Diagnosing ADD or ADHD: a Pediatrician’s Perspective

Last updated on September 13th, 2015 at 01:10 am

We have all been exposed to ADD or some form of it for many years now.  It is a very common “diagnosis” and it is usually the teacher, parent or physician who initially  brings up the subject about your child.   ADD (Attention Deficit Disorder) or ADHD (Attention Deficit Hyperactivity Disorder) is suggested and even diagnosed based on clinical (observational) criteria. This is to be distinguished from other medical issues for which one can run specific tests.  It, however, is not the only diagnosis which describes children who are very impulsive, hyperactive, unable to concentrate on any topic, and are underachievers in school in spite of being very bright beginning under seven years of age and who is seen to have these same issues in different social settings such as school, home, groups (church, scouts, etc.) consistently.

You may recognize these “symptoms” as very common observations in children in general, but when it becomes an issue significant enough to disrupt the family and school function it is something that should be evaluated.  There are many issues for which these symptoms apply to children; learning disabilities, emotional disorders, mental retardation, psychological illnesses, and these can all be confused within the same child.  To make matters worse, two or more of these can exist at the same time in the same child.

A suspicion of ADD or ADHD is the first step in determining the problem.  There are many questionnaires that parents and teachers are asked to fill out that can point in the direction of this problem.  First though, is a complete exam by your child’s primary care physician. His/her input is very important as it is up to him or her to coordinate the further evaluation and treatment (if necessary) of this problem.

A very careful and thorough evaluation should be done because of the variety of other problems (see above) that can mimic this disorder.  Your Doctor will probably require certain testing to be done, up to and including a full, and expensive neuropsychological evaluation.  This kind of evaluation can help pinpoint some of the more pertinent issues and rule out some symptoms that could point in the wrong direction.  Therefore, this is not usually a diagnosis that is made on your first or even second visit to your Doctor.

Many feel that this disorder is becoming much more prevalent;  I really don’t feel this is the case.  Many conditions that were passed over in the past are now recognized as part of an attentional deficit subgroup.  The level of awareness in the general population and in teachers and Physicians particularly has been raised, and what was considered something that children would just “grow out of” is now recognized more often as early attentional problems.  There have also been an explosion of testing materials (questionaires, etc) and medication for treatment.

When the issue is thoroughly evaluated, the methods of “treatment” usually are  condensed to educational, psychological, and/or  medication.  All are important if the situation points in this direction in order to grasp the concept and use all means to help these children get through this very frustrating problem.

In one of the next several posts I will try to delve into the three approaches as mentioned above.

Is Social Media Making Your Kids Less Smart?

Last updated on March 2nd, 2018 at 02:49 pm

Eight in ten teens have a profile on at least one of the many social media websites out there and most of them are on it daily, according to a recent report.

This is hardly big news if you have a teen in the house – or even a tween like I do. Although social sites like Facebook and Instagram require users to be at least 13 years old, many of my daughter’s friends had Instagram accounts since fifth grade. My burning question: How’s all this posting, tweeting, and liking going to affect getting good grades?

In college students, at least, it doesn’t seem to make a difference. In a study at the University of New Hampshire, 63 percent of undergrads who used social media for an hour or more a day got As and Bs compared to 65 percent who used it for a half-hour or less. But, research from a couple of years ago on middle- and high-school students suggests that social networking is a big distraction. The researchers from the University of California observed students studying in their homes for 15 minutes afterschool. They found that the kids who checked Facebook once during that studying time had lower grades than students who stayed on task. I wonder if this problem might have been solved with one simple rule we have at home: You can’t check your phone, iPod, or other electronic device until after all homework is done.

The American Academy of Pediatrics also has weighed in on the use of social media websites by tweens and teens. In reading over the report, I was surprised about the educational benefits of social media that the group listed, including “enhancement of individual and collective creativity” and the “expansion of one’s online connections through shared interests to include others from more diverse backgrounds.” I never really thought about it, but I guess all those cute photos with sayings that the kids are always posting and re-posting on Instagram are pretty creative. And the ability to connect with kids of the same age from around the world could definitely give your child a more global view.

I suppose what it all comes down to is supervision. The TV time limits we had when my daughter was younger have simply been redefined to include anything electronic – whether it’s texting, Facetiming, social networking, or watching Good Luck Charlie. If her grades slip, we’ll have to re-visit the issue, of course. But, for now, I’m okay with it. How about you?

Is Competition Hurting Your Kids?

Last updated on March 3rd, 2018 at 11:19 am

Kids face more competition than ever, and that’s not always a bad thing. Competing at something they’re passionate about helps build self-esteem, motivation and persistence. The problems come when the only thing they’re passionate about is winning.

Overly competitive kids often lose their love of the activity, even if they were passionate about it to begin with. “When there’s no prize, they don’t want to do it anymore,” says Wendy S. Grolnick, psychology professor at Clark University and co-author of Pressured Parents, Stressed-out Kids: Dealing With Competition While Raising a Successful Child.

And while being a winner may make kids popular (at least temporarily), being overly competitive can have the opposite effect, according to Susan Newman, social psychologist and author of The Case for the Only Child. “Kids don’t like kids who don’t share the ball,” she says. “It’s a sure way to lose friends, and it’s damaging to the team. You’re not able to be a team player if you have to be the star.”

The consequences of extreme competitiveness aren’t just social. Unchecked, it can lead to long-term problems, such as chronic stress and low self-esteem. Here’s how to ensure competition is a healthy, not harmful, experience for your kids.

1.  Change the focus.

When your kids come home from playing a game, do you automatically ask, “Who won?” Don’t. Kids hear it as “Winning is everything.” Worse yet, they think it’s how you measure their worth, according to Grolnick. “They narrow in on that: Not only is it a nice thing when I win, I’m a good person if I win. And I’m a bad person if I don’t. They think you don’t like them as much when they don’t win.” So focus on the game itself, not the outcome. Ask how the game went, who did what and how they played.

2.  Have them share, not hoard, their strength.

One way to keep competition in perspective is to encourage your kids to share their abilities with kids who aren’t as talented or skilled. Have them hold a practice session with the younger kids in the neighborhood, or offer to tutor kids in the subject they excel in. By helping others improve their performance, your kids will see that their talent has value beyond the trophy or award.

3.  Beware of stress.

For many kids, competition leads to harmful levels of stress, and neither you nor they can see it, according to Grolick. “There’s a lot of burnout in terms of sports,” she says. “It looks like they’re enjoying it, but it’s very stressful.”

Watch for the classic signs of stress: headaches, trouble sleeping, stomachache, appetite loss, and depression. A less obvious symptom: They are unable to stop pushing themselves.

4.  Don’t force competition.

Parents need to let kids find the activities they want to excel at. Pushing them to compete at something they’re not passionate about is futile, according to Newman. “You may get a surge of competitiveness, but in the long run, there’s not much you can do. Down the line they may develop their own sense of wanting to compete for things they’re passionate about.”

5.  Check your own competitiveness.

Parents who get heated up and vocal at their kids’ games send a strong, damaging, message: The thing to get passionate about is winning, not playing your best. Another bad modeling example is when you talk about your own performance in negative terms, according to Newman. When you come home from the gym, say “I lifted 5 pounds more than yesterday” rather than “I can’t even lift 20 pounds.”

“You need to focus on effort,” says Newman. When you have a positive attitude about being competitive, whether it’s against your own goals, or other people, you’ll teach your kids the meaning of positive competition.

Ride The Brain Train: Nurture Your Child’s Developing Mind

Last updated on March 3rd, 2018 at 11:53 am

In this New Era of neuroplasticity, we have grown to learn that early brain development is so important for infants, toddlers and children. The brain is an amazing organ, growing changing and adapting to life experience.

Did you know that your baby is born with more than 100 billion neurons, or brain cells — all that he or she needs for a lifetime. Many people do not. That is why in 2011, we have partnered with several colleagues and parents to help education about brain based interventions become common knowledge in families across the US and the UK.

We call our educational initiative The Brain Train and this is our goal: To inspire parents, educators and grandparents to share one brain-based fact with three people in an effort to bring brain-based education to 100,000 families in 2011. Now, you don’t have to become a neuroscientist, you simply have to feel motivated to learn and share kernels of knowledge with people you love. Our colleagues Wendy Young, Sue Atkins and Deborah McNelis have helpful brain-based parenting tips on their sites. Everything from The benefits of interacting face to face with your little ones to preventing Melt-downs with activities and fun! We’ve already started airing brain-based shows on Dr. Lynne Weighs In #Blog Talk Radio. If you have brain-based knowledge to share please do so on our FB page.

Four Valued Yet Simple Facts You Can Share Today:

1. Your child’s brain is primed at birth for learning. Research conducted at the College of Family and Consumer Sciences at the University of Georgia concludes that your baby’s brain will develop more in the first five years of life than throughout the rest of his life, and a significant amount of research points to the first three years of life as being most critical to your baby’s developing brain.
2. According to Zero To Three – “The first three years of life are a period of incredible growth in all areas of a baby’s development. A newborn’s brain is about 25 percent of its approximate adult weight. But by age 3, it has grown dramatically by producing billions of cells and hundreds of trillions of connections, or synapses, between these cells.”
3. As an infant and young child, brain cells are not yet linked to form the complex networks required for mature thought processes. As your baby grows into a toddler and preschooler, brain synapses grow and connect, forming the neurological foundation upon which he will build a lifetime of skills. By the time an infant is two or three years old, the number of synapses is approximately 15,000 synapses per neuron (Gopnick, et al., 1999). This amount is about twice that of the average adult brain.
4. The brain is so efficient that it prunes connections that are not used and deemed not needed by the brain. That is one reason it is so important to develop language, motor and social-emotional pathways through interaction, communication, love, nutrition, exploration and play in the early years.

According to Deborah McNelis of @braininsights:

The brain organizes through a “use it or lose it” process. The brain eliminates and strengthens connections in an effort to become more efficient. So, experiences that are repeated frequently lead to brain connections that are retained. Connections that are not used often due to lack of repeated experience are eliminated. This is how a child’s brain adapts to the experiences in daily life.

Brain development is valuable for school-aged children as well. Activities such as soccer, martial arts, horseback riding, swimming and activities that include movement across the anatomical planes of the body increases synaptic connections. It turns out that yoga and meditation are not simply calming but likely brain building.

If you are ready to Take A Ride on The Brain Train consider these books and check back often for new tips and insights.

• Bright Toddler: Understand and Stimulate Your Child’s Development – by Richard C. Woolfson
• Brain Rules for Baby: How to Raise a Smart and Happy Child from Zero to Five by John Medina
• The Whole-Brain Child: 12 Revolutionary Strategies to Nurture Your Child’s Developing Mind by Daniel J. Siegel and Tina Payne Bryson

For coaches, clinicians and social workers, join our May training to bring brain-based parenting to your practice.

Thank you! For making brain-based parenting knowledge universal.  Share the knowledge!

****************************************************************************************************************************

This post reflects Dr Kenney’s “The Family Coach Method” used in practice for a number of years, and released for publication just over a year ago. The Family Coach Method is ‘rug-level,’ friendly and centered on the concept of families as a winning team – with dozens of age-appropriate sample conversations and problem solving scenarios to guide a family to the desired place of mutual respect, shared values and strengths. The goal is to help children to develop the life skills, judgment and independence that can help them navigate the challenges of an increasingly complex world. The Family Coach Method is also being taught as an Educational Series where parents can join with other moms and dads in live calls with Dr Kenney.

Kathy Ireland Urges Funding for Down Syndrome Research

Last updated on March 3rd, 2018 at 12:55 pm

Model, actress, designer and mother Kathy Ireland is now the aunt of a three-month old girl with Down Syndrome.  Kathy reminds us that one out of every 800 babies has Down Syndrome in her touching opinion piece for AOL Health.  Kathy has been advocating for Down Syndrome research, which faces budget cuts due to the economic crisis and growing healthcare costs.  Kathy urges each of us to write to your area’s legislators to urge them to support funding for research on prevention and treatment for Down Syndrome.

Pesticides and ADHD

Last updated on March 3rd, 2018 at 01:21 pm

Everyday Health ran a good article on pesticides and ADHD.  Sure, we all want to eat a healthy diet full of fresh produce, so how can we steer clear of pesticides on that food?  Most experts say buying organic and washing food very well before eating it is the best bet.  A new study that will appear in the June issue of Pediatrics has shown a link between high levels of pesticides and ADHD.  The study points out that ADHD is most probably genetic, but that being exposed to pesticides before age 6 increases the chances that the child will exhibit symptoms of ADHD.

You can find a local farmers market or stand here.

« Previous Page — Next Page »