Getting the ADHD Diagnosis Right: What to Say to Your Child’s Pediatrician

At least 63 common conditions can cause behavior that looks like ADHD. In other words, you or your child's teacher might think that your child has ADHD when in fact they have something else.

It’s easy to make the wrong diagnosis and well-meaning parents, teachers, even pediatricians are doing it everyday.

Misdiagnosing ADHD remains a serious problem because the wrong diagnosis often means a prescription for powerful stimulant drugs that your child doesn’t need.

If your child is taking a drug she doesn't need because of the wrong diagnosis, she could have side-effects, sometimes serious, to these drugs.

As a parent, when your child’s teacher says "I think Angela has ADHD," ask the teacher to describe Angela's specific behavior. Ask if Angela acts this way in other classes. Did she act this way in class last year.

Always keep in mind that teachers are not medical doctors or trained in psychology, much less psychiatry. They do not qualified to diagnosis ADHD, anymore than they are qualified to diagnose pneumonia, cancer, or brain tumors. That is not their job.

If the teacher says that he doesn't think Angela has problems in other classes and didn’t have a problem last year, then you know it’s aschool problem or a learning problem. It's not ADHD.

If the teacher says "Yes, Angela acts like this in all her classes and her behavior was similar last year," then it’s time to take Angela to her pediatrician. However, it's NOT time to tell the pediatrician that you and Angela's teacher think she has ADHD.

Seven Strategies to Help Your Child's Pediatrician Make the Right Diagnosis:

1. Describe the symptoms such as “His teacher says he can't sit still at school.” "She just never pays attention to anything. Seems so spacey." Never start by saying "I think he has ADHD and so does his teacher. Talk about behavior rather than using the terms ADHD, ADD, or attention-deficit disorder.

2. Never suggest that your child needs drugs for ADHD. Many well-meaning, busy pediatricians will write a prescription for powerful stimulant meds for your child just because you ask without doing a physical exam.

3. Ask for a complete physical including a blood test for lead poisoning, low levels of vitamin D, anemia—three conditions that can cause behavior that looks like ADHD.

4. Ask if any of the drugs your child is now taking can cause symptoms that look like ADHD--hyperactivity, spacey-ness, inattentiveness, or impulsivity.For example, some asthma and allergy meds can cause ADHD-like symptoms.

5. If you still think your child might have ADHD, ask for a referral to a child psychiatrist for a brain scan, such as a qEEG. Unfortunately insurance doesn’t usually pay for brain scans and they can be a bit expensive.

Even if a brain scan isn't available, ask for a referral to a child psychiatrist anyway. Pediatricians are not trained in neurological conditions, psychiatric drugs or ADHD. You want the best care you can get for your child.

6. If you and the child psychiatrist agree that your child has ADHD and you want to try medication, get a referral for a complete cardiovascular workup and an ekg or ecg. (Electrocardiogram) In rare cases, heart problems have occurred with children taking stimulant medications.

Bottom line: If you decide to try ADHD medication for you child, make sure it is prescribed by a psychiatrist and that your child is monitored by the psychiatrist. Pediatricians do not receive the specialized training in these drugs that psychiatrists get.

7. Remember that many highly effective non-drug alternatives, such as Smart Brain Games™ are out there for ADHD. Ask about these programs. Stimulant drugs aren't the only solution to ADHD and often not the best solution.

However, if you do decide to put your child on ADHD medication, many of the non-drug resources for ADHD can and should be used in conjunction with the meds. It's not unusual for a child to be able to stop taking meds or take a lower dose after using some of the alternative strategies consistently.

ADHD is real and can certainly create havoc for kids, their parents, and teachers. But ADHD is also wildly over-diagnosed. Make sure your child gets an accurate diagnosis. You can pick up a copy of "63 Common Conditions that Can Cause ADHD-like Symptoms" to look over before you go the doctor. Or even take it with you.

Be sure to leave me a comment?  Let readers know your experiences with diagnosing ADHD.

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About Dr. MaryJo Wagner

MaryJo Wagner, PhD, helps you help your kids transform ADHD behavior for success. Sign up at Coaching & Accountability to get your questions answered with a complimentary Transformation Session.

Comments

  1. I never knew that pediatricians did not received specialized training in stimulant drugs that psychiatrists get. At least I have a guide now how to see if pediatrician makes the right decision.

  2. The majority of this information is quite important. However, I would suggest a few counter points to consider. First, pediatricians do, in fact, receive significant training in psychotropic medicines such as stimulants and nonstimulants. The statement that "Pediatricians are not trained in neurological conditions, psychiatric drugs or ADHD" is wrong. I am a pediatrician trained in all of these things. In fact, many pediatricians have significantly more training in ADHD management (and comorbidities) than PhD's.
    Secondly, I don't understand why this nonphysician author is recommending a "complete cardiovascular workups" for patients with ADHD. It is unfortunate that this blanket statement is educating the masses to this effect. The current medical literature refutes the efficacy, value and cost of screening most children. This recommendation is 5 years outdated and can create unnecessary burden and parental anxiety. A cardiovascular history by your medical doctor may be sufficient to screen you child, depending on your situation.
    It is unfortunate that patients have had negative experiences when approaching their pediatrician about ADHD, or else I assume some of these comments would be unnecessary.

    • Thanks for your comments. I agree 100 percent that pediatricians know significantly more about psychotropic medications than I do or any other PhD. However, in my experience with clients and my own personal experience, pediatricians and general practitioners generally are not as well trained in these medications as psychiatrists. I appreciate your concern about ADHD. Sadly I know of too many pediatricians willing to give out a prescription for stimulant drugs when Mom says Johnny's teacher says he has ADHD. Obviously you aren't one of those. Thank you.

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