Is it ADHD or Something Else?

Now that school has been back in session for a couple of months, many parents are attending parent-teacher conferences.

These meetings can be a great opportunity to hear how children are functioning at school, and we all hope to hear glowing reports! However, they can be a source of stress and upset when teachers raise concerns about a child’s behavior or academic performance.

While most educators I’ve worked with over the years are very balanced in their discussion of student strengths and challenges, some have a tendency to over-focus on areas of weakness and can leave parents feeling very badly about their child’s school experience. It’s unfortunate that parents are sometimes told things like “I’m sure she has ADHD” or “you need to see the doctor about getting him on medication”.

Perhaps you’ve had an experience like this that has left you feeling confused and frustrated. I’ve had numerous parents tell me over the years that they felt “forced” to talk to their child’s pediatrician about diagnosis and/or medication because of things that were raised at a school conference, without any real discussion or investigation of the issues underlying the symptoms. Sadly, there are many primary care physicians who will write prescriptions for stimulant medications on the basis of a single teacher or parent report, without looking at the issue carefully.

The reality is that there can be MANY root causes of symptoms such as inattention and hyperactivity. Many people, unfortunately including professionals, believe that if a child is struggling to focus and attend in school, or if they also have impulsive and hyperactive behavior, that they automatically have ADHD. Not only is that not true, it can be a dangerous assumption. Even for children who do meet the diagnostic criteria for ADHD, there are always underlying reasons they are exhibiting these symptoms. A knee-jerk reaction to diagnose and medicate children because they are having challenges with attention and hyperactivity is poor practice, and often leaves the real needs unaddressed.

Before you feel like your child’s only option to ever be successful in school is to get a diagnosis and prescription, consider all of the following issues that can cause inattention, hyperactivity, and/or poor school performance:

  • Boredom
  • Perfectionism
  • Learning challenges (ex: reading or math learning disability)
  • Social isolation, peer pressure and/or bullying
  • Poor visual acuity (child can’t see well)
  • Poor auditory acuity (child can’t hear well)
  • Poor visual processing (child can’t make sense of what s/he is seeing)
  • Poor auditory processing (child can’t make sense of what s/he is hearing)
  • Poor working memory (can’t recall what s/he is supposed to do)
  • Lack of self-confidence
  • Poor teacher-student relationship
  • Diet high in sugar and simple carbohydrates
  • Poor protein intake
  • Not eating or drinking enough throughout the day
  • Zinc deficiency
  • Iron deficiency
  • Magnesium deficiency
  • Omega-3 fatty acids deficiency
  • Seasonal allergies
  • Food allergies
  • Food sensitivities
  • Chronic viral or bacterial infections
  • Steroid medications
  • Antibiotic medications
  • Anxiety
  • Obsessive-compulsive thoughts and behaviors
  • Depression
  • Adjustment issues (ex: new home, parent divorce, or recent family death)
  • Lack of physical movement opportunities
  • Sensory-processing challenges
  • Overwhelming environment
  • Constant focus on the negative – child feels incompetent
  • Not getting enough hours of sleep at night
  • Poor quality sleep
  • Excessive time spent on electronics during the day
  • High stress and/or conflict at home
  • And more…

The above list is by no means exhaustive, but it highlights the fact that it is never as simple as saying “this child is inattentive in school so he has ADHD”. As parents and professionals we owe it to children to carefully examine their symptoms and challenges so we are appropriately addressing their needs. If you are a parent dealing with this issue I want you to feel empowered to work with educators and healthcare professionals to really investigate what is going on. Parents should never feel forced into having their child diagnosed and/or medicated. It should be a collaborative effort between parents and professionals to identify the root causes of a child’s symptoms and what supports are needed to improve performance.

Have you been in a situation like this with your child? Share your experience in the comments.

What You Should Do Next:

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