It’s my first official substack newsletter. Yipee! I am hoping this is useful, and I am totally open to your feedback so reach out on instagram or by commenting to let me know what you’d like to see next.
I know many have been distracted by election news, but I’d like to share a bit about what I think parents should know about ADHD. It’s important that we recognize, diagnose and treat ADHD to help set our children up for success - not just academically.
If you’re not so interested in the ADHD, maybe you have a baby or are expecting, scroll to the bottom for the link to my fun holiday gift guide. I will do my best to include content for a range of ages in the newsletter.
ADHD has been on the minds of many parents as we are spending more time with our children than ever, doing more schooling at home, with less available expertise. Many pediatricians are used to the backup school provides in terms of identifying children who may have ADHD. In fact, it’s part of the diagnostic criteria that concerning symptoms are identified in two environments ie. at school and at home.
But even if you are only at home, it shouldn’t preclude us from considering and diagnosing ADHD. Making the diagnosis can help obtain treatment that will help the child and the family and the earlier the better. Treating ADHD isn’t just about academic outcomes. We know that these symptoms affect the development of self esteem and social skills and friendships.
As many as 8-10% of school-aged children have ADHD. Often symptoms present before age 12. There are two clusters of symptoms you should know about.
The commonly identified one is hyperactivity and impulsivity. Children who are hyperactive fidget, have trouble staying seated, are restless, have difficulty playing quietly, seem to be always on the go, and talk excessively. Impulsivity may present as difficulty waiting turns, blurting out answers, interrupting others, or becoming quickly frustrated. We may see children with hyperactivity or impulsive features having more injuries and long-term we know this has health implications. Adults with ADHD may have more car accidents or be more likely to make risky choices with substances or sexual activity.
But perhaps EVEN more important to know is the second cluster of symptoms inattention. Symptoms of inattention include being careless with details, having difficulty paying attention and listening, failing to follow through, difficulty organizing, avoiding tasks requiring mental effort, losing things, and being distractible. Inattentive ADHD symptoms often aren’t apparent until 8-9 years of age, are more likely in girls, and in children born before 32 weeks. I worry about parents and teachers missing inattentive ADHD because it can be more subtle.
If you are wondering if your child might meet criteria, you can look at one of the evidence based guidelines for ADHD diagnosis here. If you check a lot of boxes about your child, plan a visit to discuss with your doctor. Treatments before age 6 can start with behavioral interventions, but most children with ADHD benefit from a combination of behavioral/occupational therapies and medication.
While you are waiting for an evaluation consider the following:
Is your child getting enough sleep?
Fatigue impairs focus. The quantity of hours should be appropriate for age and the quality of sleep matters too. Fitful sleep or loud snoring may indicate the quality of sleep is insufficient.
Does your child get enough exercise?
When cooped up and less active some children may show more hyperactivity and bouncing off the walls. Children need at least an hour of physical activity a day regardless, be sure you’re getting that in. Preschool children often can’t tolerate more than an hour a day of sedentary activity.
Are there learning differences?
Often parents may need to ask for help to be sure the expectations are developmentally appropriate. A child who is struggling academically may need an individualized educational plan with testing to understand whether there are learning issues that require attention.
Lastly, please teach your children to be considerate of others, I hear children sometimes saying “Ugh she is so ADHD” as a put down and it’s not appropriate. Children (and adults) with ADHD can thrive with the right supports in place.
The holiday gift guide
I have been sharing a lot of serious content, but I put together the holiday guide just for fun. As a mom and as a pediatrician, I thought I would have a unique perspective in which gifts have the most value for our kids - both in fostering development and fun. There are no affiliate links or ads, and I tried to link to a variety of stores. The focus is on kids under 10. Check it out and let me know what you think!