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3 Things Every Parent Should Know About Diagnosing and Treating ADHD—Commentary

08/21/19 Catherine M. Soprano, MD, Clinical Assistant Professor of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University; Attending Physician, Diagnostic Referral Division, Nemours/Alfred I. duPont Hospital for Children

What toddler doesn’t have a hard time sitting still?

This reality makes it tough for parents to distinguish between a child who’s a healthy ball of energy and one whose difficulty paying attention or impulsive behaviors are a sign of attention-deficit/hyperactivity disorder (ADHD). The Centers for Disease Control and Prevention reports ADHD diagnoses are on the rise. More than half of Americans (52 percent) personally know someone who has been diagnosed with ADHD, according to recent survey by Harris Poll on behalf of the Merck Manuals.

Yet, an ADHD diagnosis is still controversial. Seven in ten Americans in that same survey somewhat or strongly agreed that ADHD is over diagnosed in today’s culture. That perception can create a lot of uncertainty for parents wondering if their child should be tested for ADHD and what a diagnosis might mean for their future. Some parents may resist ADHD testing or diagnosis for their children. They don’t want the stigma or hope the child will grow out of it. But if behavior is impacting a child’s success or happiness, it’s always better to talk to a pediatrician early on to explore all of the options available.

To help clear up confusion, here are three things every parent should know as they explore ADHD diagnosis and treatment for their child.

1. An ADHD diagnosis takes time

ADHD is a brain disorder that develops at or shortly after birth, but symptoms typically aren’t apparent until age four or five and often not until children are in elementary or middle school. Symptoms fall into two categories:

  • Impulsivity: Excessive fidgeting, restless, inability to sit still
  • Inattention: Trouble concentrating, difficulty doing quiet tasks


These symptoms overlap with the symptoms of many other conditions, and nearly two thirds of children with ADHD also have another mental, emotional, or behavioral disorder. Many children with ADHD also have a combination of the impulsive and inattentive categories of ADHD symptoms.

That overlap makes diagnosing ADHD a challenge, and it’s not unusual for a diagnosis to take months. The process begins with a comprehensive medical exam followed by detailed questionnaires completed by parents, teachers, and other caregivers. In order to be diagnosed with ADHD, children must experience symptoms in all environments, not just at home or school, and experience symptoms for at least 6 months. That’s why it’s critical to involve all a child’s caregivers in the evaluations. It can be a frustrating and time-consuming process with follow-up appointments, referrals, and additional assessments.

2. There are treatment options beside medication

According to the Manuals survey, three in ten Americans believe prescription medication is the only way to treat ADHD. The reality is, medications are only one part of an effective treatment plan and are not necessary in every case. Behavioral therapy, aimed at helping the child and parents manage the condition, is the first treatment strategy. Each child requires a different treatment plan, but there are several broad behavior-based techniques doctors and therapists suggest:

  • Make environmental changes. Create set areas for work, play, quiet time, etc. to establish a routine and minimize distractions.
  • Set reachable goals. Encourage children to succeed in the short term and create opportunities for children to be successful.
  • Keep behavioral responses consistent. Praise and celebrate when children do good things and use consistent, calm discipline when their behavior is negative.


In the classroom, an individualized education plan (IEP) is a valuable tool for success in children with ADHD. Each school handles IEPs a little differently, but creating a specific plan that meets a child’s needs can help set reasonable expectations and chart a course toward improving behavior. Parents should know they can always request that their child be evaluated for an IEP.

3. Consistency is key

When it comes to diagnosing and treating ADHD, consistency is critical. Physicians don’t take this diagnosis lightly. Identifying ADHD means looking for a consistent pattern of symptoms across different milieus and over several months.

Once a child is diagnosed, treatment must be consistent. That means establishing habitual parenting strategies and discipline methods—no easy feat for any mom or dad. Most Americans understand the importance of this controlled environment. Eighty-six percent of respondents to the Manuals survey believe children with ADHD benefit from having a more structured environment.

But parents don’t have to do it alone. They should seek out resources to support that consistency. Share good behavior strategies with family members, friends, and other caregivers. Work with teachers and schools to develop robust and personalized IEPs. Rely on physicians and therapists to develop effective parenting tools and strategies. Refer to the Manuals page on ADHD for more information and to prepare for a conversation with your child’s pediatrician.


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