Understanding Attention Deficit Hyperactivity Disorder (ADHD): What's Really Going On In the BrainJune 21, 2021
BIRMINGHAM — Most kids are “squirrely” from time to time—not paying attention or acting impulsively. When these actions become more severe, and start to interfere in a child’s life or cause distress, that child may be experiencing attention deficit hyperactivity disorder (ADHD).
Dr. Wayne Fleisig, clinical psychologist at Children's of Alabama, has been working with kids for 30 years and has served on the Parents Magazine Board of Advisors since 2010. His specialty is in working with kids with ADHD—much-needed expertise, as approximately eight percent of children have the disorder.
One challenge parents face is finding the right diagnosis. “Unfortunately there's not a lab test for this. We gather information from parents, teachers, from the kids themselves, and we make the diagnosis according to that,” states Dr. Fleisig.
Characteristics of ADHD
To be fair, the term “attention deficit” is a bit misleading. The mechanics behind ADHD are much more complex.
“The crux of ADHD is that the mind does not allow me to stop between my want, or my thought, and my action. So, I don't stop long enough to be able to think, remember, plan, organize, or process new information. Basically, it's like the brakes on the brain are not working well,” explains Dr. Fleisig. “Really, ADHD should be called ‘difficulty stopping and giving yourself enough time to think’ disorder. This is what's confusing to parents. They often think it's about attention, but it's really about the inability to stop, so you can spend some time thinking.”
He also urges parents and caregivers to understand that the child isn’t purposefully behaving in a certain way. Surmounting evidence points to ADHD being a natural, physiological difference in the way parts of the brain function.
Why Early Intervention Is So Important
As with any disease or disorder, early intervention is critical. While some parents may decide to “wait it out,” hoping their child will outgrow certain behaviors, not addressing ADHD can have a domino effect down the road.
“My feeling is that most people do not outgrow it. They may learn to compensate over life. So, they may not get a job that's detail oriented, but rather one that’s more conceptual. But, it is still a very significant thing. It's not a death sentence, but it definitely causes significant problems if it's not well-treated,” cautions Dr. Fleisig.
In fact, people who have ADHD—when it's not well treated—have much higher rates of failing school, dropping out of school, injury from accident, attempting suicide, and getting involved with crime, drugs, and alcohol. Many become sexually active at an early age.
Multidisciplinary Treatment Approach
For many kids with ADHD, the most successful approach is a combination of working with a psychologist or a therapist on behavior management. Individual therapy is often appropriate. Additionally, many kids with ADHD qualify for special education services through the school system.
Parents will also likely meet with a medical professional to discuss the possibility of medication. When medication is warranted, its job is to act like brakes on the brain—helping the child to be able to stop, so they can then use their thinking.
A Final Note for Parents: You Are Not Alone
One pervasive challenge among parents or other caregivers is the perception of “bad parenting.” They may start to feel guilty; that for some reason, they are the reason their child is acting such a way. Dr. Fleisig is adamant this is not the case.
“This is not from bad parenting. It is just the way they're born. It tends to be genetic,” he assures. “Raising kids with ADHD is very, very difficult. All of these problems are frustrating, and you may feel like, ‘I’m failing as a parent. My kid is just a bad kid.’ But, you have to stop, take a step back, and say, maybe this is ADHD.”
The good news is, the more experts learn about the science behind ADHD, the better they can approach treating it. “We have a lot of optimism. If you feel your child may have ADHD, it's important to consult with a professional who's qualified to diagnose it—someone who spends a lot of time working on ADHD, because you want to get a thorough, good assessment.”
**To listen to an in-depth conversation on this topic with Dr. Wayne Fleisig, clinical psychologist at Children's of Alabama, follow this link: https://radiomd.com/childrensalabama/item/44865