During the assessment process it is of great importance for the physician or clinician to consider other possible causes of inattention, impulsivity, or hyperactivity in your child (or teen, or yourself). In fact, this is probably the most important element of a good assessment. There are several possible causes of these behaviors, especially in children, and the clinician must have great certainty that these other possible causes have been ruled out before giving the label of "Attention Deficit Hyperactivity Disorder" to your child.
One of the first things to have ruled out is a thyroid problem. Only MD's can do this, so off they go for a physical. This is not a common problem, but it does happen, even in children. Thyroid problems can cause inattention, learning problems, even hyperactivity and impulsivity in some. Once that has been ruled out by the doctor, then other environmental or emotional causes of inattention, impulsivity, or hyperactivity need to be ruled out.
Depression in children often causes inattention, as in adults, and also often causes impulsivity and irritability and excessive restlessness or agitation. Anxiety disorders in children can result in agitation, impulsivity, hyper- vigilance, motor restlessness, and excessive startle responses, as well as inattention to task. Significant emotional traumas can also result in these behaviors. Physical or sexual abuse, divorce or other significant loss, or the death of a loved one.
Physical traumas can also cause the same behaviors as ADHD, such as a minor head injury from an auto accident, sports injury, falling as a child, and so on. For example, one of my "ADHD" kids, who was extremely hyperactive and also very oppositional and at times violent toward others, took part in one of our research projects. As part of the study we "brain mapped" him (QEEG) at the onset of the study. We saw two small head injuries in the back of the head and one big injury in the front of the head.
The frontal problem was expected, but the problems in the back of the head were not. I simply asked the parents, "When did he bash the back of his head?" They thought for a minute and remembered that when he was about six weeks old he had fallen out of his crib onto a hard flood so hard that they had to call an ambulance to take him to the hospital. They had forgotten about the incident during the clinical interview, but the mapping showed a clear problem. He fell on the back of the head, causing those injuries, and the brain "sloshed" forward causing the frontal injuries. These injuries have resulted in a lack of inhibition and cortical control, temper outbursts, and learning problems. The diagnosis here would not be ADHD, but rather a head injury.
Mark my words, in the next five years you will see lots of research showing that playing soccer causes minor head injuries from "heading" the ball. A brain researcher friend of mine has seen this several times now in treating soccer players (professional and collegiate) for memory problems and other cognitive problems.
Every once in a while we see someone who has been exposed to toxins come down with cognitive problems. We live one of the biggest agricultural areas in the world, and sometimes people get sprayed by chemicals, or get exposed to pesticides other ways. This can result in all kinds of neurological problems.
Tourette's Syndrome is also commonly misdiagnosed as ADHD. Think of it as basically ADHD with tics, and it is a close genetic cousin to ADHD. But it is important to know the difference, as the treatment for ADHD is often stimulants, and sometimes stimulant medications can make Tourette's worse. You can learn a great deal about Tourette's Syndrome in a great book by David Comings, MD, titled, "Tourette Syndrome and Human Behavior." It should be available through your library.
What are the major things to look for then? The big clue is in knowing whether the target behaviors (inattention, or impulsivity, or hyperactivity) have always been apparent to some degree or other, or if they just started one day. And if they just "started one day," then did they start as the result of some event (traumatic or environmental) ?
ADHD is usually "always there" while the other things tend to have a starting date. Tourette's is the exception, as sometimes it has "always been there," and sometimes it has a starting date. Realistically, if it looks like ADHD, then it probably is, but as a clinician the other possibilities must always be ruled out before making a diagnosis and developing a treatment plan. Information on the different types of ADHD and specific treatment recommendations is available at the ADHD Information Library.
Douglas Cowan, Psy.D., is a family therapist who has been working with ADHD children and their families since 1986. He is the clinical director of the ADHD Information Library's family of seven web sites, including http://www.newideas.net, helping over 350,000 parents and teachers learn more about ADHD each year. Dr. Cowan also serves on the Medical Advisory Board of VAXA International of Tampa, FL., is President of the Board of Directors for KAXL 88.3 FM in central California, and is President of NewIdeas.net Incorporated.
Using Behavioral Therapy For The Relief Of Adhd
Children who suffer from ADHD often experience difficulties at home or in school. What can be seen as unruly behavior in young children can become overwhelming in children as they reach their teens. They may perform badly in their academic work, become involved in fights or struggle to make friends. Some end up being moved from one school to another due to disruptive behavior. So it?s important to try and find relief of ADHD while children are young.
Attention Deficit Disorder
Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder (ADD/ADHD) have been widely used labels since the early 1990s. They are considered catch-all diagnoses by many clinicians.
People with Attention Deficit Disorder
Today, we hear about the medical condition called Attention Deficit Hyperactivity Disorder (ADD or ADHD), and wonder if our children might just be hyperactive.
9 Things that Doctors Say about ADD or ADHD
Attention deficiency disorder (ADD) or attention deficiency hyperactivity disorder (ADHD) may not put a person's life in danger, but it can definitely affect his level of achievement and contentment. If you have reason to suspect that your child has ADD or ADHD, don't fool yourself into thinking that TLC can make this serious condition go away. It won't. Learn what doctors have to say about ADD or ADHD and know why you should have your child's condition treated immediately.
Adult ADHD: Beating The "Three-Quarter Rule"
In this article we are going to address some of the wonderful questions Adult ADHD people have written in with, asking about how to "focus and finish" with Adult ADHD. Here's a really great one from Judy...
Adhd And Treatments That Offer An Alternative To Medication
Current estimates put between 4 and 12 % of school children, as having ADHD and treatment plans for this chronic condition will generally include the use of medication to modify behavior. However, these do come with side effects are not all children will respond to them, which is why some parents prefer to adopt an alternative method to replace or work alongside medications to minimize the dose.
Tips for High School Teachers with ADHD Students: Setting Up Your Room
Thank you to all of our professional educators who dedicate themselves to our children! We know how difficult it can be working with ADHD children, so here are your teacher tips for the week, brought to you by the ADHD Information Library and ADDinSchool.com.
ADHD Medication? Not For Sufferer Who Became Millionaire Overnight
ADHD sufferer Tellman Knudson reveals the secrets for overcoming his crippling disorder without medication and allowed him to go from broke to becoming a multi-millionaire in just months.
Amino Acids Adhd Supplements: They May Help
Different people have different theories regarding the cause or causes of ADHD. The current theories are that genetics play a big factor in the development of ADHD. This supports the argument for amino acid ADHD supplements.
The Effectiveness of ADHD Vitamins on ADHD
Can ADHD vitamins be used to treat ADHD instead of merely relying on stimulant medication? This is a very common question one gets to see in Web 2.0 sites such as blogs. ADHD is a mental-related problem in which people affected by it have problems of attention, impulsivity with or without hyperactivity. Scientists are not able to identify the exact causes of ADHD as yet, but many believe it is gene related. Some other possible causes bandied about include iron-deficiency, premature birth, a family history of mental retardation and low socio-economic status.
Things You Should Know About ADD-ADHD
ADD and ADHD, these are two terms often used interchangeably to decribe a common neurological problem in which a child find it difficult to concentrate on any task for more than a couple of minutes and they also can't seem to sit still.
School Issues: When Should an ADHD Child Be Held Back In School?
This can be a very complicated issue, so I don't mean to suggest that my comments here are the definitive thoughts on the subject. For a parent to even consider the issue, things have to be pretty problematic at school.
Attention Deficit Hyperactivity Disorder is Not Related to I.Q.
It's important to know that Attention Deficit Hyperactivity Disorder and Intelligence, as measured by I.Q.
Stress Can Create Symptoms of Attention Deficit Disorder
Stress can affect virtually any part of the body and produce physical, mental and emotional symptoms weakening the immune system and impairing coordination and thinking ability. Stress comes from relationships, from school or work situations, and from our own expectations.
Treatment Options for ADHD
Ritalin has been shown through the years to be very effective in the treatment of Attention Deficit Disorder symptoms. Although it has potential side-effects which many families would like to avoid, we have seen it help a lot of people.