But the Checklists Say It's ADHD

The first step in determining whether your child has attention problems is when you or the teachers notice high activity level, off-task behavior, difficulty sustaining attention or limited effort on low-interest tasks. The next step is often a discussion with the pediatrician or school personnel. At this point, parents are often given checklists which are meant to compare their children’s behavior to that of other children in their age range.

But what do these checklists really tell you? Are you willing to consider medication based on these alone? The answer depends on your child.

Difficulty with attention and executive functioning (which are the skills that help people organize and plan behavior and thinking) are caused by many different mental health and learning problems. Symptoms that seem like ADHD are common among children with autistic spectrum disorders, anxiety, depression or learning disorders. In addition, medical difficulties such as sleep apnea, narcolepsy and other disorders cause difficulty with attention.

Therefore, scoring high on a checklist may not tell you much about what is causing difficulty staying on task. A comprehensive evaluation of your child’s learning, attention and emotional functioning is preferable as it provides a roadmap for intervention and helps you rule-out other causes for the attention problems.

You should never accept a diagnosis based on checklists alone if your child has certain characteristics. Testing should be conducted for all children with a history of anxiety or mood problems. Emotional stress can reduce a child’s energy level, disrupt their sleep, and cause distracting negative thoughts. In addition, children who engage in repetitive behaviors, become excessively focus on certain topics, have difficulty reading social cues or experienced early language delays should participate in a thorough evaluation to determine whether the executive functioning difficulties are related to a Pervasive Developmental Disorder.

The evaluation is necessary not only to determine an accurate diagnosis but also to ensure that interventions are planned appropriately. Children with emotional issues or PDD can react differently to stimulant medication than children without those factors. In addition, behavioral plans and reminders may not be as effective as they are for children with ADHD alone because they fail to address the underlying cause of the difficulties.

The process of testing may seem daunting and time consuming, but the information you gain will help you feel confident in the diagnoses and avoid ineffective treatments.

Erika Madison Ph.D.
Licensed Clinical Psychologist
Mindwell Psychology