It’s really sad how many parents come to my office with little information about their child’s behavior as it may relate to ADHD because it makes it more difficult for any physician diagnosing ADHD the right way.
Often, all they know is that a teacher said, “He’s hyperactive and he’s going to fail this grade because of it.”
In my experience, 90 percent of the time, there is something wrong. The other 10 percent of these kids suspected of ADHD will end up having symptoms misinterpreted as abnormal, and they will not be ADHD.
(Please note that that doesn’t mean those 10 percent don’t need to be seen. It’s just as important for parents to know that their children’s symptoms are normal as it is for them to know they are not!)
As you read further in this chapter, you’ll discover the essential elements of making an accurate ADHD diagnosis. In addition, you’ll learn what I consider key observations about ADHD, behavior problems in general, and their evaluation and treatment.
In today’s fast-paced world where insurance companies often try to squeeze the last penny of profit out of medical care and push doctors even harder to provide that care in less time and for lower costs, it’s highly possible that your ADHD doctor could forget to ask the one most important question when it comes to diagnosing ADHD the right way.
In addition, sometimes what you fail to tell the doctor is more important than what you tell him or her. And it’s because of these two realities (e.g., parents being uninformed about their child’s behavior and the human limitations of doctors) that you, as a parent, must be prepared to provide the best information and ask the right questions about your child’s suspected behavior problem.
The single most important piece of information your doctor needs to make a correct diagnosis is whether the symptoms, or ADHD-like behavior, has been observed in two or more environments (home, school, elsewhere).
The following questions are designed to help you gather such information regarding various areas of your child’s life, which you should then provide to your doctor upon your child’s next visit.
Sometimes what you fail to tell the doctor is more important than what you do tell.
It’s very possible that your ADHD doctor could forget to ask the one most important question.
How do teachers relate to your child?
How does he or she relate to them?
Do they rub on each other’s last nerve?
Does your child have problems with other kids in the class?
Is he or she the victim of bullying?
What type of feedback have you gotten from the teacher? Is it verbal or written?
Does your child have impulsive behaviors? These may include: not being able to sit in his chair when expected to do so, wandering around the classroom, or blurting answers out of turn.
Has your child’s teacher evaluated his ability to understand instructions about class work and homework? Often kids with learning disabilities or vision and hearing problems, and kids who have problems interpreting what is said will just “pretend” or “appear” to understand what the teacher says or does, so they won’t appear stupid. Inattention or not being able to focus on the task at hand is an important and necessary part of an ADHD diagnosis.
Is your child staying in at recess or after school for failure to complete assignments or because of behavior problems? Ask his teacher! Don’t rely on the written report card summary. Teachers may forget specifics while trying to fill out twenty or thirty of those things!
Over the past twenty-five years, I’ve evaluated at least thirty ADHD kids who were “cured” by moving them to a new teacher in another classroom or to a new school.
Look for part 2 of this article.
Frank Barnhill, M.D. is a family physician who is the author of Mistaken for ADHD and specializes in diagnosing ADHD the right way.
This is an excerpt from his book Mistaken for ADHD and in previous articles he talks about how to diagnose ADHD the wrong way and today diagnosing ADHD the right way.