Tuesday, April 3, 2012

When is ADHD a problem?

Attention Deficit / Hyperactivity Disorder (ADHD) affects 2-16% of school children. Many parents, teachers, and doctors consider a trial of ADHD medication a reasonable course of action when behavior problems seem to stem from an inability to sit still and/or concentrate. But why do we jump into treatments before determining if there is a problem?

Sometimes kids are just being kids!

A disability is an impairment that affects one or more "major life activities." What major life activities do we expect for children? To have positive social interactions, to learn about their world, and to be reasonably self-sufficient for their age. Often the ADHD symptoms we see are problems because of the adults, not the child. Consider the following questions.

Does the behavior prevent the child from achieving her goals? If she is so distracted she can't learn the rules to a game she wants to play, or so active she can't finish a book she is enjoying, there might be a problem. If the behavior is manifest through unfinished homework, daydreaming during instruction, or hours playing outside, the issue might be an unwillingness to focus rather than an inability.

Does the behavior compromise personal safety of self or others? Our responsibility as parents is to keep our children safe. (Within reason. No bubble wrap, please.) Impulsively decorating an entire wall with stickers is significantly different from impulsively running into a busy street to get a ball. Look critically at behavior to determine if there is a pattern of unsafe behavior.

Does the behavior damage important relationships? If parents or siblings are unable to cope with a behavior, the child may need help in modifying the behavior to maintain a supportive home environment. If the offended parties are 'friends' your child doesn't like, it's probably OK to let that relationship end.

If the answer to all three questions was no, then a medical treatment seems unnecessary. If you are concerned about your child's academic performance, meet with the teacher. Ask to do a classroom observation and compare your child's behavior to the class. Is he being age-appropriate? If not, consider pursuing a 504 plan or possibly an IEP to make the academic environment work for your child. Or, skip that mess all together. Home-school!


  1. I'm definitely not one to just to using meds for anything, but man to ADHD meds help when they are really needed! My BIL is 16 and has been on meds for about 2 years and they have really helped him to focus. While school work was an issue, his social interactions were an even bigger challenge. I think because he is older, it is easier for him to express what he is feeling and how his ADHD affects him. Even on the meds he still sometimes has trouble following a conversation which is extremely frustrating for him, especially because his peers just don't get it. He did public schools for 5th, 6th & 7th grades, but he was miserable. So he went back to home schooling - sort of. He attends the same home schooling academy where I teach 2 days a week (he's actually in one of my classes) but it seems to be a good mix of what he needs. Unfortunately, because the school is smaller, sometimes teachers are less willing or able to accommodate needs of students with ADHD or other learning disabilities (which frustrates me to no end!).
    I think that you make some great points and it drives me crazy when meds are the FIRST thing that people try to "fix" the ADHD. It is always going to be there, it is not going to be fixed or just go away - you have to learn about it and learn how to adjust and live with it and help your child to understand, as they get older, so that they can try to be deliberate about watching their actions. I think behavior modification could be helpful either alone, or in conjunction with meds (if they are truly needed).