A+ Advice for Parents

Evaluating Son for ADHD Can Be Trying, but Worth It

Q: My son's first-grade teacher suggested that we have him tested for attention deficit hyperactivity disorder (ADHD), even though he's well above grade level. He has a hard time paying attention. She says he doesn't listen, talks with classmates and sometimes makes them mad. My cousin says he needs more discipline. I worry about him taking ADHD drugs. Should we test him?

A: When a young learner exhibits troubling behavior, parents encounter many perspectives on testing for ADHD -- from teachers, learning specialists, pediatricians or other parents. Everyone's got an opinion, some more helpful than others.

Your son's teacher is concerned about his ability to function socially and be successful in school. Most children get better at paying attention as they age, so if he's not showing progress, she's right to alert you. Making a diagnosis and coming up with a plan to modify the behavior is time-consuming and often a trial-and-error process.

First, do your homework. Websites like understood.org can be valuable resources. Many books also offer advice. Start with "Taking Charge of ADHD, Third Edition" (Guilford Press, 2013), "Smart But Scattered" (Guilford Press, 2009) and "Raising Boys With ADHD" (Prufrock Press, 2012).

Two, use any techniques from his teacher or from your research that might be helpful in managing his behavior, such as:

-- Make sure your son is close to you during activities like reading aloud or playing games, to make it easier for him to pay attention.

-- Give immediate and frequent consequences for negative or positive behaviors.

-- Give tangible rewards like tokens or play money that can be redeemed for cool stuff.

-- Break all tasks, especially projects, into smaller chunks. Describe concrete steps to him (e.g., how to tidy a room).

-- Use prompts and reminders, especially for rules and time intervals.

Three, prepare him for possible testing. An ADHD test usually involves observation forms completed by parents and the teacher and a visit to a pediatrician, who does an assessment and makes a diagnosis.

Many parents think ADHD means medication. Not necessarily. Attentional problems should always be addressed first through behavioral and environmental modifications. The doctor may make a recommendation for medication, but the decision to act on it always rests with the parents.

Before you consider any testing, document your son's behavioral patterns in various settings with a range of people; note differences where there may be different expectations or different stimuli. Observe him in restaurants, shopping malls, after-school activities or friends' houses. Can he read social cues from peers in these settings? Such difficulties can be signals for learning differences besides ADHD.

Parents must know their child well enough in different contexts and advocate for what he needs to do his best, says Susan Henry, a National Board Certified primary teacher in Massachusetts.

"Your goal, once you learn what factors help him pay attention and what sets him off, is to find ways to modify his activities, put in place counseling and other supports and reinforce appropriate behavior. This could include drug therapy."

But, she maintains, "Your intervention now will pay off later."

(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.)

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