ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) & ATTENTION DEFICIT DISORDER (ADD) CAN BE DIFFICULT CONDITIONS TO ASSESS.
You May Be Asking: “Is my teen just not trying hard enough or is there really a medical or chemical imbalance that is out his/her control … something that causes him/her not to perform well in academics?”
In my experience one or both of these factors can be true. It typically takes a comprehensive assessment to discover which situation is dominant: neurology vs. behavior. With the right tools sometimes a counselor can evaluate what the next step to assess this condition. At Young Counseling Services we currently use the CONNERS 31 to make the first assessment. After this initial test is completed, one of these “next steps” may be a recommendation to a 3-4 session comprehensive assessment from a licensed psychologist who specializes in the field. Another recommendation may be to consult your pediatrician. Another may be to continue counseling to build skills to manage impulse control and increase organizational skills.
TO START OFF, ASK YOURSELF THESE QUESTIONS ABOUT YOUR TEEN:
Inattention: Is your teen easily distracted, forgetful, having difficulty learning something new or staying focused on completing a given task, easily bored, losing things, not listening when spoken to, slower and less accurate at processing information than other teens, daydreaming and confused, struggling to follow directions?
Hyperactivity: Is your teen constantly moving or talking, touching everything in sight, struggling to sit still, unable to work quietly, or having difficulty sleeping?1
The DSM-5TM defines ADHD as a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, has symptoms presenting in two or more settings (e.g. at home, school, or work; with friends or relatives; in other activities), and negatively impacts directly on social, academic or occupational functioning. Several symptoms must have been present before age 12 years.1
Overview of the DSM-5TM medical classification system for ADHD
- Does your teen have a regular pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development?
- Six or more of the following symptoms have continued for at least 6 months that are unusual for his/her developmental level and negatively impacts social and academic/occupational activities. Please note: The symptoms are not just oppositional behavior, defiance, hostility, or failure to understand tasks or instructions. For older adolescents and adults (age 17 and older), five or more symptoms are required
- Were several of these conditions present prior to age 12 years?
- Are several inattentive or hyperactive-impulsive behaviors present in 2 or more settings and cause problems with (e.g. at home, school, or work; with friends or relatives; in other activities)?
- Are the behaviors not due to other mental health, drug use or other medical conditions?
WHAT DOES THE RESEARCH SHOW?
‘A 10-year study by National Institute of Mental Health found that brains of children and adolescents with ADHD are 3-4% smaller than those of children who don’t have the disorder and that medication treatment is not the cause of this size difference (Brain Imaging in Children with ADHD). Basic neuroimaging research is being conducted to further delineate the pathophysiology of ADHD, determine diagnostic utility of neuroimaging, and elucidate the physiological effects of treatment. However, the research is not definitive enough for practical application of neuroimaging.
Many of the symptoms classified as ADHD symptoms of inattention are actually symptoms of executive function impairments. Executive function refers to a wide range of central control processes in the brain that activate, integrate, and manage other brain functions.
Best put, Thomas E. Brown, Ph.D., of Yale University compares executive function to the conductor of an orchestra. The conductor organizes, activates, focuses, integrates, and directs the musicians as they play, enabling the orchestra to produce complex music. Similarly, the brain’s executive functions organize, activate, focus, integrate and direct, allowing the brain to perform both routine and creative work.
The components of executive functioning that impact school or work:
- working memory and recall (holding facts in mind while manipulating information; accessing facts stored in long-term memory)
- activation, arousal and effort (getting started; paying attention; completing work)
- emotion control (tolerating frustration; thinking before acting or speaking)
- internalizing language (using self-talk to control one’s behavior and direct future actions)
- complex problem solving (taking an issue apart, analyzing the pieces, reconstituting and organizing them into new ideas).”3
IF YOU THINK YOUR TEEN MAY HAVE BE SUFFERING FROM THE ABOVE:
THEY ARE NOT ALONE.
“Recent surveys asked parents whether their child received an ADHD diagnosis from a health care provider. The results show that:
- Approximately 11% of children 4-17 years of age (6.4 million) have been diagnosed with ADHD as of 2011.
- Boys (13.2%) were more likely than girls (5.6%) to have ever been diagnosed with ADHD.
- The average age of ADHD diagnosis was 7 years of age, but children reported by their parents as having more severe ADHD were diagnosed earlier.”5
Collaboration with community services is key to many teens success.
Here is what a local community resource manager had to say:
“As the Ontario County Children and Youth SPOA Coordinator, Jeff has referred several youth and families to SPOA, and has worked collaboratively over the past few years to help ensure that we had the clinical information we needed to activate referrals. In mental health service provision, collaboration among service providers is paramount, and Jeff’s attention to this vital aspect of service delivery is very much appreciated.”
-Kris Sweeney, LCSW-R, ACSW – Ontario County Children and Youth SPOA
WHAT YOUNG COUNSELING SERVICES IN VICTOR, NY HAS TO OFFER:
- We have convenient hours, starting at 7 AM Monday through Thursday, and as late as 8 PM on Monday and Wednesdays for those who need appointments after school, work or extra-curricular activities.
- We accept most insurances. We will work with people who have financial hardship.
- We are located in an under-served area in Victor, NY.
- Jeff is licensed in NYS and has over 20 experience with treating adolescents.
- Many teens at the last session report their experience: “Counseling really helped, things are much better now. I got the things I needed to feel less anxious and depressed.”
NEXT STEPS TO TREATMENT:
- Call your Primary Care Physician for a consultation.
- Research your options for counseling and ADHD/ADD assessments in your area.
- Call/Text Young Counseling Services in Victor, NY at 585-444-1808 for a consult or an appointment.
Young Counseling Services: Located in Victor, NY. Also servicing surrounding areas such as: Bloomfield, Canandaigua, Clinton Sprints, Fairport, Farmington, Henrietta, Honeoye Falls, Lima, Geneva, Macedon, Manchester, Mendon, Newark, Palmyra, Perinton, Pittsford, Shortsville,
1 http://www.crchealth.com/troubled-teenagers/adhd-in-teenagers/ About CRC Health CRC Health provides specialized behavioral health care services in the U.S. Each day, we treat more than 30,000 people with drug and alcohol addiction, learning differences, weight management issues, eating disorders, and other behavioral issues. October 2, 2016.
2 http://www.dsm5.org/documents/adhd%20fact%20sheet.pdf American Psychiatric Publishing, APA is a national medical specialty society whose more than 36,000 physician members specialize in the diagnosis, treatment, prevention and research of mental illnesses, including substance use disorders. Visit the APA at www.psychiatry.org. October 2, 2016.
3 http://www.chadd.org/Understanding-ADHD/About-ADHD/The-Science-of-ADHD.aspx Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), is a national nonprofit organization that improves the lives of people affected by ADHD through education, advocacy, and support. CHADD is in the forefront in creating and implementing programs and services in response to the needs of adults and families affected by ADHD through collaborative partnerships and advocacy, including training for parents and K-12 teachers, hosting educational webinars and workshops, being an informative clearinghouse for the latest evidence-based ADHD information, and providing information specialists to support the ADHD community. October 2, 2016.