Your child can’t sit still and you can barely get him to do his homework. And chores? He forgets that he is supposed to make his bed by the time he makes it to his room. You have yelled at him, grounded him, taken things away and even tried bribing and incentive programs. His grades are on a downward spiral, his teacher is at a loss - and you are at the end of your rope.

According to 2006 National Center for Health Statistics, 4.7 million elementary school aged children are reported to have attention-deficit/hyperactivity disorder, also known as ADHD. While there are still those that question the validity of an ADHD diagnosis, experts like Mina Dulcan, M.D., a Child and Adolescent Psychiatrist and the Head of Child and Adolescent Psychiatry at Children’s Memorial Hospital, say that ADHD is not only a real disorder, if left untreated, it can be devastating.

“There are two types of ADHD kids,” says Dulcan. “The child with the inattentive kind of ADHD will avoid tasks requiring sustained mental effort, have trouble sustaining attention, is easily distracted, will not appear to be listening, will struggle following through on instructions, is forgetful, makes careless mistakes, has problems with organization and is constantly losing things. The hyperactive and impulsive ADHD child is always on the go, fidgets and squirms constantly, has difficulty when asked to remain seated, runs and climbs excessively or when inappropriate, has difficulty waiting or taking turns, talks excessively, blurts out answers out of turn, and is constantly interrupting and intruding on others.” To warrant a diagnosis, says Dulcan, one must carry six out of the nine traits listed in either grouping. Dulcan says some ADHD children will fall under both categories.

Many people have a hard time believing a child has ADHD because many kids with ADHD appear inconsistent, says Dulcan. They can’t focus 40 minutes in school but can focus for hours on a video game. This inconsistency can make one think that a particular action or lack of action, on the part of the child is due to defiance or laziness rather than inability.

The child will be labeled bad, troublesome, and defiant. The parent who can not make the child conform will be labeled bad, ineffective, too lenient, etc.

“Appearances can be deceiving,” says Dulcan. “Inconsistency is a characteristic of the disorder. A child with ADHD will be able to focus on and remember something he finds interesting but not something he finds boring … like his school work. It takes mental effort to put into memory something we are not interested in, like spelling words. The child without ADHD can do it, but the child with ADHD has a harder time.”

There is still much that is unknown about ADHD. According to the National Resource Center on ADHD, brain scan studies have found at least three separate but interactive brain regions that seem to be associated with ADHD patients and it is believed to be largely genetic. Treatment is for the symptoms, not the disorder itself.

Dulcan says that if parents are seeing ADHD symptoms that can not be otherwise explained they should bring their children to a doctor, pediatrician or a child psychologist. Diagnosis usually comes after a rated survey/questionnaire – filled out both by teacher and parents – is evaluated by the doctor. If a case is severe it can be diagnosed as early as age three or four.

Lack of concrete physical testing leaves much to interpretation. And, to make a grey area even greyer, many symptoms on the list can have other underlying causes. Make sure you child is eating right, getting enough sleep and isn’t reacting to food allergies which can sometimes cause similar symptoms. See your child’s doctor and rule out any other possible medical explanations for the symptoms before seeking an ADHD diagnosis. Even things like eyesight and hearing should be checked. And, if it is ADHD, don’t worry. There are medications and behavioral therapy methods that can help.

Parents are often afraid of using ADHD medication, says Dulcan, but they shouldn’t be. “There is a lot more hysteria about ADHD medication – more so than the medicine deserves.” There are situations when medication should not be used, such as if the patient has heart problems, high blood pressure or suffers from depression, says Dulcan.

“Like with any medication, there can be side effects, but they are usually minor - loss of appetite or trouble sleeping, and can often be eliminated by changing the medication or dose.” And Dulcan says, “Not treating a child with ADHD is not without its own side effects.”

“Not treating a child with ADHD leaves them at risk for lower grades, having no friends, and likely to hurt themselves because they are impulsive,” says Dulcan, who sites research that shows that untreated kids with ADHD are prone to low self-esteem, don’t go as far in school, don’t have as good of jobs as their siblings, are less likely to have a successful marriage, more likely to “self-medicate” experimenting with drugs and alcohol, and if male – more likely to be in traffic accidents or have trouble with the law. “It is not just about doing well in school,” says Dulcan, “it is about doing well in life.”

For more info

Dulcan suggests the following resources:

For information on ADHD visit www.chadd.org

For a guide on ADHD medicine, go to parentsmedguide.org

Taking Charge of ADHD: The Complete, Authoritative Guide for Parents, Russell Barkley, PhD.

Making the System Work for your Child with ADHD, Peter Jensen, MD.