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dear doctor

Does my child have AD/HD?

A child psychiatrist weighs in.

Dear Doctor,

My 6-year-old son is the kind of kid who is always in motion. As a toddler, he was constantly running, jumping and climbing—on everything. Now that he’s in school, his teacher says he often has a hard time sitting still in class, and he is easily distracted. My mother thinks I should have him evaluated for AD/HD, but I’m hesitant because I don’t like the idea of him taking medication every day. Isn’t this just normal for an active first grader?

Sincerely,

“Exhausted Mom”

Dear Exhausted Mom:

The picture you paint certainly looks a lot like what we see with children who have attention-deficit hyperactivity disorder, or AD/HD. In preschoolers, the most common signs are motor hyperactivity, impulsivity, and a short attention span. Kids this age often get identified because they’re like motors that don't stop.

In many cases, the best person who can help distinguish AD/HD from typical child behavior is the classroom teacher, because even though kids can be very active at home, the expectation is they're able to sit still in a classroom and participate. There are a variety of different rating scales that teachers complete to help us diagnose AD/HD. The one we typically use is called the Vanderbilt, and in addition to a teacher questionnaire, it also includes a parent questionnaire, and a self-report form that the child fills out. Usually, you try to have consensus between what the parent says, what the teacher says, and what the individual child says.

In addition, we look at family history, since AD/HD is an inheritable condition. So generally, when you see a child who has AD/HD, the question is, does anyone else in the family have it? 

As child psychiatrists, one of the biggest concerns we have is what happens to a child who is untreated for AD/HD. The goal for all children is to help them reach their fullest potential, and the truth is, if a child with AD/HD doesn’t get diagnosed properly, they're going to have more academic decline as the academic rigor increases. Studies also show that children who are untreated for AD/HD have lower self-esteem and are more likely to develop substance abuse disorders. 

That’s why treatment for AD/HD is so important. The question isn’t medicine or no medicine—it’s what do we have to do to help the child reach their full potential? And that may or may not include a stimulant medicine for the AD/HD.

“The goal for all children is to help them reach their fullest potential and the truth is, if a child with AD/HD doesn’t get diagnosed properly, they're going to have more academic decline as the academic rigor increases.”
Victor Fornari, Child and Adolescent Psychiatrist
Dr. Victor Fornari, Child Psychiatrist | Photo credit: The Well

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Published September 10th, 2019