|Detecting ADHD Early|
According to a poll taken my the website www.schoolfamily.com, 86% of parents agree with the statement, "Our children are expected to learn more sooner than before." The question of catching ADHD early or detecting ADHD early is complicated by the fact that we are expecting a lot more out of our kids at an earlier age.
According to the American Academy of Pediatrics (APA), ADHD can now be diagnosed as early as age four. Previously, because of developmental variations among children, you had to be at least 6 years of age before you were given this diagnosis. The developmental variation of children has not changed but what is expected of them at a younger age has. Focus is not something that we usually associate with four or five year olds so a 4-5 year old that is unfocused is, as far as I am concerned, pretty normal.
I recently received a long email from a mom of a five year old girl who was very worried about her child and the progress that she had made in Kindergarten. She was not reading, she was very unfocused and her teachers wanted her medicated. The women had taken her daughter to her pediatrician and the pediatrician had determined that it was too early to diagnose this particular child with ADHD.
This child had a late birthday and would not be six until August. The pediatrician explained to the mother that her child was not a slow learner but rather that her child was young. The mother wanted to detect ADHD early to "catch ADHD" and all the negative consequences associated with this learning disorder as soon as possible. She was very concerned that her daughter was already falling behind and wanted to know where her daughter could now go to get treatment.
This particular pediatrician did not feel as though this child's symptoms were abnormal enough, for her age, to even warrant a referral to a psychiatrist and he sent this family away without any advice on what to do for the school problems that the child was encountering. This is a shame and a waste of a good opportunity to begin the school behavioral interventions that we know help all students succeed (see Ebook-Ten Tips to Help Inattentive ADHD Students Succeed at School).
With regards to what is normal or not, parents know if there child falls out of the range of normal. I have a copy of the ADHD behavioral checklist on my Free ADHD stuff page but for very young kids this checklist is of limited use. I also believe that it is completely possible, in fact probable, that this child will be no better in a year. According to the mom, the child is inattentive at home as well. I trust that the mother knows her child and knows that there is truly a problem but I agree with the Pediatrician that there is no need to put a five year old on a stimulant.
There will 12 more years of potential therapy ahead. Starting Ritalin or Amphetamines at five is, in my opinion, premature unless the child is uncontrollably hyperactive, disruptive or has other severe classroom behavioral issues. The presence of Inattentive ADHD symptoms and learning problems, in a five year old, should not prompt a teacher or parent to immediately jump on a medication bandwagon. Parent and teacher may have succeeded in detecting ADHD or "catching ADHD' early but they may have also been seeing the normal trajectory of a young Kindergartner.