Jen, what does early intervention for ADHD look like?
Most doctors don't seem to evaluate for it until age 5 or so, saying there are no testing instruments that are accurate before that age. True? Myth?
Book recommendations?
DeeDee
I totally agree, Deedee. I don't think any doctor will diagnose at age 4, however if/when ADHD is diagnosed, the earlier it is treated, the better the long-term outcome.
When I refer to treatment, I am talking about counseling, behavior mod therapy, ABA, teaching organizational strategies, environmental modifications, (among others), and sometimes medication, depending on severity. Parents can begin working on some of this at home very early on. Not that this is easy by any means. I struggle with it daily. Even with a diagnosis and active treatment (medication and home and school strategies-starting counseling this week), it's a work in progress at our house. Right now, we're trying to figure out if our son also has an anxiety disorder in addition to ADHD.
I don't know of any 4-year-olds on medication, but I do know of 5-year-olds who take ADHD medications. The behavior mod techniques and counseling can benefit any child with ADHD-like symptoms whether it's actual ADHD, OEs, etc. Doctors/therapists will sometimes use a diagnosis of "emerging ADHD" for younger children if a medical diagnosis is needed to warrant treatment. Sometimes this diagnosis is changed to ADHD as the child gets older. Sometimes, with maturity the ADHD-like behaviors resolve. If this occurs, I'd say the child never had ADHD to begin with, but the counseling and strategies were likely beneficial nonetheless.
The whole medication debate is another matter altogether, and those decisions depend on the doctor and the parent. My son started medication at 6, but I felt secure with the diagnosis once I let myself "go there" and accept the truth. It took me a while to be ready to hear it although I suspected it for a while. Had I had real doubts I would not have taken that route. We knew we had to do something because the ADHD was interfering with learning.
As for testing instruments, most doctors use parent/teacher questionnaires. Some do neuro-psych testing, but I don't know any that are normed for children that young. I would caution against an ADHD (or any other)diagnosis at 4 years old, especially with a gifted child, to avoid misdiagnosis. However, I do feel strongly that the earlier a child receives help, the better off they'll be.
I like the book: Smart but Scattered by Peg Dawson, EdD and Richard Guare, PhD. Also, The Mislabeled Child by Brock Eide, M.D., M.A. and Fernette Eide, M.D. I'm also reading a book called The Survival Guide for Parents of Gifted Kids. I'm sure there are many others parents here can recommend.
Oh, another thought on early suspicions of ADHD-I'd certainly look at family history. Obviously, if a parent, sibling, or other close relative has it, the more likely it is that your child could have it too.
This is an interesting article:
http://www.wrightslaw.com/info/2e.gifted.adhd.pdf
