Many parents see signs of an attention deficit in toddlers long before the child enters school. For example, as a 3-year-old, Henry's son already displayed some signs of hyperactivity. He seemed to lose interest and dart off even during his favorite TV shows or while playing games. Once, during a game of "catch," he left the game before the ball even reached him!
Like Henry's son, a child may be unable to focus long enough to play a simple game. Or, like Mark, the child may be tearing around out of control. But because children mature at different rates, and are very different in personality, temperament, and energy level, it's useful to get an expert's opinion of whether the behaviors are appropriate for the child's age. Parents can ask their pediatrician, or a child psychologist or psychiatrist to assess whether their toddler has an attention disorder or is just immature, has hyperactivity or is just exuberant.
Seeing a child as "a chip off the old block" or "just like his dad" can blind parents to the need for help. Parents may find it hard to see their child's behavior as a problem when it so closely resembles their own. In fact, like Henry, many parents first recognize their own disorder only when their children are diagnosed.
In many cases, the teacher is the first to recognize that a child is hyperactive or inattentive and may consult with the school psychologist. Because teachers work with many children, they come to know how "average" children behave in learning situations that require attention and self control. However, teachers sometimes fail to notice the needs of children like Lisa who are quiet and cooperative.
School-age and preschool children are often evaluated by a school psychologist or a team made up of the school psychologist and other specialists. But if the school doesn't believe the student has a problem, or if the family wants another opinion, a family may need to see a specialist in private practice. In such cases, who can the family turn to? What kinds of specialists do they need?
The family can start by talking with the child's pediatrician or their family doctor. Some pediatricians may do the assessment themselves, but more often they refer the family to an appropriate specialist they know and trust. In addition, state and local agencies that serve families and children, as well as some of the volunteer organizations listed in the back of this booklet, can help identify an appropriate specialist.
Knowing the differences in qualifications and services can help the family choose someone who can best meet their needs. Besides school psychologists, there are several types of specialists qualified to diagnose and treat ADHD. Child psychiatrists are doctors who specialize in diagnosing and treating childhood mental and behavioral disorders. A psychiatrist can provide therapy and prescribe any needed medications. Child psychologists are also qualified to diagnose and treat ADHD. They can provide therapy for the child and help the family develop ways to deal with the disorder. But psychologists are not medical doctors and must rely on the child's physician to do medical exams and prescribe medication. Neurologists, doctors who work with disorders of the brain and nervous system, can also diagnose ADHD and prescribe medicines. But unlike psychiatrists and psychologists, neurologists usually do not provide therapy for the emotional aspects of the disorder. Adults who think they may have ADHD can also seek a psychologist, psychiatrist, or neurologist. But at present, not all specialists are skilled in identifying or treating ADHD in adults.
Within each specialty, individual doctors and mental health professionals differ in their experience with ADHD. So in selecting a specialist, it's important to find someone with specific training and experience in diagnosing and treating the disorder.
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