ADHD Part 3: What's Next?
When it is possibly ADHD, WHAT NEXT?
Okay, so after reading the basic and alternative explanations, perhaps you are still suspicious of your child’s ADHD-type symptoms (read parts 1 and 2 if you haven’t yet!).
We just explored a variety of psycho-social factors that may be tricking the brain into ADHD-type symptoms. The sad thing is that even though the American Academy of Pediatrics (AAP) acknowledges all of these factors, most pediatricians won’t explore them during a visit; they usually are not trained or given the luxury of time to do so. If the doctor follows the AAP’s protocol, he or she conducts or orders a thorough evaluation of the child’s physical and mental health prior to making such a diagnosis. If ADHD is then confirmed, the AAP further strongly recommends that for ages 4-5, the first line of treatment should be therapeutic/behavioral intervention (aka counseling). For children 6-11, a combination of medication and therapeutic/behavioral intervention is strongly recommended, with school placement given special attention in the treatment plan. For adolescents, a heavier emphasis is placed on medication and less on therapeutic interventions, but still states “preferably both.” Essentially, if the pediatrician is not being thorough for diagnosis and/or not recommending therapy, you should keep exploring your options. (I do believe that medication has its place, just hang in there.)
Since this level of attention is not often afforded in many pediatric practices, I would caution all caregivers NOT to simply go to the pediatrician and detail your (admittedly frustrating) challenges with the child’s achievement as your end game. You may walk out with a quickly slapped label and a prescription to a long road for trial-and error and side-effects. Do feel free to discuss your concerns with him or her and request a referral to a counselor or psychologist if they do not offer that up.
So, what should you do? If you and others in the child’s life suspect that ADHD may be at play, please make an appointment with a counselor or psychologist (maybe get that referral by calling the pediatricians’s office or insurance company). These professionals will assess all aspects of the child’s development, family history, and functioning. They will administer assessments that ask you more than whether your child has trouble completing a task. They will see your child as a whole person, not a patient who met a checklist and therefore needs medication. (If you want help with choosing which type of professional to see, read my guide.)
“Getting a proper diagnosis of ADHD also opens doors to services and academic accommodations that may be otherwise unavailable.”
Why having the right diagnosis is helpful: Many kids do have an under-functioning prefrontal cortex for a variety of fixed factors, including genetic and neurologic reasons. Getting a proper diagnosis of ADHD also opens doors to services and academic accommodations that may be otherwise unavailable. It may also help the child (and parents!) understand and normalize their experience, reducing a significant amount of frustration and improving the child’s self-image.
What role should medication play? For truly ADHD kids, medication really can help them tap into their fullest potential for achievement and overcome an otherwise incredibly challenging academic setting. (See! I’m not a med basher!) To explore the medication route, I highly recommend seeing a psychiatrist who would be willing to do a buccal swab (cheek swab). They can send it to the lab who synthesizes the child’s DNA with a variety of medications, and therefor actually eliminate much of the trial and error families endure when finding the right medication! Yay, future! Once the right medications are established, you can ask the pediatrician if they would be willing to take on the medication management from there. Many medications take a few weeks or even months to reach their full effect, and some have risks of stopping abruptly. Be sure to discuss all of this with the prescribing physician so you know what to expect and avoid any major mistakes in the medication process.
And, in keeping with the American Academy of Pediatrics, partner your child’s treatment with a counselor. Regardless of age, there are helpful tools and identity-affirming activities that will help him or her maximize their fullest potential. And more than likely, the counselor will probably help you as the parent learn skills to interact with your ADHD child in sensitive yet successful ways.
A diagnosis of ADHD, when accurate, truly is the best step. The services, skills, and (yes) understanding that result are worth the time and energy.
If you have questions or concerns about your child’s psychological, social, or emotional well-being, please reach out to me or another trusted professional. Kailey@miraclecitycounseling.com or 407. 917. 6828.
All the best,
Kailey Mahan
LMHC