A specialist will obtain the necessary information from the child’ parents and school reports.

Questions to the Parents

A specialist will ask certain questions regarding your child. Listed below are the topics on which parents will be questioned.

• Child’s medical past, including even mental health problems
• Family history of ADHD and mental health problems
• Child’s development and temperament
• About ADHD symptoms and the time when you started observing them in your child
• Other problems that the child might have
• Relationship with your child (also of your partner)
• Parenting problems, if any

In rare cases, parents will need to examine their child’s behavior through a rating scale. This scale is similar to a questionnaire to detect the severity of symptoms.

Information from the Child’s School

After obtaining information from the parents, the specialist will need information from your child’s school teachers. The information will be collected about:

• Class behavior
• Academic achievements
• Relationships with other students
• Reaction to discipline and authority

Similar to parents, the teachers might be asked to use the rating scales to evaluate the behavior of your child.

Going Ahead with the Assessment

The specialist might need to assess your child to seek whether he/she is suffering from a physical disease that is the cause of the symptoms or making them severe. The other purpose of the assessment is to examine the mental state and find out the minute details required for identifying effective, but suitable medication. Gathering such details also aids the specialist to identify the need of other assessment, for instance, by a speech therapist or hearing expert.

Another type of mental examination might be conducted wherein the child’s mental abilities are assessed. This type of assessment is known as ‘psychometric’ assessment and measures certain mental abilities such as IQ, speech, and reading ability. More tests can also be conducted that measure attention, impulsiveness, depression, autism, learning disability, and dyspraxia (affects co-ordination). These tests are required because they can tend to hide the presence of ADHD symptoms in your child.

Rules for Diagnosing

During the process of diagnosis, the medical experts need to follow two unique sets of criteria. These are ICD-10 and DSM-IV-TR. However, there is no direct method of indicating that a person has ADHD. Therefore, although the two criteria are required for the diagnosis, the specialist must give his/her medical opinion.

ICD-10

ICD-10 refers to a collection of criteria laid down by the World Health Organisation (WHO) for diagnosing hyperkinetic disorder (ADHD is much more than this).

DSM-IV

The American Psychiatric Association has laid down the DSM-IV-TR criteria to diagnose different types of ADHD, such as hyperkinetic disorder (a severe one).

ICD-10 versus DSM-IV

Table 1.1 lists the differences between ICD-10 and DSM-IV

Fewer children who exhibit severe symptoms are diagnosed with ICD-10. This would indicate that these children who are diagnosed as having ADHD are not provided with the treatment. While, some experts are of the opinion that a broad range of people are diagnosed with DSM-IV.

Age of Diagnosis

It is quite difficult to diagnose ADHD in pre-school children, because they are commonly active, which cannot be counted as abnormal behavior.

Children at primary school are suitable for the diagnosis of ADHD. The diagnosis is done between the age periods of 5-11 years. During this period, the symptoms of ADHD are apparent and clear, as the rules and routine of a school make the symptoms come out very easily, which can be noticed immediately.

If a young child exhibits extreme hyperactiveness, this can be a green signal of a medical condition already persisting and negatively affect his/her development, for example, autism.

But remember, even teenagers and adults can have ADHD that needs diagnosis.

After Diagnosis

The first step after diagnosing a person as having ADHD is to devise a treatment plan. This might include medicines to be given, educational methods, behavioral therapy, and psychotherapy.

After assessing your child, the specialist will work with you, your child, and his/her teachers prior to initiating the treatment. During this period, he/she might give a score for different characteristics of your child’s behavior. This rating/assessment acts as a base or a parameter based on which the specialist can determine how much your child has improved in the near future due to the treatment. Actually, for each characteristic of the behavior, a target is specified by the specialist for you child. To measure the effectives of the treatment, the child is again scored on each aspect and this is compared with the figure/grade your child had scored before the treatment. For instance, you might be asked how many times your child beats his/her younger sister.

During the treatment, your child will be monitored regularly to:

• Measure the effectiveness of the treatment for the important symptoms
• Identify how much dose of a medicine is suitable
• Detect any side-effects of the medicines given
• Determine how well your child is integrating emotionally, educationally, and socially

Not only your child becomes away from their family members and relatives, but he/she also becomes away from other children, friends, and teachers. Following problems might arise with family and friends.

• Parents can be weighed down and feel unable to tackle their child’s behavior.
• Parents may not attend social events in an attempt to avoid problematic behavior that might impart a feeling of isolation.
• Friends, relatives, and neighbors feel free to pass negative judgments, which can hurt relationships.
• The destructive behavior of your child might hurt other family members to such an extent that those relationships are no longer there.

So, let’s understand how to retain the relationships keeping in mind the goal of overcoming ADHD.

Problems with the Siblings

Following problems might arise with the siblings.

• The other children, who are not suffering from ADHD, at home fight feel envious, as a child with ADHD needs special care, attention, treatment, and support.
• The other children at home may dislike the lack of attention and feel that their parents are least bothered for them, as the focus of attention is now the child with ADHD.
• The siblings might replicate the bad behavior the child having ADHD.
• The other children might not be very much dissatisfied with the life at home, as they feel that there are many conflicts.
• Siblings might also have a feeling that their brother/s or sister/s having ADHD is/are interfering in their life.
• The other children at home might have a feel that their sibling is given more privileges. “I never get that”, “You never talk to me like that” is a common complaints of other children.

Problems between the Partners

If there is a difference of opinion between you and your partner and think differently on maintaining discipline and on parenting styles with regards to ADHD, your relationship is likely to become sour. For example, the mother might feel that it is better to stop working and spend all the time to deal with the child’s behavior, attend medical counseling, get the child to the therapist, and attend meetings for the statementing process. This would actually inflict a financial burden due to increase the family budget. Further, if too much time is given to the child without spending any time with your partner, there are full chances that you relationship might suffer.

Sometimes, it might so happen that there is only one parent to take the care of the child, while the other shows no interest or is away from home. This even makes it more difficult for the left parent to deal with ADHD. This results is subsequent bitterness in the relationship.

Adjusting the Child with ADHD into the Family

• Provide short and clear instructions to your child. Discuss with the child and make him/her understand how he/she should behave in varied situations and tell how to handle a troublesome situation.
• Observe the situations that can force a child for bad behavior and enter into the matter prior to the starting of any problem due to disliked behavior.
• Explain all the rules with your older children.
• Never criticize the child, rather criticize the behavior. For example, say, “It makes me feel very sad when you shout at your brother”; instead of saying, “You are a nut and don’t know how to behave with anyone.”
• Try to calm down everyone at home in problematic situations. Avoid any arguments or any thought of agitating them.
• Try to convince other members in the family not to take it personally to their mind, when the situation is beyond the control or when your child has crossed all limits.
• Be positive all the time. Avoid too much scolding to your child with ADHD, which can result in low self-esteem.
• Make your relatives and friends understand that it is seriously necessary for them to accept your child. One way to look positively is that older relatives tend to have less patience with a busy child, which can results in only brief visits.

Tackling Uncaring Relatives or Friends

Listed below are the problems of unsympathetic relatives and friends.

• They have a wrong belief that there is no such medical condition as ADHD. Mostly, they are of the opinion that your child is naughty and does all this intentionally. Further, they will comment you as a bad parent and will advise you to spank your child.
• Some friends and relatives might have an over confidence that they know everything about ADHD, as they might be reading about it frequently in a newspaper or might have viewed about it on TV. So, based on this, they will rebuke you for not putting any extra efforts, such as opting for complementary medical therapies or an exclusion diet.
• Sometimes, according to their belief, they can also rebuke you for opting for medication or not opting for medication.
• Some of them might ignore or drop you. This might pinch you, but just remember that you and your child are not responsible for this. This is because it is their weakness that and their problem. True friends are the ones who will understand your state and problems. So, a friend who does not want you is not worth to be concerned about.

Listed below are the options that you have to deal with such relatives or friends.

• If you feel your relatives and friends are open-minded, try to educate them, as they will listen. Sometimes, it might happen that due to their over confidence, if you show them some reports of an expert, they might say that the expert does not know anything.
• Give them a polite smile always.
• Say ‘Thank You’ after listening to their advice.
• Inform them that you have taken your doctor’s advice and are acting accordingly.
• Just put them out of your mind once you reach home.

Sources of More Help

If you feel that you are not able to deal with the relationships, see if you can discuss with someone about it. This is because, when the problem has just begun, it is easy to manage and solve it; rather than waiting for the problem to grow and then finding a solution of uprooting it.

You can contact the following sources in the above case.

• Your GP
• Counselors, such as Parentline Plus
• Family negotiation, wherein a trained counselor aids you to view the problem objectively and help you all come to a solution
• Support groups, such as Adders or ADDISS. Such groups have such members already who have faced such situations in life and therefore, are in a better position to help you too.