Is It ADHD or Anxiety due to the Coronavirus?

Schools are starting to reopen during a pandemic.  Many schools are still arguing about if teachers and students over 12 years old must be vaccinated in addition to arguing if students and teachers must wear masks while at school.  While these debates are occurring students are adjusting to be back at school and many students are adjusting to new schools entirely. A student who was a freshman in high school last year never set foot on the high school campus because most schools were operating remotely. Therefore, they are sophomores this year, but it is the first time they have been on campus or interacted with other students and teachers.  For many students they are experiencing anxiety and panic attacks as they return to school.  Additionally for high school students, they really missed out on an entire year of their high school experience. How will this impact them?

Now that schools have resumed so has the fighting parents and teenagers have over getting homework completed and turned in on time.  This means parents are once again getting notices from their children’s schools that their child is not doing homework and not paying attention in class. When kids were attending school remotely, many teachers and parents were not as concerned because they knew doing school remotely was very difficult.  However, now that students are back in the classroom, teachers and parents are no longer ignoring attention issues or difficulties with homework.

As a result, some schools and family members may be suggesting to parents that their child has ADHD and needs medication.  Many parents are not sure about the diagnosis and they are concerned about their child taking ADHD medication.  I hear this very often from parents and do many assessments on children to determine if a child has ADHD.  Yes ADHD is a really disorder, but too many teachers and schools rush to the conclusion that a child has ADHD and needs medication.  Additionally given everything children have been through with the pandemic and remote learning, we need to be very careful about labeling a child with ADHD.  There are a number of other options such as depression, anxiety and boredom.

According to statistics by the American Psychological Association, five percent of children in the United States have ADHD.  It is also more common in males, however it does also occur in families.  According to the CDC 15.9% of boys and 5.6% of girls have ADHD. However, not every child who has ADHD requires medication.  Many children can be treated with psychotherapy and behavior modification.  Therefore, if your child is diagnosed with ADHD do not rush to medicate your child.  There are different subtypes of ADHD and different severities of the diagnosis.

If you child does have ADHD, they are entitled to accommodations such as extra time taking a test.  It’s important to get them the accommodations they need.  Children who have ADHD, but do not receive accommodations tend to show signs of low self-esteem around the fifth grade.  Accommodations for ADHD can be covered by a 504 plan. However, if your child has severe ADHD and needs resource assistance too, they are entitled to an Individual Educational Plan (IEP).  Many schools may tell parents ADHD does not qualify for an IEP.  This is not true.  The severity of the ADHD determines if a child needs an IEP.  They would qualify under the categories of Emotional Disturbance or Other Health Impairments.

If you feel your child may have ADHD or their school suggests the idea, make sure you have your child appropriately assessed by a professional who specializes in ADHD.  In the past schools would often diagnosis children with ADHD.  Schools are no longer supposed to make this diagnosis.  If they feel a child might have ADHD, they are supposed to have your child evaluated.  Many parents take their child to their pediatrician, however, many pediatricians are not trained in diagnosing ADHD.  I would suggest having your child evaluated by a mental health clinician trained in working with children and in assessing for ADHD. 

As I stated above, if you are going to have your child evaluated for ADHD, make sure you take your child to a mental health clinician who specializes in children and in doing assessments.  The assessment for ADHD is not very difficult and an appropriate evaluation by an appropriate mental health clinician should cost around $250 depending on where you live.  I have seen some parents who have spent thousands of dollars getting CT scans, MRIs and PET scans.  You do not need an expensive scan of your child’s brian to diagnosis ADHD.

The DSM V, the diagnostic manual that mental health clinicians use, list the criteria needed for the diagnosis.  I am including a link to the Center for Disease Control which list the criteria for the diagnosis and other information about ADHD, http://www.cdc.gov/ncbddd/adhd/diagnosis.html.  Typically the diagnosis can be made by a clinician interviewing the parents, having a play session or two with the child and observing the child at school or consulting with the teachers.  However, remember if you are going to have your child evaluated for ADHD, you want a mental health clinician who specializes in treating children and assessing children for ADHD.  Your child’s pedestrian should be able to refer you to someone or if you call your insurance they will probably have referrals.

Before you rush to have your child assessed, remember some basic facts.  Most children between the ages of two to five are very active.  They also have very short attention spans.  Sometimes you need to give a child some time to mature especially if you have a boy.  Remember boys mature slower than girls and tend to be more active than girls.  It is important to keep these facts in mind when you are wondering if your child has ADHD.

Now if you child is more hyperactive than other kids his age or his attention span is shorter than most kids his age, there might be an issue.  Also if there is a strong family history of ADHD in the family such as his father had ADHD as a child and paternal and maternal uncles all had ADHD as children, there might be an issue.  Also if your child was born premature or there were complications during the pregnancy or child birth, there might be an issue.  Premature babies or babies with a difficult pregnancy or birth are more likely to have ADHD and learning disabilities.

Bottom line, if someone suggests that your child has ADHD don’t rush to the pedestrian seeking medication.  Compare your child’s behavior to other children and consider the risk factors. If your child doesn’t have many risk factors for ADHD maybe wait six months and reassess the situation.  Also remember many children are experiencing anxiety due to the pandemic.  Anxiety can easily look like ADHD.  Therefore, instead of medication, maybe your child needs therapy for anxiety.

The most important thing to remember is if you decide to have your child assessed for ADHD, make sure you go to a mental health clinician who specializes in children and ADHD.  You want a mental health clinician who specializes in treating children with ADHD and assessing children for ADHD.  Also remember you do not need any expensive scans like a CT scan.  There are other treatment options besides medication, so do not rush to medicate your child either.  Consider all the treatment options.

Dr. Michael Rubino specializes in treating children and assessing children. He has over 24 years experience treating and assessing children and teenagers.  For more information about Dr. Michael Rubino’s work visit his websites at www.rcs-ca.com, www.RubinoCounseling.com or his Facebook page www.Facebook.com/Drrubino3 or his podcasts on Spotify or Apple.

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