|

Translate/Traduisez/Übersetzen Sie/Traduzca/Traduca/Traduza:

During the assessment process it is of great importance for the physician or clinician to consider other possible causes of inattention, impulsivity, or hyperactivity in your child (or teen, or yourself). In fact, this is probably the most important element of a good assessment. There are several possible causes of these behaviors, especially in children, and the clinician must have great certainty that these other possible causes have been ruled out before giving the label of "Attention Deficit Hyperactivity Disorder" to your child.

One of the first things to have ruled out is a thyroid problem. Only MD's can do this, so off they go for a physical. This is not a common problem, but it does happen, even in children. Thyroid problems can cause inattention, learning problems, even hyperactivity and impulsivity in some. Once that has been ruled out by the doctor, then other environmental or emotional causes of inattention, impulsivity, or hyperactivity need to be ruled out.

Depression in children often causes inattention, as in adults, and also often causes impulsivity and irritability and excessive restlessness or agitation. Anxiety disorders in children can result in agitation, impulsivity, hyper- vigilance, motor restlessness, and excessive startle responses, as well as inattention to task. Significant emotional traumas can also result in these behaviors. Physical or sexual abuse, divorce or other significant loss, or the death of a loved one.

Physical traumas can also cause the same behaviors as ADHD, such as a minor head injury from an auto accident, sports injury, falling as a child, and so on. For example, one of my "ADHD" kids, who was extremely hyperactive and also very oppositional and at times violent toward others, took part in one of our research projects. As part of the study we "brain mapped" him (QEEG) at the onset of the study. We saw two small head injuries in the back of the head and one big injury in the front of the head.

The frontal problem was expected, but the problems in the back of the head were not. I simply asked the parents, "When did he bash the back of his head?" They thought for a minute and remembered that when he was about six weeks old he had fallen out of his crib onto a hard flood so hard that they had to call an ambulance to take him to the hospital. They had forgotten about the incident during the clinical interview, but the mapping showed a clear problem. He fell on the back of the head, causing those injuries, and the brain "sloshed" forward causing the frontal injuries. These injuries have resulted in a lack of inhibition and cortical control, temper outbursts, and learning problems. The diagnosis here would not be ADHD, but rather a head injury.

Mark my words, in the next five years you will see lots of research showing that playing soccer causes minor head injuries from "heading" the ball. A brain researcher friend of mine has seen this several times now in treating soccer players (professional and collegiate) for memory problems and other cognitive problems.

Every once in a while we see someone who has been exposed to toxins come down with cognitive problems. We live one of the biggest agricultural areas in the world, and sometimes people get sprayed by chemicals, or get exposed to pesticides other ways. This can result in all kinds of neurological problems.

Tourette's Syndrome is also commonly misdiagnosed as ADHD. Think of it as basically ADHD with tics, and it is a close genetic cousin to ADHD. But it is important to know the difference, as the treatment for ADHD is often stimulants, and sometimes stimulant medications can make Tourette's worse. You can learn a great deal about Tourette's Syndrome in a great book by David Comings, MD, titled, "Tourette Syndrome and Human Behavior." It should be available through your library.

What are the major things to look for then? The big clue is in knowing whether the target behaviors (inattention, or impulsivity, or hyperactivity) have always been apparent to some degree or other, or if they just started one day. And if they just "started one day," then did they start as the result of some event (traumatic or environmental) ?

ADHD is usually "always there" while the other things tend to have a starting date. Tourette's is the exception, as sometimes it has "always been there," and sometimes it has a starting date. Realistically, if it looks like ADHD, then it probably is, but as a clinician the other possibilities must always be ruled out before making a diagnosis and developing a treatment plan.

Article Keywords: Special Education

A Quick Note From The Publisher... If you like the article above, you may be interested in the following article which is also related to Special Education... The Use of Color to Treat Learning Problems I am the queen of color. Or, so I tell my students as I work with them, invariably using color as a training tool. Of course, they also think I'm a nut case, and that may well be true, but the bottom line is this: I get results with color. A normal child spends most of his day in school, dealing with black and white. Most of this day is spent with a black lead pencil, books printed in black and white, and worksheets and workbooks also printed in black and white. It seems their world is black and white, perhaps with a few colored moments. For a left-brained child, this is not an issue at all. His brain does not require color to function well. However, a right-brained child, who sees the world in color and pictures, craves and needs color to succeed in an academic setting. Without it, he loses interest in the topic at hand and slowly fades away. This student is often diagnosed as having Attention Deficit Disorder or a learning disability. This may indeed be true. But, more often than not, this child is misdiagnosed and misunderstood. However, I have had excellent results with these right-brained kids simply with the use of color. Following are some color activities that have proven to be extremely helpful for students with learning problems. 1. When they do their math, I have them use a colored pencil. I use blank paper and model the correct math steps using a colored marker. Each step gets a different color. 2. Math facts are taught using color, a story, and a picture. The entire fact is included with the story and picture. The traditional black and white flash cards that don’t have the answer available will not work with a student with learning problems. These kids need other clues to help them memorize. That is where the picture, story, and color come in. 3....