD is will help you determine the type of help you and your child will need. For instance, you may need to consider medication for your child such as stimulant or non-stimulant medication.

You may need to organise academic assistance, social skills training and even a parenting course to support you, and help you manage those behaviours that always push the limits. Find yourself a psychologist who specialises in ADHD by contacting the New Zealand Psychological Society, talk with them about your options and ask them to help you find a paediatrician who specialises in the disorder.

You will be more supported by having such specialists involved. Another wonderful place to find information and support is ADHD New Zealand. Their website has lots of resources and they can help link you up to professionals working in this space too.

Common Myths About Children with ADHD

There are lots of myths about ADHD and you could write an entire book on it.

One of the more common ones is that ADHD is only a modern day disorder.  The truth is the symptoms of ADHD were formally recorded by a physician back in 1798.

Other common myths include sugar and diet as a cause of ADHD.  Again, not true.  Sugar does not cause ADHD nor does diet. Some children might have a reaction to food colouring or food additives, and these reactions might see the child’s behaviour change.  This however, is not ADHD – change the child’s diet to a healthy one, and the behaviour changes.

Another common myth is around hyperactivity. An ADHD child with hyperactivity is actually easier to diagnose. Many people with ADHD exhibit more of the third category ‘inattention’. This is where your child may be forgetful, easily distracted, or have a poor attention span. Some children in this category may even present no hyperactive-impulsive tendencies at all.

What is Happening in the Brain of an ADHD Child?

Through the latest medical imaging such as MRIs and FMRIs we have been able to see deep into the brain.

This has allowed researchers to find five regions of the brain that are underactive and undersized in the brains of people with ADHD.  It is these areas of the brain that are responsible for controlling attention, behaviour, memory and moods.

As we see in children with ADHD they are impulsive, have poor social skills, poor behavioural control and poor attention to name just a few.

Because ADHD is a neurological disorder, it effects children on so many levels and in so many ways. Dr Stuart Passmore says,

children with ADHD very often have learning disorders, they may have very few friends, depression, anxiety and struggle with school. Sadly, children with ADHD are very often aware they are ‘different’ some how to the other children, that there is something ‘wrong’ with them, and this deeply impacts their self-esteem.”