I have an eight-year-old son. His last report card consisted of an A+ in math, an A+ in reading and a B+ in all his other courses. He was doing great and his state mastery tests came back with high scores. In the past 2 months, however, we have noticed that our son has become very inattentive. We find ourselves reminding him to do things such as pick up his room, turn off the lights, tie his shoes, etc. It’s been a constant hassle to get things done.
We received a phone call from his teacher today, who, for the past 15 years, has worked with kids with this type of behavior. She said that our son has been very active and can’t concentrate, his handwriting has become very small and not clear and his math grade has dropped to a B. The teacher suggests that we have our son tested for ADD. She is concerned because he is a very smart child.
In what other ways can I help my child? I hear so many awful things about ADD that it scares me to get him diagnosed.
Anytime there is a distinct and worrisome change in a child’s behavior, I believe it is important to have an evaluation done by a child psychiatrist or a behavioral pediatrician (a pediatrician specializing in the behavior issues of children). Unlike a child psychologist or a school counselor, both of these specialists are medical doctors who have received special training in the mental and neurological functioning of children, and so they are able to assess the presence of medical or neurological problems as well as learning disabilities and psychiatric disorders in kids.
The kind of sudden and clear-cut change you describe in your son deserves a very thorough work-up. Attention-deficit disorder (ADD) is not the only diagnosis that should be considered (and in any case, it is not typical for ADD to be diagnosed suddenly and unexpectedly in an 8-year-old who was previously doing well in school; usually the symptoms have existed for quite some time, generally at or just before the age of 5). Your son’s general medical health and neurologic health should be evaluated.
Many medical disorders can affect a child’s behavior and functioning — for example, childhood diabetes, a low-grade infection, seizure disorders and so on. Your son’s hearing and vision will also need to be examined. Once these factors have been considered and ruled out, the specialist will perform a thorough examination of the family, school, and social factors currently affecting your son. The doctor will certainly consider a number of psychiatric and psychological factors, and will look into diagnoses of ADD, obsessive compulsive disorder and mood disorder, among others. For instance, depression in children is often characterized by a sudden change in school performance and ability to concentrate, even though the child is unable to express that he is depressed.
It is important that, as the parent, you approach your son’s evaluation and any possible treatment recommendations in an open and supportive manner. If you go into this feeling scared or ashamed, your son will pick up on it — and this could create a sense of distress or shame in him which will only make things worse. Behavioral disorders in a child are just like any other medical disorder. They can be diagnosed and treated, and the outcome is always best when the whole family is rooting for the child and is involved in the treatment in an active and positive manner.
After a thorough examination and diagnosis, it is possible that the specialist you see may recommend medications for your son. Again, rather than immediately jumping to conclusions and getting worried or upset, take the time to educate yourself and your family. Talk it over with the specialist to get all of the background information on the medication that you need. Do some extra reading and look up additional information from reputable health resources on the web. Talk to other parents who have had experience with the medication. Although the issue of medicating chldren with certain behavior disorders is a sensitive and controversial topic, a number of thoughtful studies have shown that the careful use of medications is immensely helpful. Appropriate medication allows the kids to have a good experience with school and with peers, so that their whole psychosocial development and sense of self-esteem does not get disrupted because of the behavioral problems.