Pediatrician Houston TX

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ADHD

ADHD Doctor in Houston?

News Flash:

You may have heard of a new book released this month about ADHD and the influence of the pharmaceutical industry. The astronomical rise in ADHD diagnosis and treatment from 5% to now 15% of high school aged students over the last 15 years.

 

ADHD Nation

Children, Doctors, Big Pharma, and the Making of an American Epidemic

By Alan Schwarz

 

In particular, in Texas, the CDC data shows a rise from 7.7% diagnosis of ADHD in 2007 to 10.1% in 2010.

http://www.cdc.gov/ncbddd/adhd/prevalence.html

 

Frequent Questions posed to the pediatrician or ADHD Doctor:

  • “I don’t think he is responding to his name. When should he understand his name? Does he have an attention problem?”
  • “My toddler is so hyper! Does he have ADHD?”
  • “I can’t get my child to read every page – she just wants to look at the pictures over and over. Does she have ADHD?”

 

First consider the diagnosis of ADHD based upon DSM 5 criteria (abbreviated version):

  1. A persistent pattern of at least 6-months duration of inattention +/- hyperactivity (impulsivity) that INTERFERES with functioning or development.
  2. Several of the symptoms must have been present prior to the age of 12.
  3. Several of the symptoms are present in 2 or more settings (e.g. home, school).
  4. There is clear evidence that the symptoms interfere with social, academic or occupational functioning.
  5. The symptoms are not explained by another mental illness.

 

When should an evaluation be considered?

  • If a young child less than 5 years old is not able to function in a group setting and home setting, he should be evaluated by a child psychologist. Sometimes this may result in a diagnosis of Disruptive Behavior Disorder or other psychological diagnosis, but generally a diagnosis of ADHD is not made prior to age 5. The child less than 5 is still making great strides in brain development and use of psychotropic medications in this age group should be rare.
  • If a child 5-7 years of age is struggling to function at home and in school, an evaluation by a psychologist would be in order. Due to differing levels of development, a thorough evaluation through a child psychologist is the best method to evaluate a child between the ages of 5-7 years old.
  • Children > 7 years-old who are struggling to function at home and school can be evaluated by their pediatrician. This evaluation includes a complete history and physical exam, a few laboratory screening tests including blood counts and a thyroid panel, and a thorough review of several sources for Vanderbilt Symptom Rating Scales (usually 2 teachers and 2 adult family members). The pediatrician also requests the parent to have the child evaluated for learning differences through the school or a private evaluator.

 

How is the diagnosis made?

  • Child Psychologists use a combination of direct child observation, parent and “teacher” reported symptoms and psychological testing.
  • Pediatricians first complete a thorough history and physical exam to assess the scope of the behavior problems and to identify any medical problems that can masquerade as ADHD. These can include sleep disorders (or lack of sleep), thyroid problems, anemia, environmental factors and use of medications. We ask the parents and teachers to complete Vanderbilt Questionnaires and then meet with the child and parent again to review the results and discuss treatment options (if indicated).

 

What are the best treatment options?

  • Behavior Interventions: Many studies have shown the benefits of Parent Behavioral Training by a child psychologist or other behavior specialists. As the child grows older, the psychologist shifts the behavioral training from the parent along to the child/parent team.
  • Medications: Sometimes (if the impairment in performance is significant) medications may be prescribed for treatment by a child psychiatrist (particularly if the child is less than 7 years old) or a pediatrician. Before medications are prescribed, it is best to check for any potential risks to treatment such as unrecognized liver, kidney and thyroid functions problems (blood screening tests) and unrecognized risk for cardiac arrhythmias (EKG test).
  • Close symptom monitoring- at least every 3 months. ADHD medications can cause more side effects than benefits in some children. When ADHD medications cause poor sleep for example, the child’s attention may be even more impaired due to drowsiness than before treatment. Persistent appetite suppression while on ADHD medications can cause problems with weight loss and growth. For these reasons, every child on ADHD medication treatment must be evaluated in person by their doctor every 3 months to continue on treatment.

 

Does the child with ADHD grow up to be an adult with ADHD?

  • In general, ADHD persists for life, but the symptoms may wax and wane throughout the lifetime.
  • Some children develop strong coping skills (especially when behavior therapy is provided early) and may not require medication throughout their lifetime.
  • Many teens find that they can focus better in college when they have the freedom to set their own schedule and they are studying things that interest them more specifically.

 

Community Resources:

http://www.chadd.org/

  • National Resource Center for ADHD

Houston Area Schools and Resources:

  • The Briarwood School
    Briarwood is a school for children who present with dyslexia, dysgraphia, dyscalculia, ADD, and language processing challenges. Over 85% of Upper School graduates attend college.
    12207 Whittington Dr., Houston, Texas 77077
    281-493-1070, www.briarwoodschool.org
  • Crossroads School, Inc.
    Crossroads School, an academic, not-for-profit institution addressing the educational and emotional needs of children with Learning Differences, ultimately transitioning students into a conventional school setting.
    5822 Dolores Street, Houston, TX 77057
    713-997-1221, www.crossroadsschoolhouston.org
  • HISD | SpecialEducation Resources for Parents
    The purpose of special education is to minimize the impact of the student’s disability while maximizing opportunities for the student to fully participate in his/her natural environment. The Houston Independent School District offers a variety of special services at its campuses and through community agencies and hospitals within its boundaries. The Office of Special Education Services serves approximately 16,300 eligible students between the ages of 3-21. www.houstonisd.org/portal/site/SpecialEducation
  • The Joy School
    The Joy School prepares students with learning differences to return to traditional classroom settings by enabling them to reach their academic and social potential in a safe, supportive environment.
    One Chelsea Boulevard, Houston, TX 77006
    713-523-0660 or 1-800-685-4935, www.thejoyschool.org
  • Monarch School
    Provides a therapeutic education for children grades K through 12 with neurological differences
    2815 Rosefield Dr., Houston, Texas 77080
    713-479-0800, www.monarchschool.org
  • The Parish School
    Our mission is to identify, educate, and empower children who have language and learning differences.
    11001 Hammerly Blvd., Houston, TX 77043
    713-467-4696 x126, www.parishschool.org
  • The Tutoring Center
    We have a unique system of delivery that helps children increase their concentration, attention span, and focus while strengthening their academic skills.  We work with students who have dyslexia, ADD/ADHD, and learning disabilities.
    3361 Westpark Drive, Houston, TX 77005
    713-589-7061, www.TutoringCenter.com
  • Thinkers Education Center
    Specializes in the following: tutoring students with disabilities, reading therapy, cognition training, interactive metronome, visual and auditory processing issues, and critical thinking.
    2620 Fountain View, Suite 318, Houston, TX 77057
    713-781-4960, www.thinkersed.com

 

 

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