For most parents, a pediatrician or family practitioner is the first call when a child falls ill. But when it comes to a complicated issue like attention deficit hyperactivity disorder (ADHD)/attention deficit disorder (ADD), sometimes that trusted physician may not be the most appropriate person to diagnose or treat ADHD.
If you suspect your child might have ADD/ADHD, it is appropriate to call your child's primary doctor. But you might want to consider asking for a referral to another physician if your medical caregiver's analysis isn't as thorough as it should be. For instance, if a practitioner uses little more than a questionnaire to diagnose ADHD, that's a red flag that you may need another physician , says Erik Fisher, Ph.D., a clinical psychologist in Atlanta. “A good evaluation is worth its weight in gold,” he says. Further, you may need to enlist other professionals, such as a developmental pediatrician or occupational therapist. Follow these guidelines to make sure you get the right specialists onboard.
Get Personal for a Good Fit
Personalities that mesh — both with the parent and the child — are always important in any productive doctor-patient relationship. But when it comes to treating a child with ADHD, Fisher says parents need to find someone who understands that diagnoses and treatments are always changing, and what works for one child won't necessarily mean success in another. Your doctor should also be familiar with the American Academy of Pediatrics' 2011 ADHD guidelines, which lay out recommendations for the diagnosis and treatment of ADHD in different age groups, such as preschoolers, school-age children, and teenagers.
“Experience and flexibility in point of view are factors to consider in a practitioner,” he says. “All attention deficits are not the same, and some things that look like ADD or ADHD may not be.” Make sure you feel confident in your diagnosing doctor's level of familiarity with both ADHD and the common misdiagnoses and coexisting conditions, such as depression, learning differences (like dyslexia), substance abuse (in teens), or even physical problems like allergies or eyesight difficulties.
Find Your Child's ADD/ADHD “Dream Team”
If you're confident in the diagnosis, finding the right team to treat your child is the next step in overcoming ADD/ADHD difficulties. Developmental pediatrician Walt Karniski, M.D., founded Tampa Day School in Tampa, Fla. to help ADHD kids work with the specialists they need on a regular basis. He says putting together a group of doctors to help kids overcome their ADHD is key.
When I was in private practice, had a psychologist to counsel parents, speech and language therapist, an occupational tutors tutoring program,” he says. Karniski emphasizes that parents should realize while medical interventions are key for certain age groups, they're not right all kids, other options also be considered.” If physician has medication as his only tool, can begin forget about treatments,” cautions.
- Pediatrician (general): Your child's pediatrician will probably be your first contact when the ADD/ADHD diagnosis comes up. And while the pediatrician probably isn't the only person you want treating your child, he or she is still a very important member of the team.
- Psychiatrists and psychologists: The difference between these two related disciplines is medicinal: psychiatrists can dispense prescriptions, while psychologists cannot, except in a few U.S. states. But both can be important team members. Teens and school-age kids may benefit from ADHD drugs, but the new ADHD guidelines specify that for preschoolers, behavioral therapy should be the first line of treatment. Both psychiatrists and psychologists can work with kids on things like neurofeedback, an emerging treatment for ADHD, which helps kids learn to better focus through monitoring their own body. They can also help with the emotional issues that often go hand-in-hand with ADD/ADHD, such as poor self-esteem and depression.
- Developmental pediatrician: While a general pediatrician deals with all aspects of the child, a developmental pediatrician will look at developmental issues and find the underlying medical causes. This specialist can be a good source for an initial diagnosis; some developmental pediatricians, as in Karniski's former private practice, may also employ a team of specialists to assist with other aspects of ADHD.
- Pediatric neuropsychologist: According to Fisher, another ADD/ADHD practitioner parents might consider is a pediatric neuropsychologist. While this specialty may have an overwhelming name, these doctors are some of the most qualified to appropriately diagnose and treat ADHD because of their understanding of not only brain mechanisms, but also behavioral and developmental issues in kids.
- Pediatric occupational therapist: Many kids with ADHD also have problems with things like fine motor skills, Karniski says. “ADHD often affects things like handwriting and written output more than something like reading or math,” he notes. Occupational therapists can assist with this type of remediation, as well as other issues like auditory or visual distractibility.
- ADD/ADHD coach: If your child is having trouble getting a handle on dealing with everyday tasks, an ADD/ADHD coach might be a worthwhile addition to your team. “ADHD coaches help people better understand how their own ADHD is affecting them,” says Tara McGillicuddy, an ADD/ADHD coach and founder and director of ADDClasses.com. Coaches can also help kids focus on their strengths, organize their lives better, and improve social skills. If you're looking for a coach to work with your child, try the web. McGillicuddy says many coaches work over the telephone, so you can team up with someone from just about anywhere. The website ADHDCoaches.org is a good starting point.
- Therapist: Unfortunately, ADD/ADHD can cause problems in a child's life that can affect self-image. When kids get a diagnosis, it can be a relief, but they may still have issues that can't be cured with medical or occupational intervention alone. “Chances are that kids with ADHD may have other conditions like low self-esteem, some anxiety, some depression,” says Deborah A. Pearson, PhD, professor of psychiatry at the University of Texas Medical School in Houston. “You are going to have to find appropriate treatment for that, like psychotherapy and behavioral treatments.”
Finally, remember that the key is having a multi-faceted treatment program that you and your child's primary ADD/ADHD physician put together. “You can't just give a magic pill and make all the problems go away,” Pearson says. “There has to be an overall treatment program for success.”