Q: My 8-year-old son's teacher suggests evaluating him for attention deficit hyperactivity disorder because he is unfocused and distractible. While he's more fidgety than his sister, he can sit transfixed all day on video games. Could video games cause these inattentive behaviors?
A: There is no evidence that TV or video games cause ADHD, yet super-fast-paced TV shows and video games have a special appeal for kids who have ADHD, says Dr. Natalie Weder, a child and adolescent psychiatrist at the Child Mind Institute (childmind.org).
"If you think about 'SpongeBob,' or a video game, there's never a second when there's nothing happening on the screen," she says. "If you're playing a video game, you have to immediately respond; otherwise, you lose. You don't have time to think.
"Kids with ADHD are very drawn to that because it makes them have to pay attention. There are no gaps for them to start thinking about something else."
When kids are absorbed in video games, they aren't displaying the kind of attention required by day-to-day tasks, such as getting ready for school or finishing an assignment.
While it may appear your son shows sustained attention in a video game, "the truth is that the task is changing so rapidly, short bursts of attention are all that's involved," says Dr. Ron Steingard, also a child psychiatrist at the Child Mind Institute. "These games are constantly shifting focus, and there is instant gratification and reward."
If your son is "transfixed all day" on games, change your parenting game plan. The American Academy of Pediatrics recommends no more than an hour per day of total media screen time for elementary school-age children.
That much screen time means time not spent doing other things more valuable for their development, notes Weder. "It takes time away from doing more creative or more learning-based activities, and from interaction with family and friends that helps them with their social skills."
If you decide to get him evaluated, know that the process isn't an exact science. First, talk with his teacher and school specialists to gather more information on why they made the suggestion. Next, do your homework to learn the definition of ADHD. Become familiar with the debate about over-diagnosis and over-prescribing of drugs.
There are reputable websites that describe the evaluation and diagnosis process, such as the American Academy of Pediatrics (healthychildren.org); the Child Mind Institute, (childmind.org); the National Institute of Mental Health, (nimh.nih.gov); and the National Resource Center on AD/HD (help4adhd.org).
Then visit your pediatrician for a screening to rule out any physical conditions, such as hearing problems. If you're confident that your pediatrician has experience with ADHD, he or she may be able to evaluate your son. If not, ask for a referral to an ADHD specialist -- a neurologist, child psychiatrist, child psychologist or licensed counselor who has deep experience and can apply it to your son's case.
In the meantime, cut back on video games. At an age when developing social skills is critically important, "no kid should spend unlimited time sitting in front of a screen in lieu of playing with other kids," says Steingard.
(Do you have a question about your child's education? Email it to Leanna@aplusadvice.com. Leanna Landsmann is an education writer who began her career as a classroom teacher. She has served on education commissions, visited classrooms in 49 states to observe best practices, and founded Principal for a Day in New York City.)