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Monthly NewsNote
February 2008
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ADD and The Young Child
ADD symptoms can often emerge very early. With significant symptoms such as hyperactivity, the child is often identified early and some kind of action is taken because of the difficulties the behaviors create. But there may be milder ADD symptoms that parents first notice, and this creates a problem because they are not sure what to do. The topic of parents dealing with symptoms in a young child is something I would like to discuss in the edition of the Epstein ADD NewsNote.
Let’s look at two cases: Rich is now 7. He was just okay in kindergarten and did not learn what he was supposed to. In first grade he is just okay again. But now Rich is having trouble reading, never finishes anything, and says he is bored. Homework time is a disaster as he can’t focus for more than a couple of minutes.
Lilly is 8. She has very good grades. But recently the teacher reported that she daydreams, is distractible and is not finishing her work. Her mom, who knows about ADD, wonders what she should do.
The core of these problems is the fact that a young child has problems consistent with ADD. The parents are aware of this, perhaps from their own experience, or from a teacher who may have mentioned it.
Parents wonder what they should do. They are doing what they can to help such as talking to the teacher, helping with homework, etc. But there may feelings of inadequacy because they are not able to make things “right” and guilt because they begin to think of treatment. Thus the problem expands to include not only the child but also the family.
When I make a suggestion that the child be evaluated I often get a negative response. Comments like, “All boys are like that,” or “I don’t want my child on medication” are typical. However, I do have a few suggestions for handling the kind of problems described.
First, focus on the child’s self esteem:
- Are they feeling dumb or stupid?
- Are they developing negative feelings about school?
- Are they getting depressed?
If any of these are true, something needs to be done. Initially, they can be educational in nature. Perhaps a tutor or someone to teach organizational skills might be a start. Meetings with the school can help define the problems and point toward some help the teacher can offer.
But if these things do not help, a medical consultation is necessary. I feel it is very necessary to handle identified problems as early as possible. Once the diagnosis is made a treatment plan can be developed. Sometimes a diagnosis requires testing to determine whether there are learning disabilities, perceptual problems etc.
From that point the program can be developed. This would include the involvement of educational specialists, perhaps parental guidance, and if necessary medication.
But let’s go back to the child who does not have self esteem problems but does show ADD difficulties. What should be done? It is often fine to have a period of watchful waiting with support for the child if there are weak areas. Many times a problem noticed in 2nd or 3rd grade can just be followed until 4th or 5th grade. At some point action will be needed, but it is okay just to follow the situation.
The early observation of a school problem is always positive. Methods of thinking about it if the symptoms are consistent with ADD have been discussed. Whatever pathway is chosen, it is important that the problem be understood and followed.
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