Originally posted in The National Post, Toronto Canada

– By Stuart Forman

Play Doctor for a minute.

An eight-year old shows these signs: easily distracted, restless, and acts out without thinking. Normal childhood behaviour or ADHD?

Proper diagnosis is one challenge surrounding attention deficit hyper-activity disorder. ADHD hinders a child’s ability to regulate activity level (hyperactivity), inhibit behaviour (impulsivity), and attend to the tasks at hand (inattention). The symptoms can differ for each child, and even between settings (e.g. home and school).

How common is ADHD?

Estimates range from one in 20 school-age children to 5 percent or more. ADHD advocacy groups say the condition is under-diagnosed and under-treated. Many critics respond that parents, teachers and doctors slap the ADHD label on children who previously would simply be regarded as energetic.

Whatever the prevalence, ADHD has widespread impacts. “It can affect every aspect of life, from social to academic, from family dynamics to self-esteem,” says Bob Gottfried, Ph.D a Toronto ADHD specialist. When the behaviours associated with ADHD are recurring, health experts say it’s time to investigate.

Treatments involve education and medication

A doctor can start by exploring the child’s behaviour, how long symptoms have been present, and what issues they cause. Other professionals could be involved in the assessment, like a psychologist or a speech and language pathologist.

“You look for patterns like a child who isn’t performing to common standards, can’t listen or disrupts consistently,” says Bob Gottfried.

Even if the root issue isn’t ADHD, he says an evaluation can flag other conditions (e.g. anxiety disorder) or events (e.g. family breakup) that can cause similar behaviour. While there’s no test” for ADHD, doctors might order some tests, e.g. hearing or vision, to identify or rule out other potential causes for the symptoms. (NOTE: there is no test as in x-ray or a blood test is currently available, however advanced assessments including brain EEG and neuro-cognitive testing can point out to the exact areas of the problem and in turn direct a patient to the appropriate treatment modality.)

Treating ADHD, says the Canadian Paediatric Society (CPS), can involve training for parents, strategies to change the child’s behaviour, programs to help the child in school and medication.

Many therapies are promoted as alternatives to drugs, including changes in diet, vitamin supplements, herbs, antioxidants, homeopathy, and hypnotherapy. However, notes the CPS, these alternative therapies haven’t had the same kind of scientific review or testing as the medications that doctors use for ADHD. So proceed cautiously and talk to your doctor first.

One myth is that children outgrow ADHD. Toronto’s Hospital for Sick Children notes that 60-80 percent of children diagnosed with ADHD will still have symptoms as teens or adults – another reason why early identification and intervention are so important.

NOTE: so far, neuro-cognitive training is the only modality that has been proven to actually resolve impairments associated with ADHD.