CityView Magazine

and homework. They have difficulty sustaining attention, especially to things they find boring. Even though they are looking right at you they don’t seem to listen when spoken to directly and fail to follow through on your instructions. They have difficulty organizing tasks and activities. They avoid things that require sustained mental effort. They are often forgetful and lose things all the time. They are easily distracted by external stimuli. Don’t these symptoms describe all of us some of the time? A diagnosis of ADHD requires that symptoms must be present for at least six months. They shouldn’t be due to a recent move or life stress. The symptoms have to be maladaptive and must cause impairment in two or more settings. They must also be inconsistent with the child’s developmental level. Some impairment should have been present before the child was 7 years old. If you think your child has ADHD, how can you test for it? According to guidelines published by the American Academy of Child and Adolescent Psychiatry, an evaluation should consist of clinical interviews with you and your child. The clinical interview can be done by your primary care physician, a clinical social worker or a child psychologist, psychiatrist or neurologist. In North Carolina, only physicians may prescribe stimulant medication, if needed. Interviews should include questions about school performance, evaluation for anxiety, depression and other disorders, and a review of your child’s medical, social and family history. There are several commonly-used scales that, by themselves do not diagnose ADHD, but are important adjuncts. These include the Conners Parent Rating Scale, Conners Teacher Rating Scale, SNAP-IV and SKAMP and the Vanderbilt ADHD Diagnostic Parent and Teacher Scales, among others. What causes ADHD? The overwhelming evidence now shows that the principle cause of ADHD is genetics with at least eight genes involved. Studies of twins estimate that heritability is 76 percent. Can parenting styles cause ADHD? There is absolutely no evidence that ordinary variations in child-rearing practices contribute to ADHD. However, children with ADHD perform better in structured settings, so providing as much structure and consistency (of bedtime, mealtime, etc.) is helpful. Teaching your child organizational skills, planning skills and providing check sheets may help them tremendously. Providing positive feedback and rewards helps to offset the negative messages your children may receive due to their ADHD. It is important to become your child’s advocate. He or she may need an Individualized Education Plan (IEP) in order to perform at school. Michael Phelps’ mom became his biggest advocate. She now contributes to an ADHD Web site, giving advice to other parents of children with ADHD. She believed in her son, and he overcame his diagnosis to become one of the greatest athletes of all time. CV Dr. Salzberg teaches and sees patients at the Southern Regional AHEC Family Medicine Center. CityViewNC.com | 59

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