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Difficult Behavior Or Attention Deficit Disorder?


Your five-year-old boy does fine in his kindergarten class but he’s extremely active—more active than normal, you think. It seems like he simply can’t sit still, and to be honest, it drives you nuts. You constantly have to keep your eye on him. You think he must have attention deficit disorder (ADD). Are you likely to be right?

Chances are, your boy probably does not have ADD. In general, ADD-type behavior needs to be exhibited in two places before the child is diagnosed with the disorder. Child psychiatrists explain there are many reasons for a child to act ‘hyperactive.’ Unfortunately, sometimes parents or teachers jump to the conclusion that any kind of highly active behavior indicates the presence of ADD.

Other health problems and disorders, learning disabilities, depression, troubles at home—any of these can cause a child to be hyperactive, perform poorly at school or have trouble concentrating. In other words, having difficulty learning in school, for example, doesn’t automatically mean your child has ADD.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual IV, or DSM-IV, an estimated 3 to 7 percent of children suffer from ADD, or ADHD, as it’s often called (for “attention deficit hyperactivity disorder”). Causes and risk factors are not known, but it seems to be more common in boys than girls.

What are the symptoms of ADD?
There’s a highly specific list of criteria your child must meet before getting an ADD diagnosis. That’s why it’s so important for a child to have an evaluation by a qualified professional. This could be a psychiatrist, social worker, neurologist, pediatrician, family physician, psychologist or professional counselor, among others. In addition to having a license to practice, these professionals should also have experience and training in the diagnosis and treatment of ADD. Clinicians often need about three visits to make an ADD diagnosis.

Experience with ADD is important because children with the disorder often have other conditions as well. Trained professionals are better able to detect additional problems. This leads to the most appropriate treatment and a better outcome for your child.

It’s generally parents and teachers who are the first to notice the symptoms of ADD, which include:

  • Inattention
  • Hyperactivity
  • Impulsive behavior

A child can have one symptom or a combination of the symptoms, but most of the time, there is an ADD diagnosis only if the child also suffers some kind of “functional impairment.” For example, a child who seems extremely active all the time but who does well in school, knows how to make friends and has good relationships with family members is not likely to have ADD. And as we mentioned above, the child needs to be exhibiting the ADD symptoms in at least two settings—school and home, for example.

Medication: Not Always the Answer

It can be stressful for parents when their child seems out of control, maybe a little “wild” or unable to sit still. Sometimes, parents who have heard about ADD assume their child has it. They know there’s a drug children take to calm them down and help them focus, and they figure they’ll simply ask a doctor to prescribe this drug. But responsible doctors will not prescribe ADD medication lightly.

In some cases, taking ADD medication when you don’t have ADD can make things worse. And if ADD is not present, it’s important to find out exactly what, if anything, is going on with your child and how to treat it.

If it turns out that your child does have ADD, there’s a lot of support out there for you and your family. Talk with your child’s doctor or other healthcare provider for advice about connecting with other families of children with the disorder. You may also want to visit the Web site for Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) ( CHADD is a national organization that provides in-depth ADHD information to parents, educators, professionals, the media and the general public.

The Centers for Disease Control and Prevention; Pediatrics, May 2000; Diagnostic and Statistical Manual IV, American Psychiatric Association, 2000;
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