Well I'm off for the next month for some family time and travel. I won't be writing until March. I hope you will use the bulletin boards to start a conversation with each other. I hear from so many of you who want to talk to other adults about your experiences. So here's your chance..
Now for this week's questions and answers...
Q.#1. Does my toddler ahve ADD? [Guest responder!]
I had a question from a woman about how young you can tell if a toddler has ADHD. This woman believes her 3 and half year old is a likely candidate but wants to know when he can get formally tested and treated. -and how to handle the excessive chatter and activity in this interim period when she says meds aren't appropriate and symptoms aren't dangerous but merely disruptive. She wanted thoughts and advice on early detection and behavioral techniques. This woman is also recently diagnosed as well as her teenage daughter.
I turned this one over to an expert, Dr. Roger Lauer, PhD, a child and adult clinical neuropsychologist here in Ann Arbor who has great expertise in this area.He was kind enough to make this response.
"Diagnosing younger children is a challenging task and it should be carried out by a clinician who is familiar with typical development in children. Most importantly, one should recognize that children have a smaller repertoire of behaviors compared to adults, but a larger range of tolerance for their deviant behavior. It is possible to diagnose ADHD in young children, but a comprehensive assessment would be recommended. Knowing that the diagnostic criteria for ADHD suggests an onset before age 7 would indicate that many children who eventually receive this label show signs earlier in life.
The majority of these children do not come to the attention of professionals until they reach school age. To be identified so early in life (age 3) would mean that the behavior was quite obvious (or in the case of the person who wrote to you, their awareness was raised possibly due to their own diagnosis). I would recommend an assessment by a pediatric neuropsychologist who will examine many possible reasons for the described behavior. If ADHD is found, then behavioral intervention is most helpful. This typically involves helping the child and his family to alter their behavior, with an emphasis on anticipating situations where difficulties will arise and proactively intervening. Also, developing a reward system to help foster new behavior and responses is suggested. Given that a parent may also have this diagnosis, I would recommend parent guidance work to assist the parents in developing more effective parenting strategies. On this same note (and connected to my point above), we would want to insure that the parent was not misinterpreting typical behavior in children as problematic due to their own struggles.
Lastly, an evaluation by a child psychiatrist could be suggested, to explore possible medication intervention. I typically do not suggest this avenue for intervention at such a young age unless all other treatment has failed to change the behavior, or if the child has multiple deficits that need remediation and it would be helpful to eliminate excessive inattention and overactivity as a hurdle to achieving success with other therapies (e.g., a child with a severe speech and language disorder who cannot benefit from language therapy because of their inattention or hyperactivity). I would caution that my response to this question is based on generalities and not on a specific case. As in my own practice, every child is unique and each case requires a comprehensive evaluation with possibly different recommendations depending on developmental history, medical history, family history, school history, and social history (to name a few areas of importance)."
Roger Lauer, Ph.D.
Child Clinical Neuropsychologist
Thanks Dr. Lauer!
Thanks Dr. Lauer!
Q.#2. ADD and spirituality
A woman wonders why she doesn't hear more about ADD and affiliations with religious organizations since she recognizes that adults with ADD often don't feel connected to other people and don't take the time for this. She wonders if anyone has addressed this possible important spiritual affiliation in the lives of those with ADD.
A.
The person who addresses the need for "connectedness" in most depth is Dr. Edward Hallowell, known in the ADD field for Driven to Distraction. Now, the noted psychiatrist has addressed this issue for everyone in his book Connect (Pantheon Books, N.Y.1999) in which he certainly includes the need for spiritual connectedness.
In my experience, adults with ADD have a great deal of trouble keeping up their important connections. Time just passes by, they are overwhelmed with other commitments. Many adults with ADD have told me how badly they feel when people mistake this for not caring, when really the opposite is in their hearts. They feel so ashamed usually when they miss an important occasion to connect, that they withdraw more. An accepting supportive place as the writer of this question suggests, where they could gather and re-group, sounds like a wonderful way to try and put more balance into their lives as well as find that much sought after connection that could give them something to hold on to in the middle of chaos.
See you in March!
Warm Regards-
Sari
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(c) 1999 Sari Solden. Unlawful to duplicate without expressed permission.