Is It Attention Deficit Hyperactivity Disorder or Just Boy Behavior?

Have you ever wondered if your son had A.

Is It Attention Deficit Hyperactivity Disorder or Just Boy Behavior?

It has been suggested to you that your son may be suffering from attention deficit. This information has come to you via a teacher or a child care worker or family member or maybe it has crept into your own mind without any suggestion from anyone. You struggle with the idea and you wonder, is it really attention deficit or is he just being an active boy. After all, the symptoms of attention deficit and the normal behavior of boys can look remarkably alike. They are distractible, don’t stay focused on one thing for very long, can be impulsive, are forgetful (except for details of video games!) don’t listen for directions and are constantly moving. Sound like your boy?

The diagnosis of ADHD has increased tremendously over the past three decades, if the prescription of medication to treat the disorder is any indication. In the years between 1987 and 1996 there was a 600% increase in the prescription of medication for the treatment of ADHD. (the increase in the prescriptions was for children enrolled in HMOs, during that same period there was only a 17% increase in enrollment in the HMOs). This is a staggering increase in the diagnosis of ADHD, add to this that boys are three times more likely to be diagnosed with ADHD than are girls and the question of if this is boy behavior or ADHD is a significant one.

The only way to really tell the difference between the two is a very thorough diagnosis. Unfortunately, between the pressures on teachers and classrooms and the busy health care practitioner there can be a rush to diagnose a child with ADHD simply by looking at the diagnostic criteria from the Diagnostic and Statistics Manual Fourth Edition (DSM IV) and declare a child to be indeed ADHD, particularly if his behavior and academic performance is suffering. One study in Australia showed that three fourths of the children diagnosed with ADHD had been improperly diagnosed (Australia has the highest use of psychostimulants for ADHD in children).

Fortunately, most experts agree that there is a way to accurately diagnose ADHD but they are also quick to point out that there are a number of disorders in children that can present like ADHD. Some of these disorders are depression, anxiety, learning disabilities among others. It is also possible that what looks like ADHD simply is immaturity due to the fact that the maturity rate among boys varies significantly from boy to boy, particularly compared to girls. If you suspect that there may be a problem with ADHD, make sure that you are getting a good assessment, remembering that ADHD is what is called a “rule out” disorder. A rule out disorder is one that is diagnosed partially by ruling out other, more readily identifiable disorders.

The diagnosis of ADHD is done usually by comparing your son’s behavior with boys his own age. Even within this comparison there are tolerances built into the measures to account for variability among individuals. It is also important to note that behavior that is showing up in only one setting (such as at home but not school, or school but not after care, or at school but nowhere else) is not likely to be ADHD, it is most probable that something else is going on. These comparisons are done using questionnaires constructed specifically to evaluate children for a select number of disorders, including ADHD. It is also widely accepted that children less than elementary school age should not be diagnosed with ADHD as the symptoms of ADHD and toddlerhood are too similar.

So the question of whether it is boy behavior or ADHD can really only be answered with a thorough evaluation. If you choose to ask your pediatrician about the issue, make sure he or she is familiar with the guidelines established by the American Academy of Pediatrics for diagnosing ADHD. This will demonstrate that at least they have some awareness of the complexity of diagnosing ADHD and will not be in a hurry to prescribe medication. Recognize that you son is going to active and distractible unless actively enganged in an activity. Don’t expect him to sit quietly and play without movement or noise. This is just not the way boys are. However, if his distractibility or activity seems to be excessive, make sure that you get a good assessment.

Needing more information about ADHD? A more detailed and complete article on this important issue of boys and ADHD can be read at Boys Behavior, a web page dedicated to Boys and Their Unique Behavior http://boysbehavior.thehomeschoolorganizer.com